What is Vagifem?
Vagifem is a local hormone replacement therapy (HRT). Each small vaginal tablet contains 10 micrograms of estradiol, a form of oestrogen, and comes preloaded in a single-use disposable applicator.
What is it used for?
Vagifem relieves menopausal symptoms in and around the vagina, sometimes called vaginal atrophy. These symptoms are caused by lower oestrogen levels after menopause and may include:
Vaginal dryness
Irritation, itching or soreness
Pain during sex
Associated urinary symptoms, such as pain when urinating
Vagifem works locally by releasing oestrogen directly where it is needed.
How long does it take to work?
You may notice an improvement within a few weeks. However, it can take up to 3 months for your body to adjust and for you to feel the full benefit.
How do I use it?
Open the blister pack at the plunger end.
Insert the applicator into the vagina until you meet gentle resistance, around 8 to 10cm.
Press the plunger to release the tablet.
Withdraw and dispose of the applicator.
Dose
First 2 weeks: Insert 1 vaginal tablet every day.
After the first 2 weeks: Insert 1 vaginal tablet twice a week—for example, every Tuesday and Friday.
You can start treatment on any convenient day. Follow the instructions given by your clinician.
What if I miss a dose?
Use the missed dose as soon as you remember. Do not use a double dose to make up for it.
Special considerations
The dosing schedule is the same for all adults prescribed Vagifem. HRT should generally be used at the lowest effective dose for the shortest time needed to manage symptoms.
Experience in treating people over 65 is limited, and this medicine is not for children.
Vagifem contains gelatine and is therefore not suitable for vegans. It may also be unsuitable for anyone who prefers not to use animal-derived ingredients.
Pregnancy, contraception and breastfeeding
Vagifem is not a contraceptive and is intended only for postmenopausal women.
If you are under 50 or it has been less than 12 months since your last period, you may still need contraception. Ask your healthcare professional for advice.
If you become pregnant, stop using Vagifem immediately and contact your healthcare professional. Do not use Vagifem while breastfeeding.
Important safety information
Vagifem is a local form of HRT, so very little oestrogen is absorbed into the rest of the body. A progestogen is therefore not generally needed to protect the womb lining, even if you have not had a hysterectomy.
Report any unusual or unexpected vaginal bleeding to your doctor promptly.
Possible side effects and risks
Common side effects include:
Headache
Stomach or abdominal pain
Vaginal bleeding, discharge or discomfort
Vaginal thrush
Because Vagifem is a local treatment with very low absorption, the risks associated with systemic HRT—such as blood clots, stroke and breast cancer—are considered much lower. They should still be considered, particularly with long-term use.
Read the Patient Information Leaflet for the full list of side effects, contraindications and precautions.
Monitoring and follow-up
Your clinician will normally review your treatment after 3 months, followed by a check-up at least once a year. Reviews may cover:
Symptom control and whether HRT remains suitable
Side effects or vaginal bleeding
Weight and blood pressure
Whether further checks, such as a bone-density scan, are needed
Examine your breasts regularly and attend routine screening appointments, including mammograms and cervical screening where applicable.
When should I stop treatment and get medical advice?
Stop using Vagifem and seek medical advice immediately if you experience:
Signs of a blood clot, such as painful swelling in a leg
Swelling of the face, tongue or throat; difficulty swallowing; hives with breathing difficulties
Yellowing of the skin or eyes
A significant rise in blood pressure
A new migraine-type headache
Pregnancy
Conditions requiring closer supervision
Tell your clinician if you have, have previously had or developed any of the following:
Uterine fibroids or endometriosis
Risk factors for blood clots or oestrogen-dependent tumours
High blood pressure
Liver disease
Diabetes, with or without vascular complications
Gallstones
Migraine or severe headaches
Systemic lupus erythematosus
Endometrial hyperplasia
Epilepsy
Asthma
Otosclerosis
Storage
Do not refrigerate. Keep the medicine out of the sight and reach of children.
Need help?
For questions about your medication or alternative treatments, email [email protected].