Estriol cream

Estriol cream belongs to a group of medicines called hormone replacement therapy (HRT). It is used to relieve menopausal symptoms in the vagina such as dryness or irritation. In medical terms this is known as vaginal atrophy. This condition is caused by a drop in the levels of female sex hormones in your body before and after menopause. Shortage of oestrogen may cause the vaginal wall to become thin and dry. This can cause symptoms, such as: 

• Irritation in the vagina. 
• Painful sexual intercourse. 
• Vaginal yeast infection (vaginal thrush). 

Estriol cream is used to reduce these symptoms. The cream contains an oestrogen hormone. It is inserted directly into the vagina, so the hormone is released where it is needed. This may relieve discomfort in the vagina within a few days or weeks. 

Always use this medicine exactly as your doctor or pharmacist has told you. You should check with your doctor or pharmacist if you are not sure. 

When to start treatment with Estriol cream 

See the package leaflet for more information or consult a doctor or pharmacist. 

How much to use 

For vaginal problems 

The usual dose is one applicator up to the ring (0.5 mg estriol in 0.5 g of cream) a day for the first two to three weeks (maximum four weeks). Then the dose is one applicator up to the ring twice a week. 

Your doctor will prescribe the lowest dose that relieves your symptoms. Your doctor may want you to stop from time to time (every two to three months for a period of four weeks). This is to check if you still need treatment. 

How to apply the cream 

This medicine comes in a pack together with a clear plastic applicator. Use the applicator to apply the cream in the vagina. A good time to do this is before going to bed. 

The package leaflet contains step-by-step introductions on how to use the applicator.  

If you use more of this medicine than you should or if you swallow it accidentally 

If someone has swallowed some cream by accident, or too much cream is applied at any time, there is no need to worry. However, you should talk to your doctor. See the package leaflet for more information.  

If you forget to use this medicine 

• Apply the missed dose when you remember, unless you are more than 12 hours late. 
• If you are more than 12 hours late just skip the missed dose. 

If you stop using this medicine 

Keep using this medicine, even if you seem to be better. If you stop too early or too suddenly your problem may return. 

The use of HRT carries risks which need to be considered when deciding whether to start taking it, or whether to carry on taking it. For more information on these risks, see the package leaflet. 

Do not use this medicine if: 

• You have or have ever had breast cancer, or if you are suspected of having it.  
• You have cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium), or if you are suspected of having it. 
• You have any unexplained vaginal bleeding. 
• You have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated. 
• You have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism). 
• You have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency). 
• You have or recently have had a disease caused by blood clots in the arteries , such as a heart attack, stroke or angina. 
• You have or ever had a liver disease and your liver function tests have not returned to normal. 
• You have a rare blood problem called porphyria which is passed down in families (inherited). 
• You are allergic (hypersensitive) to estriol or any of the other ingredients of this medicine (listed in section ‘Further information’). 

If any of the above conditions appear for the first time while using this medicine, stop taking it at once and consult your doctor immediately. 

Warnings and precautions 

Tell your doctor if you have ever had any of the following problems, before you start the treatment, as these may return or become worse during treatment with this medicine. If so, you should see your doctor more often for check-ups: 

• Fibroids inside your womb. 
• Growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia). 
• Increased risk of developing blood clots (see the package leaflet for more information). 
• Increased risk of getting an oestrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer). 
• High blood pressure. 
• A liver disorder, such as a benign liver tumour. 
• Diabetes. 
• Gallstones. 
• Migraine or severe headaches. 
• A disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE). 
• Epilepsy. 
• Asthma. 
• A disease affecting the eardrum and hearing (otosclerosis). 
• Fluid retention due to cardiac or kidney problems. 
• Hereditary and acquired angioedema. 

Note: This list is not exhaustive. Please refer to the package leaflet for a complete list of warnings and precautions associated with the use of this medicine. 

Other medicines and Estriol cream 

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription, herbal medicines or other natural products. Estriol cream is known to interact with other medicines (see the package leaflet for a list of medicines).  

Like all medicines, this medicine can cause side effects, although not everybody gets them. 

See your doctor straight away, if you notice any of the following serious side effects – your doctor may decide to stop you using the cream: 

• Your blood pressure rises. 
• Your skin or the whites of your eyes go yellow (jaundice). 
• You suddenly have migraine-type headaches. 
• You have signs of a blood clot. 
• You have any of the problems listed in package leaflet. 

These side effects are rare. 

Other side effects include: 

• Irritation or itching of the skin in or around your vagina when you start to use this medicine. This usually gets better after a few weeks. 
• Increased vaginal discharge, bleeding or spotting. 
• Gallbladder problems. 
• Skin problems such as a rash or an allergy to the sun. 
• Breasts become swollen, tender or painful. 
• Headaches. 
• Feeling sick or being sick. 
• Flu-like symptoms. 

If you have any of these side effects, tell your doctor. They may decide to stop your treatment for a while. 

This list is not exhaustive. For a complete list of possible side effects, see the package leaflet. If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in the leaflet. 

What this medicine contains: 

• The active substance is estriol. Each gram of cream contains 1 milligram of 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. 

Manufacturer: 

Aspen Bad Oldesloe GmbH 
Industriestrasse 32-36 
D-23843 Bad Oldesloe 
Germany 

Estriol is only available on prescription in the United Kingdom. A doctor can write a prescription for Estriol cream after an online consultation. The cost of the consultation is included in the price.

Read the official package leaflet before use. The package leaflet contains important information on the use and the risks associated with Estriol cream. The package leaflet for Estriol cream is available for download here.