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Vagifem - 10 mcg Pessary

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Vagifem is a form of hormonal replacement therapy, used to relieve vaginal symptoms caused by menopause. It works by replacing oestrogen that your body is not making enough of.
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What is Vagifem?

Vagifem is a type of hormone replacement therapy. Hormone replacement therapy is a treatment used to relieve menopause symptoms, by replacing the hormones that your body is making at lower levels because of menopause. HRT medication is designed to treat the symptoms caused by low oestrogen.

Specifically, Vagifem is used to treat women's health problems such as vaginal dryness or irritation, known as atrophic vaginitis. This is caused by a drop in the level of oestrogen in your body due to menopause.

Vagifem is available on prescription from your doctor or pharmacist. Alternatively, we can prescribe it to you following an online consultation. Contact us to find out more.

Vagifem is a brand name - the active ingredient is called estradiol hemihydrate.

For more information about Vagifem, consult the patient information leaflet.

How it works

As women become older, their body changes and produces less oestrogen. Oestrogen is an important female sex hormone, and declining levels of oestrogen can affect the lining of the vagina. A lack of oestrogen in the blood can lead to vaginal dryness, irritation, burning or itching, and can make sex painful or uncomfortable, or can make vaginal or urinary infections more likely.

Vagifem vaginal tablets release a small amount of oestrogen into the vaginal area, and provide relief from vaginal symptoms of menopause. They can be used to offset the symptoms of the menopause until your menopause passes.

Vagifem is available as a 10 mcg tablet. It can take between 8 to 12 weeks for your symptoms to improve.

Before you take it

You should not use Vagifem if you are allergic to estradiol or any of the other ingredients in Vagifem. You should discuss with your doctor an alternative treatment for your conditions if you find that you are allergic to Vagifem in any way.

You should use Vagifem with caution if you have high blood pressure.

Prolonged use of oestrogen-only hormone therapy medication such as Vagifem for an extended period of time can increase your risk of developing endometrial cancer, or cancer of the womb lining. You should make sure you consult with your doctor when taking HRT. It can also cause thickening of the lining of the womb.

It’s possible you may experience breakthrough bleeding or spotting. If this happens you must contact your doctor for an examination as it may mean you are experiencing endometrial hyperplasia, meaning that the lining of your womb has become thicker.

There is evidence to suggest that you are at an increased risk of developing breast cancer when using oestrogen only HRT such as Vagifem. This is dependent on how long you take Vagifem. However, the likelihood of you developing breast cancer returns to normal after you stop taking this medication. You can mitigate this risk by regularly checking your breasts for abnormalities.

The use of oestrogen-only HRT has also been associated with a slight increased risk of ovarian cancer.

Vagifem has been associated with an increased risk of medical conditions such as stroke, liver disease and blood clots in the veins. This risk can be up to 50% more likely in women taking HRT versus women who are not, especially in the first year of taking it. Blood clots can be very serious, and should you get one it can cause chest pain, feeling faint, heart attacks, difficulty breathing and loss of consciousness. In some cases it can be fatal.

There is a suggestion that Vagifem can help prevent heart disease or heart attacks if taken early on in menopause. However, in some women, especially later in menopause, it has been shown to increase your chances of developing heart problems.

Vagifem is intended for postmenopausal women only. It should not be used by any woman who is pregnant. It’s possible to get pregnant while taking Vagifem if your menopausal symptoms have lasted less than 12 months, so you should ensure you are still using effective contraception within this period.

If you get pregnant while taking Vagifem, stop taking it immediately and tell your doctor.

Oestrogen-only HRT such as Vagifem may interact with some other drugs. You should speak with your doctor before taking Vagifem if you are taking any of the following:

  • Anticoagulants, such as warfarin
  • Blood pressure lowering medication, such as ramipril and amlodipine
  • Any other medication applied within the vagina

This is not an exhaustive list of drug interactions or warnings. For a complete list, you should consult the patient information leaflet, or speak with your doctor.

Dosage Instructions

You must always use this medication exactly as prescribed by your doctor or pharmacist. Never exceed the stated dose. If you are in any way unsure of how to take Vagifem, you must consult your doctor for clarification.

You can start using the medication on any day that suits you. The package will include Vagifem 10 mcg estradiol vaginal tablets and a vaginal applicator for each tablet.

Your doctor will aim to prescribe you with the lowest dose that effectively treats your symptoms. If you feel your dose is too weak or too strong, you must first go to your doctor before adjusting your dose of Vagifem.

For the first two weeks, insert one tablet every day into the vagina using the applicator. After this period, use one vaginal tablet twice a week, leaving three or four days between each dose.

Vagifem tablets are for vaginal use only. They must not be swallowed.

Store Vagifem in a cool, dry place, out of the reach of children and pets.

Common Side Effects of Vagifem

Like all medicines, Vagifem has the potential to cause side effects. Usually mild to moderate in nature, they should go away on their own. However, if they persist, or if they concern you in any way, you should talk to your doctor or pharmacist. Potential side effects can include:

  • Headaches
  • Stomach or abdominal pain
  • Vaginal discomfort, discharge or unusual vaginal bleeding

Vagifem may also cause more serious side effects. These are more rare, but you should report side effects to your doctor, who will be able to decide whether the medicine is still suitable for you. These possible side effects can include:

  • Vaginal yeast infection
  • Rash
  • Weight gain
  • Hypertension
  • Hot flushes
  • Nausea or vomiting
  • Diarrhoea
  • Fluid retention
  • Increased chance of getting cancer of the breast or cancer of the uterus
  • Signs of liver problems - yellowing of the skin or whites of the eyes

Vagifem may also cause a severe allergic reaction in some patients. This is very rare but it is an emergency, so if you believe you are experiencing an allergic reaction, you should seek medical assistance right away. Symptoms of an allergic reaction include:

  • Hives or nettle rash
  • Trouble breathing or speaking
  • Wheezing
  • Tightness in the chest or throat
  • Skin rash, including redness, itching, blistering or peeling

Not all related side effects are listed here. For a full list, you should consult your doctor or the patient information leaflet.

Frequently Asked Questions (FAQs)

How do I store the applicator?

The applicator is disposable. Do not reuse the applicator - throw it away like you would a tampon applicator.

Will my symptoms disappear on their own after menopause?

Some menopausal symptoms, such as hot flashes or cold sweats, go away on their own after menopause. However, symptoms of vaginal atrophy often do not go away, as they are caused by the lower level of oestrogen your body is making.

How long do I need to take Vagifem?

You should take Vagifem for as long as your doctor or healthcare provider tells you to. They will continue to monitor the risks and benefits of the medication, to see whether it remains suitable for you to take.

I’m pregnant. Can I take Vagifem?

Vagifem is intended for postmenopausal women and is not suitable during pregnancy. If you become pregnant while using Vagifem, you must stop taking it and consult your doctor. Vagifem also passes into breast milk, so do not use it while you are breastfeeding.

What happens if I miss a dose?

If you are on a dosing schedule and you miss your dose of Vagifem, simply take it as soon as you remember. Never double up to make up for a missed dose. It’s best to take Vagifem at the same time each day.

What happens if I take too much?

If you insert too many Vagifem tablets, they are unlikely to harm you, but you should discuss it with your doctor or pharmacist.

More Information
Dosage Instructions Please see medicine label for the dosage instructions.