I m sure you are very frustrated by your symptoms. The cause is likely more than one problem, and will try to help, keeping in mind that you don t have insurance. Without hormones, the genital skin thins and becomes irritated from that alone. You do not need expensive patches. One tube of topical estrogen cream will last a very long time. I suggest using a peas size amount two or three times a week overnight. You and your husband may also have yeast, a fungal skin infection especially common in people who are prone to high blood sugars or on medications like antibiotics or steroids. Over the counter monistat ot terazole cream may help, use 2-3 times a day until improved, then as needed combined with an over the counter hydrocortisone- a pea size once daily for the first three days to calm down all the irritation. Avoid soaps with perfume, and use soap sparingly in the genital area. Keep this up for a few weeks including around the anal area. If you feel better you are on the right track, but it may take a while to thicken the tissue with the estrogen and treat the inflammation and fungal infection. If not better after 3-4 weeks then despite no insurance, its time to see a local physician, a gynecologist. In my experience, most respond to the treatment I outlined. Avoid a lot of sweets, carbs and sugars.