Gina HRT Tablets

Gina is a low-dose vaginal oestrogen tablet that’s used as a type of hormone replacement therapy (HRT) to help deal with symptoms of menopause.

• Gina is suitable for women who are older than 50 and have not had a period in at least 1 year.
• It’s a local vaginal HRT, which means it treats the area it has been applied on rather than circulating in your blood.
• The active ingredient in Gina is estradiol hemihydrate.

Your Gina tablets will arrive pre-loaded into an applicator, which you insert into your vagina to release the tablet. Once inserted, the tablet dissolves, releasing oestrogen directly into your vaginal tissue. This works to replace the hormones that have been reduced by menopause.

What is Gina used for?

Gina is used to treat vaginal atrophy or urogenital atrophy, which is one of the most common symptoms of menopause. Vaginal atrophy is the clinical term used to describe when your vagina is dry, sore or itchy. This can also make sex painful or uncomfortable. Vaginal atrophy tends to occur due to low oestrogen levels, which is typical during menopause, thins the tissue surrounding your vagina. Gina replaces the oestrogen you’ve lost, improving or getting rid of your symptoms.

Please note that use in women under 50 or who are not postmenopausal is an ‘off-label’ use for Gina. All medications we offer are fully licensed within the UK. Some medications, such as this, we prescribe for conditions or circumstances that are outside of the license, also known as ‘off-label’. Prescribing ‘off-label’ is common practice by healthcare professionals to ensure a medication can safely benefit as many patients as possible. This is always based on updated information and evidence since the product first became available.

Gina is a form of HRT, which means it works by replacing the hormones you naturally lose as you go through menopause. It does this by releasing additional oestrogen into your vaginal tissue, which stops you from developing uncomfortable symptoms.

How long does Gina last?

Once inserted into your Vagina, Gina tablets take around 8 hours to dissolve, but the effects of Gina continue after they have dissolved. You should continue to feel the positive impact of using Gina for as long as you continue to use it.

How long does Gina take to work?

Gina starts working immediately, but you may not feel its full effects until you’ve been taking it for at least 4-8 weeks. It’s important to remember that how long Gina takes to work can vary from person to person. Still, if you’re not noticing any benefits after 3 months of continued use, you should speak to your doctor, who may recommend a more suitable alternative treatment.

You take Gina by inserting the pre-loaded applicator into your Vagina to release a tablet. Initially, you will take 1 tablet a day for 2 weeks. After this, you will lower your dose to 1 tablet twice weekly. It’s fine to take Gina any time of the day that works for you, but you must try to take it at the same time each day.

Full instructions on how to take Gina are available in the patient information leaflet it arrives with, but if you’re still not sure how to take Gina, you should speak to your doctor.

Taking Gina:

1. Wash your hands thoroughly and make sure they’re dry
2. Take out 1 applicator
3. Position the applicator so that you can press the ‘applicator plunger’ with one finger
4. Prepare to insert the applicator by getting into a comfortable position
5. Slowly insert the applicator into your vagina
6. Press the ‘applicator plunger’ all the way in to release the tablet
7. Remove the applicator from your vagina.

• Continue taking Gina for as long as your doctor tells you to. While you can stop at any time, it may cause your symptoms to come back.
• If your symptoms come back after stopping Gina, you can start taking it again.
• If you miss a dose of Gina, take it as soon as you remember. Never take a double dose.

Gina tablets have been proven to effectively treat symptoms of menopause like vaginal dryness, itching and soreness. National guidelines recommend Gina as a low-dose vaginal oestrogen tablet if you are going through menopause and need help managing your symptoms.

Gina can cause side effects, and if you do get them, you should speak to your doctor.

Common side effects:

• Headache
• Stomach pain
• Vaginal bleeding, discharge or discomfort

Uncommon side effects:

• Fungal infections
• Rashes
• Nausea (Feeling sick)
• Weight gain
• High blood pressure
• Hot flushes

Rare side effects:

• Diarrhoea
• Worsened migraines
• Water retention
• Generalised hypersensitivity

Stop using Gina and seek medical advice if you:

• get new vaginal bleeding, spotting or itching.
• have endometriosis, and your symptoms come back.
• develop a vaginal infection.
• get yellowing skin or yellowing whites of your eyes (jaundice).
• notice your blood pressure increasing (may cause headaches, tiredness, and dizziness).
• get migraine-like headaches for the first time.
• become pregnant.

If you get side effects that could be signs of an allergic reaction to Gina, seek immediate medical attention.

Do not use Gina if you:

• are allergic to any of the ingredients in Gina
• have had any vaginal bleeding since your periods stopped
• have or have ever had womb or ovarian cancer
• have any vaginal or lower abdominal symptoms which haven’t been diagnosed properly yet
• have or have ever had a blood clot, or a clotting disorder
• have or have ever had breast cancer
• have cardiovascular disease, or have recently had a cardiovascular event (e.g. a heart attack or stroke)
• have or have ever had liver disease, and your liver function tests have not normalised
• have a blood problem called ‘porphyria’

Before starting Gina, speak to your doctor if you:

• have a history of endometriosis
• have a history of endometrial hyperplasia
• are receiving a type of HRT (including tablets or patches) that circulates in the blood
• are switching from another vaginal oestrogen HRT
• have uterine fibroids (Leiomyoma)
• have an increased risk of blood clots
• have an increased risk of womb, ovarian or breast cancer
• have high blood pressure
• have a liver disorder
• have diabetes
• have gallstones
• get migraines
• have systemic lupus erythematosus (SLE)
• have epilepsy
• have asthma
• have a disease that affects your eardrum and hearing (otosclerosis)
• have a very high level of fat in your blood
• have fluid retention from cardiac or kidney problems
• have hereditary and acquired angioedema

Gina isn’t the right treatment for everyone, which is why it’s important to make sure it’s safe for you first. We recommend Gina for women who are older than 50 and have not had a period for over 1 year.

There are many forms of HRT available that help with different symptoms. At ZAVA, we can provide:

• Estriol cream
• Elleste Duet (Conti)
• Ovestin
• Estradot
• Vagirux
• Vagifem
• Premique
• Kliovance
• Kliofem
• Ovestin
• Tibolone
• Estradot and Utrogestan sequential
• Estradot and Utrogestan continuous
• Femoston-Conti
• Evorel Sequi
• Evorel Conti

Finding the right HRT isn’t always easy, but we’re here to help. During your consultation, your doctor will note down your preferred treatment but may recommend a different treatment that’s more suitable to your health and needs.

Can I buy Gina over the counter?

Gina is available to purchase without a prescription. This means you can buy it over the counter, but you will have to answer a few questions so the pharmacist can make sure it’s safe and suitable for you.

Gina is available without a prescription because vaginal atrophy, which Gina treats, can be diagnosed based on your symptoms without needing a doctor to examine you. Also, as Gina is a low-dose medication, your chances of getting harmful side effects are very low.

Can I get Gina on the NHS?

You can get Gina on the NHS, but you need a prescription from your doctor first. Your doctor may decide a different HRT is more suitable for you.