Book a consultation

Vaginal estrogen: what is Blissel and how do I use it?

Blissel is a clear, water-based gel which is used to treat symptoms such as vaginal soreness, pain and discomfort which are caused by a reduction in estrogen levels during the perimenopause and menopause.

Symptoms occur in and around your vagina, vulva and surrounding tissues, and you may experience urinary symptoms such as urinary tract infections (UTIs) or passing urine more frequently.

How does Blissel work?

The hormone estrogen keeps your vagina healthy by acting as a natural lubricant. When levels of estrogen start to decline, the tissue lining your vagina can thin and become drier, and your bladder and the tube running from it (the urethra) also can thin and become weaker.

Blissel works by replacing the lost estrogen normally produced in your ovaries. It is inserted into your vagina, so the hormone is released where it is needed most, helping to relieve soreness and irritation, and can reduce the risk of UTIs.

Related: Gina vaginal estrogen: what you need to know

When and how do I use Blissel?

Blissel comes with an applicator which you can screw onto the neck of the tube of gel.

You squeeze the tube to fill the applicator up to the filling mark. To apply the gel, simply lie down, insert the applicator into your vagina, and push the plunger all the way in to release the gel. It’s best to do this before you go to bed.

For the first three weeks of treatment Blissel should be applied once per day. After the first three weeks you should only need to use it twice per week, although your healthcare professional may recommend using it more frequently if your symptoms don’t resolve.

Alternatively you may be recommended to use the gel externally on your vulva or other areas which you gently apply with your fingertips.

What doses does Blissel come in?

One applicator of Blissel contains 50mcg of estriol, which is a type of estrogen made naturally in your ovaries.

What are the benefits?

Blissel is a newer product which contains a lower dose of estriol than most other creams or pessaries. As it’s water based, it’s not as thick and sticky as creams so is less messy to use. It also dries more quickly, so it’s a good option for external use. The water-based formulation means it’s safe to use if you rely on latex condoms or a diaphragm for contraception.

Who is Blissel suitable for?

Blissel is a lower-dose, gentler option, which is less likely to cause irritation. It’s a good choice to treat external soreness, and it’s safe to use alongside other forms of hormone replacement therapy (HRT) including gels, sprays and patches. Blissel may also be suitable for people who are unable to take HRT as it is not absorbed into your body.

Can I expect any side effects?

When you first start using Blissel you may notice some itching or irritation, but this usually settles. Let your doctor know if you continue to experience irritation, or experience any vaginal bleeding.


British National Formulary: Estriol

MIMS online: new low-dose oestrogen gel for vaginal menopause symptoms

Vaginal estrogen: what is Blissel and how do I use it?

Looking for Menopause Doctor? You’re in the right place!

  1. We’ve moved to a bigger home at balance for Dr Louise Newson to host all her content.

You can browse all our evidence-based and unbiased information in the Menopause Library.