Ovestin analogues are non-hormonal. What cheap analogues can replace Ovestin cream? Contraindications and possible side effects

Prohibited during breastfeeding

Not suitable for children

Has restrictions for older people

Has limitations for liver problems

Has limitations for kidney problems

Ovestin is an original drug containing estriol. Producing countries: France and Holland. Like any branded drug, Ovestin has cheaper structural analogues and substitutes with similar effects.

In the female body and, to a lesser extent, the male body, the endocrine glands produce specific steroid hormones - estrogens. They influence almost all metabolic processes necessary to maintain homeostasis. There are three subtypes of estrogens: estriol, estradiol and estrone, each of which is responsible for certain biochemical processes. The main component of the drug Ovestin is estriol.

Estriol reaches its highest concentration in a woman’s body during pregnancy; the rest of the time, this hormone remains at a relatively low level. Of all three subtypes, estriol is considered the least active and rapidly degrading hormone.

However, it was found that estriol has high specificity for receptors located in the genitourinary system, and therefore it began to be introduced into the treatment of such conditions as atrophy of the mucous membrane of the lower genitourinary system, in pre- or postmenopausal periods, especially in patients who have undergone surgical interventions on the genital organs.

Estriol, acting in isolation on epithelial cells with specific receptors for it, improves trophism, helps restore the biocenosis and acid-base balance of the vagina, improves resistance to pathogenic microorganisms, and reduces symptoms during menopause.

Ovestin is available in several pharmacological forms: tablets for oral administration, suppositories and as a cream for intravaginal administration:

Analogs of Ovestin in composition are presented in various forms of release: tablets, suppositories and in the form of cream. Complete analogs in composition containing the same component are represented by the following trade names:

1. Estriol.
2. Estrocad.
3. Estriol-M pessaries.
4. Ovipol Clio.
5. Orniona.
6. Elvagin.
7. Estrovagin.

Cheap analogues of Ovestin in tablets

Among the inexpensive drugs that have similar indications to Ovestin and a similar mechanism of action, but are based on a different active component, are the drugs Proginova, Microfollin, Klimen, etc.

Proginova

Refers to estrogen drugs, 1 tablet contains estradiol valerate 2 mg. Estradiol is one of the subtypes of estrogen that affects the metabolism of many substances. Proginova contains synthetic estradiol, which is almost identical to biogenic. Estradiol is the most active subtype of estrogen, necessary for the normal development, functioning and trophism of the female reproductive system and many other tissues and organs. In the male body, it is produced in small quantities by the adrenal cortex.

Proginova is taken 1 tablet daily for the first 3 weeks. Next, it is recommended to take a one-week break. The feasibility, duration and need for further therapy are decided together with the attending physician. Indications include hormone replacement therapy in cases of identified estrogen deficiency in postmenopausal women.

Contraindications:

1. Pathological sensitivity to the components of the drug.
2. Suspicion or diagnosed breast cancer at any stage.
3. Estrogen-dependent malignant tumor of any location.
4. Bleeding from the genital tract without an established cause.
5. Excessive growth of the endometrium, resistant to treatment.
6. Disruption of the hemocoagulation system, tendency to thrombosis.
7. Dysfunctional pathologies, liver tumors.
8. High levels of triglycerides in the blood.

Ovestin and Proginova contain estrogens, but their different fractions: Ovestin has estriol, Proginova has estradiol, as a result of which the drugs have some differences in indications for use.

The role of estrogens

Side effects:

1. Cephalgia, dyspepsia.
2. Skin hyperimmune manifestations in the form of a rash.
3. Uterine bleeding, changes in the amount of menstrual blood released, intermenstrual spotting.
4. Changes in body weight, swelling.
5. Pain in the mammary glands.
6. Deterioration of mood, dizziness, blurred vision, tachycardia.

Microfollin

Synthetic estrogen, 1 tablet contains 0.05 mg ethinyl estradiol. Microfollin contains ethinyl estradiol, which is similar to human estrogen. Causes proliferation of the inner layer of the uterus, improves trophism of tissues of the female reproductive system. It exhibits a powerful antiandrogenic effect, as a result of which it is widely used in the treatment of prostate cancer.

It is taken orally, the dose is selected individually for each patient. For prostate carcinoma, a starting dose of 0.05-0.1 mg three times a day is prescribed, which is subsequently reduced for maintenance therapy. In case of prolonged absence of menstruation not associated with pregnancy, women are prescribed 0.05 mg daily for 20 days, after which therapy is continued with progesterone for 5 days. To stop lactation for 3 days you need to take 1 tablet daily, then ½ tablet. For acne - half or 1 tablet daily.

Microfollin

Indications:

1. Menstrual irregularities (absence of menstruation, small amount of blood released, uterine bleeding, intermenstrual bleeding).
2. Termination of lactation.
3. Acne.
4. Prostate carcinoma.
5. Climax.

Contraindications include estrogen-dependent tumor diseases of various locations, malignant neoplasms of the mammary gland, a tendency to thrombosis and/or a history of thromboembolic complications, and impaired functioning of hepatocytes.

Unlike Ovestin, Microfollin contains a more active fraction of estrogen - ethinyl estradiol, and therefore has a wider range of indications and different regimens of use.

Side effects: pathological reactions to the components, cephalgic syndrome, nausea, vomiting, osteoporosis associated with an imbalance in calcium metabolism, bone marrow pathology, its hypoplasia, swelling.

Klymen

This is an estrogen-progesterone drug. 1 tablet of Clymene contains 2 mg of estradiol and 1 mg of cyproterone acetate. Clymene contains synthetic estradiol, which is identical to endogenous estradiol. It compensates for estradiol deficiency that occurs in patients during menopause, thereby reducing symptoms associated with the onset of menopause.

Cyproterone acetate is a synthetic analogue of endogenous progesterone, which has an active antiandrogenic and antiproliferative effect. Due to the fact that the isolated use of estradiol causes hyperproliferation of the endometrium, the addition of a progestogen component eliminates this undesirable effect.

Clymene is used according to the following schemes:

1. If similar drugs have not been previously used, then Climen should be taken from the 5th to the 25th day of the menstrual cycle, one tablet daily.
2. If it is necessary to switch from another hormonal drug, Klimene should be taken immediately after the end of the previous course, without taking a break.

The package contains 21 Clymene tablets in two colors (white and pink), which are used daily. During the first 11 days, take 1 white tablet, the next 10 days - 1 pink tablet. Indications: estrogen deficiency in pre- and postmenopause, prevention of osteoporosis during these periods (in women with an increased risk of developing the disease).

Contraindications:

1. Hypersensitivity to components.
2. Suspicion or established breast cancer, estrogen-dependent tumor of another location.
3. Metrorrhagia without a diagnosed cause.
4. Proliferation of the endometrium.
5. Hypercoagulation of blood (history of thromboembolism).
6. The period of pregnancy and breastfeeding.
7. Hepatocyte dysfunction.
8. Increased triglycerides in the blood.

Climen differs from Ovestin in having a more active estradiol and an additional component - cyproterone, due to which Climen can be used and indicated for patients with an increased risk of osteoporosis. The dosage and method of application also vary.

Inexpensive analogues in candles and gel

Suppositories intended for intravaginal administration and gels containing female sex hormones have their advantages, including: a more local effect, therefore it is possible to use small dosages, which helps reduce unwanted effects and reduces the number of contraindications.

Ovipol Clio

Drug group - drugs containing female sex hormones of the estrogen series. The active component is estriol, which is contained in 1 suppository at a dosage of 500 mcg. There are many receptors for estriol in a woman’s body, which are concentrated mainly in the cells of the uterus, vagina, mammary gland, hypothalamus, pituitary gland, etc.

By binding to receptors located on the surface of cells of the female reproductive system, the drug improves blood circulation, metabolism, enhances the proliferation of the inner layer of the uterus, balances the acid-base state, and normalizes normal biocenosis in the vaginal cavity. The steroid hormone also affects carbohydrate and fat metabolism.

The drug is used intravaginally, 1 suppository at night (before bedtime). Duration of treatment is 2-3 weeks. It is not recommended to take more than 1 suppository per day.

Indications for use:

1. Estrogen deficiency during menopause or premenopause, manifested by thinning of the mucous membrane of the urogenital tract and other symptoms, pre- and postoperative period (surgeries with intravaginal access).
2. Menopause, accompanied by characteristic symptoms that bring discomfort and/or disruption of general well-being.
3. Infertility (if the cause is due to a cervical factor).
4. Pain during intercourse, vaginal dryness, itching, enuresis.
5. For diagnostic purposes.

Contraindications include hyperreaction to the components of the drug, pathology of the blood coagulation system such as hypercoagulation, various manifestations of thrombosis in the anamnesis, severe liver pathology, estrogen-sensitive tumors of the reproductive system, metrorrhagia without an established cause, pregnancy.

Hypercoagulation

The original drug and its analogue Ovipol Clio differ only in the price category, the latter is cheaper.

Side effects:

1. Discomfort, irritation at the injection site.
2. Tension and pain in the mammary glands.

Estrogel

Natural estradiol in gel form for cutaneous use. 1 g of gel contains 0.6 mg of active substance; with one press, 1.25 g of gel is released, which corresponds to 0.75 mg of estradiol. The use of estradiol transdermally allows the drug to act by bypassing the liver, which minimizes the negative effect on hepatocytes and increases the half-life.

Estrogel replenishes estrogen deficiency during menopause and premenopause. 1 dose of gel, which is equal to 1 press (0.75 mg of the active component), is applied to large areas of intact skin (abdomen, forearm, lower back, etc.) in a thin layer 1 time per day after morning or evening skin cleansing. The duration of use is 21-28 days per month. The dose may vary (on average no more than 2.5 g of gel per day); in the future, it is necessary to take a one-week break. Further therapy is determined by the doctor individually for each patient.

Indications:

Contraindications are similar to the drug Ovipol Clio.

Estrogel differs from Ovestin in its pharmacological form and method of administration (Estrogen is a gel intended for transdermal administration, Ovestin is a cream for vaginal administration). The drugs contain different estrogen fractions and dosages.

Undesirable effects:

Estrocade

The drug is available in suppositories containing 0.5 mg of estriol. The mechanism of action is similar to Ovestin. Estrocad is used according to the following schemes:

1. For atrophic manifestations of the lower urogenital tract, 1 suppository daily for 3 weeks, then the dose is reduced to 0.5 mg (1 suppository) twice a week.
2. Before and after surgical interventions with vaginal access in postmenopausal women - for 2 days, take 0.5 mg daily (in the preoperative period) and 1 suppository twice a week (in the postoperative period).
3. For diagnostic purposes, it is used for a week every other day before taking a smear.

Indications include replacement therapy with estrogen in case of their insufficiency (dryness and thinning of the mucous membrane of the urogenital tract, pain during sexual intercourse, itching and discomfort in the vagina, mild enuresis), in the treatment of patients who are in the period of menopause or postmenopause, who are undergoing surgery with vaginal access or after it. For additional diagnostic purposes if atrophy is suspected, after taking a smear from the cervical canal.

Contraindications coincide with the contraindications of the drug Ovipol Clio. Estrocad and Ovestin are similar in all criteria, the only difference is the different manufacturer and price of the drugs.

Undesirable effects: tension, engorgement and tenderness of the mammary gland, peripheral edema, the presence of transparent mucous discharge, increased blood pressure, muscle cramps, cephalgic syndrome, skin hyperpigmentation.

Drug substitutes in ampoules

Ovestin is not available in the form of ampoules, however, some pharmacological companies produce medications that contain hormonal agents for parenteral use.

Sinestrol

The drug refers to hormonal drugs used for pathologies of the genital area. The active ingredient is hexestrol. One ml contains 1 mg or 20 mg Hexoestrolum.

Hexestrol is an estrogenic synthetic drug with a non-steroidal structure. By specifically affecting receptors, it improves metabolic processes, blood circulation, prevents the leaching of calcium from the blood and prevents fragility of bone tissue in postmenopausal women.

The drug is injected deep into the gluteal muscle at a dose of 1-2 mg daily, the duration of the course depends on the indication:

Indications: ovarian hypofunction, which is manifested by underdevelopment of the female genital organs, amenorrhea, disorders during menopause and postmenopause, therapy for breast cancer in women over 60 years of age, therapy for prostate cancer.

Contraindications: dysfunctional conditions of the liver and kidneys, mastopathy, the presence of foci of endometrioid tissue, metrorrhagia, tumors in women under 60 years of age, diabetes mellitus, blood hypercoagulation and complications associated with it, pathological sensitivity to the components of the drug.

Ovestin and Sinestrol differ in the active substance, release form, method of administration, course of therapy, indications and contraindications.

Side effects:

Folliculin

Refers to estrogens intended for parenteral administration in cases of pathology in the reproductive system. 1 ml of solution contains 1 mg of estrone. The mechanism of action is similar to Ovestin.

Method of administration: the drug is administered intramuscularly, the dosage is selected individually. Usually the drug is prescribed 1-2 ml daily from 15-17 days to 1-2 months or more. The next step is to prescribe progesterone intramuscularly for 5-8 days.

If labor is weak or the pregnancy is postterm, 4-5 ml is prescribed 2-3 hours before the administration of birth-stimulating drugs.

Indications:

Contraindications are identical to the list of restrictions when taking Ovestin and its other analogues. Folliculin differs in its active ingredient, method of application and release form. Undesirable effects are similar to Ovestin.

There are contraindications. Consult your doctor.

Preparations containing Estriol (Estriol, ATC code G03CA04):

Commercial names abroad (abroad) - Aacifemine, Evalon, Hormomed, Klimadoral, Klimax-E, OeKolp, Orgestriol, Orgastyptin, Ortho-Gynest, Pausanol, Physiogine, Styptanon, Synapause, Triovex, Trophicreme, Xapro.

Ovestin in candles - official instructions for use:

Clinical and pharmacological group:

Estrogen drug.

pharmachologic effect

Estrogen drug. An analogue of a natural female hormone. Replenishes estrogen deficiency in postmenopausal women and reduces postmenopausal symptoms. Most effective in the treatment of genitourinary disorders. With atrophy of the mucous membrane of the lower genitourinary tract, estriol helps normalize the epithelium of the genitourinary tract and helps restore normal microflora and physiological pH in the vagina. Increases the resistance of epithelial cells of the genitourinary tract to infections and inflammation, reducing complaints such as pain during sexual intercourse, dryness, itching in the vagina, reduces the likelihood of vaginal infections and urinary tract infections, helps normalize urination, and prevents urinary incontinence.

Unlike other estrogens, estriol has a short period of action, since it is retained in the nuclei of endometrial cells for a short period of time. It is assumed that a single daily dose does not cause endometrial proliferation. Therefore, cyclic administration of progestogen is not required and withdrawal bleeding does not occur. In addition, estriol has not been shown to increase mammographic density.

Pharmacokinetics

Suction

When the drug is used orally or topically, estriol is quickly and almost completely absorbed.

Cmax of estriol in plasma is achieved 1-2 hours after intravaginal use.

Distribution

In plasma, almost all (90%) estriol is associated with albumin and, unlike other estrogens, is practically not associated with sex hormone binding globulin (SHBG).

Removal

Excretion of estriol (in bound form) is carried out mainly by the kidneys; about 2% is excreted unchanged through the intestines. Excretion of metabolites in the urine begins within a few hours after administration of the drug and continues for 18 hours.

Indications for use of the drug OVESTIN®

• hormone replacement therapy (HRT) for the treatment of atrophy of the mucous membrane of the lower genitourinary tract associated with estrogen deficiency;
• pre- and postoperative treatment of postmenopausal women during operations via vaginal access;
• for diagnostic purposes in case of unclear results of a cytological examination of the cervix (suspicion of a tumor process) against the background of atrophic changes.

Directions for use and dosage

Suppositories should be inserted into the vagina at night before bed.

When treating atrophy of the mucous membrane of the lower genitourinary tract, 1 suppository per day is prescribed for the first weeks, followed by a gradual reduction in the dose, based on symptom relief, until a maintenance dose is reached (i.e., 1 suppository 2 times a week).

For pre- and postoperative therapy of postmenopausal women, during surgical interventions via vaginal access, 1 suppository per day is prescribed for 2 weeks before surgery; 1 suppository 2 times a week for 2 weeks after surgery.

For diagnostic purposes, if the results of a cytological examination of the cervix are unclear, 1 suppository is prescribed every other day for a week before taking the next smear.

When initiating or continuing treatment for postmenopausal symptoms, use the lowest effective dose for the shortest possible duration.

In women not receiving HRT, or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin® can be started on any day. Women who are switching from a cyclic regimen of HRT medications should begin treatment with Ovestin® 1 week after stopping HRT medications.

Side effect

As with any other drug that is applied to the surface of the mucous membranes, Ovestin® suppositories can sometimes cause local irritation or itching.

Sometimes there may be sensitivity, tension, soreness, and an increase in the size of the mammary glands. These undesirable reactions are usually short-lived and passing, but at the same time may indicate the use of too high a dose.

Acyclic spotting, breakthrough bleeding, and metrorrhagia are also noted.

When HRT using estrogen-progestagen-containing drugs, the following side effects were also observed, the connection of which with the use of Ovestin has not been proven:

• benign and malignant estrogen-dependent neoplasia (endometrial and breast cancer);
• venous thromboembolism (deep vein thrombosis of the legs or pelvis, pulmonary embolism) occurs more often with the use of HRT than without therapy;
• myocardial infarction, stroke;
• cholelithiasis;
• skin and subcutaneous diseases (chloasma, erythema multiforme, erythema nodosum, hemorrhagic purpura);
• dementia;
• increased libido.

Contraindications to the use of the drug OVESTIN®

• known, known or suspected breast cancer;
• diagnosed or suspected estrogen-dependent tumors (for example, endometrial cancer);
• bleeding from the vagina of unknown etiology;
• untreated endometrial hyperplasia;
• the presence of venous thrombosis at present and in history;
• active or recent thromboembolic arterial disease (eg, angina, myocardial infarction);
• acute liver disease or a history of liver disease after which liver function tests have not returned to normal;
• porphyria;
• established hypersensitivity to the active substance or to any of the excipients of the drug.

Carefully

If any of the following conditions are present or have been previously noted and/or worsened during previous pregnancies or previous hormonal treatment, the patient should be under the direct supervision of a physician. It must be taken into account that these conditions may recur or worsen during treatment with Ovestin®, especially if:

• leiomyoma (uterine fibroids) or endometriosis;
• previous thromboembolic disorders or existing risk factors for such disorders;
• risk factors for estrogen-dependent tumors, for example, 1st degree of heredity for breast cancer;
• arterial hypertension;
• benign liver tumors (for example, liver adenoma);
• diabetes mellitus with or without a vascular component;
• cholelithiasis;
• jaundice (including a history during a previous pregnancy);
• liver failure;
• migraine or severe headache;
• systemic lupus erythematosus;
• history of endometrial hyperplasia;
• epilepsy;
• asthma;
• otosclerosis;
• familial hyperlipoproteinemia;
• pancreatitis.

Use of the drug OVESTIN® during pregnancy and breastfeeding

Ovestin® is contraindicated during pregnancy. If pregnancy occurs during therapy with Ovestin®, treatment should be discontinued immediately.

The majority of epidemiological studies conducted to date regarding unintentional fetal exposure to estrogens indicate no teratogenic or fetotoxic effects.

Use for liver dysfunction

The drug is contraindicated in patients with acute liver disease or a history of liver disease after which liver function tests have not returned to normal.

In case of liver failure, use the drug with caution.

Use for renal impairment

Estrogens can cause fluid retention, and therefore patients with impaired renal function should be closely monitored by a physician. In the terminal stage of chronic renal failure, there should be special monitoring due to a possible increase in the level of circulating active components of Ovestin.

special instructions

To treat postmenopausal symptoms, HRT should only be started for symptoms that adversely affect quality of life. In all cases, a thorough assessment of the risks and benefits of treatment should be carried out at least once a year. HRT should only be continued for a period of time when the benefit outweighs the risk.

Medical examination/observation

Before starting or resuming HRT, a detailed individual and family history should be established. Based on the medical history, contraindications and warnings for the use of the drug, it is necessary to conduct a clinical examination, including examination of the pelvic organs and mammary glands. During treatment, it is recommended to conduct periodic medical examinations, the frequency and nature of which vary from person to person, but at least once a year. Women should be informed about the need to report changes in the mammary glands to their doctor. Tests, including mammography, must be performed in accordance with generally accepted screening standards.

Therapy should be discontinued if a contraindication is identified and/or if the following conditions occur:

• jaundice and/or deterioration of liver function;
• significant increase in blood pressure;
• resumption of migraine-type headaches;
• pregnancy.

Endometrial hyperplasia

To prevent stimulation of the endometrium, the daily dose should not exceed 1 suppository (500 mcg estriol). This maximum dose should not be used for more than 4 weeks.

Breast cancer

Based on the results of the randomized, placebo-controlled Women's Health Initiative (WHI) trial and epidemiological studies including the Million Women Study (MWS), an increased risk of breast cancer was reported in women taking estrogens, estrogen-progestogen-containing combinations, or tibolone. for HRT for several years. For all HRT, the increased risk becomes noticeable after several years of use and increases with duration of use, but returns to baseline levels a few (maximum 5) years after stopping treatment.

In the MWS study, the relative risk of mammary cancer with conjugated equine estrogens (CEE) or estradiol (E2) was higher when a progestogen was added, both cyclically and continuously, regardless of the type of progestogen. There was no confirmation of changes in the degree of risk with different routes of administration.

In the WHI study, continuous use of a combination of conjugated equine estrogen and medroxyprogesterone acetate (CEE + MPA) was associated with mammary tumors that were slightly larger in size and more likely to have metastases to local lymph nodes compared with placebo.

No such risk is known for Ovestin. A recent population-based case-control study of 3,345 women with invasive breast cancer and 3,454 controls found that estriol, unlike other estrogens, was not associated with an increased risk of breast cancer. In this regard, it is important that the patient is aware of the risk of developing breast cancer in relation to the known benefits of HRT.

Venous thromboembolism

HRT is associated with a higher relative risk of developing venous thromboembolism (VTE), i.e. deep vein thrombosis or pulmonary embolism. One randomized controlled trial and epidemiological studies found that the risk for women receiving HRT was 2-3 times higher than for patients not receiving such treatment. For women not using HRT, the incidence of VTE that is likely to occur over a 5-year period is estimated to be approximately 3 in every 1,000 women aged 50-59 years and 8 in every 1,000 women aged 60-69. years. In healthy women using HRT for 5 years, the number of additional cases of VTE over a 5-year period should be 2-6 cases (average 4) for every 1000 women aged 50-59 years and 5-15 cases (average 9) for every 1000 women aged 60-69 years. VTE is more likely to occur during the first year of HRT than later in life. In relation to Ovestin, such a risk is unknown.

Generally accepted risk factors for VTE include a relevant personal or family history, high obesity (BMI >30 kg/m2) and systemic lupus erythematosus. There is no consensus regarding the role of varicose veins in the development of VTE.

Patients with a history of VTE or known thromboembolic conditions are at increased risk of VTE. HRT may increase this risk. In order to exclude a predisposition to blood clots, a careful individual and family history of thromboembolism or recurrent spontaneous miscarriage is necessary. Until a thorough assessment of thromboembolic factors has been carried out, anticoagulant treatment or HRT should not be started. For women already receiving anticoagulant treatment, careful consideration of the benefit/risk of HRT is required.

The risk of VTE may increase with prolonged immobilization of the patient, extensive trauma, or a large volume of surgical intervention. After surgery, special attention should be paid to preventive measures to prevent VTE. In cases where prolonged immobilization is unavoidable after elective surgery, particularly after abdominal or orthopedic surgery of the lower extremities, temporary cessation of HRT should be considered 4-6 weeks before surgery if possible. If Ovestin® is used for the indication “pre- and postoperative treatment of postmenopausal women during operations with vaginal access,” prophylactic treatment must be provided to prevent thrombosis.

If VTE develops after starting treatment with Ovestin®, then treatment with the drug must be discontinued. Patients should be informed to seek immediate medical attention if they experience a symptom of a potential thromboembolism (eg, painful leg swelling, sudden chest pain, shortness of breath).

Randomized controlled trials have not confirmed the positive effect of continuous use of a combination of conjugated estrogens and medroxyprogesterone acetate (MPA) on the state of the cardiovascular system. Two large clinical trials, the WHI and the HERS (Heart and Estrogen-Progestin Replacement Therapy Study), confirmed the possibility of a possible increased risk of cardiovascular disease during the first year of use and a lack of overall benefit.

There is only limited data available for other HRT medications, so it is not certain that these results also apply to other HRT medications.

A large randomized trial (WHI) found that an increased risk of ischemic stroke may be considered as a side effect in healthy women during treatment with continuous use of a combination of conjugated estrogens and MPA. For women who do not use HRT, the number of strokes that may occur over a 5-year period is about 3 in every 1000 women aged 50-59 years and 11 in every 1000 women aged 60-69 years. It has been found that for women who use conjugated estrogens and MRAs for 5 years, the number of additional cases increases by 0-3 cases (average 1) for every 1000 patients aged 50-59 years and 1-9 cases (average 4 ) for every 1000 patients aged 60-69 years. It is unknown whether the increased risk also applies to other HRT drugs.

Ovarian cancer

Long-term (at least 5-10 years) estrogen monotherapy (as HRT) in women who have undergone uterine surgery is associated with an increased risk of ovarian cancer, which has been found in several epidemiological studies. It has not been proven that long-term combined HRT or monotherapy with low-active estrogens (for example, Ovestin®) has any other risk.

Other states

Estrogens can cause fluid retention, and therefore patients with impaired renal function and cardiovascular insufficiency should be closely monitored by a physician. In the terminal stage of chronic renal failure, there should be special monitoring due to a possible increase in the level of circulating active components of Ovestin.

Estriol is a weak gonadotropin inhibitor and has no other significant effects on the endocrine system.

There was no convincing evidence of improvement in cognitive function. The WHI trial provided evidence of an increased risk of eventual dementia in women who started using the combination of conjugated estrogens and MPA continuously after age 65 years. It is unknown whether these results apply to younger postmenopausal women using other HRT medications.

Overdose

The acute toxicity of estriol in animals is very low. An overdose of Ovestin® when administered vaginally is unlikely. However, if large quantities of the drug enter the gastrointestinal tract, nausea, vomiting and cessation of bleeding in women may develop.

Treatment: there is no specific antidote. If necessary, symptomatic treatment should be carried out.

Drug interactions

In clinical practice, no interaction has been observed between the drug Ovestin® and other drugs.

The metabolism of estrogens may be enhanced when used in combination with compounds that induce enzymes involved in drug metabolism, particularly cytochrome P450 isoenzymes, such as anticonvulsants (phenobarbital, phenytoin, carbamazepine) and antimicrobial agents (rifampicin, rifabutin, nevirapine, efavirenz).

Ritonavir and nelfinavir exhibit inducing properties when used in combination with steroid hormones.

Herbal preparations containing St. John's wort (Hypericum perforatum) may induce estrogen metabolism.

Increased metabolism of estrogens may lead to a decrease in their clinical effect.

Estriol enhances the effect of lipid-lowering drugs.

Weakens the effects of male sex hormones, anticoagulants, antidepressants, diuretics, antihypertensives, hypoglycemic agents.

General anesthesia, opioid analgesics, anxiolytics, some antihypertensive drugs, and ethanol reduce the effectiveness of the drug.

Folic acid and thyroid medications enhance the effects of estriol.

Conditions for dispensing from pharmacies

The drug is approved for use as a means of OTC.

Storage conditions and periods

The drug should be stored in a dry place, protected from light and out of reach of children, at a temperature of 2° to 25°C. Shelf life - 3 years.

The instructions are quoted from the Vidal pharmaceutical website.

Ovestin cream - method of application and dosage:

Dosage regimen

The cream should be inserted into the vagina using a calibrated applicator at night (before going to bed).

1 application (applicator filled to the ring mark) contains 500 mg of cream, which corresponds to 500 mcg of estriol.

When treating atrophy of the mucous membrane of the lower genitourinary tract - 1 application per day for the first weeks (maximum 4 weeks), followed by a gradual reduction in dose, based on symptom relief, until a maintenance dose is reached (i.e. 1 application 2 times a week) .

For pre- and postoperative therapy of postmenopausal women, for surgical interventions via vaginal access - 1 application per day for 2 weeks before surgery; 1 application 2 times a week for 2 weeks after surgery.

For diagnostic purposes in case of unclear results of cytological examination of the cervix - 1 application every other day for a week before taking the next smear.

If a dose is missed, the missed dose must be administered on the same day as soon as the patient remembers (the dose should not be administered 2 times a day). Subsequent applications are carried out in accordance with the usual dosage regimen.

When initiating or continuing treatment of postmenopausal symptoms, use the lowest effective dose for the shortest possible duration.

In women not receiving HRT, or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin can be started on any day. Women who are switching from a cyclic regimen of HRT medications should begin treatment with Ovestin® cream 1 week after stopping HRT medications.

Instructions for use for patients

1. The cream is inserted into the vagina at night (before bedtime).
2. Remove the cap, turn the cap over and use a sharp rod to open it.
3. Screw the applicator onto the tube.
4. Squeeze the tube to fill the applicator with cream until the piston stops.
5. Unscrew the applicator and close the tube with the cap.
6. In a lying position, the end of the applicator is inserted deep into the vagina and slowly press the piston all the way, introducing the cream.

After administering the drug, remove the piston from the cylinder and wash the cylinder and piston with warm water and soap. Detergents should not be used. After this, the cylinder and piston are rinsed generously with clean water.

Do not immerse the applicator in hot or boiling water

Ovestin is a drug based on the natural female hormone estriol, which is actively used to treat various diseases, stabilize hormonal levels, restore the natural microflora of the vagina, and also increase the resistance of the genitourinary system to infections. The disadvantage of the drug is its high cost. That is why many are looking for an Ovestin analogue that would be cheaper and at the same time have similar pharmacological properties.

Ovestin is a hormonal drug with a short-term effect. Thanks to its composition, this product promotes the regeneration of endometrial mucous tissue, restores the acid balance of the vagina and its natural microflora. Accordingly, analogues should have similar capabilities. When choosing a Russian-made ointment, you must carefully study the indications for use, since in many ways it is this factor that determines whether the product you are looking for is an analogue.

Analogues must have the same capabilities as the original drug, namely:

• prevention of inflammatory processes in the female genitourinary system. In this case we are talking about preventive measures;
• improvement of urinary function;
• getting rid of such an unpleasant problem as urinary incontinence;
• prevention of possible complications after surgery affecting the vagina or peri-vaginal areas;
• diagnostics of smears for additional research if the initial results did not allow us to find out the cause of the pathology;
• treatment of atrophic changes in the vaginal mucosa, due to which its mucosa is too dry, which leads to a persistent feeling of discomfort, as well as pain during sexual intercourse.

Ovestin is available in the form of vaginal suppositories, topical ointments or tablets.

Accordingly, it can be taken in various ways, depending on the form of release. The same applies to analogues - they can also be in the form of vaginal suppositories, creams or tablets for internal use.

It is noteworthy that regardless of the type of drug, its effectiveness does not change in any way. The different forms of release are mainly due to the need to select the optimal drug, taking into account existing contraindications, which will be discussed in detail below.

Regardless of the form of release, the pharmacological agent is used once a day. In difficult cases, for example, with urinary incontinence, the daily dose can be increased to two uses of cream, two tablets or suppositories.

The course of treatment is a strictly individual process that should be developed exclusively by the attending physician. It is strictly forbidden to self-medicate, especially with the help of hormonal drugs, which include Ovestin and its most common domestic analogues. In general, therapy can be significantly adjusted during treatment, which is associated with improvement/worsening of the condition and severity of negative symptoms.

If you accidentally missed the time of taking the drug, the required dose should be taken 12 hours before the next dose. After this, you can continue treatment according to the previously developed regimen.

With tablets and vaginal suppositories, everything is clear - the former are swallowed, the latter are inserted into the vagina. In turn, Ovestin cream should also be used inside the vagina. It is not necessary to stick your fingers with ointment in there - it is not hygienic and can cause significant discomfort. The tube of cream is equipped with a special applicator, with the help of which the medicine must be administered as directed. Similar drugs must have the same device.

Today, the domestic pharmacological industry produces a sufficient amount of products that can be considered an analogue of this hormonal drug. Many of them coincide in the main active ingredient, some - in the ATX code. It is necessary to consider the first group, since the second, despite a similar effect, do not contain estriol, and therefore cannot be considered full-fledged analogues.

The most common medications similar to Ovestin:

Contraindications

Ovestin has many contraindications, in which taking the drug is completely or partially prohibited. The same applies to analogues of the drug, since the main active ingredient in them is also estriol.

We list all existing contraindications:

• pregnancy and lactation;
• liver dysfunction;
• porphyria;
• unclear bleeding from the vagina;
• venous or arterial thromboembolism;
• hypersensitivity to individual components of the drug;
• oncological diseases;
• suspected breast or endometrial cancer;
• myocardial infarction;
• stroke;
• hypertension;
• angina pectoris;
• asthma;
• otosclerosis;
• phlebeurysm;
• diabetes mellitus (regardless of stage);
• hepatitis;
• uterine fibroid;
• pancreatitis.

As you can see, there are quite a lot of contraindications. If you ignore them, side effects may occur:

• a feeling of burning, stinging, itching and irritation in the vaginal area;
• vaginal discharge, including bloody discharge;
• increased blood pressure;
• painful sensations in the mammary glands;
• signs of intoxication of the body - headache, weakness, nausea.

Accordingly, if you have at least one contraindication, you should not tempt fate. It is strongly recommended to use another drug for treatment. Today in Russia you can purchase high-quality analogues of Ovestin with much fewer contraindications and similar effectiveness.

ritonavir and nelfinavir are known to be potent inhibitors, but, on the contrary, they exhibit inducing properties when used with steroid hormones;

a clinically significant increase in estrogen metabolism can lead to a decrease in the effectiveness of Ovestin and to a change in the pattern of uterine bleeding.

Estriol may increase the pharmacological effects of corticosteroids, succinylcholine, theophylline and troleandomycin.

Use during pregnancy or breastfeeding

During pregnancy, Ovestin is not prescribed to women.

fertility

Ovestin is intended only for the treatment of women after menopause (natural and surgically induced).

pregnancy

Ovestin is not used during pregnancy. If a woman becomes pregnant during treatment with Ovestin, the drug should be stopped immediately.

The results of epidemiological studies conducted today on the effect of estrogens on the fetus do not indicate the presence of a teratogenic or fetotoxic effect.

lactation

Non-hormonal treatment

Women who have a contraindication to the use of hormonal suppositories Ovestin or their analogues are prescribed non-hormonal agents.

Let's look at the most popular non-hormonal suppositories:

1. Klimaktol-Antikan are homeopathic candles containing oils of sea buckthorn, lemon balm, hops and homeopathic essences of the same plants.
   They effectively relieve dryness, burning and itching in the vagina, while simultaneously restoring its mucous membrane. Candles treat inflammatory processes. In addition, they help increase sexual desire, which is important during menopause to maintain a woman’s physical and mental health. The course of treatment is 30-60 days, during which 1 suppository is inserted into the vagina before bedtime.
2. Beautiful – vaginal suppositories whose main components are propolis and saffron.
   In addition to them, the product contains essential oils of other medicinal plants. Suppositories moisturize the vaginal mucosa, and thereby eliminate dryness. They also promote rapid regeneration of cells in the vaginal mucosa. Treatment is carried out for 10-14 days, introducing 1 suppository into the vagina before a night's rest.

Treatment with a non-hormonal drug should only be prescribed by a specialist. If a woman wants to change the product she is using to another, then this can only be done after consulting with her doctor.

Homeopathic remedies have a long course of treatment, but it does not need to be shortened to get the effect. The decision to extend the course of treatment or cancel it is made only by the doctor.

Dosage form

Considering the variety of forms of the drug Ovestin, patients often ask the following question: which is better to choose, suppositories or cream, or should they limit themselves to tablets.

It is impossible to say unequivocally that any option is better, since each form of the medicine performs its functions efficiently.

Treatment with suppositories is carried out for a month. First, one suppository is inserted into the vagina at night. If positive changes are observed after 2 weeks, the dose of Ovestin is reduced to 2 suppositories per week (1 time every 3 days).

How to handle Ovestin candles is described in detail in the instructions for use. How much do Ovestin candles cost: 15 pcs per pack. the consumer pays 1,400 rubles.

Sold in a 15 g tube.

Auxiliary components improve the functioning of the active hormone and ensure comfortable use of the product. The required dose of Ovestin cream is administered into the vagina using a special applicator (it is filled to the mark).

The standard dosage regimen is 1 dose once a day, preferably at night. If the condition clearly improves, treatment is carried out twice a week. A tube of Ovestin cream can be purchased for 1,500 rubles.

Pills

According to the instructions, Ovestin tablets are taken in 2 - 4 pcs. in a day. Then the dose is reduced to 1 – 2 mg/day, which is equivalent to 1 – 2 tablets. For patients with complaints of urinary incontinence, the daily dosage is increased to 8 mg.

For women of reproductive age diagnosed with infertility, Ovestin is prescribed in courses from the 6th to the 15th day of the menstrual cycle. The drug will work if infertility is associated with low survival of sperm in the cervical uterus.

In Russian pharmacies, Ovestin tablets are sold at a price of 900 – 1400 rubles per pack of 30 pcs.

Topical products act in the problem area. Relief of symptoms is felt within half an hour after administration of the drug. Candles are more convenient to use than cream. However, they take a long time to be absorbed by the vagina. What is better to choose, candles or Ovestin cream, decide for yourself.

How long can suppositories and other forms of Ovestin be used? The answer to this question depends on the specific situation.

For example, in the process of preparing for surgery, if access through the vagina is provided, menopausal women use 1 Ovestin suppository daily. The first course begins 2 weeks before surgery, the second - in the postoperative period and lasts 14 days.

For the same purpose, it is permissible to take tablets:

• Two weeks before surgery – 4 – 8 mg.
• In the postoperative 2-week period – 1 – 2 mg.

If the patient prefers to use cream instead of tablets, she uses it once a day before surgery for 2 weeks. Subsequently, after the operation, the product is used twice a week.

For pathological menopause, Ovestin tablets are taken in a dosage of 4–8 mg. As the condition improves, the dose of the drug is gradually reduced. If the results of the smear analysis are unclear, to improve the results, 1 suppository is given every other day for a week. Then the smear is retaken.

What to do if you miss your next dose? If the time interval between doses does not exceed 36 hours, doctors recommend taking the missed dose and then following the standard regimen.

Side effects

After reading reviews from doctors on Ovestin suppositories, the side effects can be identified as follows:

1. Chloasma.
2. Dementia.
3. Heart attack or stroke.
4. Increased libido.
5. Baldness.
6. Erythema nodosum.
7. Pulmonary embolism.
8. Endometrial neoplasia.
9. Breast cancer.
10. Cholelithiasis.
11. Thrombosis of the veins of the lower extremities.
12. Unexpected heavy bleeding.
13. Hemorrhagic purpura.
14. Skin and subcutaneous inflammatory processes.

But these are all the worst side effects that are rarely encountered in medical practice. An overdose of Ovestin produces adverse effects such as nausea, vomiting and vaginal bleeding. Treatment in these cases is symptomatic.

Suppositories can cause local itching and irritation of intimate organs. Some women complain of breast engorgement.

Similar phenomena are usually observed in the first days of using Ovestin. Subsequently, if the dosage has not been exceeded, the discomfort disappears without medical intervention.

Ovestin's analogues

On the pharmacy display case you can see many medications containing the hormone estriol. If, due to contraindications and price, Ovestin does not suit the consumer, he can choose a suitable remedy from analogues.

How to replace Ovestin candles:

• Ovipol Clio. The hormonal drug selectively affects the internal genital organs, bladder and urethra. Suppositories prevent inflammatory processes in the genitals and restore the epithelium. One package costs about 600 rubles. There are 15 suppositories there.
• Estrocad, a German-made drug, is prescribed to menopausal women for replacement therapy and protection of the genital tract in the pre- and postoperative period. The price of the drug starts from 700 rubles.
• Estrovagin. The suppositories have a pharmacology similar to Ovestin, but cost no more than 700 rubles.
• Estriol - intravaginal suppositories are sold for 1100 - 1300 rubles. Package contains 30 pcs.

As for Ovestin vaginal cream, it is easier for patients to find cheaper analogues. By agreement with your doctor, the expensive drug can be replaced with the Finnish gel Divigel.

The medication, packaged in sachets, enhances libido, moisturizes the vagina and increases the amount of cervical discharge. Cost – 450 – 500 rubles.

Elvagin can be bought for 500 rubles. An Indian-made cream effectively treats vaginal atrophy. There are no Elvagin tablets, but vaginal suppositories are available on sale.

Studying information about the drug Ovestin and reviews for menopause and various gynecological disorders that occur in women, we can come to the conclusion that the drug slows down the aging process of the genital organs.

By maintaining the vagina in normal condition, the beneficial hormone makes a woman healthy and able to be sexually active.

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In clinical practice, there have been no reports of interactions between Ovestin and other drugs. Although data are limited, interactions between Ovestin and other drugs are possible.

The following interactions have been reported with oral use of combined contraceptives, which may also apply to the use of Ovestin.

Ritonavir and nelfinavir (also strong inhibitors), on the contrary, exhibit an inducing effect when used simultaneously with steroid hormones. Herbal preparations containing St. John's wort (Hypericum perforatum) may induce estrogen metabolism.

active ingredient: estriol;

1 suppository contains 0.5 mg estriol

excipients: solid fat.

Vaginal suppositories.

The suppositories are torpedo-shaped, white.

In addition to suppositories, Ovestin is available in the form of tablets and cream. It is impossible to unambiguously assess which is better. The choice of dosage form is made by the attending physician after assessing the general condition of the patient and the available indications for use.

Ovestin tablets contain lactose monohydrate, so they should not be taken by women suffering from diabetes. The daily dosage of the drug will be 4-8 mg.

For symptoms of menopause, as well as for vaginal atrophy, the course of treatment with tablets will be 30 days.

Before surgery, the drug is taken for 2 weeks.

As for Ovestin Cream, the standard regimen involves administering one dose once a day, before bedtime.

There are such analogues of the drug Ovestin in the form of suppositories:

• Estrovagin;
• Ovipol Clio;
• Estrocad;
• Sinestrol;
• Klymen;
• Tephastrol.

The price of the original drug Ovestin depends on its release form.

In pharmacies in St. Petersburg, suppositories can be purchased for 1,100 rubles (quantity - 15 pieces).

The cost of the cream (15 g) is about 1370 rubles.

The price of tablets (30 pieces per package) is about 1200 rubles.

In clinical practice, no interaction has been observed between the drug Ovestin® and other drugs.

Ritonavir and nelfinavir exhibit inducing properties when used in combination with steroid hormones.

Herbal preparations containing St. John's wort (Hypericum perforatum) may induce estrogen metabolism.

Increased metabolism of estrogens may lead to a decrease in their clinical effect.

Estriol enhances the effect of lipid-lowering drugs.

Weakens the effects of male sex hormones, anticoagulants, antidepressants, diuretics, antihypertensives, hypoglycemic agents.

General anesthesia, opioid analgesics, anxiolytics, some antihypertensive drugs, and ethanol reduce the effectiveness of the drug.

Folic acid and thyroid medications enhance the effects of estriol.

It is administered the night before bedtime using a special applicator. It is filled to the special mark. The dose corresponds to 1 tablet, suppository. Includes 500 mcg estriol.

• When treating atrophy of the mucous membranes of the bladder and vagina, the product is applied daily for about 4 weeks. After the unpleasant symptoms decrease, reduce the dosage to once every 2 weeks.
• Before surgery, the product is used daily for 2 weeks. After surgery - twice a week.

Instructions for using the cream:

1. Remove the cap and use the sharp end to open the protective film of the tube;
2. The applicator is put on the tube, pressed on it until it is filled to the specified value;
3. Close the tube;
4. Place the product in the vagina in a lying position;
5. The applicator is inserted as deep as possible, pressing the piston to the base.

After use, wash the applicator in warm water and soap and rinse well. Do not boil it or place it in too hot water.

Instructions for candles

If a patient is prescribed Ovestin during treatment, the instructions for use of the drug must be strictly followed.

The drug can be used as a cream, tablets, suppositories, and at the same time, regardless of the method of administration, it remains equally effective. When using any form of the drug, be it ointment tablets or suppositories, it is taken once a day.

Instructions for using Ovestin in the form of a cream suggest that the product is administered before bedtime using a special applicator. Initially, it is used every day; if there is a noticeable improvement in the condition, you can switch to a twice-weekly administration regimen. The duration of treatment depends on the disease.

Tablets are usually prescribed in a dose of 2-4 pieces. (4-8 mg) per day for one month, then the dose is reduced to 1-2 tablets (1-2 mg) per day. If a person has urinary incontinence, a higher dose of the drug may be prescribed.

Administration of suppositories is indicated once a day, and when symptoms gradually decrease, you can switch to administering suppositories twice a week.

Suppositories are administered once a day, and when symptoms improve, they switch to more rare administration - 2 times a week.

If preparations are being made for surgery using a transvaginal approach, one suppository is administered every day, treatment begins two weeks before surgery.

If a dose of the drug was missed, and the interval between doses was no more than 36 hours, you should take the dose that was missed and continue treatment as usual. If the interval is more than 36 hours, then taking Ovestin continues according to the scheme.

Ovestin suppositories, reviews of which confirm the positive effect of the drug, are used for atrophic changes in the vaginal mucosa.

Typically, such processes occur due to a lack of estrogen. They are accompanied by dryness, itching, pain during sexual intercourse, and discomfort in the vaginal area.

Ovestin suppositories are usually prescribed for pain during urination, urinary incontinence, and frequent urination. In addition, the drug can be used for the prevention and treatment of infertility, which is associated with the cervical factor, as well as in the presence of pathologies of the genitourinary tract.

According to the instructions for use, Ovestin tablets are taken with water, preferably at the same time of day. The daily dose should be taken in 1 dose.

1. For atrophy of the lower genitourinary tract caused by estrogen deficiency, 4-8 mg per day is prescribed for the first 4 weeks, followed by a gradual reduction in the dose in accordance with symptoms until a maintenance dose of 1-2 mg per day is achieved.
2. For pre- and postoperative treatment during vaginal surgery in the postmenopausal period - 4-8 mg per day for 2 weeks before surgery, 1-2 mg per day for 2 weeks after surgery.
3. In the treatment of menopausal disorders (hot flashes, night sweats) - 4-8 mg for a week with a gradual dose reduction. For maintenance therapy, the minimum effective dose should be used.
4. For infertility caused by the cervical factor, as a rule, 1-2 mg per day is prescribed from the 6th to the 15th day of the menstrual cycle. However, in different patients the daily dose can vary from 1 mg to 8 mg. The dose should be increased every month until the optimal effect on the cervical mucosa is achieved.

If a woman misses the next dose and the delay is no more than 12 hours, she must take the pill as soon as possible. If the delay is more than 12 hours, you should skip one dose and then take the drug at the usual time.

The suppositories should be inserted into the vagina at night before bedtime.

1. When treating atrophy of the mucous membrane of the lower genitourinary tract, 1 suppository per day is prescribed for the first weeks, followed by a gradual reduction in the dose, based on symptom relief, until a maintenance dose is reached (i.e., 1 suppository 2 times a week).
2. For diagnostic purposes, if the results of a cytological examination of the cervix are unclear, 1 suppository is prescribed every other day for a week before taking the next smear. If a dose is missed, the missed dose must be administered on the same day as soon as the patient remembers (the dose should not be administered 2 times a day). Subsequent applications are carried out in accordance with the usual dosage regimen.
3. When initiating or continuing treatment of postmenopausal symptoms, use the lowest effective dose for the shortest possible duration. In women not receiving hormone replacement therapy (HRT), or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin can be started on any day.

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Women who are switching from a cyclic regimen of HRT should begin treatment with Ovestin 1 week after discontinuation of HRT.

• For atrophy of the mucous membrane of the lower genitourinary tract, 1 suppository per day during the first weeks, followed by a gradual reduction in the dose to a maintenance dose (for example, 1 suppository 2 times a week) depending on the degree of symptom reduction.
• For pre- and postoperative treatment of postmenopausal women with vaginal surgical interventions, 1 suppository per day for 2 weeks before surgery; 1 suppository 2 times a week for 2 weeks after surgery.
• As an aid to diagnosis when obtaining an atrophic picture of a cervical smear, 1 suppository every other day for a week before taking the next smear.

If you miss the next dose of the drug, you should administer the drug immediately after the mention, unless this happens on the day of the next dose. In the latter case, the missed dose should be skipped and treatment continued according to the usual dosage regimen. Do not administer 2 doses in one day.

mode of application

Ovestin vaginal suppositories should be inserted into the vagina in the evening before bed.

When initiating or continuing treatment of menopausal symptoms, use the lowest effective dose for the shortest period (see Appropriate Precautions for Precautions).

For women who are not receiving hormone replacement therapy or who are transitioning from continuous oral combination hormonal replacement therapy, treatment with Ovestin can be started on any day.

Women who are switching from a cyclic regimen of hormone replacement therapy should begin treatment with Ovestin 1 week after completion of the cycle.

Instructions for use of Ovestin suppositories indicate that their use is recommended for such phenomena and disorders as:

• atrophy of the vaginal mucosa associated with a lack of estrogen in the body;
• frequent urge to empty the bladder;
• pain during intercourse;
• dryness and burning in the vagina;
• urinary incontinence;
• infertility caused by cervical factor.

Also, the use of these vaginal suppositories is indicated for the prevention of complications associated with surgical interventions in which access was carried out through the vagina, as well as to prevent inflammatory processes in the urogenital area.

If there are indications for the use of Ovestin suppositories, then this should be done as follows:

• administer one suppository once a day, before bedtime;
• When the severity of symptoms decreases, suppositories can be used twice a week. This usually occurs after two weeks of use;
• during the period of preparation for surgery performed through transvaginal access, one suppository is administered per day. It is recommended to start prophylactic use of Ovestin 2 weeks before the intended intervention.

Note! During the therapeutic course using Ovestin suppositories, it is not recommended to simultaneously use antiretroviral, anticonvulsant and antibacterial drugs, as well as those containing St. John's wort.

• hormone replacement therapy (HRT) for the treatment of atrophy of the mucous membrane of the lower genitourinary tract associated with estrogen deficiency;
• pre- and postoperative treatment of postmenopausal women during operations via vaginal access;
• for diagnostic purposes in case of unclear results of a cytological examination of the cervix (suspicion of a tumor process) against the background of atrophic changes.

Suppositories should be inserted into the vagina at night before bed.

When treating atrophy of the mucous membrane of the lower genitourinary tract, 1 suppository per day is prescribed for the first weeks, followed by a gradual reduction in the dose, based on symptom relief, until a maintenance dose is reached (i.e., 1 suppository 2 times a week).

For pre- and postoperative therapy of postmenopausal women, during surgical interventions via vaginal access, 1 suppository per day is prescribed for 2 weeks before surgery; 1 suppository 2 times a week for 2 weeks after surgery.

For diagnostic purposes, if the results of a cytological examination of the cervix are unclear, 1 suppository is prescribed every other day for a week before taking the next smear.

If a dose is missed, the missed dose must be administered on the same day as soon as the patient remembers (the dose should not be administered 2 times a day). Subsequent applications are carried out in accordance with the usual dosage regimen.

When initiating or continuing treatment for postmenopausal symptoms, use the lowest effective dose for the shortest possible duration.

In women not receiving HRT, or women who are switching from continuous use of an oral combination drug for HRT, treatment with Ovestin® can be started on any day.

Women who are switching from a cyclic regimen of HRT medications should begin treatment with Ovestin® 1 week after stopping HRT medications.

• known, known or suspected breast cancer;
• diagnosed or suspected estrogen-dependent tumors (for example, endometrial cancer);
• bleeding from the vagina of unknown etiology;
• untreated endometrial hyperplasia;
• the presence of venous thrombosis at present and in history;
• active or recent thromboembolic arterial disease (eg, angina, myocardial infarction);
• acute liver disease or a history of liver disease after which liver function tests have not returned to normal;
• porphyria;
• established hypersensitivity to the active substance or to any of the excipients of the drug.

Carefully

If any of the following conditions are present or have been previously noted and/or worsened during previous pregnancies or previous hormonal treatment, the patient should be under the direct supervision of a physician.

It must be taken into account that these conditions may recur or worsen during treatment with Ovestin®, especially if:

• leiomyoma (uterine fibroids) or endometriosis;
• previous thromboembolic disorders or existing risk factors for such disorders;
• risk factors for estrogen-dependent tumors, for example, 1st degree of heredity for breast cancer;
• arterial hypertension;
• benign liver tumors (for example, liver adenoma);
• diabetes mellitus with or without a vascular component;
• cholelithiasis;
• jaundice (including a history during a previous pregnancy);
• liver failure;
• migraine or severe headache;
• systemic lupus erythematosus;
• history of endometrial hyperplasia;
• epilepsy;
• asthma;
• otosclerosis;
• familial hyperlipoproteinemia;
• pancreatitis.

The drug is contraindicated in patients with acute liver disease or a history of liver disease after which liver function tests have not returned to normal.

In case of liver failure, use the drug with caution.

Estrogens can cause fluid retention, and therefore patients with impaired renal function should be closely monitored by a physician. In the terminal stage of chronic renal failure, there should be special monitoring due to a possible increase in the level of circulating active components of Ovestin.

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Among the short-acting drugs, Ovestin is distinguished. The active ingredient is estriol.

The component is considered a natural female hormone. In the endometrium it has a non-stimulating effect, in the vagina it is responsible for the regeneration of the epithelium.

Thanks to the effective action of the drug Ovestin, the normal pH environment is restored and the natural microflora is normalized.

The complex helps restore the pathological area, as well as increase local immunity.

The medicine is prescribed for infertility, urinary incontinence, as a preventive measure for complications, during an operating process with transvaginal access.

The medicine is sold at an affordable price, from 250-1370 rubles.

Russian-made analogues

Unlike the original medicine, similar versions of the drug Ovestin are cheaper. In Russia, medications containing estriol are available for sale in several options.

The selection of Russian-made medicines can be found in the table below:

Ukrainian substitutes

Unlike the original drug Ovestin, Ukrainian substitutes have a similar effect and have a medicinal effect on the development of genitourinary diseases.

They treat female organs and help cope with illness after surgery. Analogs go on sale at an average price: from 76 to 465 hryvnia.

• Folliculin
  The medicine is prescribed for insufficient ovarian function. Diseases include primary and secondary amenorrhea, infertility, and genital hypoplasia.

  The medication helps cope with postpartum weakness. Folliculin is prescribed for post-term pregnancy. The pharmacy sells the drug at a price of 76 hryvnia.

• Colpotrophin
  The medication eliminates urogenital disorders that appear after a lack of estrogen.

  The drug effectively copes with urinary incontinence, eliminates dryness and itching in the vagina. After removal of the ovaries, Colpotrophin is prescribed.

  The medicine has a healing effect on the vulva, as well as the vagina and perineum, which are damaged after childbirth.

  The drug is sold at an affordable price, it can be purchased from 220.00 to 465.80 hryvnia.

• Menostar
  The medicine serves as a prophylactic agent during postmenopausal osteoporosis in women, but taking into account that at least 5 years have passed since menopause occurred. The price of the drug is 120 hryvnia.

Other foreign analogues

In addition to the listed funds, there are foreign analogues of the drug Ovestin.

Modern pharmacology has presented similar medications that do not have inferior properties and are no different from Soviet manufacturers.

Similar preparations of the main remedy Ovestin contain the same substances that have an effective effect as the original product. The page presents the cheapest medicines that are available at pharmacy kiosks.

External data does not change; the country of origin tries to preserve the composition and affiliation of analogues.

The manufacturer sets the final price, so the drugs are not expensive. When choosing a medication, you need to pay attention to the side effects that are included in each medication instructions.

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