Sunday, April 30, 2023
First a quick summary of Ovestin Cream.
Ovestin Cream is used to treat Vaginal Atrophy (VA) with/without Urogenital Atrophy (UA) in menopausal women.
Vaginal Atrophy is when reduced Oestrogen, due to the menopause, causes inflammation, drying and thinning of the vaginal walls. Symptoms include vaginal discomfort, dryness or pain during sex and sometimes increased cases of thrush.
Urogenital Atrophy is when these same reduced Oestrogen levels in the body also cause inflammation, drying and thinning of the external genital area including the urethra (the tube that carries urine from your bladder to outside your body) and the vulva.
Symptoms are similar to VA - dryness, discomfort and itching but this time on the outside of the vagina, the vulva, labia, perianal area and forward towards the clitoris.
You might also find that you need to wee more often as the bladder and urethra walls weaken, this can be most noticeable at night, or find that you’re experiencing an increased number of urinary tract infections (UTIs) as conditions inside the urethra change and allow bacteria to flourish.
Yes it does. Ovestin is a cream and contains the drug Estriol, which is a synthetic version of Oestrogen. It is applied inside the vagina using an applicator and can also be applied thinly to the external genital area, like the vulva and labia, to treat UA.
The most common issues reported by patients using Ovestin cream are texture and usability, including irritation and burning sensations, especially at the start of treatment.
There are a couple of potential causes for a burning sensation when using Ovestin.
Firstly, it is listed as a possible side effect in the patient information leaflet. Technically referred to as “application site irritation and pruritus”, these are general terms used to describe skin discomfort, including burning, itching, soreness or irritation.
These symptoms are usually most severe at the start of treatment, during the early weeks of treatment when you are using Ovestin every day.
Another potential cause for the burning sensation is the degree of your VA/UA. When your internal or external genital skin is depleted of Oestrogen it becomes thin and dry, this makes it both easily irritated and easily damaged, it can feel particularly uncomfortable internally when using the vaginal applicator.
As a comparison, you have probably had chapped lips at some time. You might have even had lips that were so sore and broken that anything you put on them would make them tingle, burn or sting, even gentle products like Vaseline.
This can be the case with VA/UA, although the Ovestin is helping the skin to repair, it can still feel uncomfortable to use.
The final consideration is the product itself, it is possible to have a sensitivity to one of the ingredients in Ovestin cream. If you have sensitive skin elsewhere on your body, or have had reactions to other skin products before then this could be the case.
To test this, you could apply a very small smear of Ovestin to another area of skin, I usually recommend the inner wrist, and see if it causes a reaction like stinging or redness. You should only do this once.
If you are still early on in your treatment, particularly those first weeks when you are using Ovestin every day then the advice is often to carry on. As your skin absorbs the Oestrogen and returns to its former, healthier state these symptoms should reduce.
That said, only you know how bearable the burning and irritation is for you, so here are some other considerations and advice.
Blissel Gel is another vaginal product containing the drug Estriol. Although it is technically a lower strength than Ovestin, most women find it just as effective.
The main difference between Blissel and Ovestin is that Blissel is a water-based gel, as opposed to Ovestin which is an oil-based cream.
Blissel is a newer product to the market and the water-based formula is designed to provide moisture to the vaginal tissues alongside the Oestrogen, relieving the symptoms of VA/UA faster and feeling more comfortable to use.
It is absolutely safe to switch from Ovestin to Blissel, you do not need to reduce one before starting the other, just substitute.
For example, if you are in the early weeks of using Ovestin daily, switch to Blissel and carry on, you do not need to restart those weeks.
If you are using Ovestin twice weekly, you should swap the Ovestin for the Blissel, without repeating those starting weeks of using it daily.
Contact us if you would like further advice or clarification about switching from Ovestin to another Vaginal Oestrogen.
All Vaginal Oestrogens are safe to use alongside tablet, patch, gel or spray HRT.
We are huge advocates for these products, especially during the start of VA/UA treatment. Lubricants and moisturisers are not quite the same thing but most vaginal products can be used as both.
These products can be used safely with all Vaginal Oestrogen treatments, although not at exactly the same time. If you are using Ovestin daily, use a vaginal moisturiser in the morning or afternoon. If you are using Ovestin less frequently, use it on one of your non-Ovestin days, at night is best if you can.
You should also consider using a lubricant at the same time as your Ovestin. Applying a water-based lubricant to the vagina and applicator can make using Ovestin a gentler and smoother experience as well as adding some temporary moisture to those tissues.
VA and UA symptoms should improve after around 3 months of using vaginal Oestrogen as prescribed. If you experience little to no improvement after 3 months you should speak to your prescriber or get in touch with us.
This is not personalised advice. To speak to one of our clinically trained team about finding the right treatment for you, email us at [email protected] or call us on 01295 262925.