Vagifem (Estradiol Vaginal estrogen) is a female hormone (estrogen) medication. It is used by women to help reduce vaginal symptoms of menopause such as vaginal dryness, itching, and burning; painful or difficult urination; and sudden need to urinate immediately in women who are experiencing or have experienced menopause (change of life; the end of monthly menstrual periods). These symptoms are caused by the body making less estrogen. This medication works by replacing estrogen that is normally produced by the body.

A doctor's prescription is required to buy Vagifem.

Always use Vagifem as directed by your physician. Estrogen vaginal tablets are usually inserted once a day for the first 2 weeks of treatment and then are inserted twice a week as long as treatment is needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Do not use more or less of it or use it more often than prescribed by your doctor.

Before using estradiol, tell your doctor or pharmacist if you are allergic to vaginal estrogen or if you have any other allergies.

Tell your doctor or pharmacist about your medical history, especially of: vaginal bleeding of unknown cause, certain cancers (such as breast cancer, cancer of the uterus/ovaries), blood clots, stroke, heart disease (such as heart attack), liver disease, kidney disease, family medical history (especially breast lumps, cancer, blood clots), family or personal history of a certain swelling disorder (angioedema), blood clotting disorders (such as protein C or protein S deficiency), high blood pressure, diabetes, high cholesterol/triglyceride levels, obesity, lupus, underactive thyroid (hypothyroidism), mineral imbalance (low or high level of calcium in the blood), a certain hormone problem (hypoparathyroidism), uterus problems (such as fibroids, endometriosis), gallbladder disease, asthma, seizures, migraine headaches, mental/mood disorders (such as dementia, depression), a certain blood disorder (porphyria).

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using vaginal estrogen, call your doctor immediately.

Vaginal estrogen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• breast pain or tenderness
• nausea
• heartburn
• vomiting
• dizziness
• nervousness
• depression
• irritability
• difficulty falling asleep or staying asleep
• changes in sexual desire
• hair loss
• unwanted hair growth
• spotty darkening of the skin on the face
• sudden feelings of heat or sweating
• difficulty wearing contact lenses
• leg cramps
• swelling, redness, burning, itching, or irritation of the vagina
• vaginal discharge
• painful or difficult urination
• back pain
• cold symptoms
• flu symptoms

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or seek emergency medical attention:

• bulging eyes
• pain, swelling, or tenderness in the stomach
• loss of appetite
• weakness
• yellowing of the skin or eyes
• joint pain
• movements that are difficult to control
• rash or blisters
• hives
• itching
• swelling of the eyes, face, tongue, throat, hands, arms, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medicine.

What should I know about storage and disposal of this medication?

Keep vagifem in the container that it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community.

What should I do if I think I'm experiencing an overdose?

If you think there has been an overdose, get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

What should I avoid while using Vagifem?

Avoid smoking while taking Vagifem. It can greatly increase your risk of blood clots, stroke, or heart attack while using estradiol.

Avoid using other vaginal products without your doctor's advice.