- Side Effects
- Patient Information Leaflet
What is Estriol Cream
When women reach menopause, several biological changes begin to occur, one of which is a decrease in oestrogen production. As a result of low oestrogen production, vaginal dryness occurs, which further leads to inflammation, itching as well as other painful symptoms. Such symptoms tend to affect the sensitive lining of the vagina. Due to such occurrences, the likelihood of one developing urinary and vaginal infections increases significantly.
In order to combat vaginal dryness and other symptoms associated with it, a hormone replacement therapy (HRT), known as Estriol Cream, is used. It can prove to be life-changing for most users.
What is contained in Estriol?
The primary active ingredient in each tube is Estriol. However, there are various inactive ingredients. They may include eutanol G, lactic acid, sodium hydroxide, purified water, sorbitan monostearate, cetyl palmitate, glycerol, stearyl alcohol, cetyl alcohol, polysorbate 60, as well as chlorhexidine hydrochloride.
Can I buy Estriol Online?
Before you can purchase Estriol cream online, you will be required to fill in a medical questionnaire. This questionnaire is compulsory as it ensures whether or not the product you intend to purchase is safe and appropriate for you. Specialists will assess your answers. They will determine the level of necessity and safety. Once the treatment has been deemed suitable for the individual, they will issue the prescription. The prescription will allow you to purchase the treatment right away.
How effective is Estriol?
Oestrogen cream is a very effective form of treatment for the thinning of the cells lining the urethra and vagina, as it helps restore the cells and pause the continued depletion. One major benefit to the cream being applied directly to the affected area is that the required dose is lower than orally taken oestrogen and yet still achieves highly effective results. Clinical trials demonstrated relief from symptoms of the vagina, such as dryness, itching and inflammation, during the first weeks of treatment.
Why choose Estriol?
Estradiol, estrone, and Estriol are the three naturally occurring oestrogen hormones. Since Estriol had always been considered the weakest of the three due to the level of its oestrogenic effects within the body, it had often been overlooked in the treatment of menopausal side effects. And yet, more recently, studies have discovered that due to this supposed weakness, it comes with fewer potential side effects and possible dangers than when using hormone replacement products with higher potency oestrogens. Issues linked to synthetic hormones circulating through the body when taken orally can include stimulating the ductal cells in the breast, uterine lining and endometrial cells, increasing the risk of cancers in these areas.
Conversely, studies so far have demonstrated that low-dose vaginal oestrogen creams did not instigate such stimulated growth when used over a long-term basis. It also gives a good alternative option to women who either cannot or do not want to use HRT tablets or patches.
How should I take Estriol?
The cream comes with a plastic application used to apply the correct amount of medication.
- Remove the tube cap and open the tube if it is the first time you have used it
- Screw the end of the applicator onto the tube
- Squeeze the tube until the tube is filled up to the marker, signifying one dose.
- Place the cap back on the tube once you have removed the applicator
- Lie down, place the applicator into the vagina and push the free end down until the full dose is inserted.
- Wash the barrel and plunger in hot soapy water and rinse well. Do not use detergents or boiling water on the applicator.
- Stay lying down once applied, if possible, to avoid leaking.
For menopausal problems, you will usually be prescribed enough for one full applicator of cream to be used each night for either two or three weeks. This may then be reduced to twice a week once your symptoms decrease, but your doctor will discuss your current symptoms and give you a personalised prescription based on these and your answers in the medical assessment form.
You should take a break from using the cream every 8 to 12 weeks to discover whether you still require it. Your doctor can review the length of time it’s used for, as well as any necessary breaks.
How does Estriol work?
When menopause causes the vaginal tissues to thin, the resulting symptoms, such as dryness and inflammation, can be challenging to live with. The use of an oestrogen medication such as Estriol supplements the vagina with the oestrogen the ovaries no longer produce naturally, easing the symptoms and giving relief.
How long can I use Estriol for?
Women are usually recommended to use the cream each night before bed for 2 or 3 weeks before lowering it to twice a week, but your doctor will discuss it with you.
It has been studied and seen to be safe for long-term use, with regular reviews by your doctor to ensure it is still the most appropriate and effective medication for you.
What are the side effects of Estriol?
Estriol can cause side effects, but not everyone will develop them. If you experience any of these side effects mentioned below or develop any other issues after using this cream, contact your doctor, who may decide to stop or change the treatment.
Side effects of Estriol cream may include irritation or itching in or around your vagina, excessive discharge, undiagnosed vaginal bleeding, rash or hives, sudden sensitivity to sunshine, swollen breasts, tender breasts, pain in breasts, headaches or migraines, nausea (feeling sick), symptoms of the flu, application site irritation and pruritis, fluid retention, postmenopausal spotting as well as vomiting.
Other Warnings to Consider
Levels of oestrogen absorbed into the bloodstream are very low due to being taken topically rather than orally or injected. As such, it is unlikely to affect any other medications you use but be sure to discuss other treatments you currently take with your doctor before starting Estriol to be certain.
Though studies have shown that oestrogen applied topically lowers the chance of developing more serious conditions such as cancer, it is always wise to assume that increased risks are possible. Keep this in mind, and make sure you book regular reviews of your treatment with your doctor.
Ensure you do not let other people touch the cream as it is absorbed through the skin, and they may get a dose of the oestrogen. Ensure to wash and dry your hands well after use for this exact reason.
Is Estriol Cream right for me?
There are ingredients present in Estriol cream that may not be suitable for every individual. In addition, there may be underlying causes, certain health conditions or interactions with medications you are currently taking that could render Estriol cream useless or unsafe. Consult your GP to determine whether it is a right fit for you.
Contraindications to Estriol Cream
As mentioned, Estriol cream may not work for everyone. You should not use Estriol cream if you are under 18. There are several other contraindications associated with Estriol cream. Before using the cream, inform your GP if:
- You are allergic to soy or peanuts
- You or a family member has had breast cancer
- You have or have had endometrial cancer
- You have or have ever had endometriosis, fibroids in your womb or endometrial hyperplasia
- You have or have had blood clots
- You have an abnormality that makes you prone to developing blood clots
- You have had a heart attack or angina
- You have porphyria
- You experience abnormal vaginal bleeding
- You have acute liver disease
- You have a history of liver disease which is not resolved
- You are pregnant
- You are breastfeeding
- You have diabetes
- You have or have had gallstones
Interactions with Estriol Cream
Estriol cream is absorbed directly into the bloodstream through the vagina in relatively low amounts. This means that the risk of interaction with other medications is relatively low. However, that is not the case if you simultaneously use multiple vaginal medications, like creams or pessaries, for other conditions, such as thrush and other infections.
Do not use Estriol if you are on any other vaginal treatments.
Note that you can use lubricants and moisturisers while using Estriol cream. But remember that Estriol cream can potentially damage diaphragms and condoms.
Alternatives to Estriol Cream
How long does it take for Estriol Cream to work?
Estriol cream typically takes three to six weeks to work.
What’s the difference between Vagifem and Estriol Cream?
One of the most popular alternatives to Estriol cream is Vagifem. One of the main differences between the two treatments is that Vagifem is available as a vaginal tablet, while Estriol cream comes as a cream. Although vaginal creams often present with fewer side effects as opposed to tablets, you get quicker and more noticeable results from using tablets. In addition to this, Vagifem contains estradiol, which is a significantly stronger form of oestrogen. However, Estriol, as the name suggests, has Estriol, which is a weak oestrogen.
They are similar in the sense that both treatments are inserted directly into the vagina with the help of an applicator. Also, they are both used to relieve menopausal symptoms, such as vaginal dryness, itchiness, along with irritation.
What dosage of Estriol cream should I choose?
Initially, your GP will start you off with the lowest dose of Estriol cream, then monitor your symptoms and the efficacy of the treatment. In most cases, the typical dosage of Estriol cream is one full applicator, equivalent to 0.5 g each day for the first two to three weeks.
After three weeks, your GP will lower your dose to one full applicator twice weekly at the exact times each week instead of every day.
Can I use Estriol cream before an operation?
If you are planning to undergo surgery, inform your GP that you are using estriol cream.
Will I need to use Estriol cream for the rest of my life?
No. The effects of Estriol cream tend to wear off as soon as you stop using it. Due to this factor, you can use the cream long-term.
How is Estriol Cream stored?
You can store Estriol Cream by doing the following:
- Keep the tube tightly closed after each use
- Keep the tube out of reach from children or pets
- Keep the tube stored in a cool and dry place
Who should not use Estriol Cream?
The following should not use Estriol Cream:
- Pregnant women
- Women who are lactating
- Women with undiagnosed vaginal bleeding
- Women who have or had breast cancer
What should I do if I use a large amount of Estriol Cream?
Keep in mind that the acute toxicity of Estriol is very low. This means that overdosage with Estriol cream after vaginal administration is highly unlikely. However, in cases where large quantities of the cream are ingested, it can prove to be a serious condition. Symptoms like nausea, vomiting and withdrawal bleeding in females may occur. Seek medical attention right away.
Side effects of using Estriol can include:
● Irritation or itching in or around your vagina
● Discharge or bleeding
● A rash
● Sensitivity to the sunshine
● Swollen or tender breasts
● Flu symptoms
● Application site irritation and pruritis
● Fluid retention
● Postmenopausal spotting