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 dryness, irritation and pain during sexual intercourse. These symptoms are typically caused by a decrease in the levels of estrogen in the body, which happens naturally after menopause (when your periods stop due to lower hormone levels). Topical estrogen works by replacing the estrogen in the body to help relieve these symptoms.

How should I take or use this medication?

• Do not stop using your medication without checking with your healthcare professional.
• 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 your 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).

Directions for use
	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 if it is not close to the next dose. Otherwise, you should skip the missed dose and take the next dose at the usual time. Do not take two doses together 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 (such as deep vein thrombosis or pulmonary embolism), migraine headaches, epilepsy (fits), diabetes 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

You can also find out about drug allergies by watching these videos:
They are available in English, 中文, Melayu and தமிழ்: Drug Allergies

Other rare but serious side effects include:

• Unusual vaginal bleeding or spotting
• Sudden, new severe headaches
• A large rise in blood pressure which may cause headaches, tiredness, dizziness.
• Signs of liver problems: dark urine or light-coloured stools, nausea, vomiting, loss of appetite, severe stomach pain, yellowing of your eyes or skin.
• Signs of blood clots: Painful swelling and redness of the legs, sudden chest pain, difficulty breathing.

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

How should I store this medication?

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

How do I throw away this medication safely? ​

Pack this medicine into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.