Gina is a type of local hormone replacement therapy (HRT) used to help manage the symptoms of menopause.

• It is for women who are over 50 and have not had a period for at least 1 year.
• It is a local vaginal HRT, which means it does not circulate in your blood, but treats the area it’s been used on.
• It is a low-dose oestrogen tablet containing the active ingredient estradiol hemihydrate.

Gina tablets come pre-loaded into an applicator which is inserted into your vagina before releasing the tablet. The tablets slowly dissolve to release oestrogen into your vaginal tissue, replacing the reduced hormones. It’s the first ever HRT for post-menopausal people that’s available over the counter without a prescription.

What is Gina used for?

Gina is used in treating one of the most common symptoms of menopause - vaginal atrophy or urogenital atrophy. Vaginal atrophy is a term used for when your vagina becomes dry, sore or itchy, and it can also make sex painful. Vaginal atrophy usually occurs when your oestrogen levels drop during menopause, thinning the tissue around your vagina. By taking Gina, you replace the oestrogen you’re missing to improve and get 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 works by replacing hormones that naturally decline during menopause to stop you from developing uncomfortable symptoms. It does this by slowly releasing oestrogen into your vaginal tissue.

How long does Gina last?

After inserting Gina tablets into your vagina, it slowly dissolves over around 8 hours. However, the effects of Gina continue after it has dissolved. It should last for as long as you continue to use the treatment.

How long does Gina take to work?

You should start noticing the positive effects of taking Gina around 4-8 weeks after starting treatment, but this varies depending on the person. If you are not noticing the effects of Gina after taking it for 3 months, you should speak to your doctor as it may not be the right treatment for you.

How effective is Gina?

Gina tablets are clinically proven to treat your symptoms and their causes effectively. National guidelines recommend low-dose vaginal oestrogen tablets like Gina as the first treatment for menopausal symptoms such as vaginal dryness, itching and soreness.

Gina is inserted directly into your vagina using a preloaded applicator. You will start out taking 1 tablet each day for the first 2 weeks of treatment. After the first 2 weeks, you will take 1 tablet twice a week. You can take Gina at any time of the day, but you should try to make sure it’s at the same time every day.

Make sure you always follow the instructions in your patient information leaflet, and if you are still not sure about your dose or how to use the medication, you should speak to your doctor or pharmacist.

Using the applicator

1. Make sure your hands are clean and dry
2. Take out a single applicator
3. Hold the applicator so that one finger can press the ‘applicator plunger’
4. Get into a comfortable position and prepare to insert the applicator
5. Insert the applicator slowly into your vagina
6. Gently press the end of the applicator (the plunger) all the way in. This will release the tablet
7. Slowly remove the applicator from your vagina

• You should continue taking Gina for as long as your symptoms persist or as long as the doctor tells you to.
• If you stop taking Gina and your symptoms come back, it’s safe to start taking Gina again.
• If you forget to take a dose, take it as soon as you remember. Do not take a double dose.
• You can stop taking Gina at any time, but doing so may cause your symptoms to come back.

You can buy Gina from most UK pharmacies and online doctors like Superdrug Online Doctor.

Can I buy Gina online

You can buy Gina online quickly and easily with Superdrug Online Doctor.

All you need to do is:

• Answer a few questions about your health
• A doctor reviews this to make sure it’s a safe and suitable treatment for you
• You can get it delivered to your door or collect it from your nearest pharmacy

The questions you’ll be asked online are the same questions you would be asked by a pharmacist in-store. This is to make sure it’s safe for you to take.

Can I buy Gina over the counter?

Gina is the first form of HRT available without a prescription, which means you can buy it over the counter. The pharmacist will ask you a few questions before selling it to you to make sure it’s safe and suitable for you to take.

Gina is available over the counter because it is used to treat vaginal atrophy, which can be diagnosed based on its symptoms alone without the need for a physical examination by a doctor. This makes it more suitable to be available over the counter as your pharmacist can check it’s right for you. As Gina is also a very low-dose medication, it’s unlikely to cause major side effects or be harmful if taken incorrectly.

Can I get Gina on the NHS?

Gina is available on the NHS, but you will need a prescription from your doctor in order to get it. Your doctor may also decide that a different form of HRT is more suitable for you.

Like all medicines, Gina can cause side effects. If you do get side effects, you should speak to your doctor or pharmacist.

Common side effects of using Gina (affecting 1 in 10 people):

• Headache
• Stomach pain
• Vaginal bleeding, discharge or discomfort
• Uncommon side effects of using Gina (affecting 1 in 100 people):
• Fungal infections
• Nausea (Feeling sick)
• Rashes
• Weight gain
• Hot flushes
• High blood pressure

Rare side effects of using Gina (affecting 1 in 10,000 people):

• Diarrhoea
• Water retention
• Worsened migraines
• Generalised hypersensitivity (e.g. anaphylactic reaction/shock)

Stop using Gina and speak to your doctor as soon as you can if:

• You get any new vaginal bleeding, spotting or itching.
• You have endometriosis, and your symptoms come back.
• You develop a vaginal infection
• You get yellowing skin or the whites of your eyes (jaundice). These can be signs of liver disease.
• Your blood pressure rises (may cause headaches, tiredness, and dizziness).
• You start to get migraine-like headaches for the first time.
• You become pregnant.

If you get any side effects that could indicate an allergic reaction to Gina, stop taking it and get immediate medical attention.

Gina isn’t suitable for everyone. It is recommended only for women who are over 50 and have not had a period for at least 1 year. Some conditions and medications can also make Gina less effective or possibly unsafe for you to take. If you’re concerned about starting Gina because of another condition or medication, you should speak to a doctor first.

Do not use Gina if:

• You are allergic to estradiol or any of the other ingredients of Gina
• You have or have ever had womb or ovarian cancer
• You have symptoms like vaginal bleeding or pain, bloating or swelling in your lower abdomen or pelvis that you have not told your doctor about.
• You have had any vaginal bleeding since your periods stopped due to menopause.
• You have or may have endometrial hyperplasia
• You have previously been treated with an oestrogen-only HRT and have not had your womb removed (hysterectomy).
• You have noticed any changes in your vagina such as thickening or a lump, or any shrinking or scarring.
• You have a current vaginal infection
• You have a condition called ‘vulval dermatoses’
• You have severe vaginal itching, itchy patches or rash.
• You have or have ever had breast cancer
• You have or have ever had a blood clot
• You have or have recently had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina.
• You have a blood clotting disorder
• You have or have ever had liver disease, and your liver function tests have not returned to normal.
• You have a rare blood problem called ‘porphyria’, which is passed down in families (inherited)

Talk to your doctor if you have any of these conditions before starting Gina if you have:

• a history of endometriosis
• You have a history of endometrial hyperplasia
• You are receiving a type of HRT (including tablets or patches) that circulates in the blood
• You are switching from another vaginal oestrogen HRT
• You may also want to talk to your doctor if you’re taking Gina and have:
• Uterine fibroids (Leiomyoma)
• An increased risk of developing blood clots
• Increased risk of getting womb, ovarian or breast cancer
• High blood pressure
• Liver disorders, such as a benign liver tumour
• Diabetes
• Gallstones
• Migraines or severe headaches
• Systemic lupus erythematosus (SLE)
• Epilepsy
• Asthma
• A disease affecting the eardrum and hearing (otosclerosis)
• A very high level of fat in your blood (triglycerides)
• Fluid retention due to cardiac or kidney problems
• Hereditary and acquired angioedema

There are many different types of HRT and medications available, so if Gina is not suitable for you, there may be another option that can help.

We provide the following HRT treatments at Superdrug Online Doctor:

• Estriol cream
• Ovestin
• Estradot
• Vagirux
• Vagifem
• Premique
• Kliovance
• Kliofem
• Tibolone
• Indivina
• Femoston-Conti
• Evorel Sequi
• Evorel Conti