Vagifem 10 mcg treats vaginal symptoms that happen after menopause. Symptoms may include itching, irritation, soreness, vaginal dryness, painful urination, and pain during intercourse. These uncomfortable vaginal changes in and around the vagina after menopause are normal and treatable.

Vagifem delivers treatment directly to the vagina. It is a local estrogen treatment and should not be confused with systematic hormone replacement therapy. Here local means that topical treatment is applied directly to the vagina, urethra, or vulva. Local delivery of estrogen results in lower doses of estrogen compared to systematic estrogen treatments. It limits the amount of hormones a woman may be exposed to. For maximum effects, use it under a doctor’s supervision.

Read the prescription carefully before you start using the medication. If you have doubts regarding the usage of the medicine, check with your doctor. Vagifem 10 mcg is a cream you apply to your vagina with a convenient, predosed, single-use applicator made of smooth plastic.

Use this medication as directed by your doctor, usually once daily for the first two weeks and then twice a week after that. Use of estrogen vaginal cream alone or in combination with progestin should be limited to the shortest duration. The usual dosage range is 2 to 4 gm (marked on the applicator) daily for 7 to 14 days.

After 7 to 14 days, a maintenance dose of one mg (to be measured with an applicator) thrice a week may be implied after vaginal lubrication has been achieved. Follow your doctor's advice for more information.

Do not begin treating yourself with Vagifem cream if you have unusual vaginal bleeding. Inform your doctor about unusual vaginal bleeding right away while you are using Vagifem. Using estrogen as a monotherapy may increase your chance of getting uterus cancer. Vaginal bleeding after menopause can be a warning sign of uterus cancer. Estrogen vaginal cream is not indicated in children. Your doctor should check any unusual vaginal bleeding to find the underlying cause.

Also, do not start using estrogen vaginal cream if any of the following applies to you:

   — Have unusual bleeding

   — Have been diagnosed with a bleeding disorder

   — Currently have or had blood clots

   — Had a stroke or heart attack

   — Currently have or have had liver problems

   — Are allergic to estrogen or any of the other ingredients present in it

Before you use estrogen cream, tell your doctor about all your medical conditions if you are pregnant or breastfeeding. You should also inform your doctor if you have surgery or will be on bed rest. Tell your doctor about all your medications, including prescription, over-the-counter, and herbal supplements.  

Common side effects of Vagifem include breast pain, irregular vaginal bleeding/spotting, stomach or abdominal cramps, bloating, fluid retention, nausea, vomiting, hair loss, fluid retention, and vaginal yeast infection.

Serious but less common side effects include stroke, breast cancer, cancer of the lining of the uterus,  heart attack,  breast cancer, blood clots, gall bladder, high blood pressure, high levels of fat in the blood, changes in your thyroid hormone levels, liver problems, enlargement of benign tumours of the uterus, visual abnormalities, high and low blood calcium, cancer change of endometriosis, worsening of swelling of face and tongue in women with a  history of angioedema.

Call your doctor immediately if you get a new breast lump, unusual vaginal bleeding, severe headaches, changes in vision or speech, shortness of breath, fatigue, and weakness.