Vagifem (Estradiol) is used to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) in women who are experiencing menopause ('change of life', the end of monthly menstrual periods). Some brands of estrogen are also used to treat vaginal dryness, itching, or burning, or to prevent osteoporosis (a condition in which the bones become thin and weak and break easily) in women who are experiencing or have experienced menopause. However, women who need medication only to treat vaginal dryness or only to prevent osteoporosis should consider a different treatment. Some brands of estrogen are also to relieve symptoms of low estrogen in young women who do not produce enough estrogen naturally. Some brands of estrogen are also used to relieve the symptoms of certain types of breast and prostate (a male reproductive gland) cancer. Estrogen is in a class of medications called hormones. It works by replacing the estrogen that is normally produced by the body.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Your doctor may prescribe a progestin to help lower this risk. Call your doctor at once if you have any unusual vaginal bleeding.

Wash your hands before and after inserting Vagifem.

Use the applicator provided to measure the prescribed dose of estradiol vaginal cream. Take apart the cream applicator and wash it with mild soap and warm water after each use.

Each Vagifem tablet is supplied in a single-use disposable applicator. Throw the tablet applicator away after one use.

You should not be able to feel the vaginal ring once it is in place. Leave the vaginal ring in place for 90 days, then remove it. Your doctor may want you to replace it with a new ring. The ring does not need to be removed during sexual intercourse. If the ring is bothersome, you may remove it, rinse it with warm water, and reinsert it after intercourse.

To remove the ring, loop a finger through the ring and gently pull it from the vagina. Call your doctor if you have trouble removing a vaginal ring.

Your doctor should check your progress on a regular basis to determine whether you should continue this treatment. Self-examine your breasts for lumps on a monthly basis and have a mammogram every year while using estradiol.

If you need major surgery or will be on long-term bed rest, you may need to stop using Vagifem for a short time. Any doctor or surgeon who treats you should know that you are using estradiol.

Before taking estrogen,

• tell your doctor and pharmacist if you are allergic to any brand of Estradiol. Ask your pharmacist or check the manufacturer's patient information for a list of the inactive ingredients in the brand of Estradiol you plan to take.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. 
• Using estradiol may increase your risk of cancer of the breast, uterus, or ovaries. Talk with your doctor about this risk.
• tell your doctor if you have or have ever had unusual vaginal bleeding that has not been checked by a doctor; liver disease; a history of heart attack, stroke, or blood clot; an increased risk of having blood clots due to a heart problem or a hereditary blood disorder; or a history of hormone-related cancer, or cancer of the breast, uterus/cervix, or vagina.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking estrogen, call your doctor immediately.  
• Estradiol can slow breast milk production. Tell your doctor if you are breast-feeding.

Estrogen may cause side effects including but not limited to:

• nausea, vomiting, bloating, stomach cramps;
• headache;
• swelling in your hands or feet, weight gain;
• breast pain; or
• vaginal itching or discharge, changes in your menstrual periods, breakthrough bleeding 

Tell your doctor if any of these symptoms are severe or do not go away.

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
• signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;
• signs of a blood clot--sudden vision loss, stabbing chest pain, feeling short of breath, coughing up blood, pain or warmth in one or both legs;
• swelling or tenderness in your stomach;
• jaundice (yellowing of the skin or eyes);
• memory problems, confusion, unusual behavior;
• unusual vaginal bleeding, pelvic pain; 
• a lump in your breast; or
• high levels of calcium in your blood--nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, lack of energy.
• Remove the vaginal ring and seek emergency medical attention if you have: fever with nausea, vomiting, diarrhea, dizziness, fainting, muscle pain, fainting, and/or sunburn-like skin rash. These may be signs of a life-threatening disease called toxic shock syndrome.

Q: Why is Estradiol prescribed?

A: Estradiol is for "local" (physical) treatment of vaginal menopause symptoms. 

Q: Does Estradiol have a generic alternative?

A: Estradiol is available in its brand name Vagifem.

Q: Will Estradiol be uncomfortable?

A: No, you should not be able to feel the medication once it is in place.

Q: How should I store this medication?

A: Keep this medication in the container 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).