Estriol cream (Ovestin): vaginal estrogen in a tube

• What it is: estriol 1 mg per gram vaginal cream, 15 g tube with an applicator.
• Rx status: prescription only.
• Price: ₱1,009 per 15 g tube (Watsons). Prices checked October 2026.
• Used for: GSM (genitourinary syndrome of menopause): dryness, burning, itching, pain with sex, urgency.
• Used with: alone, or with systemic HRT.
• Alternative in PH: vaginal estradiol tablet (Vagifem).

How long one tube lasts depends on your schedule, so check the cost calculator for an example.

Filipinas on Reddit report using it for exactly this: one listed "Vaginal estrogen for dryness ... Ovestin but it's a prescription med" (r/kwarentahin). That is experience, not evidence, but it shows the product is known locally.

Low estrogen thins the tissue of the vagina and the opening of the urethra. These changes usually get worse over time without treatment. Vaginal estrogen restores the tissue locally.

The Irish Ovestin label lists one application a day for the first weeks (at most 4 weeks), then a gradual reduction, based on how your symptoms respond, to a maintenance dose such as one application twice a week. One applicator filled to the ring mark is 0.5 g of cream (0.5 mg estriol), used at bedtime. The Philippine leaflet may differ slightly. Your doctor sets the dose and how long.

What the guidelines say:

• The Menopause Society 2022: vaginal estrogen can be used at any age and long term.
• NICE NG23 (2024): offer vaginal estrogen, including to women on systemic HRT, and continue for as long as needed (summary).

Vaginal estrogen can also lower the chance of repeated urinary tract infections after menopause: a 2023 systematic review found it improves urinary symptoms and reduces recurrent UTIs, and the 2025 US urology guideline on GSM recommends it for this (Christmas et al., Menopause 2023). Preventing UTIs is not one of the uses printed on the label. See bladder symptoms.

Cream or tablet? The cream can be spread on the outer area too, which some women like for itching and soreness. It is messier than a tablet. Compare them on our vaginal estrogen page.

The label lists these as reasons not to use it. Check with your doctor first if you have:

• Bleeding after menopause or any unexplained vaginal bleeding.
• Known, past or suspected breast cancer, or another estrogen-dependent cancer such as womb cancer. Your oncologist should be involved.
• Untreated thickening of the womb lining (endometrial hyperplasia).
• A current or past blood clot in a leg or lung, or a known clotting disorder.
• Recent or active angina or heart attack.
• Acute liver disease, or past liver disease where liver tests have not returned to normal.
• Porphyria, or an allergy to any ingredient.

The label lists itching where the cream is applied, a burning feeling in the vagina or vulva, discharge, pain when peeing, breast discomfort and flu-like symptoms. It says these are usually short-lived, but they can also be a sign the dose is too high, so tell your doctor if they continue.

Stop and see a doctor for any bleeding or spotting, or symptoms that get worse. The label says bleeding on treatment should always be checked.

Note: the NHS warns that some estrogen creams can damage condoms and diaphragms and stop them working properly. If you rely on condoms, ask your doctor or pharmacist.

Prices checked October 2026. A tube and a tablet are priced differently, so compare monthly costs on the cost calculator using the schedule your doctor gives you.

Both are prescription only and both count as vaginal estrogen under The Menopause Society 2022 and NICE 2024 guidance. Neither is "stronger medicine" in a way that matters for most women; the right one is the one you will actually keep using.

Many Filipinas never mention dryness because it feels awkward. Your doctor has heard it before. Ask:

• Are these changes from menopause, or is something else going on?
• How much cream per dose, and how often after the first weeks?
• Can I put it on the outer area for itching?
• Can I use it with my HRT?
• Would it help my bladder symptoms or repeat UTIs?
• With my medical history, is there any reason to avoid estrogen cream?

For help starting the conversation, see talk to your doctor.

• Vaginal estradiol (Vagifem): a small tablet, less mess.
• Systemic HRT such as estradiol gel helps the whole body, but dryness can still need local treatment. See HRT for menopause.
• Non-prescription vaginal moisturisers and lubricants for comfort. They do not rebuild the tissue.

Read more on vaginal dryness, then find a doctor who will take it seriously.