Over-the-counter vaginal estrogen coming soon?

Watchdogs are expected to announce a change in classification of some types of hormone treatments for the perimenopause and menopause. A relaxation of rules could see products such as vaginal estrogen becoming available at your local pharmacy without the need for a prescription from your doctor or nurse.

Around 70-80% of women experience symptoms in their perimenopause and menopause that affect the genital area and urinary function (known as Genitourinary Syndrome of Menopause or GSM). When the hormone estrogen declines during the perimenopause and menopause, your vulva and vagina can become sore and dry.

However, studies have shown that less than 10% of women seek treatment for these, often embarrassing, problems despite local hormonal preparations being very effective at restoring lubrication and relieving pain and irritation.

Some women may be reluctant to make an appointment with a healthcare professional to discuss such personal details and feel like their discomfort is not a ‘big enough’ problem to trouble their doctor about, but if they can pop to their local chemist instead this will hopefully make it easier and more accessible for women to find relief and comfort.

Vaginal estrogen comes in the form of a pessary, cream, or gel that is inserted into your vagina (usually at night time) to improve symptoms such as dryness and soreness of your vulva and vagina. Some women find wearing underclothes or sitting down for long periods of time uncomfortable whereas other women find penetrative sexual intercourse unbearable.

The low levels of estrogen can also cause urinary problems such as needing to urinate more frequently or having leaks of urine or more frequent infections like cystitis. When severe, these problems can be extremely debilitating for sufferers. Vaginal estrogen preparations also often help with these symptoms.

Without treatment these symptoms tend to get worse over time and don’t usually improve. Easy access to this very safe and effective local hormone treatment will be a welcome step towards improving the lives of all those going through the perimenopause and menopause, and a change in the rules will encourage greater autonomy for individuals to manage and improve their own quality of life.

Women who take HRT can still safely use vaginal estrogen products and around 20% of women taking HRT need to use vaginal estrogen due to experiencing these localised symptoms.

Read our factsheet about vaginal symptoms and treatments here or browse our wide range of films, podcasts, or guidelines on the topic in our Menopause Library by refining your search and selecting ‘Genitourinary Syndrome of Menopause’.