7.2 Treatment of vaginal and vulval conditions

7.2. Treatment of vaginal and vulval conditions

7.2.1 Preparations for vaginal atrophy

Refer also to HRT section 6.4.1.1.

Topical Hormone Replacement Therapy

Topical oestrogen may be used alone in the short term in the minimum effective amount.

Long term use may require oral progestogen for 10 - 14 days each month.

First Line

GREEN Ovestin® (estriol) vaginal cream 0.1%

Second Line

GREEN Vagirux (estradiol hemihydrate) vaginal tablets m/r 10 microgram [link to SPC]

[May be used in women with or without an intact uterus]

GREEN Estring ®7.5micrograms/24 hours - estradiol releasing vaginal ring

7.2.2 Vaginal and vulval infections

Fungal infections

Vaginal candidiasis should be treated primarily with pessaries or cream inserted high into the vagina. Cream may also be

needed for vulvitis and other sites of infection.

GREEN Clotrimazole, cream 1% , vaginal cream 10%, vaginal tablet 500mg

Other infections

GREEN Clindamycin vaginal cream 2%

GREEN Metronidazole 0.75% vaginal gel

AMBER Nystatin pessary 100000 units [Unlicensed. Only to be used upon recommendation by dermatology, gynaecology or

microbiology]

RED Boric acid 600mg capsule [Unlicensed, for use by dermatology]

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