9 September 2026
Updated dosing of vaginal oestrogens for prophylaxis of recurrent urinary-tract infections
We have recently updated the indication and dosing information for vaginal oestrogens (estriol and estradiol) for prophylaxis of recurrent urinary-tract infections to support recommendations in NICE guideline NG112 ‘Urinary tract infection (recurrent): antimicrobial prescribing’. In both estriol and estradiol monographs, the previous indication for postmenopausal women has been widened to include patients with a female urinary tract who are perimenopausal, menopausal, and postmenopausal. We have also added unlicensed estriol doses for low dose (500 micrograms) and ultra-low dose (30 micrograms) pessaries and ultra-low dose (50 micrograms/g) vaginal gel.
To guide dosing decisions for both estriol and estradiol, our editorial team consulted with an expert from the British Menopause Society; the Joint Formulary Committee subsequently ratified these new doses. The rigorous content creation process followed by the editorial team is described here.
