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7.2 Treatment of vaginal and vulval conditions

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      Vagifem® (estradiol) vaginal tablets m/r 25 microgram    
[For post menopausal urogential conditions, inserted every 3 months; maximum duration of use 2 years]
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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 public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service 
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