Vagifem Tablets - 10mcg

What is Vagifem?

Vagifem pessaries are a local hormone replacement therapy (HRT) used to relieve vaginal symptoms of menopause, like dryness, irritation, and discomfort. They contain a 10 micrograms (mcg) of estradiol, a type of oestrogen, and deliver the hormone directly to the affected area to restore moisture and improve your vaginal health.

Unlike systemic HRT, Vagifem works locally, which means it focuses on relieving vaginal symptoms without significantly affecting the rest of the body.

What is Vagifem used for?

Vagifem is used to treat vaginal atrophy (also known as atrophic vaginitis), a condition commonly experienced during and after menopause due to declining oestrogen levels.

Symptoms of vaginal atrophy may include:

• vaginal dryness
• itching or irritation
• pain during sex
• increased risk of urinary infections

How does Vagifem work?

These tablets are a type of pessary, meaning they are inserted into the vagina using a pre-loaded applicator. Vagifem tablets then dissolve inside your vagina and release medication directly into the surrounding tissue.

By restoring your oestrogen levels locally, Vagifem helps improve the thickness, elasticity, and moisture of vaginal tissues, in turn relieving your symptoms.

How long does it take Vagifem to work?

Some people begin to notice their symptoms easing within a few weeks of using Vagifem, but it may take longer to experience the full effects of the treatment.

• Initial improvement: 2–4 weeks.
• Full benefits: up to 8–12 weeks.

The more consistent you are with your treatment, the more likely you are to see relief, especially during the initial daily treatment phase.

Pros and cons of Vagifem

Pros

• Effective relief for vaginal dryness and discomfort.
• Local treatment with low systemic absorption.
• Easy-to-use applicator.
• Suitable for ongoing use under medical supervision.

Cons

• Requires regular application.
• May cause mild irritation in some users.
• Not suitable for everyone (e.g. certain hormone-sensitive conditions).
• Symptoms may return if treatment is stopped.

How to use Vagifem tablets

Always follow your prescriber’s instructions when using Vagifem.

The typical dosing schedule when using Vagifem is:

• First two weeks: use one tablet a day.
• After first two weeks: use one tablet twice weekly for maintenance.

When using Vagifem, you should:

• Insert the applicator gently into the vagina.
• Release the tablet as directed.
• Dispose of the applicator after use.
• Wash your hands before and after application.

How long does it take for Vagifem to dissolve?

Vagifem pessaries are designed to dissolve inside your vagina shortly after you've inserted them. While the exact time can vary, they typically dissolve within a few hours, allowing the medication to be absorbed by the vaginal tissues.

Can you use Vagifem and estriol cream together?

Both Vagifem and estriol cream contain oestrogen, so combining the two may increase your oestrogen levels beyond what’s required. To make sure your treatment only targets the intended area, and isn’t fully absorbed into your bloodstream, it’s generally best to only use one vaginal oestrogen treatment at a time unless advised otherwise by a healthcare professional.

If symptoms are not improved when using one of the two treatments, speak to your prescriber about suitable alternatives.

Potential Vagifem side effects

Vagifem is generally well tolerated, but some side effects may occur.

Common side effects:

• vaginal irritation or itching
• abdominal discomfort
• headache

Less common side effects include:

• vaginal bleeding or spotting
• breast tenderness
• nausea

For more information on Vagifem side effects, please read the patient information leaflet.

Effects of stopping Vagifem

If you stop using Vagifem, symptoms of vaginal atrophy may gradually return. This is because the underlying cause (reduced oestrogen levels) remains.

For long-term management of your symptoms, your clinician may recommend ongoing treatment.

When not to use Vagifem pessaries

Vagifem may not be suitable if you:

• have a history of oestrogen-sensitive cancers (e.g. breast cancer)
• have unexplained vaginal bleeding
• have untreated endometrial hyperplasia
• are allergic to any of the ingredients

Always consult a healthcare professional before starting treatment.

Storage information

• Store below 25°C.
• Keep in original packaging.
• Keep out of sight and reach of children.
• Do not use after the expiry date.

Alternatives to Vagifem tablets

If Vagifem is not suitable for you, other treatments for vaginal atrophy include:

• vaginal oestrogen creams (e.g. estriol creams like Ovestin and Ovesse)
• vaginal rings that release oestrogen over time
• other vaginal tablets or pessaries
• non-hormonal lubricants and moisturisers

Which treatment you choose will depend on your symptoms, how you prefer to apply your treatment, and what your clinician recommends.

Frequently asked questions about Vagifem tablets

Do Vagifem tablets cause weight gain?

Weight gain is not a commonly reported side effect of Vagifem, as it's a low-dose, local treatment with minimal absorption into your bloodstream.

Can you use Vagifem once a week?

The maintenance dose of Vagifem is typically twice weekly. Using it once a week may not effectively ease your symptoms, unless you're advised otherwise by a healthcare professional.

Can you use Vagifem three times a week?

You may be advised to adjust your dosing to three times a week, but this should only be done under medical supervision.

Is Vagifem safe for long term use?

Vagifem can be used long-term if prescribed and monitored by a healthcare professional. Local oestrogen treatments are generally considered safe for extended use.

Is Vagifem the same as HRT?

Vagifem is a form of HRT, but it's local (vaginal) HRT, meaning it targets symptoms in a specific area rather than affecting the whole body.

Sources

• Menopause. NHS. [Accessed 27 April 2026].
• Hormone replacement therapy (HRT). NHS. [Accessed 27 April 2026].
• Vaginal dryness (atrophic vaginitis). NHS. [Accessed 27 April 2026].
• Vagifem 10 micrograms vaginal tablets. [Accessed 27 April 2026].
• Menopause: diagnosis and management. National Institute for Health and Care Excellence. [Accessed 27 April 2026].
• Menopause. NICE Clinical Knowledge Summaries. [Accessed 27 April 2026].
• Hormone replacement therapy. British Menopause Society. [Accessed 27 April 2026].