Reported reasons for stopping VVA treatments were due to symptoms becoming less bothersome (18%), the medication could not reverse the vaginal changes (18%), consolidated relief of symptoms (18%), the cost of the treatment (10%), and the assumption symptoms would subside in due course (10%).¹¹

However, consumer research shows how women on prescription VVA treatment are significantly more concerned about the long-term effects compared to over-the-counter treatments. Over a third of women using a prescription treatment are somewhat worried (28%) or very worried (8%) compared to 16% in total of women using an OTC lubricant or an OTC moisturiser.

When prescribing oestrogens, NICE says that the woman should be advised that:¹⁷

• symptoms often recur when treatment is stopped;
• adverse effects from vaginal oestrogen are “very rare”; and
• she should alert her GP if unscheduled bleeding occurs.

The European Medicines Agency has issued an advisory about high dose products limiting use of a single treatment period of 4 weeks for oestradiol creams providing 100mcg/g (0.01%). Vaginal oestrogen products in the UK are considered low dose.^18,19