Phase I-B Study to Evaluate the Safety, Tolerability and Efficacy of IZN-6NVS for the Treatment of AV and DIV

Inclusion Criteria: 1. Women over age 18 2. For groups 1 and 2: I. Self-reported amenorrhea for at least 12 months or documentation of menopause based on serum E2 ≤ 150 pg/ml. II. Self-reporting of at least one moderate to severe symptom of vaginal atrophy on a 4-point scale (0=none; 1=mild; 2=moderate; 3=severe): * Vaginal dryness * Vaginal discomfort or irritation * Vaginal itching * Vaginal pain associated with sexual activity * Vaginal discharge * Vaginal Malodor III. Clinical impression of atrophy based on examination of vaginal cytological smear. IV. Vaginal pH \>4.5 V. Endometrial thickness ≤5 mm as determined by US, with no abnormalities noted. 3. For group 3 (DIV): Clinical diagnosis of DIV in pre-menopausal women without estrogen deficiency. 4. For all groups: I. Willing to comply with use of an intravaginal cream containing S. nigra, C. asiatica, and E. purpurea extracts. II. Normal PAP smear within the last 3 years. III. Able to provide informed consent. - Exclusion Criteria: 1. Subjects recruited in group 1 should not be actively treated for breast, uterine or ovarian cancer within the past year. 2. Vaginal bleeding of unknown cause within 60 days of enrollment 3. Vaginal infection requiring treatment within 30 days of enrollment 4. Any known allergy to the plant extracts in the study cream 5. Any serious disease; concomitant steroid use or sex hormone treatment 6. Endometrial thickness \> 5 mm measured by ultrasound for women enrolled with diagnosis of atrophic vaginitis 7. Use of any vaginal moisturizer (e.g. Replens, Gynomonal) within 30 days of enrollment. 8. In groups 1 and 2, Use of any oral, transdermal, vaginal, or systemic estrogen or estrogen/progestin product within 30 days of enrollment. 9. Current urinary tract infection (UTI) (clinical complaints of UTI or dipstick urinalysis positive for nitrates or blood) 10. History of venous thromboembolic disease. 11. Use of another investigational agent within 12 weeks of screening. 12. Any medical or psychiatric condition that, in the investigator's opinion, would preclude the subject from complying with the study protocol, including the completion of questionnaires. 13. Subjects with DIV who are pregnant or trying to become pregnant will not be included in the study. Similarly, if a subject with DIV becomes pregnant during the study, that patient will be removed from the study. \-