netFormulary

Lancashire and South Cumbria
Formulary

7 Obstetrics, Gynaecology, and urinary-tract disorders

07-02-01 Topical HRT

Transdermal oestrogens are absorbed and should be used in the smallest effective amount and if required long term should be combined with an oral progestogen in women with an intact uterus. For low-dose vaginal oestrogen, a progesterone is not needed for endometrial protection, as systemic absorption of vaginal oestrogen is minimal.

Estradiol vaginal 10 microgram tablet

Formulary

Vaginal tablets 10microgram

MHRA: Hormone replacement therapy (HRT): further information on the known increased risk of breast cancer with HRT and its persistence after stopping

Estriol cream

Formulary

0.1% vaginal cream, 0.01% vaginal cream

Currently estriol vaginal cream can be prescribed in two forms:

· Estriol 0.1% (Ovestin®) cream which contains 0.5mg estriol per 0.5g application

· Estriol 0.01% (formerly Ortho-Gynest®) cream which contains 0.5mg estriol per 5ml application

Despite Ovestin® 0.1% cream being 10 times stronger, the amount of cream delivered per application is 10 times less than that of Estriol 0.01% cream, meaning that both creams deliver an identical amount of estriol per application, that being 0.5mg.

Contains nuts - contraindicated in patients with hypersensitivity to nuts

Estriol gel 50mcg/g

Formulary

2nd line agent - only to be considered in women who are unable to use estriol pessaries.

Estriol pessaries

Formulary

0.03mg pessaries, 0.5mg pessaries

Oestrogens, Topical Estring^®

Formulary

Only used in patients who can't use cream or pessaries.

Prasterone Intrarosa®

Formulary

Pessaries 6.5mg

Use restricted to the treatment of vulvovaginal or vaginal atrophy in postmenopausal women having moderate to severe symptoms, if vaginal oestrogen, or

non-hormonal moisturisers or lubricants have been ineffective or are not tolerated.

Links