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Treatment Information

Table of contents

Vagifem: Understanding the Medication and Its Mechanism

Vagifem is a prescription medication designed to address specific symptoms of menopause in women. As women age and approach menopause, their bodies produce less estrogen, leading to various physiological changes. Vagifem, containing the active ingredient estradiol, aims to replenish these declining estrogen levels, offering relief from the discomforts associated with menopause.

What is Vagifem?

Vagifem is a vaginal tablet that belongs to a class of medications known as hormone replacement therapies (HRT). Its primary component, estradiol, is a form of the female hormone estrogen. Estradiol in Vagifem is identical to the estrogen naturally produced by the ovaries before menopause.

Why is Vagifem Prescribed?

Vagifem is specifically formulated to treat symptoms of vulvar and vaginal atrophy (VVA) due to menopause. VVA is a condition where the vaginal walls become thin, dry, and inflamed due to a decrease in estrogen levels. Symptoms of VVA include:

  • Vaginal dryness
  • Burning sensations
  • Vaginal irritation
  • Discomfort during intercourse

By addressing the root cause of these symptoms, Vagifem provides relief and improves the quality of life for many postmenopausal women.

How Does Vagifem Work?

The mechanism of action of Vagifem is centred around its ability to replace the declining estrogen levels in postmenopausal women:

  1. Estrogen Replenishment: When Vagifem is inserted into the vagina, the estradiol it contains is released and absorbed by the vaginal tissues. This local application ensures targeted delivery, addressing vaginal symptoms directly.
  2. Restoration of Vaginal Tissue: With the reintroduction of estrogen, the vaginal tissues begin to thicken and regain their elasticity. This process helps reduce dryness and inflammation, alleviating the symptoms of VVA.
  3. Maintenance of pH Balance: Estrogen plays a crucial role in maintaining a healthy vaginal pH. A balanced pH is essential for the overall health of the vaginal environment, preventing infections and promoting the growth of beneficial bacteria.
  4. Enhanced Lubrication: By rejuvenating the vaginal tissues, Vagifem also aids in natural lubrication, reducing discomfort during intercourse.

Understanding the Risk of Cancer with Vagifem

Vagifem is a prescription medication used to treat symptoms of vulvar and vaginal atrophy (VVA) due to menopause. It contains estradiol, a form of the female hormone estrogen. While Vagifem can be effective in treating VVA symptoms, it's essential to understand the potential risks associated with its use, especially concerning cancer.

1. Endometrial Cancer:

  • What it is: Cancer that starts in the lining of the uterus (endometrium).
  • Risk with Estrogen Therapy: Using estrogen-alone therapy, like Vagifem, may increase the risk of endometrial cancer. This risk seems to increase as the dose and duration of treatment are extended.
  • Recommendation: If you experience any unusual vaginal bleeding while using Vagifem, it's crucial to report it to your doctor immediately, as this could be a sign of endometrial cancer.

2. Breast Cancer:

  • What it is: Cancer that forms in the cells of the breasts.
  • Risk with Estrogen Therapy: Some studies suggest that prolonged use of estrogen therapy can slightly increase the risk of breast cancer.
  • Recommendation: Regular breast self-exams and mammograms should be part of routine healthcare for women using Vagifem. Any lumps or unusual symptoms in the breast should be reported to a healthcare provider promptly.

3. Ovarian Cancer:

  • What it is: Cancer that begins in the ovaries.
  • Risk with Estrogen Therapy: Some studies have indicated a potential increased risk of ovarian cancer with long-term use of estrogen therapy.
  • Recommendation: Be aware of the symptoms of ovarian cancer, such as abdominal pain, bloating, and changes in urinary habits. Consult with your doctor if you experience any of these symptoms.

Safety Precautions:

  • Duration of Use: It's recommended to use Vagifem for the shortest duration consistent with treatment goals. Regularly review the need for continued therapy with your healthcare provider.
  • Combined Therapy: If you have an intact uterus, your doctor might prescribe a progestin alongside Vagifem to reduce the risk of endometrial cancer.
  • Regular Check-ups: Regular medical check-ups, including pelvic exams, breast exams, and mammograms, are crucial when using Vagifem.

Side Effects and Contraindications of Vagifem

Common Side Effects:

  • Headache
  • Breast pain or tenderness
  • Irregular vaginal bleeding or spotting
  • Stomach or abdominal cramps, bloating
  • Nausea and vomiting
  • Hair loss or thinning
  • Vaginal itching or discharge

Less Common Side Effects:

  • Changes in libido
  • Mood swings, depression, or irritability
  • Increase or decrease in weight
  • Swelling of hands, ankles, or feet
  • Vaginal infection

Rare but Serious Side Effects:

  • Chest pain or discomfort
  • Lumps in the breast
  • Severe headache or migraine
  • Dizziness or fainting
  • Changes in vision
  • Slurred speech
  • Sudden shortness of breath
  • Pain or swelling in the legs
  • Weakness or numbness in the arms or legs
  • Jaundice (yellowing of the skin or eyes)
  • Memory problems or confusion

Contraindications for Vagifem

  • Known, Suspected, or History of Breast Cancer
  • Known or Suspected Estrogen-Dependent Malignancies
  • Undiagnosed Vaginal Bleeding
  • History of Blood Clots
  • History of Stroke or Heart Attack
  • Known or Suspected Pregnancy
  • Liver Disease or Dysfunction
  • Known Protein C, Protein S, or Antithrombin Deficiency
  • Allergic Reactions to Vagifem or its Ingredients

Frequently Asked Questions About Vagifem

What Is Vagifem Used For?

Vagifem is prescribed to treat symptoms of vulvar and vaginal atrophy (VVA) due to menopause, such as vaginal dryness, burning, and irritation.

How Is Vagifem Administered?

Vagifem is a vaginal tablet that is inserted into the vagina using a provided applicator.

How Often Should I Use Vagifem?

Typically, it's recommended to use one tablet daily for the first two weeks, followed by one tablet twice weekly. However, always follow your doctor's instructions.

Are There Any Common Side Effects Associated With Vagifem?

Yes, some common side effects include headache, breast pain, and irregular vaginal bleeding or spotting.

Can I Use Vagifem If I'm Pregnant?

No, Vagifem is not recommended for use during pregnancy.

Is Vagifem an Over-The-Counter Medication?

No, Vagifem is a prescription medication and should be used under the guidance of a healthcare professional.

How Does Vagifem Work?

Vagifem contains estradiol, a form of estrogen. It works by replenishing the declining estrogen levels in postmenopausal women, helping to restore the vaginal tissue.

Can I Use Vagifem While Breastfeeding?

Consult with your healthcare provider before using Vagifem while breastfeeding.

What Should I Do If I Miss a Dose?

If you miss a dose, use it as soon as you remember. If it's close to the time for your next dose, skip the missed dose and go back to your regular schedule. Do not use two doses at the same time.

How Should I Store Vagifem?

Store Vagifem at room temperature, away from direct sunlight and moisture. Keep it out of reach of children.

Treatment information

  • Product Name: Vagifem
  • Manufacturer: Novo Nordisk
  • Active Ingredient(s): Estradiol Hemihydrate
  • Administration: Vaginal Tablets
  • Presentation: Tablets
  • Available Strength: 10mcg
  • Exemption: Prescription Only
  • Dosage: Use one vaginal tablet each day for the first 2 weeks
    • Then use one vaginal tablet twice a week. Leave 3 or 4 days between each dose.
    • Description: Vagifem® belongs to a group of medicines called vaginal Hormone Replacement Therapy (HRT).
    • Drug Class: Hormonal replacement therapy (HRT)
    • Alcohol Consumption: No influence
    • When Pregnant: Do not use while pregnant. Speak to your doctor for further information.
    • When Breastfeeding: Do not use while breastfeeding. Speak to your doctor for further information.
    • Related Drug: Oestrogel
    • Price: 39.99 GBP
Click here to view the Vagifem - Patient Information Leaflet

Authored & Reviewed By

Mohamed Imran Lakhi

Mohamed Imran Lakhi

MPharm - Lead Pharmacist
Imran Lakhi is the superintendent pharmacist and founder at Prescription Doctor. He has been at the core of our team.

Published on: 29/09/2023 Reviewed on: 13/03/2024
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