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[TinaOptimist]

I recently had a bit of a disagreement with my usually lovely GP. She mentioned I would have to take break from Ovestin at some stage due to the terms of its licence. I had read in the NICE guidelines that women who needed vaginal oestrogen should be able to continue with it so I argued this point. She said it was due to the terms of the licence that we must take a break. I said that if I took a break it would cause me a lot of suffering and this was cruel. She then said well if you found you needed it and things got worse you could have it again. Surely this is not in line with the guidelines? Anyone know anything about these breaks? I know I've seen women told this before but it's ridiculous right? What else can I do but go private? I will take the NICE guidelines along next time but I know she will talk about the licence again. Are GPs so fearful where private consultants aren't ?

[CLKD]

Never been told that!  I order it as necessary, usually have 2 months 'in hand'.  I would go to a Pharmacist and ask the question and ask to see a copy of the Licence!

[TinaOptimist]

That's a good idea. I will! Thanks. 

[CLKD]

united pharamcies UK

Vaginal dryness caused by the menopause   Oestriol   Ovestin Vaginal Cream

Uses

Ovestin Vaginal Cream (Oestriol) is a hormonal medicine used for HRT (hormone replacement therapy) in postmenopausal women. It works by replacing the hormones in the body. Generally, problems affecting the vagina which are caused by insufficient oestrogen levels (dryness, infection and itching leading to pain during intercourse) as well as helping with the healing process after vaginal surgery has taken place are treated with it.

The active ingredient in this cream (sometimes called E3 or estriol) is an oestrogen that is normally produced by the body. However, depleted hormone levels can often occur as a result of the menopause. In cases such as this, treatment with oestrogen hormones may be recommended, so as to prevent and relieve vaginal dryness and reduce the risk of vaginal infections, urinary incontinence and recurrent cystitis.

Dosage and Administration

Ovestin Vaginal Cream (Oestriol) is provided with a special plunger so as to allow it to be inserted into the vagina. Women whose womb and ovaries have already been removed, or who have never undergone HRT may be told by their doctor that they can begin treatment immediately, whereas those that are changing from a different type of HRT (in which they have a period) may need to wait for a period of one week before commencing.

Doctors generally instruct women treating vaginal problems to apply one applicator of cream per day for the initial 2 to 3 weeks of treatment, after which the dosage is reduced to a single applicator twice each week. Usually, the lowest possible dosage that provides relief is used, and in some case, patients may be instructed to stop use in order to assess whether or not treatment is still required. Follow the directions provide by your doctor with regard to filling the applicator and inserting it into the vagina.

Side effects
Side effects of Ovestin Vaginal Cream (Oestriol) include:

Headache
Vaginal irritation
Swollen or tender breasts
Vaginal discharge or spotting
Problems affecting the gall bladder
Ensure that your doctor is kept informed of any side effects that occur. Serious side effects which will require immediate medical attention include rises in blood pressure, headaches which are similar to migraine, symptoms of a blood clot and any other serious reactions.

Precautions
Hormone replacement therapy is usually not suitable for women who are affected or who have a history of coronary artery disease.

This cream must not be swallowed.

Seek immediate emergency medical attention if you suffer an allergic reaction. Symptoms to watch for, which may be indicative of a reaction, include skin rashes, hives, swelling of the face or limbs, trouble breathing, and trouble swallowing.

Always use Ovestin Vaginal Cream (Oestriol) as you have been prescribed by your doctor. Never self-medicate or change your dosage without first consulting your doctor. The correct dosage can vary depending on your health, medical history, and the severity of the condition being treated.

This medication may not be safe for all patients. Before you begin using it always disclose the following to your doctor:

If you are pregnant or breastfeeding.
If you suffer from any allergies.
If you suffer from any other health conditions or illnesses.
If you are using any other medicine (including all non-prescription).
If you are using any supplements, vitamins, or herbal products of any kind.

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[CLKD]

No mention of a break! 

[MicheleMaBelle]

She's talking crap

[CLKD]

My thoughts exactly ......... what excuses they think up, hey!

[MicheleMaBelle]

  x

[TinaOptimist]

Thank you. I will ask the GP where I can locate the need for a break as a requirement. I am emboldened again!

[CLKD]

Speak to a Pharmacist?  then you have ammunition ;-)

[dahliagirl]

https://bnf.nice.org.uk/drug/estriol.html

It still says to discontinue here 

It needs updating.  It makes no sense to keep stopping and starting it.  I found it takes a good 6 months to a year to get any sort of comfortable consistency anyway. 

[CLKD]

I can't see anything about discontinuation maybe 'cos I'm tired  .   ......... certainly my GP has never mentioned such.    Perhaps he wouldn't dare   

[dahliagirl]

Improve the vaginal epithelium in menopausal atrophic vaginitis (short-term use)

By vagina
For Adult

Apply 1 applicatorful daily for 2–3 weeks, then reduced to 1 applicatorful twice weekly, discontinue every 2–3 months for 4 weeks to assess need for further treatment.


I have never heard of this in real life either.  I messed up my first boost and the doctor said it was such a tiny amount, to try again and use what I needed.

[TinaOptimist]

This must be what my doctor was referring to. She is as straight as a die and would take this at complete face value. I argued with her when she told me last week that I would have to take a break at some point. I told her it was cruel as it was helping my constant bladder urge enormously and the NICE guidelines on Menopause said it could be taken long term. She just said if I took the break but came back saying I needed it then she would prescribe it again. I said that I would have to go private if she was going to make me take a break which was so unfair. I don't know what to say to her because she truly thinks it's a condition of the licence. Feel like I have no control here 

[Maryjane]

Tina read my VA article which had to go through Dr Currie , stating VA is for life and the stop start of local oestrogen will only cause it to potentially come back worse , another case of a non uptodate GP.


Also ask he to do the maths regards the actual amount of oestrogen you are getting form it , it's minimal about two HRT pills a year .