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. |
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First Line |
GREEN Ovestin® (estriol) vaginal cream 0.1% |
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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 |
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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. |
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GREEN Clotrimazole, cream 1% , vaginal cream 10%, vaginal tablet 500mg |
Other infections |
GREEN Clindamycin vaginal cream 2% |
GREEN Metronidazole 0.75% vaginal gel |
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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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