Vagifem® (estradiol vaginal inserts) 10 mcg logo

Get to know Vagifem®

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Vagifem® (estradiol vaginal inserts) 10 mcg logo

Get to know Vagifem®

What is Vagifem®?

Vagifem® contains estradiol (an estrogen hormone) in a vaginal insert and is used after menopause to treat moderate to severe menopausal changes in and around the vagina. Vagifem® is placed directly into the vagina, right where you’re experiencing changes, to help replenish estrogen lost due to menopause.


Menopause can mark a big shift in a woman’s life. Sometimes it causes bothersome vaginal changes. The good news is that Vagifem® 10 mcg estradiol vaginal inserts can treat some of these changes.

Who should not take Vagifem®?

Do not start using Vagifem® if you:

  • have unusual vaginal bleeding
  • have been diagnosed with a bleeding disorder
  • currently have or have had certain cancers
  • had a stroke or heart attack
  • currently have or have had blood clots
  • currently have or have had liver problems
  • are allergic to Vagifem® or any of the ingredients in it

Do not start using Vagifem® if you:

have unusual vaginal bleeding

have been diagnosed with a bleeding disorder

currently have or have had certain cancers

had a stroke or heart attack

currently have or have had blood clots

currently have or have had liver problems

are allergic to Vagifem® or any of the ingredients in it

What about side effects?

Common side effects of Vagifem® include headache, breast pain, irregular vaginal bleeding or spotting, stomach or abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention, and vaginal yeast infection. Serious but less common side effects have been reported; read about other possible side effects in the Prescribing Information and the Important Safety Information below.

For more information, ask your health care provider or pharmacist. Tell your health care provider if you have any side effects that bother you or do not go away.

How Vagifem® works in your body

Not all estrogens are the same. The estrogen used in Vagifem® is called estradiol, which is the same estrogen your body makes. Vagifem® treats changes in and around the vagina that occur after menopause. Symptoms can include vaginal dryness, irritation, itching, and soreness; painful urination; and pain and bleeding during sex.

Vagifem® (estradiol vaginal inserts) 10 mcg estradiol tab

Getting started

Whether you’re new to Vagifem® or resuming treatment after a break, you can get started here.

When to take Vagifem®

For the first 2 weeks, you’ll use Vagifem® once daily. After that, you’ll reduce to twice a week, as directed by your health care provider.

You choose the days you take Vagifem®. For example, you could take it every Tuesday and Friday, as shown in the dosing schedule below. You can use Vagifem® at any time of the day that you choose, but it should be done at the same time on each dosing day.

Store Vagifem® at room temperature: 68-77ºF (20-25ºC). Do not refrigerate.

Vagifem® dosing schedule
Vagifem® (estradiol vaginal inserts) 10 mcg dosing schedule
Vagifem® (estradiol vaginal inserts) 10 mcg dosing schedule
Vagifem® (estradiol vaginal inserts) 10 mcg dosing schedule
Vagifem® (estradiol vaginal inserts) 10 mcg dosing schedule
How to take Vagifem®

Vagifem® is inserted into the vagina using a preloaded, single-use applicator. The following isn’t the complete set of instructions for use—please be sure to read all of the information in the Instructions for Use before you start.

1

Tear off a single applicator.

2

Separate the plastic wrap and remove the applicator from the plastic wrap as shown in Figure A. If after opening the package you see that the insert has come out of the applicator but has not fallen out of the package, carefully put it back into the applicator for insertion. Please keep your hands clean and dry while handling the insert.

Separating the plastic wrap and removing the applicator
Figure A
3

Hold the applicator so that the finger of one hand can press the applicator plunger as shown in Figure B.

Holding the applicator
Figure B
4

Next, select the best position for vaginal insertion of Vagifem® that is most comfortable for you. See suggested reclining Figure C or standing Figure D position.

Positioning for vaginal insertion
Figure C
Inserting the medication
Figure D
5

Using the other hand, guide the applicator gently and comfortably through the vaginal opening (see Figures C and D). If prior to insertion the insert falls out of the applicator, throw the insert and applicator away and use a new insert-filled applicator.

6

The applicator should be inserted (without forcing) as far as comfortably possible, or until half of the applicator is inside your vagina, whichever is less.

7

Once the insert-filled applicator has been inserted, gently press the plunger until the plunger is fully depressed. This will eject the insert inside your vagina, where it will dissolve slowly over several hours.

8

After depressing the plunger, gently remove the applicator and dispose of it the same way you would a plastic tampon applicator. The applicator is of no further use and should be discarded properly. Insertion may be done at any time of the day. It is advisable to use the same time daily for all applications of Vagifem®. If you have any questions, please consult your health care provider or pharmacist.

What to expect moving forward
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When to look for results

Since Vagifem® works to address the underlying cause of your menopausal vaginal symptoms, you won’t experience results immediately. But that doesn’t mean it’s not working. One study showed that Vagifem® reduced a combined score of the most bothersome vaginal symptoms at 12 weeks. You may want to talk with your partner about what to expect, too.

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How long you might stay on treatment

Once you have met your treatment goals, your health care provider may tell you to stop taking Vagifem®. You and your health care provider should talk regularly—for example, every 3 to 6 months—about whether you still need treatment with Vagifem® or, if you’ve been off treatment, whether it’s appropriate to resume. Estrogens should be used at the lowest dose possible for your treatment and only as long as you need to use this medicine.

Prescription bag with heart refill icon
Returning to treatment

The menopausal condition that causes uncomfortable vaginal symptoms is called vaginal atrophy. It’s a chronic condition, meaning it’s ongoing; it can be treated, but not cured. That’s why it’s important to know your body, talk regularly with your health care provider, and continue paying attention to your symptoms.