Ovestin Cream

Order Ovestin cream to ease your menopause symptoms

Ovestin cream is an HRT treatment containing estriol, a form of oestrogen. The cream is applied directly inside the vagina with the help of an applicator.

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Strength Quantity Price Stock
0.01%1 x 15g tube£27.00In Stock
Prices exclude a prescription fee. This treatment requires a quick online consultation,
which a doctor will review to determine if a prescription is appropriate.

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Information

Dr Samantha Miller

Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464

Information last reviewed 27/05/2021

About

What is Ovestin cream?

Ovestin Cream (generic name Estriol Cream) is a treatment for symptoms of menopause which are local to the vaginal area, including vaginal dryness, inflammation or itching, discomfort or pain during sex, vaginal tightness, spotting, painful urination, and recurrent urinary tract infection (UTI).

How does Ovestin cream work?

Ovestin cream is a type of hormone therapy (HRT) and contains estriol, a bioidentical form of oestrogen produced naturally by the body. When women reach menopause, the amount of oestrogen produced by the ovaries begins to decrease, resulting in symptoms such as hot flushes and night sweats, mood swings, irregular periods, and vaginal dryness and irritation. Ovestin cream is a local treatment that supplements the level of oestrogen in the vaginal region, reducing and often preventing the impact of symptoms such as dryness and discomfort.

Ingredients

Active Ingredients

The active ingredient in Ovestin Cream is estriol (0.01%).

Inactive Ingredients

The inactive ingredients in Ovestin cream are octyldodecanol, cetyl palmitate, glycerin, cetyl alcohol, stearyl alcohol, polysorbate 60, sorbitan stearate, chlorhexidine dihydrochloride, lactic acid, sodium hydroxide to pH 4 and purified water.

Dosage

A doctor will begin by prescribing you the lowest dose of Ovestin cream possible for your symptoms but may choose to increase the dose later on. The usual starting dose of Ovestin cream is 1 full applicator (0.5g) once daily for 2 to 3 weeks, after which you will need to lower your dose to 1 full applicator (0.5g) twice weekly, at the same times each week.

Starting Ovestin cream

Ovestin cream can be started at any time if you have had a hysterectomy, have never used HRT before, or are switching from a form of HRT that does not cause a withdrawal bleed. If you are switching from a form of HRT that does cause a withdrawal bleed, you will need to wait a week after finishing the calendar pack of your previous HRT before starting Ovestin cream.

How to use Ovestin cream?

Always use Ovestin cream as instructed by your doctor. It is best to use this treatment before going to bed at night, as you will need to insert a full applicator of cream into the vagina. Unscrew the cap from the tube of cream and turn the cap over. Use the sharp point on the top of the cap to pierce the covering of the tube opening. Screw the end of the applicator onto the opening of the tube and squeeze the tube to fill the applicator up to the red line - the plunger will stop when the applicator is full. Unscrew the applicator and replace the cap onto the tube. Lie on your back with your legs apart and place the end of the applicator as deep into your vagina as possible, then slowly push the plunger all the way down to release the cream. Once you have carefully removed the applicator, keeping the plunger pressed down as you do so, remove the plunger from the barrel and wash both parts in warm, soapy water. You may wish to use a sanitary towel overnight to protect your underwear and bedsheets from stains.
 
If you miss a dose of Ovestin cream, apply the dose as soon as possible within 12 hours. If 12 hours have already passed, skip the dose and apply your next one at the normal time. Never apply a double dose to make up for a missed one.

Pregnancy and breastfeeding

Do NOT use Ovestin cream if you are breastfeeding, pregnant, might be pregnant, or are planning on becoming pregnant.

Side Effects

Like all medicines, Ovestin cream can cause side effects in some patients. If you experience any of the following side effects, stop using Ovestin cream and consult your doctor immediately:

  • Signs of a severe allergic reaction, including swelling, irritation or rash at the area of applications
  • A rise in blood pressure
  • Yellowing of the skin or whites of the eyes (jaundice)
  • Migraine-like headaches 
  • Signs of a blood clot, including swelling of the leg or legs, sudden chest pain, or difficulty breathing

 Other side effects are usually harmless, but you should inform your doctor if they affect you. These include:

  • Irritation or itching of the skin around the vagina, which usually gets better within a few weeks
  • Increase in vaginal discharge
  • Bleeding or spotting
  • Gallbladder problems
  • Rash or hypersensitivity to sunlight
  • Swelling or tender breasts
  • Headaches
  • Nausea or vomiting
  • Flu-like symptoms

Contraindications

Do NOT use Ovestin cream if you:

  • Are allergic to estriol or to any of the other ingredients in this treatment
  • Have had angina or a heart attack (myocardial infarction)
  • Have had a blood clot (thrombosis)
  • Have had breast cancer or suspect that you have breast cancer
  • Have had cancer of the sex organs, such as endometrial cancer or ovarian cancer
  • Have unexplained vaginal bleeding
  • Have excessive thickening of the womb lining (endometrial hyperplasia) 
  • Have had liver disease, or your liver is not working properly
  • Have a rare blood problem known as porphyria

 Tell your doctor and take particular care with estriol cream if you have or have ever had:

  • Problems caused by growth of the womb lining outside of the womb (fibroids or endometriosis)
  • Problems with your heart or circulation
  • A family history of blood clots
  • Asthma
  • Diabetes
  • Migraines or severe headaches
  • Epilepsy
  • Gallstones
  • Liver or kidney problems
  • Systemic lupus erythematosus (SLE)
  • A hearing disorder known as otosclerosis

Drug Interactions

Before using Ovestin cream, tell your doctor or pharmacist if you are taking or have recently taken any other medications, including those purchased over the counter without a prescription. In particular, inform your doctor if you are taking or have recently taken any of the following:

  • Medicines for epilepsy, including barbiturates, hydantoins and carbamazepine
  • Medicines for infection, including griseofulvin and rifamycins
  • Medicines for viral infections, including nevirapine, efavirenz, ritonavir, or nelfinavir
  • Herbal preparations including St John’s wort
  • Corticosteroids, succinylcholine, theophyllines, or troleandomycin
  • Regimens for hepatitis C e.g. ombitasvir, paritaprevir, ritonavir, dasabuvir

Treatment Options

HRT

Topical treatments such as Ovestin and estriol creams, and vaginal suppositories such as Vagifem are often the first choice for women who are approaching menopause and wish to try HRT but are only effective in relieving symptoms local to the vaginal area. However, because they are not digested, they are less likely to cause side effects. It is important to remember that these creams can have a weakening effect on latex condoms and diaphragms, so you should speak to a doctor about alternative forms of contraception while using them.

Other forms of HRT can be taken orally as tablets or applied to the skin as transdermal patches. 

If you still get regular periods or have had a period in the last year, you’d be most suited for a cyclical combined form of HRT such as Elleste Duet or Evorel Sequi. If you’ve finished your periods and haven’t had a natural bleed for more than 12 months, you can take a continuous combined form of HRT such as Elleste Duet Conti or Evorel Conti.

Oestrogen-only supplements are only suitable for women who have had a hysterectomy, or who have an IUD (Mirena coil) fitted, as a progesterone supplement is necessary to prevent a build-up of the womb lining. Premarin and Elleste Solo are tablets that are taken orally, while Elleste Solo MX80, Elleste Solo MX40 and Evorel are transdermal patches that need to be changed twice weekly. Transdermal patches have the benefit of bypassing the digestive system before reaching the bloodstream, which reduces the likelihood of side effects.

A non-hormonal alternative is Tibolone (brand name Livial), a synthetic steroid that mimics the action of both oestrogen and progesterone in the body and is thought to carry fewer health risks.

Alternatives to HRT

HRT is the most effective treatment for the symptoms of menopause and is available online through Dr Felix. Some herbal remedies are thought to relieve menopause symptoms such as mood swings and hot flushes but there is little evidence to support their effectiveness. It is important to consult a doctor or pharmacist about the contents and effects of a herbal product before trying it out.

Lifestyle changes to improve menopause symptoms

Menopause can be a difficult time for many women, but you can significantly increase your quality of life by making a few lifestyle changes. Cutting down on caffeine, alcohol and spicy foods, and quitting smoking can all help to reduce the impact of hot flushes, and exercising regularly and increasing your intake of Vitamin D will help to keep your bones strong and healthy. There is little evidence to suggest that an oestrogen-rich diet will help reduce the symptoms of menopause, but some women do try increasing their intake of plant-based foods which contain phytoestrogens. These include sesame and flaxseed, nuts, dried fruits, and other fruits such as oranges, strawberries and apricots.

Q&A

How effective is Ovestin cream?

Ovestin cream is a safe and effective treatment for the vaginal symptoms of menopause and is particularly popular among women who are approaching menopause but do not want to use oral or transdermal forms of HRT. It is particularly useful for women whose most troublesome symptoms are that of vaginal dryness and irritation.

Is Ovestin cream safe?

Ovestin cream is safe for use in most women. Oral HRT appears to increase the risk of breast cancer, ovarian cancer, blood clots and stroke. However, the benefits of HRT often outweigh the risks. Topical HRTs such as Ovestin cream carry fewer risks and are not thought to be associated with an increased risk of cancer or blood clots. The hormone within Ovestin, estriol,  is bioidentical, meaning it is exactly the same as the oestrogen produced naturally by the body.

How long does Ovestin cream take to work?

The effects of Ovestin cream are usually felt within 2 to 3 weeks, during which time the cream should be used once daily. After 2 to 3 weeks, you should reduce application to twice weekly for as long as your doctor deems necessary.

Will I need to use Ovestin cream for the rest of my life?

Many women take HRT for many years, though not necessarily for the rest of their lives. The effects of Ovestin cream will wear off when you stop using it, but you may choose to switch to an oral or transdermal form of HRT to prevent the onset of osteoporosis. At a later age, many women chose to come off of HRT altogether.

Does Ovestin cream cause weight gain?

There is no evidence to suggest that Ovestin cream causes weight gain.

Can I use Ovestin cream before an operation?

If you are planning on undergoing surgery, tell your doctor in advance that you are using Ovestin cream. 

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