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Home > Drug Category > Menopausal Hormone Therapy > Ovestin and Equivalent

Ovestin Information

Ovestin is a vaginal Hormone Replacement Therapy (HRT) used to treat symptoms of vaginal atrophy caused by a drop in natural estrogen levels during or after menopause. These symptoms include vaginal dryness, irritation, itching, pain during intercourse, and increased sensitivity to urinary tract infections. It works by delivering estriol, a short-acting, naturally occurring human estrogen, directly into the vaginal tissues to normalize the vaginal lining, restore moisture, and re-establish a healthy local microflora and physiological pH.

Side Effects

Commonly reported side effects include localized skin irritation, burning, or itching in or around the vagina upon starting treatment, which usually improves within a few weeks. You may also experience increased vaginal discharge, breakthrough bleeding or spotting, breast swelling, tenderness or pain, headaches, nausea or vomiting, flatulence, abdominal pain, and flu-like symptoms.

Contact your doctor if you have any of the serious side effects, including:
• Gallbladder Disease: Increased risk of developing gallstones or gallbladder problems.
• Malignant Neoplasms: Potential increased risk of breast cancer or other estrogen-dependent malignancies with long-term use.
• Severe Angioedema: Potential for serious allergic swelling of the face, tongue, and throat.
• Severe Hypertension: Risk of a sudden, large rise in blood pressure.
• Venous Thromboembolism: An increased relative risk of developing blood clots in the deep veins of the legs or the lungs.

Seek medical attention immediately if you experience sudden chest pain and breathlessness, severe swelling or pain in one leg, difficulty speaking or weakness on one side of your face or body, a severe, unexpected migraine-type headache, or yellowing of your skin and eyes (jaundice). Do not stop using this medication suddenly without consulting your doctor if you are on a long-term treatment plan, as your vaginal symptoms may quickly return.

Precautions:

Do not use Ovestin if you have a known hypersensitivity (allergy) to estriol or any of the inactive excipients in the cream, such as cetyl alcohol, stearyl alcohol, or chlorhexidine dihydrochloride. Tell your doctor about your medical history, especially if you have:
o Active or recent arterial thromboembolic disease, such as a heart attack or stroke.
o Active, past, or suspected breast cancer or other estrogen-dependent malignant tumors.
o Acute liver disease or a history of liver disease, where liver function tests have not returned to normal.
o Previous or current blood clots (deep vein thrombosis or pulmonary embolism).
o Undiagnosed genital or abnormal vaginal bleeding.
o Untreated endometrial hyperplasia (thickening of the womb lining).
o Uterine fibroids, endometriosis, epilepsy, asthma, or systemic lupus erythematosus (SLE).

Ovestin may interact with medications that induce liver enzymes, such as carbamazepine, phenobarbital, rifampin, and St. John’s Wort. These therapies can accelerate the clearance of estriol from your body, potentially reducing its local effectiveness.

Ovestin is strictly contraindicated during pregnancy and must be stopped immediately if pregnancy is suspected or confirmed. Estriols are excreted into breast milk and may reduce the quantity and quality of milk produced, meaning use during breastfeeding is not recommended. It is recommended to speak to your doctor immediately if you are planning to get pregnant.

Unlike systemic estrogens, low-dose vaginally applied estriol, such as Ovestin, generally does not require the simultaneous addition of a progestogen to protect the uterine lining, unless otherwise directed by your doctor.

Store Ovestin at room temperature (below 25°C) in a dry place. Do not freeze the cream. Keep the tube tightly closed with its cap on after unscrewing the applicator to prevent contamination or drying out. Always store the medication safely out of the reach of children and pets.

Do I need a prescription to order Ovestin?

Yes, a prescription is required from your physician to order Ovestin.