Vagifem is a locally-acting hormone replacement therapy (HRT).

Can I buy Vagifem online?

The Online Clinic can prescribe Vagifem, so long as you have previously used this treatment. Our doctors will need to carry out an online assessment to determine your suitability.

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What is Vagifem?

Vagifem is HRT for women. It contains the female sex hormone estradiol, which is an oestrogen and is exactly like the naturally-produced estradiol from the ovaries. This medicine is a vaginal tablet that is inserted inside the vagina, where it releases oestrogen and acts locally, where needed. The tablet dose (10 micrograms) is very low compared with the dose in a tablet taken orally.

Vagifem is used to relieve menopausal symptoms, specifically of the vagina, including vaginal dryness and irritation. These menopausal symptoms result from the reduction in oestrogen secreted by the ovaries, which naturally occurs in women after the menopause. Vagifem therefore acts by replacing this loss of hormone.

How to use Vagifem

Using the applicator, the vaginal tablet is inserted into the vagina on the day of your choice. When starting Vagifem, one tablet is used every day for the first two weeks. Thereafter, one tablet is inserted two times a week, leaving a three or four-day gap between each tablet. Begin with the lowest dose of Vagifem that is effective for you and use it for only as long as you need to. Regardless of your reason for stopping this medicine, discuss this with your doctor before actually stopping. If you need to have surgery, you must discuss your use of Vagifem with the surgeon who will advise you about stopping and restarting the medicine.

You are unlikely to come to harm if you use too many tablets, as the estradiol dose per tablet is relatively low, but let your doctor know. A forgotten dose should be used when you remember, but twice the dose must never be used if you forget to use Vagifem.

Who can use Vagifem?

Postmenopausal women only can use Vagifem. There are risks associated with using HRT, which need to be considered by each woman and her doctor. Prior to starting, your doctor will take your medical history (as well as your family's) and may carry out a physical examination. Regular check-ups are recommended when on treatment. The Online Clinic can continue your treatment if you have been initiated by your own doctor or gynaecologist.

Women who have experienced an allergic reaction to estradiol or any other constituent (e.g., lactose) of Vagifem cannot use this medicine. Neither can Vagifem be used by women who have/have had breast cancer, cancer or thickening of the endometrium (womb lining), an oestrogen-sensitive cancer, unexplained vaginal bleeding, blood clot in a vein (e.g., legs or lungs) or conditions due to blood clot in an artery (e.g., heart attack or stroke), blood clotting condition, porphyria, or liver disease.

Before starting Vagifem your doctor will want to know if you have had high blood pressure, migraine/severe headaches, diabetes, a liver disorder, gallstones, high blood triglycerides (fat) levels, epilepsy, asthma, conditions affecting the immune system or the ear or causing fluid retention, any abnormalities of the endometrium (e.g., endometriosis or hyperplasia), fibroids, or if you are at greater risk of blood clots or oestrogen-sensitive cancer. Vagifem could cause these conditions to recur. Stop the medicine if you get pregnant, or develop high blood pressure, migraine, yellow-tinged eyes or skin, a blood clot (signs include leg pain and swelling, chest pain, breathing problems), or any condition (listed above) that prohibits its use.

Report all medicines that you take to your doctor as these can alter Vagifem's effect. These include treatments for epilepsy, tuberculosis, and HIV infection, or contain St John's Wort.

Vagifem side effects

You should be aware that HRT medicines that enter your blood are associated with an increased risk of endometrial, breast, and ovarian cancer; of venous blood clots, heart disease, and stroke; and of memory loss (if starting Vagifem when over 65 years of age). While Vagifem is applied locally, there may be a risk of such events occurring with its use, but the risk is considered to be very low.

Vagifem commonly causes vaginal discharge/bleeding/discomfort, headaches, and stomach pain. Less frequently, hot flushes, vaginal infection, nausea, body weight gain, hypertension, and rash occur. Diarrhoea, worsened migraine, fluid retention, and allergy may occur rarely. In general, oestrogens have been known to lead to disorders of the gall bladder and skin.

Vagifem is generally well tolerated.

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