Finnish physicians' opinions of vaginal estriol in self-care

Objective: In Finland vaginal estriol drugs became available without prescr iption in 1992, resulting in widespread advertising of these drugs to lay w omen and in an increase in sales. The purpose of this study was to find out what Finnish physicians think about the fact that vaginal estriol does not require a prescription, and if they have found any problems resulting from this. Methods: A questionnaire survey was sent to gynecologists and genera l practitioners (n = 341, 77% response rate) in Finland in 1996. Results: 6 0% of the physicians considered vaginal estriol to be suitable for over-the -counter (OTC) status, and to be much more suitable than the other estrogen containing drugs (contraceptive pill and drugs for emergency contraception ) we asked about in our study. Opinions varied by specialty, work experienc e and reported problems relating to OTC status. The most common reasons giv en for suitability referred to increased access, and those given for unsuit ability referred to general dangers of self-care. Of all physicians 12%, an d of private gynecologists (n = 33) 49% reported having observed problems w ith the OTC status, mostly in care-seeking and indications; some gynecologi sts mentioned adverse effects of the drug itself. 39% of the physicians tho ught that the best person to provide information about vaginal estriol is a physician. Conclusions: Pharmacological literature and physicians' opinion s suggest a re-evaluation of the role of physician surveillance of vaginal estriol drugs. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.