For years, Lenny Hanson has watched in alarm as the price of a drug she takes has ticked steadily upward, doubling in the past five years to more than $200 a month today. The product, Vagifem, is one form of a drug, estradiol, that is used to improve women’s sex lives by treating a painful, often unspoken condition experienced by older women: a dry vagina, which can cause uncomfortable intercourse and complications like urinary tract infections. Estradiol has been around for decades, but the price of the various creams, vaginal rings and tablets that contain the drug has climbed steadily in recent years, according to an analysis by the consumer website Good Rx. And insurance coverage is spotty — many plans refuse to cover some products or require that patients pay high out-of-pocket costs. approved a new estradiol product, Imvexxy, a development that in any other market may have offered hope for some price relief. While women privately fume about the costs, drug makers have been able to raise their prices without a public outcry in part because the topic — women’s sex lives and their vaginas — is still pretty much taboo.“Unlike Epi Pen, women are not going to be rising up and saying, ‘My vagina is dry and I don’t want to pay 2,000 to 3,000 dollars a year,’” said Dr. But in the upside-down world of prescription drugs, that isn’t happening. Lauren Streicher, the medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. Imvexxy’s manufacturer, Therapeutics MD, said that its new product would be sold at “parity” with others on the market, and did not elaborate. The story of estradiol products echoes others in the prescription-drug market, where older medicines like insulin or multiple sclerosis drugs have become more expensive, even when rivals are introduced and should make prices competitive. 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Do not start using ESTRACE if you: have unusual vaginal bleeding, have or had certain cancers (including cancer of the breast or uterus), had a stroke or heart attack, have or had blood clots or liver problems, are allergic to any of the ingredients in ESTRACE vaginal cream, or think you may be pregnant. Tell your healthcare provider: if you are breastfeeding; about all of your medical problems, your healthcare provider may need to check you more carefully if you have certain conditions, such as asthma (wheezing), epilepsy (seizures), migraine, endometriosis (including in women who have had a hysterectomy), lupus, problems with your heart, liver, thyroid, kidneys, or have high calcium levels in your blood. ESTRACE vaginal cream should be used at the lowest dose possible for your treatment only as long as needed. Although ESTRACE vaginal cream is only used in and around the vagina, the risks associated with oral estrogens should be taken into account. 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