Vagifem Vaginal Tablets

What is Vagifem?

Vagifem vaginal tablets are a form of HRT (hormone replacement therapy) for women experiencing symptoms of the menopause — in particular, vaginal dryness and discomfort.

Vagifem contains the female sex hormone estradiol, which is a form of oestrogen that is exactly like the oestrogen produced by the ovaries.

Menopause can cause a range of different unpleasant symptoms, such as hot flushes, night sweats, mood swings and vaginal dryness. These symptoms and more are all a result of a drop in levels of female sex hormones in the body — specifically oestrogen.

Because Vagifem tablets are inserted directly into the vagina, the active ingredient oestrogen works at the site of the problem. Vagifem is, therefore, an excellent choice of HRT for women that are affected by vaginal dryness, irritation, pain and problems with urination but do not need treatment for other menopausal symptoms such as hot flushes.

What is Vagifem used for?

Vagifem is specifically used to treat the changes that happen in and around the vagina during and after menopause.

This can include:

• Vaginal dryness
• Vaginal irritation
• Itching
• Problems with urination
• Pain during urination
• Vaginal pain and discomfort during intercourse
• Possible bleeding during intercourse

These menopausal symptoms are caused by the drop in oestrogen levels during and after menopause.

Vagifem replenishes lost oestrogen levels inside the vagina and is used to directly relieve these symptoms, which are known as “vaginal atrophy”.

Vagifem: bladder problems treatment

Although Vagifem is primarily prescribed to treat discomfort associated with the vagina, it can be used to treat bladder problems too.

Vagifem has proven to be effective for some women at reducing issues with the bladder and urinary tract, such as painful urination and urinary incontinence.

How does Vagifem work?

Like other HRT, Vagifem works by restoring the body’s oestrogen levels. Oestrogen is produced by the ovaries, but during menopause, the levels of oestrogen naturally decrease, resulting in a number of changes in the body.

Because Vagifem tablets are inserted directly into the vagina instead of swallowed, the oestrogen is absorbed directly where it is needed. This means Vagifem can effectively relieve discomfort, dryness and other vaginal symptoms associated with menopause.

What are the benefits of Vagifem?

Vagifem has the same benefits as other topical vaginal treatments, such as creams or vaginal rings for menopausal symptoms.

These topical treatments have been shown to quickly and effectively reduce vaginal and urinary symptoms to the same extent as oral HRT.

However, topical treatments and pessaries like Vagifem do not have the same increased risks associated with oral HRT tablets.

Further to its effectiveness and reduction in risk, because Vagifem is inserted directly into the vagina, a smaller dose of oestrogen is needed to reduce symptoms than if it is taken orally. Again, this makes experiencing side effects much less likely when using Vagifem (or any other topical HRT).

Is Vagifem safe?

Vagifem has been used internationally to treat millions of women with symptoms of menopause since 1999. There have been many studies and its use has been widely researched to indicate its effectiveness and safety.

However, as with all HRTs (and any medicine), Vagifem may cause some women to experience unwanted side effects and it may not be suitable for all women due to certain risks.

You can find out more information about the warnings and precautions associated with Vagifem on the Warnings section of this page.

Vagifem: weight loss & weight gain

There is no current evidence to suggest that there is a link between using any form of HRT and weight gain or weight loss.

However, in rare circumstances, women have reported putting on weight when using it.

It is difficult to say whether Vagifem and weight gain are really connected, as there is very little clinical evidence to suggest this. Using oestrogen-only HRT such as Vagifem can cause swelling of the body due to fluid retention, which may make women feel bloated and cause temporary weight gain. This normally improves within the first three months of use.

Women going through menopause often notice an increase in their weight, regardless of whether they are using any form of HRT or not. This is due to decreasing levels of the hormone oestrogen — low levels of which have been linked to weight gain — as well as ageing contributing to naturally slowing metabolism and loss of muscle mass.

It is important to exercise regularly and eat a healthy balanced diet. This will help you to maintain a healthy weight during and after menopause.

If you are concerned about weight gain at all, speak to your GP for guidance.

Alternatives to Vagifem

Vagifem is a topical or local HRT that is inserted directly into the vagina, as a tablet or pessary, to reduce vaginal symptoms of menopause. Using a small tablet such as Vagifem is the most common form of topical oestrogen. Vagirux pessaries are another alternative option to Vagifem that contain the same active ingredient.

Menopausal women who are looking for another form of localised oestrogen to treat vaginal dryness can also receive a prescription for either a cream, gel or a vaginal ring that is similarly inserted inside the vagina and the creams and gels can also be spread onto the surrounding skin.

You can also use vaginal lubricants such as Sylk or Replens MD alongside Vagifem vaginal tablets to help decrease discomfort experienced during the day and whilst having sex.

At The Independent Pharmacy, we offer a range of HRT on prescription, including those taken orally and patches. For more information about available treatments, take a look at our menopause (HRT) advice and treatments page.

You should speak to a doctor if you are suffering from symptoms of menopause. They will be able to discuss the best HRT options for you.

Sources

• https://www.vagifem.com
• https://www.nhs.uk/conditions/...
• https://www.ncbi.nlm.nih.gov/p...
• https://www.ncbi.nlm.nih.gov/p...
• https://patient.info/doctor/hr...
• Vagifem Patient Information Leaflet: https://www.medicines.org.uk/emc/product/5719/pil

Vagifem dosage

With any medicine, it is important to get the dose right.

Here is how much Vagifem to use:

• Use 1 vaginal tablet a day for the first 2 weeks of treatment
• After this, use 1 vaginal tablet twice a week
• Leave 3-4 days between each dose

Vagifem is suitable for menopausal women over the age of 18 years who have been prescribed it by a doctor.

You should only insert Vagifem tablets into the vagina. You should not take this medication orally.

Each tablet is pre-inserted into a single-use applicator. You will need to open a new applicator for every dose of Vagifem.

How to insert Vagifem

The full instructions for how to insert Vagifem can be found in the Patient Information Leaflet that comes with the tablets.

1. Wash your hands and dry them thoroughly before and after use
2. Open one applicator from the end, and take it out of the packet without touching the insertion end
3. Insert the end of the applicator containing the tablet inside the vagina until you reach some resistance (this will be approximately 8-10cm)
4. Release the tablet by pushing down on the plunger end of the applicator until you feel it click
5. Take out the applicator and throw it away in the bin

Always take this medicine exactly how your doctor has told you. If you are not sure, check with your doctor or pharmacist, or read the Patient Information Leaflet thoroughly for more detail.

Can you use Vagifem more than twice a week?

Vagifem should only be used as directed in the Patient Information Leaflet or as advised by your doctor.

In the first 2 weeks of treatment, you will insert 1 Vagifem tablet into the vagina every day. After this, you must only use 1 tablet twice a week.

If you do not feel that Vagifem is working for you, do not use more than is recommended.

Instead, discuss your options with a doctor or pharmacist. They may suggest alternative treatment options that might suit you better.

How to stop taking Vagifem

You should speak to your doctor before stopping using Vagifem. Your doctor will explain the effects of stopping treatment and they will be able to discuss the possibilities for further treatment with you.

Vagifem ingredients

It is important to know what is in any new medication or treatment you decide to use, especially if you have any known allergies.

Below is a list of the active and inactive ingredients that are found in Vagifem tablets.

Each Vagifem vaginal tablet contains the same active ingredient: 10 micrograms of estradiol hemihydrate.

Each Vagifem vaginal tablet contains the same inactive ingredients:

• Hypromellose
• Lactose monohydrate
• Maize starch
• Magnesium stearate

The film coating contains hypromellose and macrogol 6000.

You can find the full ingredients list in the Vagifem Patient Information Leaflet. You must read this thoroughly before using Vagifem tablets.

Vagifem side effects

In the same way as other HRT, Vagifem can cause some women to experience side effects.

Unlike other hormone replacement therapy, using estradiol vaginal inserts like Vagifem tends to result in fewer, milder side effects. On the whole, these symptoms are less common and less severe than in women who take oral HRT.

Most commonly women who use Vagifem report the following side effects:

• Headaches
• Stomach pain and nausea
• Vaginal bleeding, discharge or discomfort
• Vaginal thrush
• Rash
• Weight gain or fluid retention
• Hot flush
• High blood pressure

If you are concerned about any side effects or you do not feel that they are improving over the first few months you should discuss this with a doctor or pharmacist.

If you experience a severe side effect or have an allergic reaction you must seek medical support from your nearest emergency department as soon as possible.

You must read the Patient Information Leaflet thoroughly before using Vagifem 10mcg tablets.

Vagifem warnings

Before you start taking any new medication, it is important to familiarise yourself with the possible health risks and side effects associated with this type of treatment. Carefully reading the Vagifem Patient Information Leaflet that comes with your treatment will help.

Here are some points to note about Vagifem:

• You should not use Vagifem if you have unexplained vaginal bleeding, thickening of the womb lining, liver disease, you have ever had breast cancer or other oestrogen-sensitive cancers or have ever had blood clots or have a clotting or bleeding disorder
• Speak to your doctor before using Vagifem if you have asthma, epilepsy, diabetes, gallstones, liver disease, high blood pressure, suffer from migraines or severe headaches, endometriosis, otosclerosis, SLE, or fibroids inside your womb
• You should tell your doctor before using Vagifem if you are currently or have recently stopped using any prescribed or non-prescribed medication

If you have any questions or concerns, you should discuss these with your GP before taking this treatment.

Likewise, if you are currently taking Vagifem and you notice any symptoms or signs of the above health conditions or anything you are worried about, speak to your doctor immediately.

You will only be able to purchase Vagifem online as a repeat prescription from The Independent Pharmacy if you stay up-to-date with your annual check-up with your doctor.

Vagifem and endometrial cancer

Oestrogen-only HRT taken orally can increase the risk of developing cancer of the womb lining (endometrial cancer), as well as increased risk of developing cervical cancers and breast cancers.

Because Vagifem vaginal tablets have a very low absorption rate of oestrogen into the bloodstream it is, therefore, less likely to cause cancers.

You should see a doctor immediately if you experience any unusual vaginal bleeding or if something doesn’t feel right.

Vagifem and breast cancer

It is very important for all women that take any form of HRT to attend regular health check-ups with their GP.

You should also regularly check your breasts for any changes, including lumps, dimples or changes to the nipple. If you notice anything unusual, feel any breast pain, or anything else, it is best to get checked out as soon as possible.

Vagifem and blood clots

Using any form of HRT — including Vagifem — can slightly increase your chances of developing a blood clot in a vein or experiencing a stroke. You should see a doctor immediately if you think you are developing symptoms of a blood clot.

The following people are at an even higher risk of developing a blood clot and you should speak to a doctor before using Vagifem if any of them apply to you:

• You are immobile for an extended amount of time due to surgery, injury or illness
• Your BMI is over 30
• Your close relatives ever had a blood clot
• You have systemic lupus erythematosus (SLE)
• You have cancer

Developing blood clots can be dangerous and life-threatening, and can lead to heart attacks and strokes.

If you think you are experiencing symptoms of a blood clot, you must either call 111 or see a doctor straight away.

Vagifem and pregnancy

Vagifem should only be used by postmenopausal women and is not a contraceptive. If you are under 50 years old or have had a menstrual period in the last 12 months, you may still need to use additional contraception to prevent pregnancy.

If you become pregnant while using Vagifem, you should stop using this medication and speak to a doctor for advice.

Vagifem and breastfeeding

Vagifem is for use in postmenopausal women only. You should not use Vagifem if you are breastfeeding.