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[cjmca]

Just wondered what topical estrogen options are available in the UK? Creams, pessaries, coil type thingies..?? What's the strongest, and has anyone found some better than others for bladder / urethral  irritation?

[Maryjane]

Vagifem / estriol / ovestin and estring .

[Maryjane]

NP says estriol is pointless , vagifem , ovestin estring equal ?

But I'm not a 100_%

[babyjane]

estriol is quite weak, I believe, but it is great externally with vagifem internally, for me anyway 

[cjmca]

I found this on https://patient.info/doctor/hrt-topical

- Estriol-containing products
Gynest® 0.01% intravaginal cream (80 g with applicator).
Ovestin® 0.1% intravaginal cream (15 g with applicator).
- Estradiol-containing products
Vagifem® 10 microgram vaginal tablets (24-applicator pack).
Estring® vaginal ring (releases approximately 7.5 micrograms estradiol/24 hours) - insert high into the vagina and wear continuously. Replace every three months.


Can't get Estring in Ireland 🙄 I'd really like to try it, has anyone any experience of it? Wonder if I could get a prescription for it when over in UK, get it filled in Northern Ireland every few months..

[Maryjane]

I use it , my gynae wishes more ladies more as does my GP , put in forget for 90 days , equivalent of almost 5 vagifem aweek .

To buy privately it's about £55.00.

[babyjane]

what happens as it starts to need replacing.  Does the dose of oestrogen start to tail off causing symptoms to return?  I don't think I would be able to insert one.  Vagifem can be uncomfortable at times and you know how thin they are 

[Hurdity]

Hi cjmca

They are all listed on this website too:

https://www.menopausematters.co.uk/local.php

Just to clarify - maryjane - ovestin contains estriol. The lower concentration cream Orthogynest was replaced by a generic estriol - hence the confusion to patients! Also the generic estriol is weaker than Ovestin but used at 10 times the quanitity so actually the same amount of estriol per dose, I think.

Also estriol is not weaker as such - or rather it has lower affinity to one of the receptors that estradiol (alpha or beta - can't remember which), but binds to the other receptor - both of which are present in the vaginal bladder regions. For this reason and supported by studies, estriol containing products are as effective as those containing estradiol for a significant proportion of women ( according to specific studies). The thing is there are different doses of each - and maybe some of the studies are not comparable eg did they compare 25 mcg vagifem with ovestin for example and at what dose?

The other thing is that the dosage and effectiveness is only worked out as a particular one which is suitable for a significant number of the women studied. This means that there is always a substantial minority of women for whom these dosages or particular products don't work (at that dose or at all sometimes) - and this is where the problems arise and where individualised treatments can be needed.

cjmca - I really liked the old Orthogynest pessaries but these were discontinued. My choice even though I haven't used it, would be the Estring - but depends on the type of bedroom activities you like to indulge in, as certain ones would probably be precluded (not going into details here....) which is why I haven't gone down that route . I like estriol but can't be doing with messy applicators and washing them out. I have enough to think about with patches twice weekly, T gel daily, progesterone daily now and again and vag oestrogen twice a week without having to do that!

I find that Vagifem works (on the plumping) but does irritate my bladder more.

Hurdity x