Preparations

The different options for a vaginal oestrogen include:

1. Vaginal tablets
2. Vaginal pessaries
3. Vaginal creams
4. Vaginal gel
5. Vaginal ring

For dosing regimes, see prescribing information section.

• The active ingredient is either estradiol, estriol or prasterone depending on the preparation.
• Compared to estradiol, in most tissues estriol is a less potent hormone, however it produces full estrogenic effects in the vaginal and urethral epithelium.
• Prasterone is DHEA which is converted by the vaginal epithelium first to testosterone and then potentially to oestrogen. NICE says consider vaginal prasterone as a treatment option for troublesome genitourinary menopausal symptoms if vaginal oestrogen, moisturisers or lubricants have been ineffective or are not tolerated.
• Postmenopausal women over 50 years can buy vaginal oestrogen 10mcg tablets from pharmacists, and this is called Gina.

• For information on Ospemifene see vaginal treatments.