Ovestin

Ovestin

Ovestin, otherwise known as Estriol (which is the drug it contains) is a Hormone Replacement Therapy that comes in the form of a vaginal cream. Ovestin is an oestrogen-only HRT. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

The menopause can bring lots of ups and downs into your life, the symptoms can really affect your day to day life and happiness. Although some of these symptoms may be difficult to talk about, changes in your libido, vaginal dryness that makes sex painful or frequent vaginal infections can cause real problems, so it’s worth knowing that there are medicines and treatments out there that may be able to provide you with some relief. The menopause usually takes place somewhere between the ages of 45 and 50, with the average age in the UK being 51. The menopause happens in 3 stages: 

  • Perimenopause: the time when your periods are becoming less frequent and lighter, lasts on average 4 years
  • Menopause: once your last period finishes 
  • Postmenopause: menopause ends one full year after your last period but it usually takes 2 to 5 years for symptoms to stop

You start the menopause because your ovaries stop producing eggs, nobody knows what triggers this, although obviously if you have surgery to remove them, this can. When your ovaries stop producing eggs the levels of the hormone oestrogen in your body drop. It doesn’t happen all of a sudden, you’ll notice your periods becoming lighter and less frequent for some time before they completely stop. When the oestrogen levels in your body drop you may experience some of the following symptoms: 

  • Hot flushes 
  • Vaginal dryness 
  • Lower sex drive 
  • Night sweats 
  • Difficulty sleeping 
  • Headaches 
  • Anxiety 
  • Mood changes 
  • Palpitations 
  • Joint pain or stiffness 
  • Frequent urinary tract infections 
  • Reduced muscle mass 
  • Weak bones or osteoporosis

These low amounts of oestrogen can also lead to other problems like fragile bones or osteoporosis. It’s really important to maintain a healthy lifestyle when going through the menopause as it can help to ward off some of the symptoms and offer extra protection against things like osteoporosis.  Try to stay fit and exercise for 30 minutes a day at least 5 times a week. This can be an exercise like walking, gardening, yoga or pilates. In addition to exercise, you should eat a healthy, well-balanced diet that’s full of the nutrients your body needs. It’s also worth keeping an eye of the amount of alcohol you consume and keeping it to a minimum. If you’re a smoker then consider quitting. 

The menopause can last anything from 6 months to 13 years. Some women manage to cope very well with it, their symptoms are moderate and can be controlled or lessened with a few simple lifestyle changes, e.g. wearing layers so you have something to remove if you’re having a hot flush, exercising every day to improve sleep. For others with symptoms, like vaginal dryness life can be miserable. Symptoms can last for up to four years once your periods stop. Hormone Replacement Therapies have been developed to help women suffering from severe menopausal symptoms. Hormone Replacement Therapy is the main treatment for the symptoms of menopause in the UK. As the name suggests the idea is to re-balance the hormones in your body by adding oestrogen or a combination of oestrogen and progesterone. This can be done using several different methods: 

  • Tablets 
  • Patches 
  • Vaginal 
  • Creams 
  • Gels 
  • Pessaries 
  • Rings. 

Not all HRT treatments are taken the same way, some are used continuously, others alter along with your menstrual cycle. One vaginal cream you may want to consider is Ovestin, read on to find out more. 

What is Ovestin? 

Ovestin, otherwise known as Estriol (which is the drug it contains) is a Hormone Replacement Therapy that comes in the form of a vaginal cream. Ovestin is an oestrogen-only HRT. When you stop having periods your levels of oestrogen drop causing a number of symptoms, one of those is vaginal dryness. This is because the lack of oestrogens in your blood cause the vaginal wall to thin. The result of the thinner vaginal wall is vaginal dryness which makes sex become painful and leaves you more prone to vaginal infections. A cream like Ovestin can relieve this symptom giving you back your sex life and helping to ward off infections. 

When is Ovestin used? 

Ovestin is used for vaginal problems that come from having too little oestrogen in the body. This is usually caused by menopause. It is particularly aimed to help with the menopausal symptom of vaginal dryness which can lead to painful sex and frequent infections. It can also be prescribed for wound healing when undergoing vaginal surgery. 

How do you use Ovestin? 

Ovestin is a vaginal cream, it comes with its own applicator. You use the applicator to apply the cream in the vagina. Ovestin is applied once a day. We recommend you apply it at night. 

Step by step instructions: 

  • Remove the cap from the tube and use it to pierce the metal seal on the end
  • Screw the applicator onto the tube 
  • Squeeze the tube so that the cream fills the applicator. Fill up to the red ring mark (the plunger will stop there)
  • Unscrew the applicator and put the cap back onto the tube
  • Now apply the cream, lie down and push the end of the applicator deep into your vagina, slowly push the plunger in completely
  • Once you have finished applying the cream separate the plunger and barrel and wash them both in hand hot (not boiling) soapy water
  • Rinse well with clean water

Ovestin comes off easily in water. 

What are the dosages? 

You should always follow the advice of your doctor or pharmacist when it comes to taking medicines, below you’ll find a general guide to dosages and timings. The active oestrogen in Ovestin is called Estriol, each 5mg of Ovestin cream contains 0.5mg of Estriol. When taking Ovestin for the first time you can start treatment straight away if: 

  • You’ve had your womb and ovaries removed 
  • You’ve never used an HRT before or you are changing from an HRT that stops you from having a period

You will need to delay starting Ovestin treatment if: 

  • You are changing from a different HRT where you have a period.  

In this case, start Ovestin one week after you finish the other treatment. The normal dose for vaginal problems is: 

  • One applicator full (up to the ring) per day for the first 2 to 3 weeks 
  • After this, the dose is 1 applicator full (up to the ring) twice a week

You should be prescribed the lowest possible dose to relieve your symptoms. You may need to take a break from time to time to see if the treatment is still required. The normal dose before vaginal surgery is: 

  • Applicator full (up to the ring) per day for 2 weeks before the surgery 

The normal dose after surgery is: Do not use the cream for at least 2 weeks, then 1 applicator full (up to the ring) twice a week. If you forget to apply your dose of Ovestin apply it as soon as you remember unless it has been more than 12 hours since you should have applied it, in which case skip that dose. If you apply too much Ovestin, don’t worry it may make you feel or be sick or cause some vaginal bleeding but shouldn’t cause any long-term problems. 

What are the side effects of Ovestin? 

As with all medicines, Ovestin can cause some side effects but not everyone who uses Ovestin will get them: Important issues to look out for are: 

  • Yellowing skin or whites of the eyes (jaundice)
  • Signs of a blood clot (painful swelling in the leg, sudden chest pain, difficulty breathing) 
  • Sudden migraines or severe headaches
  • A rise in blood pressure 

If you notice any of these speak to your doctor straight away. Other side effects are: 

  • Gallbladder problems 
  • Skin irritation in or around the vagina (usually eases after a while) 
  • Increased vaginal discharge 
  • Headaches 
  • Nausea and vomiting 
  • Flu-like symptoms 
  • Rashes or skin problems 
  • Swollen, tender or painful breasts 

When shouldn’t you use Ovestin? 

You shouldn’t use Ovestin if you are allergic to any of the ingredients listed on the pack. If you have ever had any of the following you should also avoid using Ovestin: 

  • Liver disease 
  • Breast cancer 
  • Cancer of the womb lining or ovaries 
  • Excessive thickening of the womb lining 
  • Angina 
  • Heart attack 
  • Blood clots 
  • Unexplained vaginal bleeding 
  • A rare blood problem called porphyria 

Occurrences of breast cancer, cancer of the womb lining and heart disease have been shown t be slightly higher in women using HRT than women who aren’t using HRT. General health factors (weight, alcohol consumption, smoking) can also increase your risk levels for these diseases. If you are unsure about anything to do with Ovestin discuss it with your doctor. 

If you have ever had any of the following you should talk to your doctor before taking Premarin as it can make things worse or cause a recurrence so you will need more frequent check-ups: 

  • Growth of womb lining outside your womb or excessive growth in the womb lining 
  • Circulation or heart problems 
  • Diabetes 
  • Relatives who’ve had blood clots 
  • Gallstones 
  • Severe headaches 
  • Liver or kidney problems 
  • Epilepsy 
  • Asthma 
  • A disease which affects your immune system 
  • Otosclerosis (a hearing disorder) 

Does Ovestin interact with other medications? 

Always tell your doctor about any other medication you are taking before you are prescribed a new medicine. This includes complementary medicines and supplements.  Some medicines can affect the way that Ovestin works or Ovestin can affect how some other medicines work. It’s particularly important that you mention any of the following: 

  • Medicines used for epilepsy 
  • Herbal remedies containing St John’s wort 
  • Medicines for infections 
  • Medicines for viral infections 
  • Corticosteroids, succinylcholine, theophylline or troleandomycin 
  • The combination drug ombitasvir/paritaprevir/ritonavir for Hepatitis C 

Where can you buy Ovestin? 

You can buy Ovestin from any pharmacy nationwide. You can order online and get it delivered to your door or pop into any of your local pharmacies. 

Can I get Ovestin without a prescription? 

No, you cannot buy Ovestin or Estriol without a prescription, you will need to discuss the treatment with a doctor first. You could arrange an online consultation or make an appointment with your regular doctor to discuss your needs. 

 

 

References

Aspen Bad Oldesloe Gmbh. (April 2018). Ovestin Patient Leaflet. Retrieved from https://www.medicines.org.uk/emc/files/pil.5384.pdf 

Brazier, Yvette. (May 2017). What you need to know about HRT. Retrieved from https://www.medicalnewstoday.com/articles/181726.php 

Irani, Shirin. (2019). Consultant Gynaecologist Menopause. Retrieved from https://www.bupa.co.uk/health-information/womens-health/menopause 

Marlborough pharmaceuticals. (April 2016). A guide for patients prescribed Estriol 0.01% cream. Retrieved from https://estriol.co.uk/assets/docs/guide_for_patients_using_estriol.pdf 

NHS UK. (July 2016). Hormone Replacement Therapy. Retrieved from https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/ 

NHS UK. (August 2018). Menopause Treatment. Retrieved from https://www.nhs.uk/conditions/menopause/treatment/