Vaginal estrogens: What is Ovestin and how do I use it?

Ovestin is one of the most commonly-prescribed vaginal estrogen products. It’s an oil-based white cream which can be used internally and externally to relieve vaginal symptoms such as soreness, dryness and irritation.

How does Ovestin work?

Reduced estrogen levels, due to the perimenopause and menopause, can lead to the thinning and drying of your vaginal walls. This can cause a range of symptoms in and around the vagina, such as pain during intercourse, soreness and irritation, as well as urinary symptoms and infections (UTIs). As your bladder and urethra can also be affected by low estrogen, you may also experience urgency and occasional leaks. Ovestin replaces lost estrogen directly to the affected area, which helps to relieve these issues.

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When and how do I use Ovestin?

Ovestin is supplied with a reusable applicator, which you use to measure out the correct dosage of cream. You then lie down and insert the applicator into the vagina to dispense the cream – ideally before you go to bed so it stays in place for several hours. For the first two weeks of treatment, Ovestin is used every day. After that, it’s used twice per week. If this dose doesn’t improve symptoms, your healthcare professional may recommend using it more frequently.

What doses does Ovestin come in?

One applicator dose of Ovestin contains 500mcg of estriol, which is a type of estrogen made naturally in the ovaries.

What are the benefits?

As Ovestin is a cream formulation, you can apply it around the vulva using your fingertips, which can be useful if you also experience external itching and soreness. 

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Who is Ovestin suitable for?

Ovestin can be used alongside systemic HRT and because it is only applied to the affected area, it may also be suitable for women who can’t use HRT. Barrier forms of contraception, such as condoms or a diaphragm, shouldn’t be used for 72 hours after applying Ovestin as it’s oil based and could damage the latex.

Can I expect any side effects?

As Ovestin is a thick cream, some women find it a bit messy to use. It tends to leak out of your vagina after application, usually during the night, so it’s a good idea to protect your clothes and sheets. You may notice some itching or irritation when you first start using Ovestin, but this usually improves within a few weeks.

Resources

British National Formulary (BNF), ‘Estriol’