Estradiol Vaginal Tablets: Effective Relief for Menopausal Symptoms

Summary of Key Points

Estradiol vaginal tablets are a form of estrogen therapy used to relieve menopause-related symptoms such as vaginal dryness, burning, and irritation. They are also effective in treating conditions like vaginal atrophy and urinary incontinence. The medication works by replacing the estrogen that the body no longer produces after menopause. It is important to consult your healthcare provider before starting or adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.

Names of Medication

US Brand Name: Vagifem

Generic Name: Estradiol

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, “Estradiol” is the generic name.

Pharmacologic Category

Estrogen Derivatives

Hormone Replacement Therapy (HRT)

Dosing for Estradiol Vaginal Tablets

Estradiol vaginal tablets are prescribed for a variety of conditions. Below are the recommended doses for adults. Always consult your healthcare provider before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Vaginal Atrophy

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Menopausal Symptoms (Vaginal Dryness, Burning, and Irritation)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Osteoporosis (Prevention)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Hypoestrogenism (Due to Hypogonadism, Castration, or Primary Ovarian Failure)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Vulvar and Vaginal Atrophy

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Urinary Incontinence (Related to Menopause)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Dyspareunia (Painful Intercourse)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Hormone Replacement Therapy (HRT)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Endometriosis (Palliative Treatment)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Breast Cancer (Palliative Care)

Initial Dose: 10 mcg inserted vaginally once daily for 2 weeks.

Maintenance Dose: 10 mcg inserted vaginally twice weekly.

Dosage Forms and Strengths

Vaginal Tablet: 10 mcg

How to Use Estradiol Vaginal Tablets

Estradiol vaginal tablets should be inserted into the vagina using the applicator provided. Follow the instructions carefully to ensure proper use. Be sure to wash your hands before and after handling the tablet. If you miss a dose, take it as soon as you remember, but avoid doubling up on doses. Always consult your healthcare provider for further instructions, and feel free to schedule a telemedicine visit for additional assistance.

Contraindications for Estradiol Vaginal Tablets

A contraindication is a specific condition where a treatment should not be used due to potential harm. For Estradiol vaginal tablets, several contraindications must be discussed with your healthcare provider before starting treatment.

1. Breast cancer: If you have a history of breast cancer or are currently undergoing treatment, estradiol can stimulate the growth of estrogen-sensitive cancer cells.
2. Undiagnosed vaginal bleeding: Any unexplained vaginal bleeding should be evaluated before using estradiol, as it could indicate a more serious condition, such as endometrial cancer.
3. Active or past history of blood clots: Estradiol can increase the risk of blood clots, which may lead to conditions like deep vein thrombosis (DVT), stroke, or pulmonary embolism.
4. Liver disease: Estradiol is processed by the liver, and if you have liver disease, it may not be metabolized properly, increasing the risk of side effects.
5. Pregnancy: Estradiol should not be used during pregnancy, as it can harm the developing fetus.
6. Known allergy to estradiol or any component of the tablet: If you are allergic to estradiol or any inactive ingredients, avoid this medication to prevent allergic reactions.

Drug Interactions with Estradiol Vaginal Tablets

Certain medications can interact with Estradiol vaginal tablets, potentially reducing their effectiveness or increasing the risk of side effects. It is important to inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, and herbal supplements. Below are some common medications that may interact with estradiol:

1. Rifampin (Rifadin): This antibiotic can reduce the effectiveness of estradiol by increasing its breakdown in the liver.
2. Carbamazepine (Tegretol): This anticonvulsant may decrease estradiol’s effectiveness by speeding up its metabolism.
3. Phenytoin (Dilantin): Another anticonvulsant that can lower estradiol levels, making it less effective.
4. St. John’s Wort: This herbal supplement can reduce estradiol’s effectiveness by increasing its breakdown in the liver.
5. Warfarin (Coumadin): Estradiol may interfere with blood-thinning medications, complicating blood clot management.

Estradiol Vaginal Tablets in Pregnancy

Is it safe to take Estradiol vaginal tablets when pregnant?

No, it is not safe to take Estradiol vaginal tablets during pregnancy. Estradiol, a form of estrogen, can potentially harm a developing fetus if used while pregnant. If you are pregnant or planning to become pregnant, it is important to avoid this medication. Should you become pregnant while using estradiol, contact your healthcare provider immediately for guidance.

Estradiol Vaginal Tablets while Breastfeeding

Is it safe to take Estradiol vaginal tablets while breastfeeding?

It is generally not recommended to use Estradiol vaginal tablets while breastfeeding. Estradiol can pass into breast milk, which may affect milk production or have an impact on the nursing infant. If you are breastfeeding, consult your healthcare provider to discuss alternative treatments or to determine whether estradiol is appropriate for your situation.

Estimated Cost of Estradiol Vaginal Tablets

The cost of a 30-day supply of Estradiol vaginal tablets without insurance can vary. With a GoodRx coupon, prices typically range from $40 to $60, depending on the pharmacy. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a discount service like GoodRx to find the most affordable option.

Possible Alternatives to Estradiol Vaginal Tablets

Depending on the condition being treated, there are several alternative treatments or lifestyle changes that may be effective. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives.

Vaginal Atrophy

Non-hormonal moisturizers and lubricants can help relieve vaginal dryness. Another option for treating vaginal atrophy is vaginal DHEA (Intrarosa).

Menopausal Symptoms

Lifestyle changes such as regular exercise, a balanced diet, and stress management can help alleviate menopausal symptoms. Non-hormonal medications, such as SSRIs (e.g., paroxetine), may also be considered as an alternative to Estradiol tablets for menopause.

Osteoporosis

Calcium and vitamin D supplements, along with weight-bearing exercises, can help strengthen bones. Medications like bisphosphonates (e.g., alendronate) or selective estrogen receptor modulators (SERMs) may also be prescribed to prevent bone loss.

Hypoestrogenism

Hormone replacement therapy (HRT) is the most common treatment for hypoestrogenism, but non-hormonal options like SERMs may be considered for some patients.

Vulvar and Vaginal Atrophy

Vaginal moisturizers and lubricants can provide relief from symptoms of vulvar and vaginal atrophy. In some cases, vaginal laser therapy may be an option.

Urinary Incontinence

Pelvic floor exercises (Kegels) and bladder training can help manage urinary incontinence. Medications like anticholinergics (e.g., oxybutynin) may also be prescribed.

Dyspareunia

Vaginal lubricants and moisturizers can help reduce pain during intercourse. In some cases, vaginal estrogen therapy may be recommended to alleviate dyspareunia.

Hormone Replacement Therapy

Non-hormonal treatments such as SSRIs or gabapentin can help manage menopausal symptoms without the use of estrogen, offering an alternative to vaginal estrogen therapy.

Endometriosis

Non-hormonal pain relievers like NSAIDs (e.g., ibuprofen) can help manage pain associated with endometriosis. Hormonal treatments such as progestins or GnRH agonists may also be considered.

Breast Cancer (Palliative Care)

Non-hormonal treatments like pain relievers, radiation therapy, and chemotherapy are typically used in palliative care for breast cancer. Hormonal treatments are generally avoided in patients with breast cancer.

Recent Updates on Estradiol Vaginal Tablets Research

Recent research on Estradiol vaginal tablets has focused on their long-term safety and effectiveness in treating vaginal atrophy and other menopausal symptoms. A 2022 study found that low-dose estradiol vaginal tablets effectively relieve symptoms of vaginal atrophy with minimal systemic absorption, reducing the risk of side effects commonly associated with systemic estrogen therapy. Ongoing studies are also exploring the use of estradiol in combination with other therapies to improve outcomes for women with severe menopausal symptoms or hypoestrogenism.

As always, staying informed about the latest research is important. Discuss any concerns with your healthcare provider. If you have questions about whether Estradiol vaginal tablets are right for you, schedule a telemedicine appointment with one of our providers today.

James Kingsley

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