Vagifem is a vaginal oestrogen. This is not considered hormone replacement therapy, as only small amounts of oestrogen are released into the bloodstream, but it will relieve the local symptoms caused by the menopause. Vagifem comes in the form of vaginal tablets (or pessaries), which contain a naturally occurring form of oestrogen. These pessaries are inserted into the vagina.
When you take Vagifem, small amounts of oestrogen are released locally into the vaginal tissues. Vagifem is to be used short-term to provide relief from:
- itching or irritation (atrophic vaginitis).
This, in turn, should help prevent sex from becoming uncomfortable and painful. Supplementing local oestrogen will also reduce your susceptibility to vaginal or urinary infections.
To minimise the absorption of this medicine, the lowest dose to control symptoms should be used, and treatment should be stopped about every three months to see if it is still needed.
Follow the instructions provided with your Vagifem vaginal tablets carefully. The tablets should be inserted into the vagina using the applicator provided. They should NOT be taken by mouth.
One vaginal tablet should be inserted into the vagina once a day for the first two weeks. After this you should insert one tablet twice a week (every three or four days).
If you forget to insert a tablet, insert it as soon as you remember, unless it is nearly time for your next dose. In this case just leave out the missed dose and insert your next tablet as usual when it is due. Do not insert more than one tablet to make up for a missed dose.
The following side effects can affect individuals in different ways, it does not mean that all will be affected:
Common (may affect up to 1 in 10 patients):
- Stomach Pain
- Vaginal bleeding, discharge or discomfort
Uncommon (may affect up to 1 in 100 patients):
- Fungal infection in the vagina, e.g. thrush
- Weight increase
- Hot flush
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with Vagifem, please read the information provided with the medicine or consult your doctor or pharmacist.
The Estradiol from Vagifem is only absorbed from the vagina into the bloodstream to a very small extent. These warnings are most relevant to repeated or long-term use of the vaginal tablets.
Vagifem should be used with caution if you have:
- fibroids inside your womb
- a growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia)
- increased risk of developing blood clots (thrombosis)
- increased risk of getting an oestrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer)
- high blood pressure
- a liver disorder, such as a benign liver tumour
- migraine or severe headaches
- a disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE)
- a disease affecting the eardrum and hearing (otosclerosis)
- a very high level of fat in your blood (triglycerides)
- fluid retention due to cardiac or kidney problems
Vagifem should not be used if you:
- have or have ever had breast cancer, or if you are suspected of having it
- have cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium), or if you are suspected of having it
- have any unexplained vaginal bleeding
- have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated
- have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism)
- have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency)
- have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina
- have or have ever had a liver disease and your liver function tests have not returned to normal
- have a rare blood problem called “porphyria” which is passed down in families (inherited)
Please ask your doctor about using Ovestin whilst taking other vaginal medicines, for example pessaries or vaginal creams for thrush or other vaginal infections.
Ovestin should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
The patient information leaflet (PIL) is a leaflet containing specific information about medical conditions, doses and side effects. You can download a copy of the PIL here:
Patient Info Leaflet