Vagifem® is a treatment for the effects of menopause, which lowers the body’s natural levels of estrogen, an essential hormone. As the female body ages, generally from the age of 45 (although it can vary in each individual), the body produces less and less estrogen. Unless the levels are supplemented through medication, the person will start to suffer multiple symptoms, mainly heat flashes, itching, painful urination and intercourse, and general vaginal discomfort.
More about Estrogen
There is more than one type of hormone in the group called estrogens:
- Estradiol is the most common form in females although it does also exist in males. During a woman’s reproductive years, estradiol levels are at their highest
- Estrone is a weaker form of the hormone, and starts to overtake estrogen levels in the body after menopause. The body can convert estrone to kinds of estrogen.
- Estriol is prominent during pregnancy, promoting uterine growth and preparing for delivery, when levels peak just before birth.
Together, all of these forms in combination are known as conjugated estrogens.
Estrogen stimulates the growth of egg follicles in the womb, strengthens the lining of the vagina and helps to maintain the mucous membrane that lines the uterus. The formation of breast tissue during puberty and controlling the flow of milk after giving birth are also dependent on estrogen.
More about Menopause
It’s important to understand that menopause is not a disease or an infection. During the normal life cycle of girls, and later of women, the body goes through three phases where the levels of estrogen hormones change substantially. In the early years, up to the age of around 11 or 12, girls and boys have very similar levels of hormones. From that point, girls start to produce higher levels of estrogens alongside progesterone, and boys produce higher testosterone levels. These are the main contributors to the differentiation of the adult male and female bodies. Teenage girls develop breasts and the other main components of their bodies dedicated to reproduction, like their ovaries and the shape of pelvic bones, undergo substantial changes.
For the next 40 or so years, estrogen and progesterone play a vital role in controlling the ovarian cycle, so that eggs are released regularly but sparingly to be available for fertilization roughly once each 28 days. However, the body has also evolved with recognition of when reproduction typically tapers off, and so from when women would no longer be reproducing, the production of estrogen slowly starts to decrease.
What are the Main Symptoms when Estrogen Levels are Depleted?
The primary symptoms relate to feelings in the general area of the vagina. They may start off slowly at first, but as estrogen levels fall further with aging, it may cause considerable discomfort and distress.
In the main, the symptoms around the vagina are:
- Dryness and itching on the outer areas and deeper inside
- Pain and bleeding during intercourse
- Irritation from sweating
- Painful to the touch, and to tight clothing
- Painful urination
How Does Vagifem® Work to Supplement Estrogen Levels?
Vagifem® acts to replenish the depleted levels of vaginal estrogen, which is the underlying cause of the symptoms. Made up of estradiol, it is inserted directly into the vagina, right where the estrogen lost due to menopause is lacking. The insert is absorbed into the vagina and immediately alleviates the symptoms that low estrogen levels have caused.
How Do I Use Vagifem®?
Vagifem® is supplied as a pre-packed dose (10 mcg) together with a smooth plastic single-use applicator with which you place one dose in the vagina. Once inserted, simply dispose of the applicator.
You can insert the Vagifem® dose either standing or lying down. Read more instructions in the Patient Information booklet. If you have any questions, ask your healthcare provider or pharmacist.
Although side effects are rare, tell your doctor or pharmacist immediately if you experience any of the following symptoms, or if the treatment is not helping:
- Mental or mood changes such as depression, memory loss
- Breast lumps
- Unexpected vaginal bleeding
- Nausea or vomiting
- Stomach or abdominal pain
- Yellowing of your eyes or skin
- Dark urine
- Swelling of your hands, ankles or feet
- Increased thirst/urination.
Are There Any Serious Side Effects or Cautions if I Use Vagifem®
The following are reported for the general class of estrogen replacement therapies to which Vagifem® belongs.
It may rarely cause serious problems from blood clots (such as heart attacks, strokes, deep vein thrombosis, pulmonary embolism). Get medical help right away if you have any severe side effects, including chest/jaw/left arm pain, unusual sweating, sudden/severe headache, weakness on one side of the body, confusion, trouble speaking, sudden vision changes (such as partial/complete blindness), pain/redness/swelling of legs, tingling/weakness/numbness in the arms/legs, trouble breathing, coughing up blood, sudden dizziness/fainting.
This is not a complete list of possible warning symptoms. If you notice other effects not listed above, alert your doctor or pharmacist.
What Precautions Do I Need to Take When Using Vagifem®?
- It may cause melasma, which shows as dark patches on your face and skin. You should avoid direct sunlight and tanning booths, and always use sunscreen outdoors.
- You should not smoke, since use of tobacco alongside estrogens can increase the risk in menopausal women of strokes or blood clots
- You may develop vision problems, especially if you are wearing contact lenses. Contact your optometrists or ophthalmologist if these problems occur.
- Vagifem® must not be used during pregnancy or when breastfeeding.
- This medication may interfere with some laboratory tests, possibly causing false results.
If you miss a dose, try to make it up as soon as you remember, but not if it is very close to your next normal dosage. Do not double the dose to catch up.