“Ovestin” suppositories: instructions for use in gynecology, indications, composition, analogues, reviews

• June 17, 2019
• obstetrics and gynecology
• Popova Natalya

Women's health is a rather fragile system. Malfunctions in its functioning can be caused by a variety of reasons. Both external, practically independent of the woman herself, and internal, for example, special periods of the body’s hormonal levels. Special medications help solve such problems. One of these medicines is Ovestin suppositories.

Compound

Ovestin tablets contain the active ingredient estriol , as well as auxiliary ingredients: amylopectin , potato starch , lactose monohydrate , magnesium povidone , stearate , silicon dioxide .
Ovestin suppositories contain the active ingredient estriol , as well as Witepsol S 58 as an additional ingredient.

Ovestin cream contains estriol , as well as a number of additional ingredients: cetyl palmitate , octyldodecanol , cetyl alcohol , glycerin , polysorbate , stearyl alcohol , sorbitan stearate , chlorhexidine hydrochloride , lactic acid , sodium hydroxide , water .

Release form and composition of the ointment

The drug Ovestin is available in several dosage forms. This:

• vaginal ointment (15 g tube complete with applicator);
• suppositories;
• pills.

The main active component of the ointment and other dosage forms of the drug is the hormone estriol. The dosage of the hormone in the cream is 1 mg per 1 g of product. As excipients, Ovestin ointment contains:

1. chlorhexidine hydrochloride;
2. lactic acid;
3. cetyl palmitate;
4. polysorbate;
5. octyldodecanol;
6. stearyl and cetyl alcohols;
7. glycerol;
8. sodium hydroxide;
9. purified water.

Attention! The drug is available in the form of a cream, however, experts often indicate Ovestin ointment in medical prescriptions. It is important to understand that in this case, cream and ointment are the same thing.

pharmachologic effect

The product contains the natural female hormone estriol . This is the so-called short-acting hormone. Consequently, it does not provide stimulation of proliferative processes in the endometrium . The product accelerates the process of restoring the epithelium of the vaginal mucosa, as well as optimizing the pH environment and restoring the natural microflora of the vagina. immunity increases , and an obstacle to the development of pathological flora appears.

How does the active ingredient work?

Often, pathological symptoms of disorders of the vaginal epithelium become signs of very serious diseases, even oncology. Therefore, any treatment should be recommended by a specialist after a thorough, comprehensive examination of the woman’s health. A lack of estrogen hormones can also cause certain sexual health problems. In these cases, the doctor may recommend using Ovestin suppositories in therapy. For women, the hormone estriol contained in this drug is a natural biological substance produced by the ovaries and adrenal cortex. Getting on the mucous membranes of the vagina when a suppository is introduced into the vaginal cavity, estriol is released and promotes the restoration of epithelial cells, normalizes acidity and microflora, and the mucous membrane is restored. Moreover, this type of hormone has a short-term effect, which cannot cause withdrawal bleeding or uncontrolled growth of the endometrium. As reviews from both doctors and patients say about the drug “Ovestin” (suppositories), the use of this medication in therapy helps reduce vaginal dryness, itching and genitourinary infections.

Pharmacodynamics and pharmacokinetics

The drug can be used in the presence of pathological symptoms that appear due to a lack of estrogen in the body. The drug is particularly effective in the treatment of urogenital disorders.

atrophic changes in the vaginal mucosa occur

As a result, under the influence of the drug, the level of resistance of vaginal tissue to inflammatory processes and infections increases. Women note that after taking the product, the manifestation of dryness and itching , dyspareunia , genitourinary tract infections decreases, and complaints associated with urinary incontinence .

When the drug is administered intravaginally, optimal bioavailability of the active substance is ensured at the site of its action. Estriol enters the general circulation system through absorption. of unconjugated estriol in the blood plasma increases significantly . The highest level of concentration of the substance in the blood plasma is observed 1–2 hours after its administration. Approximately 90% of estriol is bound to albumin in blood plasma.

Since estriol is an end product of metabolism , it is mainly excreted in the urine in conjugated form. Only a small part of the drug (about 2%) is excreted from the body with feces, mainly in unconjugated form.

What works in the drug?

To solve women's health problems, hormonal drugs containing special substances are often used. So the Ovestin vaginal suppositories contain just such an active ingredient - estriol. This hormone is a minor one in the group of steroidal female sex hormones estrogen, which also includes estradiol and estrone. It is produced by the follicular apparatus of the ovaries, as well as the adrenal cortex. This hormone is produced in minimal quantities by the testicles of men. Of all three natural estrogens produced by the human body, estriol has the shortest half-life. It also has the least biological activity. But this hormone binds to estrogen receptors best in the uterus, vagina, bladder and urethra.

Estriol is an important hormone for the growth and development of the uterus; it is not without reason that it is called the main hormone of pregnancy. It is noteworthy that it is during gestation that the amount of estriol found in a woman’s blood and produced by the placenta is greatest. The significance of this, albeit minor, hormone for pregnancy is enormous - it helps normalize blood flow by reducing the resistance of the walls of blood vessels, and is involved in the development of the ducts of the mammary glands for the normal discharge of colostrum and milk during lactation. An examination of a pregnant woman necessarily includes an analysis for free estriol, which allows the specialist to draw conclusions about the health of the unborn child. Therefore, one of the drugs that a specialist can recommend to a woman for certain indications is Ovestin (suppositories). The composition of this drug will be discussed below.

Indications for use

Indications for the use of Ovestin suppositories, as well as tablets and cream are as follows:

• treatment of atrophic colpitis ;
• age-related changes in the vaginal mucosa of an atrophic nature, which arise due to estrogen deficiency;
• frequent urination , painful sensations when urinating;
• urinary incontinence;
• infertility , which is associated with the cervical factor;
• for diagnostic purposes if the cytology smear results are unclear;
• preventive measures to prevent inflammation of the urogenital area;
• preventive measures to prevent complications after operations with access through the vagina.

How to buy and store medicine?

Hormonal drugs are assistants in the treatment of many diseases. Although these substances have been studied quite well, they still have many secrets. Therefore, if a doctor prescribes treatment with such drugs, it is necessary to strictly follow both the specialist’s prescription and the instructions for use. Ovestin suppositories for women are a frequently recommended hormonal drug that helps in the treatment of a wide range of problems. You can purchase it in the pharmacy chain with a doctor's prescription. The cost of a package of 15 suppositories of 0.5 mg each is about 1300-1500 rubles and depends on the region where the medicine is delivered. This drug should be stored in a cool place, away from exposing the packaging to sunlight and heat sources. After the expiration date, which is 36 months from the production date indicated on the blister, suppositories should be disposed of as household waste, because they cannot be used in therapy.

The drug with estriol "Ovestin" is one of the line of hormonal drugs of the same name. Only the attending physician can prescribe it for certain medical indications.

Contraindications

Contraindications for suppositories, tablets, and Ovestin cream are as follows:

• intolerance to the components of the product;
• pregnancy period;
• breast cancer , suspicion of developing cancer or a history of breast cancer;
• estrogen-dependent malignant tumor;
• bleeding from the vagina of unknown etiology;
• history of venous or arterial thromboembolism
• porphyria;
• acute liver disease or changes in liver tests.

Features of treatment with candles

Candles or suppositories are widely used in medicine due to a number of advantages:

• A fairly fast way to deliver drugs into the systemic circulation and they reach the target organ without significant changes. For example, when taking tablets, 100% of the substance passes through the liver, and when administering a suppository, up to 20%.
• In some cases, they can replace intramuscular injections, due to the almost identical absorption rate of the substances.
• Fewer allergic reactions.
• Due to the fact that there is no need to taste the medicine or smell it, it does not cause vomiting or nausea, and various physical and chemical combinations of substances that are undesirable for tablets (in terms of taste) can be used.
• The use of suppositories in the treatment of children and mental patients is more comfortable and convenient, because no one needs to be forced to swallow anything.

Suppositories at room temperature should retain a solid consistency, but as soon as they enter the body, the process of melting should begin at normal body temperature (36.6).

The disadvantages of suppositories are minor - they must be administered lying down and after the procedure is completed, you must remain in this position for at least 30 minutes . In addition, some substances can cause irritation of the rectal mucosa - this also limits their use.

Side effects

Medicine in the form of suppositories may cause itching or local irritation. There may be tenderness or tightness in the mammary glands. Such side effects, as a rule, are observed in the first days of using the drug, but sometimes their development indicates that too high a dose of the drug has been prescribed.

The manifestation of acyclic bleeding, metrorrhagia , and breakthrough bleeding was also noted.

The annotation for the drug notes that other side effects may develop during treatment with Ovestin. Such manifestations have been reported with estrogen-progestogen , but there is not enough data on whether Ovestin is different in this regard.

We are talking about benign and malignant estrogen-dependent tumors, thrombosis , heart attacks and myocardial infarction , gallbladder diseases, skin and subcutaneous inflammatory processes, dementia .

Hygiene rules

Parents must provide proper hygienic care for the girl’s genitals, namely:

1. Carry out washing twice a day (morning and evening). It is necessary to carry out this procedure after defecation.
2. Do not use soap very often to wash children.
3. Use ointments and creams only after prescription by a pediatric gynecologist.
4. Avoid using antiseptics.
5. Buy your child underwear made exclusively from cotton and change it daily.
6. After each diaper change, allow the skin to “breathe.”
7. Use soap without any additives for washing.

In some cases, you cannot do without using cream. The use of Ovestin for synechiae in girls is quite effective. Although it contains hormonal components, it effectively fights fusion of the labia minora. Parents who have used this drug talk about the ease of use and quick results during treatment.

Instructions for use of Ovestin (Method and dosage)

If a patient is prescribed Ovestin during treatment, the instructions for use of the drug must be strictly followed.

The drug can be used as a cream, tablets, suppositories, and at the same time, regardless of the method of administration, it remains equally effective. When using any form of the drug, be it ointment tablets or suppositories, it is taken once a day.

Instructions for using Ovestin in the form of a cream suggest that the product is administered before bedtime using a special applicator. Initially, it is used every day; if there is a noticeable improvement in the condition, you can switch to a twice-weekly administration regimen. The duration of treatment depends on the disease.

Tablets are usually prescribed in a dose of 2-4 pieces. (4-8 mg) per day for one month, then the dose is reduced to 1-2 tablets (1-2 mg) per day. If a person has urinary incontinence, a higher dose of the drug may be prescribed.

Administration of suppositories is indicated once a day, and when symptoms gradually decrease, you can switch to administering suppositories twice a week.

Suppositories are administered once a day, and when symptoms improve, they switch to more rare administration - 2 times a week.

If preparations are being made for surgery using a transvaginal approach, one suppository is administered every day, treatment begins two weeks before surgery. Further, after the manipulations, two more suppositories are administered per week for 14 days. Ovestin cream is used according to the same scheme.

If a dose of the drug was missed, and the interval between doses was no more than 36 hours, you should take the dose that was missed and continue treatment as usual. If the interval is more than 36 hours, then taking Ovestin continues according to the scheme.

Caution won't hurt

The instructions for use will tell you all the necessary information about such a drug as Ovestin suppositories. In gynecology, this drug is used to treat many diseases or pathological conditions of the female genitourinary system. Despite the fact that estriol is a female sex hormone, the use of this medication should only be recommended by a specialist who monitors the woman’s health. If a patient is prescribed therapy with a drug containing estriol according to indications, then special attention must be paid to problems such as the presence or predisposition to thromboembolic problems and severe renal dysfunction. You also need to be careful about potential porphyria, because a woman may not even be aware of such a hereditary disease that occurs latently. It is not advisable to prescribe Ovestin suppositories for herpes and otosclerosis.

Interaction

No adverse interactions with other drugs were noted.

However, it should be borne in mind that the pharmacological properties of Ovestin may determine the interaction with anticonvulsants and antiretroviral drugs, antibiotics , as well as with drugs that contain St. John's wort .

There is evidence that estriol can enhance the effect of a number of corticosteroids and theophylline .

Experts' opinion

Hormonal drugs for the treatment of gynecological problems are a popular group of drugs. The medicine “Ovestin” (suppositories) belongs to them. These suppositories receive reviews from experts mainly as recommendations. Practitioners note the effectiveness of the drug with estriol in solving certain problems. The medicine contains the hormone in a minimum therapeutic dosage, which makes it both effective and as safe as possible. Observing patients undergoing treatment with this drug, a very rare development of undesirable effects is noted; only some women complain of headaches and nausea during treatment with Ovestin suppositories. Bleeding is an even rarer side effect of the drug. Experts strongly recommend using this medication only on recommendation after a thorough examination. Compliance with the dosage and regimen of suppositories is the key to successful treatment of established problems of the female genitourinary system.

special instructions

You cannot carry out therapy with high doses of the drug for a long time (no more than a few weeks).

If long-term treatment is necessary, regular examinations of the mammary glands and examinations by a gynecologist, and careful monitoring of the coagulogram .

In the treatment of postmenopausal symptoms, hormone replacement therapy is practiced only in the presence of severe symptoms that impair quality of life.

A woman should be aware of exactly what changes in the mammary glands that appear during treatment that need to be reported to the doctor.

If factors appear that are a contraindication to treatment, or other negative changes in health status, it is necessary to stop treatment with the drug.

Because estrogen can cause fluid retention in the body, the health of people with heart failure and kidney disease should be carefully monitored.

Dosage

Pills

Taken orally at the same time of day. Maximum daily dose: 8 mg.

• Atrophy of the mucous membranes of the vagina and lower parts of the genitourinary tract due to estrogen deficiency: 4-8 mg/day. 1 month, then switch to a maintenance dose of 1-2 mg/day.
• Before and after operations with vaginal access (prevention of complications): 4-8 mg/day. 14 days before surgery, 1-2 mg/day. 14 days after the intervention.
• Menopausal manifestations: 4-8 mg/day. 7 days, then switch to the minimum maintenance dose (determined individually).
• Infertility due to cervical factor: 1-2 mg/day, taken from days 6 to 15 of the cycle. In some cases, the dose can be reduced to 1 mg or increased to 8 mg/day. The dose is increased gradually with each cycle until the maximum effect is achieved (the dynamics of the condition of the cervical canal are observed).
• Other cases: 4-8 mg/day. The duration is determined individually.

Application of Ovestin cream

The cream is injected into the vagina at night (immediately before bedtime), using a calibrated applicator. One application (with the applicator filled to the ring mark) is equal to 500 mg of cream, which is equivalent to a dose of 500 mcg of estriol.

How to administer the cream: remove the cap from the tube and open the tube with the back of it. Screw the applicator onto the tube and squeeze it until the cream fills the applicator (until the piston stops). Unscrew the applicator and close the tube with cream. Lie in a horizontal position, insert the end of the applicator deep into the vagina and slowly press the plunger until all the cream comes out.

After insertion, the applicator is removed and its parts are washed with warm soapy water, then washed for a long time with clean running water. It is unacceptable to use boiling water or very hot water for these purposes.

• Atrophy of the mucous membrane of the genitourinary tract: 1 application per day. for 1 month, then a gradual reduction in the dose down to the maintenance dose, which is 1 application 2 r. in 7 days.
• In pre- and postoperative therapy with access through the vagina, 1 application is administered daily 2 weeks before the intervention, and 1 application 2 times every 7 days for 2 weeks.
• For diagnostic purposes - 1 application every 1 day for 7 days.

Candles

Suppositories are inserted into the vagina at night (immediately before bedtime).

• Treatment of atrophy of the mucous membranes of the genitourinary tract: 1 suppository/day for 4 weeks, then gradually switch to a maintenance dose - 1 suppository twice a week.
• In the pre- and postoperative period with vaginal access: 1 suppository/day. 2 weeks before the intervention and 1 suppository per week for another 2 weeks after the operation.
• For diagnosis: 1 suppository every 1 day for 7 days before the smear.

Features of treatment

If an administration/dose of the drug was missed and no more than 12 hours have passed since the omission, it should be administered/taken immediately on the day as soon as the patient remembers the omission. If the missed dose was more than 12 hours, you should wait for the next dose, i.e. skip treatment on this day. Next, treatment is carried out according to the previously chosen scheme.

Women who are not receiving hormone replacement therapy or patients who are switching from treatment with an oral combined hormonal drug to Ovestin should begin using Ovestin on any day.

Patients who are transferred from cyclic treatment with drugs for replacement therapy begin using Ovestin 1 week after stopping the previous drugs.

Ovestin's analogues

Level 4 ATC code matches:
Synestrol

Klimara

Colpotrophin

Folliculin

Proginova

Estrofem

Estrogel

Estriol

Divigel

Microfollin

Analogs of Ovestin in Russia are the drugs Dimestrol , Hormoplex , Microfollin-forte , Tefestrol . They also contain estriol . However, the patient should not be interested in the price of analogs, but in the effectiveness of their effect on the body. Therefore, you should definitely consult your doctor about what you can replace Ovestin with.

Classification of candles

Suppositories are classified in various ways. According to the method of administration into the body, they are distinguished:

• Rectal - rectal suppositories are used by inserting them into the anus, the medicine goes directly into the rectum. Rectal suppositories in the shape of a cone or cylinder are used; any shape must have a pointed end and a thickening in the middle with a maximum diameter of 1.5 cm. On average, the weight of 1 suppository is 3 g.
• Vaginal - inserted into the vagina. Vaginal suppositories are made in the form of balls, “eggs,” or flat tubes with a round top (pessaries). Approximate weight: 4 g.
• Sticks - they are inserted into the cervical canal, the auditory canal of the auricle, and more.

According to their therapeutic effects, they are distinguished:

• Suppositories that have an analgesic effect are made on the basis of paracetamol, analgin or acelysin.
• Anti-inflammatory suppositories contain drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs): diclofenac, indomethacin and others. Used to relieve very serious pain and relieve acute inflammation.
• Gynecological suppositories - used in the treatment of gynecological diseases. They have antifungal, anti-infective, antiviral, antibacterial, and contraceptive properties. They may contain hormones (Ovestin).
• Stimulating immunity.
• Using natural ingredients (bee jelly, herbal ingredients).
• Separately, there are suppositories for constipation, hemorrhoids, dysbacteriosis, and muscle spasms.

Reviews about Ovestin

Reviews about Ovestin candles that women leave when visiting the thematic forum are mostly positive. There is a positive effect of the product as a supporting agent during menopause. Patients also leave reviews of Ovestin cream and tablets, noting that these drugs can reduce the intensity of unpleasant symptoms of menopause and help treat a number of diseases. It is also noted that the ointment is easy to use. Reviews from doctors indicate that treatment with Ovestin is predominantly effective.

Less common are reviews of how the cream was used for children. Parents note that Ovestin should be used strictly according to doctor’s recommendations for treating children. Sometimes women report a burning sensation when using suppositories at first. However, this side effect quickly disappears.

What do patients say about the medicine?

The hormonal drug "Ovestin" (suppositories) mostly receives only grateful reviews from women. It effectively copes with its tasks and is well tolerated, because only a few women report side effects. Many note the convenience of its use - once a day. This allows you to comply with the therapy regimen without missing the next dose of the drug. Many women who have entered the period of hormonal decline in the body thank the drug for its support, because it normalizes the condition of the vaginal epithelium and microflora, which allows normalizing the intimate sphere of life. A negative point for many of those who were recommended this hormonal drug for the treatment of certain diseases or conditions of the female genitourinary system is its rather high cost: for a package of suppositories you need to pay more than 1,000 rubles.

Ovestin price, where to buy

You can buy Ovestin tablets at a price of 800-900 rubles for 30 pcs. The average price of Ovestin candles is 1000 – 1100 rubles. The price of Ovestin cream 15 g is 1100-1300 rubles.

In Ukraine, the price of Ovestin ointment is 260-270 hryvnia.

• Online pharmacies in RussiaRussia
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Ovestin suppositories vaginal.
  0.5 mg 15 pcs. Uniter Industries/N.V. Organon RUB 1,171 order
• Ovestin cream vaginal. 15gAspen Bad Oldesloe GmbH

  RUB 1,357 order

• Ovestin tablets 2 mg 30 pcs. Syndea Pharma SL

  RUB 1,202 order

Pharmacy Dialogue

• Ovestin (suppositories No. 15)Organon

  RUB 1,226 order

• Ovestin cream tube 15gOrganon

  1210 rub. order

• Ovestin tablets 2 mg No. 30Organon

  RUB 1,181 order

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Svechi used for endometriosis

The appearance of foci of endometriosis is indicated by heavy menstrual flow, the appearance of brown spotting before the onset of menstruation, and pain during sexual intercourse. If, after diagnosis, the symptoms of endometriosis are confirmed, then a course of treatment is prescribed by the attending physician.

Suppositories for endometriosis are relevant for milder cases of the disease and are a more gentle therapy.

A ntikan-T

Antikan-T are homeopathic suppositories used to treat endometriosis and other gynecological diseases; they contain only natural ingredients: sea buckthorn, thuja, tea tree oil and other plant extracts. For endometriosis, the drug is prescribed in courses of -30 x 30 (break) x 30. Antikan-T has few contraindications and does not cause any side effects, but it cannot be the main treatment for endometriosis; it is usually prescribed together with other more “serious” » drugs.

From the evening with propolis and sea buckthorn

You can prepare sea buckthorn suppositories based on propolis yourself, but it is better to purchase them at a pharmacy. Today, the pharmaceutical industry offers a wide selection of suppositories with these ingredients - “Fitoleum Kyzyl May”, “Monfarm”, “Propolis - D” and others. Wax and cocoa butter are used to bind the main components.