The active ingredient is estriol at a concentration of 1mg per gram of cream (0.1%). Inactive ingredients vary by brand, Gynest and Ovestin have slightly different formulations, and some contain excipients such as cetyl alcohol that may cause local reactions in sensitive individuals. Check the specific product leaflet or ask your pharmacist if you have known ingredient sensitivities.

This depends on the specific brand. Formulations vary between products, and some may contain excipients derived from animal sources. If you follow a vegan diet, discuss this with your clinician or pharmacist, who can check the ingredients of the specific product being prescribed.

Yes, estriol cream is a form of local hormone replacement therapy. Unlike systemic HRT such as patches, gels, or tablets, it works locally in the vaginal and vulval area with minimal absorption into the bloodstream. This makes it suitable for women who cannot take systemic HRT, or who experience only vaginal and urinary symptoms without systemic symptoms such as hot flushes.

There is no clinical evidence that estriol cream causes weight gain. As a local oestrogen, it does not affect metabolism or body fat distribution like systemic HRT. Weight changes during the menopause transition are driven by the hormonal changes of menopause itself, not by local vaginal oestrogen.

Some women notice early improvements in vaginal and vulval comfort within a few days, though for full benefits it typically takes several weeks of consistent use. Most women experience significant relief within two to four weeks, with the full benefits of tissue restoration usually apparent by two to three months. Benefits for urinary symptoms, such as reduced urgency and fewer recurrent UTIs, may take longer to become fully apparent.

Estriol cream can be used long-term, often for many years. As long as it continues to provide symptom relief and you are monitored by your clinician. Because it is a low-dose local treatment with minimal systemic absorption, it does not carry the same long-term risks as systemic HRT. Your clinician will review your treatment regularly to ensure it remains appropriate for you.

Estriol cream acts locally and is not intended to affect the womb lining, it does not typically cause bleeding. If you experience any unexpected vaginal bleeding or spotting during treatment, contact your clinician for assessment.

This is a decision that should be made in consultation with your oncologist and menopause specialist. Historically, vaginal oestrogen was avoided after breast cancer, but evolving evidence suggests that low-dose local oestrogen may be safe for many women, particularly where systemic absorption is minimal. Your healthcare team will assess your individual circumstances — including the type of breast cancer you had and your current treatment — to help you make an informed decision.

No, please do not change how often you apply estriol cream without speaking to your clinician first. If you feel your symptoms are not adequately controlled, raise this at your review.

Estriol cream differs from estradiol-based vaginal treatments (such as Vagifem or Vagirux) primarily in the type of oestrogen used. Estriol is a weaker oestrogen than estradiol, though both are effective for vaginal atrophy. One practical advantage of cream is the ability to apply it externally to the vulva as well as internally, covering a larger surface area — making it particularly useful for women with external vulval symptoms. Vaginal tablets like Vagifem or Vagirux deliver a precise internal dose and are less messy. Oestrogen rings (such as Estring) are inserted once every three months and release a continuous low dose, which some women find more convenient. Intrarosa (prasterone) works via a different mechanism entirely, converting DHEA locally into both oestrogen and androgen, and may suit women who cannot use oestrogen-based treatments. Your clinician can help you decide which option best fits your circumstances.