Vaginal Oestriol to prevent vaginal stenosis (VESPA).

Radiotherapy to the pelvic region — used to treat gynaecological, rectal, or anal cancers — can cause the vaginal tissues to become scarred and narrow over time, a condition called vaginal stenosis. This can cause pain, make pelvic examinations difficult, and significantly affect quality of life and intimate relationships. This study is testing whether regularly applying a vaginal oestriol cream (a mild, low-dose form of oestrogen) after completing radiotherapy can prevent or reduce this scarring. The cream is applied at home, making it convenient and non-invasive. Participants are followed over time to assess both safety and how well the treatment works. You may be eligible if you are a woman aged 18 or older who has received pelvic radiotherapy with curative intent for a gynaecological, rectal, or anal cancer. You should be able to use an applicator to apply the cream. Women currently on hormone replacement therapy, or those who have had oestrogen receptor-positive breast cancer in the past five years, are not eligible.