D-mannose is for bladder infection. If what you need is estrogen to rebuild tissue, that might not help you. I agree it is a problem. I used soy isoflavons, sorry that's spelled wrong - which came in little capsules. It is a plant-based estrogen and stopped my hot flashes. Now, if only a topical cream will work, you have a problem. I would call whoever takes care of your E and ask that dr., maybe she/he has another idea for you to try. Maybe a smaller dose would be ok?