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Ovestin Cream (estriol) is used to treat atrophic vaginitis in peri- or post-menopausal women, to prepare the vagina for surgery, or, off-label, to treat dry, thinning skin.

The active ingredient in this product, estriol, is an estrogen hormone like estradiol and estrone. Because it is a weak estrogen, barely detectable in the human body, it has been largely overlooked by the medical community. However, the medication does provide advantages, particularly in cream form.

Getting the Most from Ovestin Cream

Estrogen levels drop gradually as a woman ages, or suddenly if a woman's ovaries are removed. Declining estrogen levels can cause a number of physical changes, many of which aren't positive, such as atrophic vaginitis, for which the symptoms include:

• Vaginal dryness
• Itching or burning
• Painful sex
• Urinary tract infections
• Incontinence
• Frequent yeast infections

Low estrogen levels change the structure of the skin, causing thinning and drying, and it does so everywhere, not just the vagina. However, symptoms are more readily apparent and distressing in the vagina, and can, fortunately, be treated with Ovestin Cream; the cream replenishes estriol, making skin thicker and more flexible, and improving overall urinary and vaginal health. Ovestin Cream is so effective at this that it's often prescribed for a couple of weeks prior to vaginal surgery, to encourage rapid healing afterward.

While skin deteriorates to some extent through most of a woman's life, skin changes happen rapidly during peri- or post-menopause, with many women experience drying, thinning, wrinkly skin. These changes can be countered---to some extent---when Ovestin Cream is applied elsewhere on the body, such as the face and neck. Results with using estriol on the skin vary, of course, but most women do report some degree of reduced wrinkles and firmer, more elastic skin.

Each container of Ovestin Cream includes an applicator, which can be filled with cream and inserted into the vagina before being released. Each applicator holds 0.5 mg of estriol. How the cream is used depends on what it's for.

Prior to surgery:

• Administer one applicator dose every day for 2 weeks prior to surgery.
• After surgery, do not apply cream for at least 2 weeks.

To treat atrophic vaginitis:

• Administer one applicator dose daily for 2 or 3 weeks.
• After the first two or three weeks, use may be reduced to one applicator dose twice per week.
• Use may continue indefinitely; reevaluate need every 3 months.

To treat other skin:

• Gently rub a small amount of cream into the skin. A pea-size amount is sufficient for the entire face. Another pea-size amount can be used on the neck. Never apply directly to the breasts.
• Treatment may be daily for the first few weeks, after which two or three times a week will suffice. Other patients use the cream daily.
• Treatment may continue indefinitely.

Note that, while absorption into the bloodstream is higher when applied vaginally, a significant amount is absorbed through other skin as well. In all uses, the minimum amount necessary to acheive results should be used, for as short a time as possible. Hormone replacement therapy is not meant to be permanent.

Warnings Before Use

Some women are at significantly increased risk of complications while using Ovestin Cream. Patients with the following should speak carefully with a doctor about risks and warning signs before using the cream:

• Endometriosis (tissue growing outside the womb)
• Endometrial hyperplasia (thickening of womb lining)
• Womb fibroids
• History, including family history, of breast cancer
• Blood clots or at high risk of blood clots
• Kidney or liver impairment
• Gallstones
• Diabetes
• Hypertension
• Epilepsy
• Heart disease

Ovestin Cream is less likely than other estrogens to cause complications, both because it is applied topically and because it contains estriol instead of estradiol. However, there is still a risk.

Using other medications with Ovestin Cream probably won't cause problems, unless those other medications contain estrogens. Speak with a doctor about using multiple estrogen products.