Keep the leaflet until you have finished your medicine. You may want to read it again.

It also contains chlorhexidine hydrochloride, eutanol G, cetyl palmitate, glycerin, cetyl alcohol, stearyl alcohol, polysorbate 60, sorbitan monostearate, lactic acid, sodium hydroxide, and purified water.

Ovestin Cream is a white cream.

There are 15 gm of cream in each tube.

The product licence is held by: Organon Laboratories Ltd, Science Park, Cambridge CB4 4FL.

Ovestin Cream is made by: Organon (Ireland) Ltd, Drynham Road, Dublin, Ireland.

It can also be used before or after vaginal surgery.

• Do you think you may be pregnant?
• Are you breast-feeding?
• Have you had a thrombosis (a blood clot)?
• Have you had tumours of the breast or other sex organs?
• Have you had unexplained vaginal bleeding?
• Have you had liver disease (such as Rotor syndrome or Dubin-Johnson syndrome) or jaundice when you were pregnant?
• Do you have porphyria (a metabolic disorder)?
• Do you have a heart or circulation disease?
• Do you have too much cholesterol or other fatty substances in the blood?
• During pregnancy or while taking steroids have you had a skin rash (herpes gestationis), severe itching or a hearing problem?

If the answer to any of these questions is YES:

• Did you tell your doctor at the last visit or an earlier visit?

• If you did NOT then you should do so as soon as possible and before using the cream.

Even so, your doctor may still want you to use it.

While you are taking Ovestin Cream regular medical checks by a doctor are recommended. Sometimes a tissue examination (cervical smear) will be necessary.

Your doctor may want you to stop using the cream from time to time to check if you still need to use it. Using oestrogens for a very long time may increase the chance of tumours of the lining of the womb very slightly.

If you are having an operation (apart from a vaginal operation) you should stop using the cream about 6 weeks before. Don't start using the cream again until you are fully mobile.

Extra supervision by your doctor may be necessary

in some cases.

Tell your doctor if you have ever had:

• a disease of the heart or circulation
• high blood pressure
• migraine headaches;

- epilepsy;

- liver disease such as jaundice;

- kidney disease;

Your doctor may want you to stop from time to time (every 2 to 3 months), to check if you still need treatment.

Before vaginal surgery the dose is 1 applicator-dose (0.5 mg oestriol in 0.5 g of cream) a day for 2 weeks before the operation. After the operation do not use the cream again for at least 2 weeks.

Keep using this medicine as prescribed by your doctor. Do not stop just because you seem to be better. If you stop too early or too suddenly your complaints may return.

One application contains 0.5 mg of oestriol.

1. Remove cap from the tube, invert it, and use the sharp point to open the tube.
2. Screw the end of the applicator onto the tube.
3. Squeeze tube to fill the applicator with the cream until the plunger stops (at the ring mark).
4. Unscrew applicator from tube and replace cap on tube.
5. To apply the cream, lie down, insert the end of the applicator deep into the vagina and slowly push plunger all the way in.

After use, pull plunger out of barrel and wash both in warm, soapy water. Do not use detergents. Rinse well afterwards.

DO NOT PUT THE APPLICATOR IN HOT OR BOILING WATER.

• These usually settle down during treatment as the body adjusts to the medicine.
• If you have any of these side effects, tell your doctor. He may decide to stop your treatment for a while.

When you start to use the cream you may have irritation or itching. Sometimes the breasts become swollen, tender or painful. Tell your doctor if vaginal bleeding occurs. Tell your doctor about any problems that you think might be caused by the cream.

Store the cream at room temperature (15-25C). Keep the cream in the original box where children cannot see or reach it.

This information was written in September 1995.

Oestrogens are produced in the ovaries. They cause sexual development in women and control the menstrual cycle during the childbearing years. When women get older the ovaries gradually produce less oestrogen. This happens at the menopause (usually around the age of 50). If the ovaries are removed surgically (ovariectomy) before the menopause, oestrogen production stops very suddenly.

Shortage of oestrogens may cause the vaginal wall to become thin and dry. So sexual intercourse may become painful and vaginal infections may occur.

These complaints can be relieved by using medicines containing oestrogen. However it may take several days or weeks before you notice an Improvement.

of the womb. So Ovestin Cream usually does not

cause vaginal bleeding.

Ovestin cream is easy to remove with water.

1. This medicine has been prescribed for your current medical problem. Do not use it for other medical problems.
2. Do not allow other people to use your medicines and do not use medicines meant for other people.
3. Tell any doctor treating you what medicines you are taking. Always carry a medical information card stating which medicines you are taking. This can also be very important in case you are involved in an accident.
4. Return unused medicines to the pharmacy for disposal.
5. Make sure that other people you may live with or who look after you read this information.