Other Brands/Names

Ovestin

How It Works

Estriol is one of the occurring estrogens with relatively weak activity, used to relieve complaints associated with low estrogen levels, particularly for women in their postmenopausal period.

When women have menopause, usually at around 45 to 55 years old of age, menstrual cycles stop and hormone production, including estrogen, declines. Lower estrogen levels can lead to a range of symptoms.

Estriol is one of three principal estrogens made by the body, alongside estrone and estradiol. Because of this, this medicine can help address symptoms that arise from estrogen deficiency.

Indications

Estriol is indicated as estrogen replacement therapy for postmenopausal women who develop symptoms due to low estrogen levels, such as:

• Vaginal dryness, irritation, or itchiness.

• Hot flashes (a sudden warm, flushed feeling on the face, neck, and chest).

Estriol is also used for infertility associated with cervical conditions.

Contraindication

Do not use this medicine in the following situations:

• Known hypersensitivity or allergy to estriol or any component of the formulation.

• Suspected or confirmed breast cancer or endometrial cancer, past history or currently have breast/endometrial cancer.

• History, previous or current, of venous thrombosis (deep vein thrombosis or pulmonary embolism) or arterial diseases (myocardial infarction, coronary artery disease).

• Unexplained vaginal bleeding.

• Presence of disorders that predispose patients to abnormal blood clotting.

• Porphyria, a hereditary blood disorder leading to porphyrin accumulation.

• Liver disease.

• Pregnancy.

Side Effects

Adverse effects that may occur include:

• Breast tenderness
• Nausea
• Spotting (light vaginal bleeding)
• Swelling from fluid retention (edema)
• Increased cervical mucus production.

Types

• Tablets: 0.05 mg, 1 mg, and 2 mg.
• Vaginal cream 1 mg/gram.

Dosage

Hormone Replacement Therapy

• Oral dose: 0.5–3 mg daily for 1 month, then 0.5–1 mg daily; or 0.25–2 mg daily if estriol is combined with other natural estrogens.
• A progestogen-containing product is required when used in women with an intact uterus.

Infertility in Cervix Disorders

• Oral dose: 0.25–1 mg daily on day 6 to day 15 of the menstrual cycle.
• The dose may be increased each month until the desired outcome is reached.

Safety

This medicine should not be used during pregnancy or while breastfeeding. In addition, it is not intended for use in children.

Drug Interactions

• Drugs that increase estrogen metabolism can lower estriol effectiveness when taken together, including:
  
  • Rifampicin (antituberculosis agent)
  • Phenytoin and carbamazepine (anticonvulsants)

• Concomitant use of estriol may influence the effects of:
  
  • Oral anticoagulants
  • Succinylcholine (sedative/neuromuscular agent)
  • Theophylline (asthma medication)
  • Troleandromycin (antibiotic)

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