Gina is a type of hormone replacement therapy (HRT) used by women to relieve menopause symptoms that affect the vagina, such as dryness or irritation.

During menopause, oestrogen levels drop and this may cause many symptoms including vaginal atrophy, where the vaginal wall becomes thinner, drier, and less elastic. This causes symptoms like dryness, itching, irritation, and pain during sex.

Gina contains the active ingredient oestrogen to replace the naturally occurring oestrogen that was produced by the ovaries before menopause. Because Gina tablets are inserted directly into the vagina, oestrogen is released exactly where it is needed to relieve any discomfort.

Gina is available over the counter without a prescription from most pharmacies or online from Superdrug Online Doctor for postmenopausal women. It is manufactured by Novo Nordisk Ltd.

Gina works by replacing the oestrogen lost during menopause. As the level of oestrogen falls in the body, it causes several symptoms, such as hot flushes, night sweats, and vaginal irritation.

Gina helps to improve vaginal symptoms by slowly releasing oestrogen to help the levels in the vagina to rise, providing relief from discomfort.

How long does Gina take to work?

Gina will begin to work immediately, but it can take between 4 and 8 weeks to fully notice the benefits. Gina starts to rebalance the pH in the vagina after 2 weeks and symptom relief is often felt after 8 weeks.

How effective is Gina?

In studies, Gina improved vaginal hormone levels and pH and relieved moderate to severe vaginal menopause symptoms after 12 weeks of treatment.

To insert Gina, follow these steps, which can also be found with your medication in the patient information leaflet:

1. Wash your hands and get into a comfortable, relaxed position, either standing up or lying down.
2. Tear off 1 of the blister packs and open it at one end. Separate the plastic wrapper and remove the applicator.
3. Hold the applicator so that one of your fingers can press the applicator plunger (if you have used applicator tampons in the past, you’ll hold the applicator in a similar way).
4. Insert the applicator carefully into your vagina, inserting about half of the applicator, but only as far as it feels comfortable, never force it.
5. Gently press the applicator plunger until you feel a click – this signals that the tablet has been released. The tablet will attach itself to the vaginal wall, it will not fall out when you stand up or walk.
6. Gently remove the applicator and throw it away with the plastic wrapper in your household rubbish.

If the tablet falls out of the applicator before you have inserted it, you’ll need to throw the tablet and applicator away and start again with a new one.

Gina is used once a day for the first 2 weeks (initial dose) and drops to twice a week (maintenance dose) after this. When you reach the maintenance dose you should leave 3 to 4 days between each dose.

You can insert Gina at any time of the day, but you should try to take it at the same time each time you take it.

What if I miss a dose of Gina?

If you forget to take your Gina dose, take it as soon as you remember. Do not take a double dose.

What if I take too much Gina?

If you have taken too much Gina, it is unlikely to be harmful if you have only done so for a short time.

If you think the dose you are taking is too strong, not strong enough, or you’re not sure if you are using it correctly, speak to your doctor for advice.

How long do I need to take Gina for?

There is no set time limit for taking Gina. Providing you are not experiencing any harmful side effects, you can use Gina for as long as it is required.

What happens when I stop taking Gina?

If you decide to stop taking Gina, it’s likely that your symptoms will return. If you want to stop taking Gina because you do not feel it is right for you, there are other menopause treatments available.

Gina is available over the counter in pharmacies without a prescription if you are postmenopausal and have not had a period for at least one year. It may also be available on the NHS or your doctor may suggest a more suitable method of HRT depending on your symptoms. You can also request treatment from online doctors or pharmacy services.

Can I buy Gina online?

Yes, you can buy Gina online at Superdrug Online Doctor.

To request Gina from Superdrug Online Doctor:

1. Fill out a brief health and lifestyle questionnaire.
2. Order your preferred treatment and make payment.
3. One of our doctors will review your order and questionnaire answers.
4. If approved, your treatment will be posted to your address or made available for collection at your local Superdrug Pharmacy.
5. If your order is not approved, one of our doctors will contact you via your account with other treatment options.

Can I buy Gina over the counter?

Yes, Gina is available to buy over the counter at most UK pharmacies, including any Superdrug Pharmacy.

If you choose to buy Gina over the counter, the pharmacist will ask you a few health-related questions to make sure it is safe for you. If the pharmacist feels Gina is suitable for you, you will be able to buy it straight away.

Can I get Gina on the NHS?

Gina may be available on the NHS. However, your doctor may offer you an alternative vaginal oestrogen that is a prescription-only medication.

Common side effects that may affect up to 1 in 10 people include:

• headache
• stomach pain
• vaginal bleeding, discharge or discomfort

Uncommon side effects that may affect up to 1 in 100 people include:

• a fungal genital infection
• feeling sick (nausea)
• rash
• weight gain
• hot flush
• high blood pressure

Very rare side effects that may affect up to 1 in 10,000 people include:

• diarrhoea
• water retention
• worsened migraines
• generalised hypersensitivity

How long do side effects last?

Gina side effects usually improve within the first few months of treatment as your body gets used to it.

What to do if you get side effects

If you are concerned about any side effects or experience any of the following serious side effects, you should stop using it and get urgent medical attention:

• suddenly feeling unwell and sweating
• being sick (vomiting)
• breathing difficulties
• fast heartbeat or feeling dizzy

Talk to your doctor if you develop any vaginal infections while using Gina.

Mild Gina side effects can usually be managed at home by:

• taking over-the-counter painkillers like paracetamol or ibuprofen for aches, pains, or headaches
• drinking plenty of water if you feel sick
• using a hot water bottle for stomach discomfort

If you cannot manage side effects at home, speak to your doctor. They may prescribe or recommend a different type of HRT to manage your symptoms.

Do not use Gina if you:

• are allergic to estradiol or any of the ingredients in the medication
• have or have ever had womb or ovarian cancer
• have had any vaginal or genital bleeding since your periods stopped because of the menopause
• have recent or suspected endometrial hyperplasia
• have previously been treated with oestrogen-only HRT and you have not had your womb removed
• notice any changes to your vulva (the external parts of your vagina)
• have a current vaginal infection
• have a condition called vulval dermatoses, severe vaginal itching, or itchy patches or rashes
• have or have ever had breast cancer
• have or have ever had a blood clot in a vein
• have or have recently had a disease caused by blood clots in the arteries like heart attack, stroke, or angina
• have a blood clotting disorder
• have or have ever had liver disease
• have a rare blood problem called porphyria

Tell your doctor before using Gina if you if you:

• have a history of endometriosis
• have a history of endometrial hyperplasia
• are already receiving HRT
• are switching from another vaginal oestrogen HRT

Other medications and Gina

Before taking Gina, you should tell your doctor or pharmacist if you are or have recently taken any prescribed, over-the-counter, or herbal medications.

Gina is a local HRT, which means it acts on the area which is affected, in this case, the vagina, and should not affect other medications. However, it may affect other vaginally applied treatments. If you are unsure, speak to your doctor or pharmacist.