Introduction
Gynest Cream is identical to a female hormone, estrogen. It is used to treat symptoms associated with menopause. This topical preparation helps to treat vaginal burning, dryness and itching caused due to lack of estrogen. You should use Gynest Cream in the way your doctor advises. It may depend on whether you have had any kind of HRT before. Even if your symptoms improve, you should continue the treatment as it has been prescribed. When you start using this medicine you may experience irritation or itching. This usually goes away if you continue using it. You may also get pain in your abdomen, a genital rash, headache and vaginal thrush (candidiasis). Tell your doctor if you experience bleeding in your vagina. Your doctor may give you an alternative medicine. Before using this medicine you should tell your doctor if you have unexplained vaginal bleeding or if you have ever had a blood clot in your legs or your lungs. Once you have started using this medicine you should have regular check-ups to discuss the benefits of your treatment. It should not interact with any other medicines. It is not usually recommended during pregnancy or breastfeeding.
Side effects of Gynest Cream
How to use Gynest Cream
This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and apply the cream by using applicator. Wash your hands after applying.
How Gynest Cream works
Gynest Cream contains oestrogen (female sex hormone). It works by delivering estrogens directly into the vagina to relieve vaginal symptoms of menopause such as dryness, burning, irritation, and painful sexual intercourse.
Indication
Infertility due to cervical hostility, Menopausal atrophic vaginitis, Menopausal hormone replacement therapy, Dyspareunia, Dryness and itching of vagina due to Oestrogen deficiency, Prevention of recurrent infections of the vagina and lower urinary tract, Micturition complaints (such as frequency and dysuria), Urinary incontinence. Pre- and postoperative therapy in postmenopausal women undergoing vaginal surgery, Climacteric complaints such as hot flushes and night sweating, a diagnostic aid in case of a doubtful atrophic cervical smear.
Administration
Tablet: May be taken with or without food.
Adult Dose
Oral Menopausal hormone replacement therapy Adult: 0.5-3 mg daily for 1 mth followed by 0.5-1 mg daily; or 0.25-2 mg daily in combination with other natural oestrogens. A progestogen is required if administered to women with a uterus. Infertility due to cervical hostility Adult: 0.25-1 mg/day on days 6-15 of the menstrual cycle. Increase dose each mth until an optimal effect is obtained. Vaginal Menopausal atrophic vaginitis Adult: As cream: Apply 500 mcg once daily, reduce to twice wkly subsequently.
Contraindication
• Pregnancy • Known, past or suspected breast cancer • Known or suspected oestrogen-dependent malignant tumours (e.g. endometrial cancer) • Undiagnosed genital bleeding • Untreated endometrial hyperplasia • Previous idiopathic or current venous thromboembolism (deep venous thrombosis, pulmonary embolism) • Active or recent arterial thromboembolic disease (e.g. angina, myocardial infarction) • Acute liver disease, or a history of liver disease as long as liver function tests failed to return to normal
Mode of Action
Estriol is a naturally occurring oestrogen. It induces normalization of vag epithelium. It is claimed to have only a mild proliferative effect on the endometrium. It only has a short retention time in the nuclei of endometrial cells.
Precaution
In order to prevent endometrial stimulation, the daily dose should not exceed 8 mg nor should this maximum dose be used for longer than several weeks. As for all hormone replacement therapies, yearly medical examination is advisable. With vaginal infections, a concomitant specific treatment is recommended. Patients with any of the following conditions should be monitored; thrombosis, severe liver disorders; porphyria; a history during pregnancy or previous use of steroids of severe pruritus, cholestatic jaundice, herpes gestationis, or otosclerosis.
Side Effect
Breast tension or pain, nausea, spotting. Fluid retention, cervical hypersecretion.
Interaction
Reduced efficacy may occur when used with activated charcoal, barbiturates, carbamazepine, griseofulvin, hydantoin and rifampicin. May possibly change efficacy of oral anticoagulants and increase pharmacologic effects of succinylcholine, theophyllines and troleandromycin.