Infertility due to cervical hostility, Menopausal atrophic vaginitis, Menopausal hormone replacement therapy, Dyspareunia, Dryness and itching of vagina due to Oestrogen deficiency, Prevention of recurrent infections of the vagina and lower urinary tract, Micturition complaints (such as frequency and dysuria), Urinary incontinence. Pre- and postoperative therapy in postmenopausal women undergoing vaginal surgery, Climacteric complaints such as hot flushes and night sweating, a diagnostic aid in case of a doubtful atrophic cervical smear. • Pregnancy • Known, past or suspected breast cancer • Known or suspected oestrogen-dependent malignant tumours (e.g. endometrial cancer) • Undiagnosed genital bleeding • Untreated endometrial hyperplasia • Previous idiopathic or current venous thromboembolism (deep venous thrombosis, pulmonary embolism) • Active or recent arterial thromboembolic disease (e.g. angina, myocardial infarction) • Acute liver disease, or a history of liver disease as long as liver function tests failed to return to normal

Drugs for Infertility, Drugs for menopausal symptoms: Hormone replacement therapy, Female Sex hormones

Estriol Cream is a Hormone Replacement Therapy (HRT). It contains the female hormone estriol (an estrogen). During menopause Estriol is used in vagina which is slowly released and absorbed into the surrounding area and into the bloodstream.Estriol induces the normalization of the vaginal epithelium and thus helps to restore the normal microflora and the physiological pH in the vagina. As a result, it increases the resistance of the vaginal epithelial cells to infection and inflammation. In comparison to other estrogens, estriol is short acting. In the years just before and after the menopause (which can be natural or surgically induced) estriol can be used in the treatment of symptoms and complaints related to estrogen deficiency. Estriol is particularly used in the treatment of urogenital symptoms.

How to use Estriol: This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and apply the cream by using applicator. Wash your hands after applying. Administration: Tablet: May be taken with or without food. Adult Dose: Oral Menopausal hormone replacement therapy Adult: 0.5-3 mg daily for 1 mth followed by 0.5-1 mg daily; or 0.25-2 mg daily in combination with other natural oestrogens. A progestogen is required if administered to women with a uterus. Infertility due to cervical hostility Adult: 0.25-1 mg/day on days 6-15 of the menstrual cycle. Increase dose each mth until an optimal effect is obtained. Vaginal Menopausal atrophic vaginitis Adult: As cream: Apply 500 mcg once daily, reduce to twice wkly subsequently.

Reduced efficacy may occur when used with activated charcoal, barbiturates, carbamazepine, griseofulvin, hydantoin and rifampicin. May possibly change efficacy of oral anticoagulants and increase pharmacologic effects of succinylcholine, theophyllines and troleandromycin.

• Pregnancy • Known, past or suspected breast cancer • Known or suspected oestrogen-dependent malignant tumours (e.g. endometrial cancer) • Undiagnosed genital bleeding • Untreated endometrial hyperplasia • Previous idiopathic or current venous thromboembolism (deep venous thrombosis, pulmonary embolism) • Active or recent arterial thromboembolic disease (e.g. angina, myocardial infarction) • Acute liver disease, or a history of liver disease as long as liver function tests failed to return to normal

Common - Vaginal irritation Breast tension or pain, nausea, spotting. Fluid retention, cervical hypersecretion.

This medicine is contraindicated during pregnancy & lactation.

Precaution: In order to prevent endometrial stimulation, the daily dose should not exceed 8 mg nor should this maximum dose be used for longer than several weeks. As for all hormone replacement therapies, yearly medical examination is advisable. With vaginal infections, a concomitant specific treatment is recommended. Patients with any of the following conditions should be monitored; thrombosis, severe liver disorders; porphyria; a history during pregnancy or previous use of steroids of severe pruritus, cholestatic jaundice, herpes gestationis, or otosclerosis.

Store below 25°C. Protect from light and moisture. Keep out of reach of children.

Estriol is a naturally occurring oestrogen. It induces normalization of vag epithelium. It is claimed to have only a mild proliferative effect on the endometrium. It only has a short retention time in the nuclei of endometrial cells.