Vaginal Estradiol (Vagifem®)

What is this medication for?

Vagifem® is a type of hormone replacement therapy (HRT) that contains a low dose of natural estrogen (estradiol), which is a female hormone. It is used to treat vaginal irritation, dryness, and pain during sexual intercourse, these symptoms are caused by decreased levels of estrogen, which happens naturally after menopause. Vagifem® works by replacing the estrogen.

How should I take or use this medication?

• Vagifem® comes as a vaginal tablet contained in a disposable applicator.
• Insert the vaginal tablet into your vagina with the help of the applicator.
• Unless otherwise instructed by the doctor, insert 1 tablet daily into your vagina for 2 weeks continuously, followed by 1 tablet two times a week. When using it twice a week, leave a 3 – 4 days gap between each dose (for example, Mondays and Thursdays or Tuesdays and Fridays).
• Do not stop using your medication without checking with your healthcare professional.

	Step 1: Tear off one single blister pack and open at the plunger end (push button). Remove the applicator from the plastic wrap as shown. The tablet is at the other end of the applicator. Keep your hands clean and dry to avoid getting the tablet wet.
	Step 2: Select the best position for inserting Vagifem® - standing with one foot on a chair or lying on your back. Insert the applicator, with the tablet at the end, into the vagina as far as comfortably possible or until resistance is met (8 - 10cm). Take care not to press the push button at the end until the applicator is inserted properly.
	Step 3: Press the push button at the end of the applicator until a click is felt. This indicates that the tablet has been released from the end of the applicator into the vagina. The tablet will stick to the vagina wall straight away. It will not fall out if you stand up or walk.
	Step 4: Remove and throw away the applicator.

What should I do if I forget to take or use this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take when taking or using this medication?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are taking any other medications, including supplements, traditional medications and herbal remedies.
• You have any unexplained vaginal bleeding.
• You have a history of or current medical conditions such as liver problems, stroke, heart disease, blood clots, migraine headaches, epilepsy, diabetes mellitus or cancer.
• You are going for surgery or will be on bed rest.

What are some common side effects of this medication? ​

As Vagifem® contains a very small amount of estrogen, the side effects are usually well tolerated.

Some of the common side effects include:

• Headache
• Stomach pain
• Vaginal discharge or discomfort

If it is painful during the insertion of the applicator into the vagina, the applicator may be moistened with water or lubricated with a lubricating cream/jelly.

What are some rare but serious side-effects that I need to seek medical advice immediately? 

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately:

• Unusual vaginal bleeding or spotting
• Sudden, new severe headaches
• A large rise in your blood pressure which may cause headaches, tiredness, dizziness.
• Dark urine or light-coloured stools, nausea, vomiting, loss of appetite, severe stomach pain, yellowing of your eyes or skin. These may be signs of liver disease.
  
• Painful swelling and redness of the legs, sudden chest pain, difficulty breathing which could be signs of a blood clot.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.