Topical oestrogen (low-potency)

Estriol

Brand names: Ovestin, Blissel

A short-acting natural oestrogen used mainly as topical (vaginal) therapy for urogenital atrophy and related menopausal symptoms.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds oestrogen receptors in urogenital tissue, restoring vaginal epithelium, pH and local blood flow with comparatively weak systemic oestrogenic effect.

Prescribing in practice

Avoid in current, past or suspected breast cancer and other oestrogen-dependent malignancies, undiagnosed vaginal bleeding, and active or recent venous thromboembolism.
Investigate any unexpected or postmenopausal vaginal bleeding before continuing therapy.
Used at the lowest effective dose for the shortest duration appropriate, reviewing the need to continue periodically as per current prescribing references.

Monitoring

Review symptoms and overall HRT risk at regular intervals, and promptly assess any abnormal vaginal bleeding.

Counselling the patient

For vaginal preparations, follow the application instructions and review with your clinician periodically.
Report any unexpected vaginal bleeding.
Attend routine breast and cervical screening as recommended.

Evidence & guidelines

Use aligns with NICE menopause guidance recommending vaginal oestrogen for urogenital atrophy.

Reference: NICE NG23; British Menopause Society; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways