Vagifem vaginal tablets are a form of HRT (hormone replacement therapy) used to manage menopausal symptoms that affect the vagina such as dryness and irritation. The tablets contain a form of the natural female oestrogen hormone, known as estradiol. This works to improve the menopause symptoms caused by lower levels of oestrogen.

Vagifem is only available as 10 microgram tablets, this is the dose usually prescribed for vaginal dryness. It comes with an applicator which you use to insert them into the vagina. These tablets should never be taken by mouth.

What are the common menopause symptoms?

Menopause is a natural part of a woman’s reproductive cycle. A woman has gone through menopause if she has not had a period bleed for 12 months.

Vaginal dryness and irritation are some of the most common symptoms of menopause. Other common symptoms of menopause are:

• night sweats and difficulty sleeping
• hot flushes
• headaches
• tiredness
• irregular periods
• anxiety
• depression
• reduced libido

In the UK, the average age for a woman to experience menopause is 51 years old.

What is vaginal dryness?

Vaginal dryness happens when the natural lubrication inside the vagina reduces over time during menopause. It causes irritation, itchiness and discomfort.

The natural lubrication inside the vagina is usually maintained by oestrogen hormone levels. If you are going through menopause, your oestrogen levels reduce overtime, so there is less lubrication inside the vagina. This leads to vaginal irritation and dryness, in addition to other menopause symptoms caused by low oestrogen levels.

Some other symptoms you may notice if you have vaginal dryness are:

• frequent UTIs (urine tract infections)
• vaginal bleeding
• pain and discomfort during sex
• soreness and itching around the vagina

During menopause, your oestrogen levels lower over time which also reduces the amount of lubrication inside the vagina, causing vaginal dryness.

Vagifem tablets contain a form of oestrogen known as estradiol. They are inserted into the vagina where they release small amounts of oestrogen regularly into the surrounding tissues. This replaces the reduced estrogen to help relieve the menopause symptoms of vaginal dryness, itching and irritation.

How long does it take for Vagifem to work?

After inserting Vagifem tablets using the applicator provided, it slowly dissolves over several hours.

You may notice improvements in symptoms of vaginal dryness as early as within 8 weeks of treatment, but it usually takes up to 12 weeks to see results after you start this treatment.

How effective is Vagifem?

National guidelines recommend that low-dose vaginal oestrogen such as Vagifem be the first choice of treatment for symptoms affecting the vagina, as these preparations can effectively control such symptoms. You may start seeing results as quickly as within 8 weeks of treatment, but it may also take up to 12 weeks.

Vagifem vaginal tablets release oestrogen in small amounts directly into the vaginal tissues so they are more effective for vaginal dryness compared to other types of HRTs like oral tablets, patches or gels which circulate in the blood. This does however mean that it has less effect on other symptoms of menopause such as hot flushes, compared to these other types of HRT.

Does Vagifem increase libido?

Vaginal dryness can cause itching and irritation which may reduce sex drive (libido).

Using Vagifem helps replace oestrogen in the vaginal tissues and restores natural lubrication, which relieves the discomfort of vaginal dryness and improves sexual experience, which may lead to improved libido.

Vagifem and bladder problems

Vaginal dryness and irritation caused by menopause can lead to bladder or urinary symptoms and cause frequent urinary infections for some. Using vaginal oestrogen tablets like Vagifem can help relieve these symptoms by restoring natural lubrication in the vagina.

You can begin using Vagifem tablets on any day that is convenient for you. Your doctor will usually prescribe one tablet daily for 2 weeks, then one tablet twice a week afterwards. When using Vagifem tablets twice a week, you should leave at least 3 or 4 days between inserting each tablet.

• You should use Vagifem tablets for as short a time as possible to treat vaginal dryness.
• You should discuss with your doctor about using it for longer after your symptoms have improved.
• You should only use it for longer if your doctor explains that the benefits outweigh the risks for you.

You should use Vagifem vaginal tablets as prescribed by your doctor. The patient information leaflet supplied with your medicine pack contains instructions on how to use the applicator to insert Vagifem tablets. Your doctor will provide further advice on the risks of using medicines containing oestrogen long term.

You can buy Vagifem online from UK registered providers like Superdrug Online Doctor. Simply complete our brief online consultation form for one of our doctors to review and check the treatment is suitable for you. If it is right for you, our doctors will prescribe the treatment and we can deliver it to your door.

Can I get Vagifem on the NHS?

If it’s suitable for you, you may be able to get Vagifem on the NHS. You will need to book an appointment with your local GP first, who will check if the treatment is right for you.

Can I get Vagifem over the counter ?

You cannot buy Vagifem over the counter as you need a prescription from a doctor first. Your doctor will review you and check it is safe for you to use Vagifem before giving you a prescription. It is also important that you have check-ups with your doctor at least once a year to ensure this treatment continues to be suitable for you.

Some common Vagifem side effects may include:

• headaches
• vaginal bleeding
• stomach pain

Some uncommon/rare Vagifem side effects may include:

• rash
• weight increase
• feeling sick
• high blood pressure
• hot flush
• thrush (fungal infection in the vagina)

If you experience any of these side effects and they become too difficult to manage, speak to your doctor for advice.

You should stop using Vagifem and seek medical attention immediately if you notice any of the following:

• a large increase in blood pressure
• migraine headaches for the first time
• yellowing of the white part of your eyes or your skin
• you become pregnant
• symptoms of a blood clot like difficulty breathing, leg swelling and sudden chest pain

Vagifem may not be suitable for women who have or have had any of the following medical conditions:

• unexplained vaginal bleeding
• blood clots
• blood disorders
• liver problems
• breast cancer
• heart attack or angina
• stroke
• cancer of the womb
• allergic to estradiol

If you have or have ever had any of the following conditions, you may need to have regular check-ups with your doctor if you use Vagifem, as they may become worse:

• asthma
• gallstones
• epilepsy
• diabetes
• high blood pressure
• migraines
• fibroids
• liver or kidney problems

You should tell your doctor if you have any of the conditions above before you start using Vagifem. The full list of all known Vagifem side effects and cautions are in the patient information leaflet supplied with your treatment pack.

Vagifem and alcohol

Vagifem is a form of HRT used to treat menopause symptoms of vaginal dryness. Drinking alcohol when taking HRTs may increase your risk of developing breast cancer.

You should discuss with your doctor about lifestyle measures you can take such as taking HRT for the shortest possible time to manage your menopause symptoms, or not drinking alcohol at all when taking HRT.

Vagifem and other medicines

Tell your doctor about all medicines you are currently taking, including over the counter medicines and herbal medicines.

Vagifem tablets are applied directly into the vagina so they are less likely to interact with other medicines in the bloodstream. Vagifem may interact with other vaginal treatments. You should also make sure any preexisting vaginal infections have resolved before using this treatment.

While Vagifem tablets are very effective in treating vaginal symptoms, other forms of HRT including oral tablets, patches or sprays may be effective at treating other symptoms of menopause.

We offer the following alternative HRT treatments at Superdrug Online Doctor:

• Estriol cream
• Ovestin
• Estradot
• Vagirux
• Premique
• Kliovance
• Kliofem
• Tibolone
• Indivina
• Femoston-Conti
• Evorel Sequi
• Evorel Conti

Vagifem or Ovestin

Vagifem and Ovestin are both used to treat symptoms of vaginal dryness and irritation caused by the menopause.

Vagifem contains estradiol and is available as vaginal tablets. Ovestin is the brand name for estriol cream and is a vaginal cream. Both are equally effective in treating vaginal dryness, but some women may prefer the vaginal cream to tablets.

Vagifem or estriol cream

Vagifem and estriol cream are both vaginal treatments for menopause symptoms of vaginal dryness and irritation. Estriol cream is the generic (unbranded) version of Ovestin.

Vagifem is available as vaginal tablets and estriol is available as a vaginal cream. Some women may prefer applying a vaginal cream to tablets.