Vagifem is a type of hormone replacement therapy (HRT) used to treat vaginal symptoms that can happen during the menopause. The vaginal tablets contain the active ingredient estradiol, a man-made form of oestrogen. Vagifem tablets are placed inside the vagina to act quickly and directly.
12 weeks / 24 tablet(s) - £45.00
What is Vagifem?
Vagifem is a type of vaginal hormone replacement therapy. It is used to treat the symptoms of menopause that affect the vagina, such as dryness and irritation.
The vaginal tablets contain the active ingredient estradiol which belongs to the group of hormones called oestrogens. Estradiol is a female sex hormone and is the same as the estradiol produced by a woman’s ovaries.
During menopause, the ovaries produce less and less estradiol until they stop producing it altogether, causing many symptoms. In the vagina, the lack of oestrogen can cause dryness and irritation which is called vaginal atrophy. Vagifem helps to treat these symptoms.
Vagifem is a brand name of estradiol topical and is manufactured by Novo Nordisk Inc. There are alternative versions available such as Vagirux or generic vaginal estradiol 10mcg tablets.
How does Vagifem work?
Vagifem works by replacing the oestrogen that is lost during the menopause. Vagifem is a tablet which is inserted directly into the vagina to provide immediate relief if you have discomfort in this area.
Vagifem is for use in post-menopausal women only. If you are under 50 or it has been less than 12 months since your last period, you should speak to your doctor for advice before using Vagifem.
Is Vagifem safe?
Vagifem is a safe and effective treatment but there are risks associated with any HRT. Once you start using it, you will need to see your doctor for regular check-ups at least once a year. You should also go for regular breast screening as recommended by your doctor.
HRT may increase the risk of:
- womb (endometrial) cancer
- breast cancer
- ovarian cancer
- blood clots
Because Vagifem is used as a local treatment in the vagina, it’s absorption into the blood is very low. So, it is less likely to cause the above conditions to get worse or come back during treatment with Vagifem. If you are concerned, speak to your doctor who can offer advice.
If you need further information about Vagifem, you can read the patient information leaflet.
How to use Vagifem
Vagifem is available in one low dose which is 10mcg. The standard treatment is to insert 1 Vagifem tablet into the vagina every day for 2 weeks, and then 1 tablet twice a week, leaving a 3 or 4 day gap between each dose.
Vaginal tablets come with an applicator and instructions showing you how to insert them.
To use Vagifem, you should:
- tear off one single blister pack and open at the push-button end
- insert the applicator carefully into the vagina until you feel some resistance, usually around 8 to 10cm
- release the tablet by gently pressing the push button until you feel a click
- remove the applicator from the vagina and throw it away
The tablet will stick to the wall of the vagina so it will not fall out when you stand up or walk. If you miss a Vagifem dose, use the medicine as soon as you remember. You should not use a double dose if you have forgotten a dose. If you use more Vagifem than you should, then you should speak to your doctor for advice.
You should not stop using Vagifem without talking to your doctor. They will explain the effects of stopping treatment and will discuss other possible treatments available to you.
Vagifem is not a form of contraception. If it is less than 12 months since you last had a menstrual period or you are under 50 years old, you may still need to use contraception to prevent pregnancy. You should speak to your doctor for advice.
If you become pregnant while using Vagifem, stop using it right away and contact your doctor.
Before the menopause, your ovaries naturally produce oestrogen to help regulate your menstrual cycle as well as produce many of your female sex characteristics. During the menopause, the amount of oestrogen produced by your ovaries lessens until the hormone is not produced anymore.
The symptoms of the menopause include:
- hot flushes
- night sweats
- low sex drive (libido)
- vaginal dryness, pain, itching, or discomfort
- difficulty sleeping
- mood changes
Vaginal HRT, like Vagifem, is a local treatment which treats menopause symptoms in the vagina such as dryness and discomfort.
If you have other symptoms of the menopause like hot flushes or night sweats, then you may want to consider other types of HRT. These can include tablets or patches.
There are 2 main types of HRT:
Oestrogen-only HRT contains just a type of oestrogen. It is often used by women who have had their womb removed and do not need a progestogen replacement (a hormone which protects the womb lining).
Combined HRT contains a combination of oestrogen and progesterone. It is used by women who have not had their womb removed and works to replace the body’s natural hormone supply.
Vagifem is for use in postmenopausal women. There is limited data on its use in women over 65. As with all medicines, Vagifem can cause side effects but not everyone will experience them.
Common side effects include:
- stomach pain vaginal bleeding, discharge, or discomfort
Uncommon side effects include:
- a fungal infection in the genital area
- feeling sick (nausea)
- hot flushes
Very rare side effects include:
- allergic reaction
- fluid retention
Vagifem is not likely to affect other medications you take because it is a local treatment in the vagina. But you should tell your doctor if you are taking any other medication, including:
- prescription medicine
- over-the counter medicine
- herbal treatments
- natural remedies
Vagifem may affect other vaginally applied treatments, like other creams or tablets. You should not use Vagifem if you are allergic to estradiol or any other ingredients of Vagifem.
You should also not use Vagifem if you have:
- or have ever had breast cancer or womb cancer
- or have ever had a blood clot in a vein
- any unexplained vaginal bleeding
- untreated excessive thickening of the womb lining
- a blood clotting disorder
- recently had a heart attack, stroke, or angina
- a rare blood problem called porphyria
Weight gain is listed as an uncommon side effect of usingVagifem, affecting 1 in 100 people. However, the link between Vagifem, as well as other types of HRT, and weight gain has not been proven.
Dr Kathryn Basford
Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.Meet our doctors
Article created: 01 Oct 2021
Last reviewed: 01 Oct 2021
Vagifem 10 micrograms vaginal tablets patient information leaflet (2020) EMC [accessed 06 September 2021]
Generic Vagifem (2021) Drugs [accessed 06 September 2021]
Hormone Replacement Therapy (2019) NHS [accessed 06 September 2021]
Menopause (2018) NHS [accessed 06 September 2020]