vaginal preparations

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  • local oestrogens in the form of pessaries or cream, ring or tablets can help dyspareunia, atrophic vaginitis, or recurrent urinary tract infections
  • topical oestrogens should be used in the minimum effective amount to minimise oestrogen absorption; if topical preparations are used long-term then some require oral progestogen for 10-14 days of each month to combat development of endometrial hyperplasia (1)

In the context of safety of usage of topical oestrogens, the Committee on Safety of Medicines has stated (2):

  • topical oestrogens should be used in the lowest effective amount to minimise systemic absorption
  • treatment should be interrupted at least annually to re-assess the need for continued treatment
  • if break-through bleeding or spotting appears at any time on therapy, the reason should be investigated and may include endometrial biopsy to exclude endometrial malignancy


  1. BNF 7.2
  2. Currrent Problems in Pharmacovigilance (2003), 29, 3.

Last reviewed 01/2018