ELMMB logo
Facebook logo Twitter logo

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

All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the
 public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service 
  Email: info.elmmb@nhs.net
 Copyright© 2016 - 2022 East Lancashire Medicines Management Board 
 All rights reserved.  Disclaimer/Terms and conditions