Postpartum Vaginal Estrogen for Breastfeeding Patients

Inclusion Criteria: * Age 18 or older * Sexually active * Singleton, term (37 weeks 0 days) birth * Planning to breastfeed or pump during the study period * History of successful breastfeeding or pumping after a prior pregnancy * Between 6 weeks and 6 months postpartum (patients may be recruited at any time during the postpartum period, but the study period will not start until 6 weeks postpartum) * Ability to consent in English * Not meeting any exclusion criteria Exclusion Criteria: * Preterm delivery * Perinatal mortality * History of difficulty breastfeeding * 3rd or 4th degree perineal laceration * Any contraindications to estrogen, including, but not limited to, breast cancer or a history of breast cancer, estrogen-dependent neoplasia, active deep vein thrombosis (DVT)/pulmonary embolism (PE) or a history of these conditions, active arterial thromboembolic disease (for example, stroke and MI) or a history of these conditions, known anaphylactic reaction, angioedema, or hypersensitivity to estrogen, hepatic impairment or disease, protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders.