Oestrogen vaginal cream and pessaries

Ovestin cream® and Ovestin pessaries®

Key points about oestrogen vaginal cream and pessaries

  • Oestrogen vaginal cream or pessaries are used to ease vaginal symptoms of menopause such as vaginal dryness, burning or itching.
  • Vaginal oestrogen is also called Ovestin cream® and Ovestin pessaries®.
  • Find out how to use the cream and pessaries and possible side effects.
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Vaginal oestrogen is a prescription medicine, that's available as a cream or as pessaries that are inserted into your vagina. It's used to ease vaginal symptoms of menopause such as:

  • vaginal dryness, burning, itching
  • discomfort or pain during intercourse
  • discomfort passing urine
  • recurrent urine infections (UTIs).

Vaginal oestrogen may also be used before and after vaginal surgery. Since vaginal oestrogen is applied directly into the vagina, less is absorbed into the body, reducing the chance of side effects.

In Aotearoa New Zealand, vaginal oestrogen is available as a vaginal cream (Ovestin cream®) or as pessaries (Ovestin pessaries®).

Photo of Ovestin cream and pessary packing and applicator

Applying oestrogen directly to the vagina has several advantages.

  • By using the cream or pessaries, the levels of oestrogen in your vaginal area increase which helps relieve symptoms.
  • The oestrogen levels in your blood aren't raised significantly, which minimises the effect of oestrogen in other areas such as the breast or uterus.
  • Vaginal oestrogen is safe to use long-term, as long as you haven’t had breast cancer.
  • If you have had breast cancer, talk to your doctor about whether vaginal oestrogen is an option for you.

Read more about menopausal hormone therapy (MHT).

  • Symptoms of menopause: use once every evening until there is an improvement, and then 2 times a week for as long as is needed. It may take several days or even weeks before you notice an improvement. This treatment usually works well but the symptoms may come back after stopping the treatment.
  • Vaginal surgery: use every evening for 2 weeks before surgery, then twice a week for 2 weeks after surgery.

Ask your healthcare provider or pharmacist to explain how to use vaginal cream or pessaries. The following is a guide.

Vaginal cream

  • Vaginal cream comes in a tube with special applicators that you need to fill with the cream. The applicator is used to measure the right dose of cream and to insert the cream inside your vagina. 
  • Fill the applicator with cream to the ring mark – do not completely fill the whole applicator. 
  • Vaginal cream is best applied at night, before going to sleep.
  • To clean the applicator, pull the plunger and wash these in warm (not boiling), soapy water. Do not use detergents. Rinse well and dry afterwards. 
  • If you forget a dose, use it as soon as you remember. But if it's the next day, just use the next dose at the right time. Don't use double the dose in one day.

Vaginal pessaries

  • Vaginal pessaries are a moulded tablet that is inserted into your vagina.
  • The pessary is best inserted at night, before going to sleep.
  • To make it easier to insert, you may need to moisten the pessaries with water first.
  • Remove one pessary from its wrapper. Either using a squatting position or lying on your back or side, insert the pessary deeply into the vagina with your finger.
  • If you forget a dose, use it as soon as you remember. But if it's the next day, just use the next dose at the right time. Don't use double the dose in one day.

Like all medicines, vaginal oestrogen can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Vaginal itching or burning 
  • This is quite common when you first start using oestrogen vaginal and usually settles within 2 weeks.
  • Tell your doctor if it bothers you. 
  • Nausea, stomach cramps
  • Changes in weight, or mood
  • Headache or dizziness
  • Tell your doctor if they bother you.
  • Breast discomfort
  • Increased vaginal discharge

  • Tell your doctor.
Did you know that you can report a medicine side effect to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

Ovestin Cream(external link) Medsafe Consumer Information, NZ
Ovestin Pessaries(external link) Medsafe Consumer Information, NZ


5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)


  1. Vulvovaginal health in post-menopausal women(external link) BPAC, 2014
  2. Estriol (vaginal)(external link) New Zealand Formulary

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Credits: Healthify He Puna Waiora Pharmacists. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland & Dr Phoebe Hunt, Sexual Health Registrar, Northland

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