Health Centres - Ortho-Gynest
How does it work?
Ortho-Gynest vaginal cream and pessaries both contain the active ingredient estriol, which is a naturally occuring form of the main female sex hormone, oestrogen.
Womens ovaries gradually produce less and less oestrogen in the period up to the menopause, and oestrogen blood levels decline as a result. The declining levels of oestrogen can cause distressing symptoms, and often affect the delicate lining of the vagina. Oestrogen deficiency can cause vaginal dryness, inflammation or itching, and this in turn can lead to sex being uncomfortable or painful, and to an increased susceptibility to vaginal or urinary infections.
Oestrogen can be given as a supplement to replace the falling levels in the body and help reduce the distressing symptoms of the menopause. This is known as hormone replacement therapy (HRT). Oestrogen (in this case in the form of estriol) can also be inserted directly into the vagina in the form of vaginal cream or pessaries, in order to directly supplement the vaginal tissues with oestrogen. This is known as topical HRT and is useful for relieving just the vaginal symptoms of the menopause.
Ortho-Gynest cream and pessaries are inserted into the vagina using the applicator provided. Both forms of Ortho-Gynest release small amounts of oestrogen locally into the vaginal tissues and are used short-term to provide relief from the vaginal symptoms of the menopause, such as dryness, itching and irritation.
Estriol from Ortho-Gynest is absorbed from the vagina into the bloodstream, which means it may potentially be associated with the same risks as other forms of HRT and so carries the same warnings. These warnings are most relevent to repeated or long-term use of the medicine. You can read more about the risks and benefits of HRT in the factsheet about the menopause linked below. To minimise the absorption of this medicine, the lowest dose to control symptoms should be used, and treatment should be stopped every three to six months to see if it is still needed. Treatment should be reviewed at least once a year with your doctor.
What is it used for?
- Vaginal symptoms of the menopause (atrophic vaginitis)
Warning!
- Follow the instructions provided with your medicine carefully. Ortho-Gynest cream and pessaries are for use in the vagina only. They should be inserted into the vagina using the applicator provided. It is usually best to do this before going to bed at night.
- Using oestrogen-only HRT tablets or patches for a long time can increase the risk of cancer of the lining of the womb (the endometrium). It is possible there may be a similar risk when oestrogen creams, pessaries or rings are used in the vagina for repeated treatments, or over a long period of time.

