Estriol Cream

What is Estriol Cream?

Estriol Cream is a form of HRT that contains the hormone Estriol, which is a type of estrogen. This HRT cream has been specifically designed to provide relief to menopausal women who suffer from symptoms of vaginal dryness or vaginal atrophy.

When women experience the menopause their ovaries stop releasing eggs, which causes the body to stop producing the same levels of oestrogen. This process can cause some women to experience a range of unpleasant symptoms including vaginal dryness.

Unlike other forms of HRT, Estriol Cream is applied high up inside the vagina using a reusable applicator, where the cream mimics the levels of oestrogen that would normally be produced by the ovaries keeping the vagina hydrated and soothed.

Estriol Cream is a great choice of HRT for menopausal women who experience vaginal dryness but who do not experience other symptoms of the menopause such as hot flushes that need to be controlled with treatment.

What is Estriol Cream used for?

Estriol Cream is used to treat vaginal dryness or vaginal atrophy in menopausal women caused by a drop in levels of oestrogen produced by the ovaries. Or to promote wound healing following vaginal surgery.

Symptoms of vaginal dryness:

• Soreness or itchiness in and around your vagina
• Pain, bleeding or discomfort during sex
• Needing to urinate more frequently
• Recurring urinary tract infections (UTI)

Vaginal dryness is a common complaint of women experiencing the menopause, however, some women will have a more severe experience than others, which can interfere with daily living.

If you are unsure if you are experiencing vaginal dryness or you are unsure of the cause you should speak to a doctor for advice.

How does Estriol Cream work?

In the same way as other HRT, Estriol Cream relieves unpleasant menopausal symptoms by restoring the levels of oestrogen that before the menopause would have been produced by the ovaries.

However, because Estriol Cream is inserted directly into the vagina instead of being taken orally or absorbed through the skin it allows the oestrogen to be absorbed exactly where it is needed. Using topical HRT provides women with fast-acting relief but with less of the risks of experiencing unwanted side effects.

How long does Estriol Cream take to work?

When women are initially prescribed Estriol Cream for vaginal dryness, most commonly they will apply the treatment once a day for 2 - 3 weeks. Most women will see noticeable improvements to their condition within this time.

If you do not feel Estriol Cream has offered you adequate relief by 4 weeks you should speak to a doctor for further advice.

Estriol Cream and weight gain

There is no contemporary research that suggests that links the use of HRT to weight gain or weight loss, however, there have been reports by women that they have gained weight whilst using HRT.

The use of oestrogen-only HRT such as Estriol Cream may cause some women to experience fluid retention which also may make women feel bloated. This normally improves within the first 3 months.

Estriol Cream alternatives

Estriol Cream is a topical or local HRT that is inserted directly into the vagina, as a cream to decrease vaginal dryness caused by the menopause. Vagifem is another form of topical oestrogen-only HRT used to combat vaginal dryness, which is available as either tablets or pessaries that are inserted into the vagina.

At The Independent Pharmacy, we also offer a range of over-the-counter, non-hormonal vaginal lubricants and moisturisers or other forms of HRT on prescription, including those taken orally and patches. For more information about available treatments, take a look at our Advice for Menopause (HRT) page.

If you are suffering from symptoms of the menopause you must discuss your treatment options with a doctor. They will be able to advise you on what is the best form of HRT to suit you.

Sources

• https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/types/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252029/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538478/
• https://patient.info/doctor/hrt-topical
• Estriol Cream Patient Information Leaflet: https://www.medicines.org.uk/emc/product/5384/pil

Estriol dosage

Estriol Cream is for topical application only for use by postmenopausal women to relieve symptoms of vaginal dryness or to aid healing before or after vaginal surgery.

Please use it as directed by a doctor. You will be prescribed the lowest dose to effectively manage your symptoms.

To treat vaginal dryness:

• Apply 1 applicator, up to the red ring mark, (0.5 mg) once a day for 2 - 3 weeks.
• After this time apply 1 applicator, up to the red ring mark, twice a week.

How to use Estriol Cream

The recommended time to use Estriol Cream is just before you go to bed.

1. For your first application, you will need to pierce the tup on the tube using the sharp point on the cap.
2. Screw the reusable plastic applicator onto the end of the tube.
3. Squeeze the tube, using both hands, to fill the applicator with cream, up to the red ring mark.
4. Unscrew the applicator from the tube.
5. Lie down and insert the applicator deep into your vagina then slowly push the plunger all the way in and remove the applicator.
6. Clean the applicator using hot soapy water.

Before using Estriol Cream please read the Patient Information Leaflet thoroughly.

How to stop using Estriol Cream

You should speak to your doctor before stopping using Estriol Cream. Your doctor will be able to explain the effects of discontinuing treatment and they will be able to discuss the opportunities for further treatment with you.

Estriol 0.01% vaginal cream dosage

Please use it as directed by a doctor. You will be prescribed the lowest dose to effectively manage your symptoms.

How to apply Estriol Cream

The recommended time to use Estriol Cream is just before you go to bed.

1. Remove the cap from the tube. Use the top of the cap to pierce the metal seal on the tube
2. One end of the applicator has a plunger. Screw the other end of the applicator onto the tube
3. Squeeze the tube so that the applicator barrel is completely filled with cream. This will push the plunger out
4. Unscrew the filled applicator and replace the cap on the tube
5. Lie down with your knees bent and spread apart
6. Gently insert the open end of the applicator well into your vagina
7. Push the plunger firmly but gently. Empty the cream into your vagina by pushing the plunger as far as it will go
8. Keep the plunger firmly pressed down. Grip the applicator by the barrel and remove the empty applicator
9. Wash your hands afterwards
10. Use a sanitary towel to stop your clothes getting stained

Before using please read the Patient Information Leaflet thoroughly.

How to stop using Estriol Cream

As with Estriol 1mg above, you should speak to your doctor before stopping using Estriol Cream.

Estriol Cream ingredients

The active ingredient in Estriol Cream 1mg : Estriol

The other ingredients are: chlorhexidine dihydrochloride, octyldodecanol, cetyl palmitate, glycerin, cetyl alcohol, stearyl alcohol, polysorbate 60, sorbitan stearate, lactic acid, sodium hydroxide and purified water.

The active ingredient in Estriol Cream 0.01% : Estriol

The other ingredients are: Benzoic acid, Arachis oil, Glyceryl monostearate, Glycerin, Glutamic acid, Purified water

Note: Arachis oil is derived from peanuts

Estriol Cream side effects

Estriol Cream, like all HRT, can cause some women to experience side effects. Symptoms are, however, less prevalent and less severe than in women who take oral HRT. Most symptoms will improve within the first 3 months of treatment.

If you are worried about any side effects or you do not feel that they are improving over the first few months you should discuss this with a doctor or pharmacist.

If you experience a severe side effect or have an allergic reaction you must seek medical support from your nearest emergency department as soon as possible.

The most common side effects associated with Estriol Cream use are the following:

• Irritation or itching around the entrance of the vagina
• Headaches
• Breast tenderness
• Stomach pain and nausea
• Vaginal bleeding, discharge or discomfort
• Rash
• Gallbladder problems
• Fly-like symptoms

You must read the Patient Information Leaflet thoroughly before using Estriol Cream.

Estriol Cream warnings

• You should not use Estriol Cream if you have unexplained vaginal bleeding, thickening of the womb lining, liver disease, have ever had breast cancer or other oestrogen-sensitive cancers or have ever had a blood clot or a clotting disorder.
• Speak to your doctor before using Estriol Cream if you have asthma, epilepsy, diabetes, gallstones, high blood pressure, suffer from migraines or severe headaches, endometriosis, otosclerosis, SLE or fibroids inside your womb.
• You should tell your doctor before using Estriol Cream if you are currently or have recently stopped using any prescribed or non-prescribed medication.

Please read the Patient Information Leaflet thoroughly before using Estriol Cream.

Estriol Cream and cancer

Estrogen-only HRT taken orally can increase the risk of developing cancer of the womb lining and also that of cervical cancers and breast cancers. However, because Estriol Cream is inserted into the vagina very low levels of estrogen are absorbed into the bloodstream and, therefore, it is less likely to cause cancers.

It continues to be very important, however, for all women that use any form of HRT to attend regular health check-ups with their GP and to also regularly check their breasts for changes and to see a doctor if they experience any abnormal vaginal bleeding.

Estriol Cream and blood clots

Using any form of HRT including Estriol Cream can slightly raise your chances of developing a blood clot in a vein or of experiencing a stroke. You should see a doctor immediately if you think you are developing symptoms of a blood clot.

The following people are at an even higher risk of developing a blood clot and you should speak to a doctor before using Estriol Cream if any of them are relevant to you:

• You are immobile for an extended amount of time due to surgery, injury or illness.
• Your BMI is over 30.
• Your close relatives have ever had a blood clot.
• You have systemic lupus erythematosus.
• You have cancer.

Estriol Cream in pregnancy and breastfeeding

Estriol Cream should only be used by postmenopausal women and is not a contraceptive. If you are under 50 years old or have had a natural period in the last 12 months you should speak to a doctor about contraceptive options.

If you become pregnant while using any form of HRT you should stop using it and speak to a doctor for advice.