Vagifem

Vagifem is a local oestrogen therapy containing estradiol, prescribed for the treatment of vaginal atrophy in postmenopausal women.

Vaginal atrophy occurs when declining oestrogen levels after the menopause cause the vaginal tissues to become thinner, drier, and less elastic, leading to symptoms such as vaginal dryness, itching, burning, and discomfort during intercourse.

Vagifem delivers a low dose of estradiol directly to the vaginal tissues via a small pessary (vaginal tablet).

Because the oestrogen is applied locally rather than taken systemically, it is absorbed primarily within the vaginal area, resulting in minimal systemic exposure.

This targeted approach makes Vagifem a well-tolerated option for women who require relief from urogenital symptoms but wish to avoid or have contraindications to systemic hormone replacement therapy.

Clinical evidence supports the efficacy of Vagifem in restoring vaginal epithelial health and alleviating symptoms associated with vulvovaginal atrophy.

Many women notice improvement within the first few weeks of treatment, with continued benefit over longer-term use.

Insert one Vagifem pessary into the vagina using the provided applicator. During the initial phase, use one pessary daily for two weeks.

After this loading period, reduce to one pessary twice weekly, with at least a three-day gap between doses. Insert the pessary at roughly the same time of day, ideally at bedtime.

Lie down during insertion for comfort and to help the tablet remain in position. Wash your hands before and after use.

If you miss a dose, insert it when you remember, then return to your usual schedule. Do not insert two pessaries on the same day to compensate for a missed dose.

Each Vagifem pessary contains 10 micrograms of estradiol. The recommended regimen is one pessary daily for the first 14 days, followed by a maintenance dose of one pessary twice weekly.

Your prescriber will review the need for continued treatment at least once a year. The lowest effective dose should always be used for the shortest duration necessary to control symptoms.

Very common (more than 1 in 10 women): headache. Common (1 in 10 to 1 in 100): vaginal discharge, vulvovaginal discomfort or itching, vaginal bleeding or spotting, abdominal pain.

Uncommon (1 in 100 to 1 in 1,000): vaginal infection including candidiasis, nausea, skin rash, weight increase, hot flushes.

Rare (1 in 1,000 to 1 in 10,000): endometrial hyperplasia, hypersensitivity reactions.

Systemic side effects are less likely with local oestrogen therapy than with oral or transdermal preparations, but remain possible with prolonged use.

Report any unexpected vaginal bleeding to your doctor promptly.

Before starting Vagifem, your doctor should carry out a thorough medical assessment, including a breast examination where clinically indicated.

Women with an intact uterus should be monitored for signs of endometrial stimulation. Treatment should be reviewed at least annually to confirm that the benefits continue to outweigh the risks.

Seek medical advice if you develop vaginal bleeding, breast lumps, sudden severe headache, visual disturbances, or signs of venous thromboembolism such as leg swelling or chest pain.

Inform your doctor about any history of breast cancer, endometrial cancer, or thromboembolic disease.

Vagifem must not be used in women with known or suspected breast cancer, known or suspected oestrogen-dependent malignancy, undiagnosed vaginal bleeding, untreated endometrial hyperplasia, active or recent venous thromboembolism, active or recent arterial thromboembolic disease, known thrombophilic disorders, acute liver disease, porphyria, or known hypersensitivity to estradiol or any of the excipients.