Gina vaginal estrogen available over the counter: what you need to know

Postmenopausal women are now able to buy vaginal estrogen over the counter for the first time in the UK.

The Medicines and Healthcare products Regulatory Agency (MHRA) said the decision to make Gina vaginal tablets available without a prescription was a ‘landmark’ change that would increase access for menopausal women.

Here’s what you need to know.

How can women access Gina?

Only postmenopausal women aged 50 years and above and who have not had a period for at least a year will be able to buy the medication.

While the MHRA stresses the risk of side-effects are very low, some women will still require a prescription of this preparation. This includes those who have had breast, endometrial or ovarian cancer, blood clots, heart disease, liver disease or stroke.

Pharmacists will use a checklist of questions to ensure that Gina is suitable for their customer.

This includes asking about their symptoms to establish a woman has vaginal atrophy, and does not have symptoms that could indicate other conditions that may require investigation.

This will include questions to identify if women may have a candida fungal infection of the vagina, which can be worsened by vaginal estrogen. Women who have a vaginal infection should not start treatment with Gina until the infection has been addressed.

Pharmacists will ask also about any medication women are taking.

Women with a history of endometriosis will be able to purchase Gina if they have previously had a prescription for vaginal estrogen and have had no recent symptoms of endometriosis.

Women already taking systemic HRT can only buy Gina if they have previously had similar vaginal estrogen or their GP has confirmed that Gina is a suitable option for them.

How much will it cost?

A 24-pack of Gina tablets costs £30, according to the manufacturer Novo Nordisk.

Women are recommended to start with one tablet a day for two weeks, before moving to a maintenance dose of one tablet twice a week.

This means the first pack will last for seven weeks, with the initial more frequent application.

Once on the maintenance dose of twice a week, the pack will last for 12 weeks, costing around £2.50 a week, Novo Nordisk says.

Where is Gina available to purchase for eligible women?

Gina became available on September 8 in 600 Boots stores and online. It is then going to be rolled out to other pharmacies in the coming weeks, according to Novo Nordisk.

What about other types of vaginal estrogen?

Low-dose vaginal estradiol has been widely used for the treatment of postmenopausal vaginal symptoms since 1991 and has a well-established safety profile, according to the MHRA.

But currently only Gina can be brought over the counter at the moment, following the MHRAs announcement.

Other vaginal preparations that also contain estradiol, including Vagifem 10 microgram vaginal tablets and vaginal creams, will still be available on prescription.

Systemic HRT medicines remain prescription only. This change currently only applies to Gina.

Find out more

MHRA announcement about the reclassification of Gina

Public assessment report from MHRA on the reclassification of Gina

Pharmacist checklist of questions to assess suitability of Gina for women