Sexual health care for women, taken seriously.
Scream Cream, vaginal estradiol, oxytocin, and standalone testosterone for women — compounded and prescribed inside a real medical relationship, not a 5-minute online questionnaire.
What we
address.
- Low libido — particularly the kind that started in midlife
- Vaginal dryness and discomfort during sex
- Painful intercourse (dyspareunia)
- Reduced arousal or difficulty reaching orgasm
- Genitourinary syndrome of menopause (GSM)
- Hormonal sexual dysfunction in perimenopause and postmenopause
- Women who want medical-grade treatment, not over-the-counter substitutes
Why this conversation hasn't happened for you yet.
Sexual health complaints in women have been historically dismissed, undertreated, and routed to therapy when the underlying issue was hormonal. The medications that work — vaginal estradiol, compounded testosterone, oxytocin, Scream Cream — are well-documented and accessible, but most primary care visits don't have the time to address them and most OB-GYN appointments don't either. We make the time, and we have the prescribing relationships to follow through.
- ✓Sexual function is endocrine territory — hormones, vasculature, neurochemistry. It's medicine, not just psychology.
- ✓The standard 15-minute primary care visit isn't enough to evaluate sexual health properly — we book 60.
- ✓Compounded medications give us dose flexibility that off-the-shelf prescriptions don't.
- ✓We coordinate with your OB-GYN where appropriate — this isn't a replacement for gynecologic care, it's a complement.
Pricing — for everyone.
Women's sexual health care at Mt. Baker Medical is available to anyone — no membership required. Members save 15% on compounded medications and have the full primary-care relationship included.
| Retail | Member | |
|---|---|---|
| Scream CreamCompounded topical for arousal · monthly supply · physician oversight | $129 / mo | $109 / mo |
| Vaginal estradiol managementMonthly · for GSM, vaginal dryness, painful sex · includes medication | $89 / mo | $75 / mo |
| OxytocinCompounded nasal or troche · monthly · for libido and arousal support | $119 / mo | $99 / mo |
| Testosterone for women — standaloneCompounded low-dose cream or troche · for patients who want T-only, not full hormone optimization | $159 / mo | $135 / mo |
How we approach it.
Real conversation first. Hormonal workup if indicated. Compounded medications tailored to your situation, not stocked-and-prescribed.
60-minute first visit.
What's been going on, since when, what you've tried, what's bothering you most. No 15-minute slot, no waiting room hand-off.
Lab work where it helps.
Hormonal panel — estradiol, progesterone, testosterone (total and free), DHEA, thyroid — when the picture warrants. Not every patient needs the full workup.
Right treatment, right route.
Topical, oral, troche, or injection — chosen for your situation. Compounded so dosing can be adjusted to response.
Follow up.
Six-week and three-month check-ins. We adjust based on what's working and what isn't — not on a stock protocol.
What we offer.
Four medications, each addressing a specific aspect of female sexual function. Compounded through Empower Pharmacy.
Scream Cream.
A compounded topical applied directly to clitoral tissue 15–30 minutes before activity. Typically combines sildenafil, L-arginine, and aminophylline to enhance blood flow and arousal. Used as-needed, not daily.
Vaginal estradiol.
Local estrogen applied vaginally to restore tissue integrity, reduce dryness, address GSM, and resolve painful sex. Strong evidence base, minimal systemic absorption, safe for most women postmenopause including many breast cancer survivors with their oncologist's input.
Oxytocin.
Compounded as nasal spray or sublingual troche, used 15–30 minutes before intimacy. Supports arousal, connection, and orgasm in women whose primary issue is the relational/sensory side rather than tissue or hormonal.
Testosterone for women.
Low-dose compounded testosterone (cream or troche) for women whose libido issue is testosterone-driven. Available as a standalone — separate from the full hormone optimization protocol — for patients who want T-only without committing to broader hormone work.
Common questions.
The five questions we get most. Schema-eligible for AI Overview citation.
What is Scream Cream?
Scream Cream is a compounded topical medication applied to clitoral tissue 15–30 minutes before sexual activity. It typically contains sildenafil (the active ingredient in Viagra), L-arginine (a nitric oxide precursor), and aminophylline (a vasodilator) — combined to increase localized blood flow and enhance arousal. It's prescribed by a physician and compounded through a licensed pharmacy, not an over-the-counter product.
What causes low libido in women?
Low libido in women is multifactorial. The most common drivers in midlife are hormonal — declining estrogen, progesterone, and testosterone in perimenopause and postmenopause. Other contributors include medications (especially SSRIs and hormonal birth control), chronic stress, sleep deprivation, relationship dynamics, thyroid dysfunction, and unaddressed vaginal pain. A proper evaluation looks at all of these together rather than defaulting to "it's normal aging."
What is GSM and how is it treated?
Genitourinary syndrome of menopause (GSM) describes the collection of symptoms — vaginal dryness, irritation, painful sex, urinary frequency or urgency — that result from declining estrogen affecting vaginal and urogenital tissue. First-line treatment is vaginal estradiol (cream, tablet, or ring) which restores tissue integrity locally with minimal systemic absorption. Non-hormonal options include hyaluronic acid moisturizers and lubricants. GSM is highly treatable; the only reason it's so often undertreated is that it doesn't get discussed.
Is vaginal estrogen safe?
Vaginal estrogen has a strong safety profile because the dose is small and the systemic absorption is minimal — much lower than oral or transdermal hormone therapy. Decades of evidence support its safety for most postmenopausal women, including most breast cancer survivors (when used with the oncologist's input). The FDA black-box warning that initially deterred use was based on systemic hormone therapy data and has since been reconsidered in light of vaginal-specific evidence.
What is the O-shot?
The O-shot is platelet-rich plasma (PRP) injected into the vaginal and clitoral tissue, marketed as a regenerative treatment for arousal and orgasm difficulties. The evidence base is limited and variable across clinics. We don't offer the O-shot at Mt. Baker Medical — patients specifically interested in PRP-based treatments are better served by clinics that specialize in this modality.
Start with a free conversation.
30 minutes with Dr. Scribner. No exam, no commitment, no charge — just a real, professional conversation about what you've been carrying.
Or call(360) 498-7529