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Incontinence - urinary, in women - Management
Intravaginal oestrogens (postmenopausal women)

Age from 40 years onwards
Estriol 0.1% cream (500mcg estriol per application)
Ovestin 0.1% cream
Insert one applicatorful into the vagina each evening until improvement occurs. Then reduce to one applicatorful twice a week.
Supply 15 grams.
Age: from 40 years onwards
NHS cost: £4.63
Licensed use: yes
Patient information: This product may damage latex condoms and diaphragms.
Estriol 500microgram pessaries
Ortho-Gynest 500microgram pessaries
Insert one pessary into the vagina each evening, until improvement occurs. Then reduce to one pessary twice a week.
Supply 30 pessaries.
Age: from 40 years onwards
NHS cost: £9.84
Licensed use: yes
Patient information: This product damages latex condoms and diaphragms.
Estradiol 25microgram m/r pessaries
Vagifem 25microgram vaginal tablets
Insert one pessary into the vagina each evening for 2 weeks, then reduce to one pessary twice a week.
Supply 30 pessaries.
Age: from 40 years onwards
NHS cost: £17.60
Licensed use: yes
Estradiol 2mg vaginal ring (7.5mcg estradiol/24 hours)
Estring 2mg vaginal ring
Insert one ring high into the vagina and wear continuously for 3 months.
Supply 1 vaginal ring.
Age: from 40 years onwards
NHS cost: £31.42
Licensed use: yes
Patient information: This ring must be replaced every 3 months.
Conjugated oestrogens 625micrograms/gram
Conjugated oestrogens 625micrograms/g vaginal cream
Insert 1-2 grams (using the applicator) into the vagina each evening for 3 weeks. Repeat after an interval of 1 week.
Supply 42 grams.
Age: from 40 years onwards
NHS cost: £2.19
Licensed use: yes
Patient information: Start using this cream on day 5 of your cycle (or at any time if your periods have stopped). This product may damage latex condoms and diaphragms.

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