Ovestin

What Is Ovestin Used For?

Ovestin is a hormone replacement therapy (HRT) cream and is a prescription only medication (POM) used to provide relief from urinary and vaginal symptoms which occur during perimenopause, menopause and post-menopause. 

Menopause can lead to an array of symptoms known as the genitourinary syndrome (GSM) which includes vaginal dryness and vaginal atrophy.  The dryness between the fold of the skin externally and internally can cause extreme irritation, burning and itching which can become painful and inflamed. It can also lead to urinary tract infections (UTI) and also lead to chronic, recurrent UTIs. 

GSM can be extremely debilitating as it needs to be treated for life because when treatment is stopped, the symptoms normally tend to start again therefore patients are normally treated with a low dose therapy which is ongoing alongside follow up appointments. This normally occurs due to a drop of oestrogen in the body, which starts to lower naturally after menopause. 

Ovestin therefore is used to replenish the lowered oestrogen levels which is primarily synthesised in the ovaries. The ovestin cream comes in an applicatorful format which is then inserted into the vagina. The cream containing oestrogen which is a hormone is released where needed into the walls of the vagina. This can help to lessen and soothe the symptoms of vaginal atrophy and also dryness. 

Read the full article for more information including warnings, precautions and side effects. The article will also provide the Ovestin cost and how to buy ovestin online in the UK

How Does Ovestin Cream Work?

Ovestin consists of estriol which is a synthetic form of the endogenous estriol found in humans. When the ovestin vaginal cream applicator is inserted into the vagina, it works by binding to the local oestrogen receptors located in the vaginal and urethral tissues. This helps to reinstate the thickness and elastic quality of the epithelium and enables the tissues to increase blood flow around the area and also increase their glycogen content. 

This is beneficial because increased glycogen in the area allows a specific type of bacteria known as Lactobacillus to function more efficiently. This lowers the pH in the vagina rendering it in a more acidic state. This further helps to increase the microbiome diversity within the vagina as a low vaginal pH creates a balanced environment for healthy bacteria to flourish and prevent future infections. 

By reducing the pH and allowing healthy bacteria to flourish, the vaginal and other surrounding tissues undergo repair reversing the effects of low estrogen hence providing relief and help soothe symptoms of vaginal atrophy and dryness by moisturising the area therefore reducing genitourinary symptoms. 

Who Can Use Ovestin?

Ovestin HRT cream can be used by women who are in the post-menopausal phase; however, it can also be used by women undergoing perimenopause. Women in these phases who are dealing with genitourinary symptoms of menopause (GSM) may suffer from vaginal dryness, itching, urinary tract infections, soreness and general malaise therefore ovestin can be used to relieve these symptoms and provide comfort.

However, it is not recommended to prescribe Ovestin for women who have or have had a history of oestrogen-sensitive cancers such as breast, ovarian and endometrial cancers. It is also not advised to use this medication if you suffer from unexplained vaginal bleeding, are at risk of blood clots or suffer from liver disease and many others. 

Scroll further down the article for more information on warnings and precautions. 

How to Apply Ovestin Vaginal Cream?

Ovestin HRT vaginal cream can be used in 2 different ways: 

For vaginal problems:

• Use 1 applicatorful up to the ring once a day normally for 2 to 3 weeks (maximum 4 weeks)
• Reduce the dose application to twice a week thereafter 

Your doctor will aim to prescribe the lowest dose possible for the start of your treatment in order to relieve symptoms. Ensure to attend follow ups with your doctor to assess further treatment if required. Your doctor may also advise you to stop the treatment every 2 to 3 months for 4 weeks as required to assess if treatment is required. 

For use before or after vaginal surgery:

Before your surgery: 

The dose is 1 applicatorful up to the ring once a day for 2 weeks before the surgery.

After surgery: 

It is recommended to avoid using the cream for at least 2 weeks after surgery. Treatment can be continued thereafter using 1 applicatorful up to the ring twice a week.

For specific instructions on how to use ovestin cream, follow the instructions below as directed:

1. It is advised to use the ovestin cream before sleeping at night. 
2. Take the tube’s cap off and turn it upside down. Use the sharp point on the cap to open the tube.
3. Attach the end of the applicator to the tube
4. Squeeze the tube until the applicator fills with the cream up to the red ring mark – the plunger should stop at the red ring mark point. 
5. Place the cap back on the tube after unscrewing the applicator from the tube.
6. During administration, lie down flat or however you feel comfortable, insert the end of the applicator into the vagina and insert it as deep as possible, pushing the plunger all the way in slowly and gently.

To clean the applicator:

1. After administration, remove the plunger from the barrel.
2. Wash both the plunger and the barrel in hot, soapy water.
3. Avoid using detergent and ensure to rinse properly with clean water.
4. Do not put the applicator in hot boiling water, only hand hot water.

If you use more medication than required or if the medication is swallowed by accident:

• In the case of accidental swallowing either by yourself or someone else, speak to your doctor if the individual feels sick or becomes sick.
• In the case of applying too much cream, that is not a cause for concern but speak to your doctor if any complications do arise. Some women also report vaginal bleeding after a few days of excessive cream use. 

In the event of missing a dose:

• Apply the missed dose as soon as you remember but within 12 hours of the designated dose time.
• In the event you are late for more than 12 hours, skip the missed dose and proceed to take the next one as normal. 

In the event of stopping usage of medication:

• Ensure to take your medication even if you feel better and not stop randomly. 
• Only stop using the medication if the side effects are prominent and you have notified your doctor who can then look for an alternative. 
• Stopping the medication upon feeling better may make the symptoms come back. 

Side Effects of Ovestin

The following table lists side effects which may occur when taking Ovestin and these range from common to potentially rare but serious side effects:

Ovestin Safety Information & Precautions

There are certain patients who cannot use ovestin and should not be prescribed this medication and these are listed below:

Do not use this medication if the following apply to you:

• You have had breast cancer in the past or could develop it in the future 
• You have oestrogen sensitive cancer such as endometrial, breast and ovarian cancers 
• Vaginal bleeding that is unexplained and occurs randomly or consistently 
• Endometrial hyperplasia (thickening of endometrium) that is untreated 
• You have had a blood clot or have had issues with blood clotting (disorder) in the past or currently 
• If you have suffered from a heart attack or stroke due to blood clots in arteries 
• If you have a diagnosed liver disease 
• Porphyria (blood disease)
• Allergic to any of the ingredients in ovestin cream 

If you do start medication and any of the above symptoms become visible or apparent for the first time, please stop taking the medication immediately and refer to your doctor as soon as possible. 

Before starting this medication, it is advised to notify your doctor if you the following applies to you or has applied to you in the past:

• Fibroids in the womb (past or current)

• Endometriosis or endometriosis hyperplasia 
• Increased risk of having blood clots 
• History of estrogen sensitive cancer in the family such a
• Hypertension (high blood pressure)
• Liver problems such as a tumour in the liver 
• Diabetes 
• Gallbladder issues such as gallstones 
• Migraines or other severe headaches 
• Autoimmune conditions such as lupus and so on
• Epilepsy and are currently taking medications for epilepsy 
• Asthma 
• Ear problems 
• Kidney problems 
• Hepatitis C and are currently on the following medications: ombitasvir/paritaprevir/ritonavir in combination with or without dasabuvir 
• Taking griseofulvin and rifamycins 
• Taking medications for viral infections 
• Taking St John’s Wort over the counter to treat depression or for any other reason 

The following table outlines certain conditions which are at an increased risk of developing during HRT treatment and should be considered before starting HRT treatment or during HRT treatment:

Ovestin Price & Cost in the UK

In the UK, Ovestin is currently prescribed as a prescription only medication (POM). It can be purchased using an NHS prescription which is charged using the standard prescription charge rate of £9.90 per item. Therefore, Ovestin vaginal cream price in the UK is charged at a rate of £9.90 for each prescription.

However, if any of the NHS exemptions apply to you then you do not have to pay the NHS charge. NHS prescriptions are currently free of charge in Scotland, Wales and Northern Ireland. 

If however, you are not exempt from paying the NHS charge, you can purchase a Prescription Prepayment Certificate (PPC) which allows you to purchase a 3 month (£32.05) or a 12 month (£114.50) certificate at a set price which works out cheaper if you need to purchase prescription-only medications often. 

In the event of a shortage of Ovestin, some pharmacies may supply generic estriol cream 1mg/g instead of the branded version; however, they are both the same medication. The NHS charge for both estriol generic and the branded Ovestin is the same. 

Where to Buy Ovestin Online

Ovestin cream UK is a prescription only medication (POM) therefore it can only be prescribed by a doctor, and dispensed by a UK registered pharmacist. It can also be purchased via a private prescription although private prescription charges are dependent on each pharmacy and do not follow the NHS charge guidelines. 

You can also buy Ovestin cream online however, the pharmacy online has to be a registered UK online pharmacy who are only able to dispense this medication after a clinical assessment. Therefore, online pharmacies such as Superdrug, Lloyds pharmacy and others can be used to order ovestin online.