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Everything you need to know about Vagifem pessaries
Everything you need to know about Vagifem pessaries
Vagifem is a local vaginal oestrogen treatment that comes in the form of a pessary (tablet) inserted directly into the vagina. It contains estradiol, a form of oestrogen that helps restore the vaginal tissues and improve symptoms of vaginal atrophy, dryness, and irritation.
Medically reviewed by Dr. Liz Andrew
BMS Accredited Doctor
Reviewed: 14/03/2025 Published: 20/03/2025
The basics
Key Information About Vagifem (10mcg Estradiol Pessaries)
Vagifem is a vaginal oestrogen treatment used to manage vaginal and urinary symptoms of menopause, including:
- Vaginal dryness, itching, and irritation
- Painful intercourse
- Recurrent urinary tract infections (UTIs)
- Urinary urgency or frequency
- Mild pelvic organ prolapse symptoms
By restoring local oestrogen levels, Vagifem helps improve the health of the vaginal and urinary tissues.
Yes, Vagifem is considered safe for long-term use when prescribed appropriately. Unlike systemic HRT, Vagifem works locally and does not significantly increase oestrogen levels in the bloodstream. This means it does not carry the same risks as systemic HRT, such as an increased risk of blood clots or breast cancer.
If you have a history of breast cancer, blood clots, or other medical conditions, discuss this with your doctor before starting Vagifem.
Yes, Vagifem is a brand name for 10mcg estradiol vaginal pessaries. It provides a precise dose of oestrogen to the vaginal tissues.
Yes, our doctors and nurses prescribe Vagifem during their consultations.
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Benefits of Vagifem
- Restores vaginal moisture – reducing dryness, irritation, and discomfort
- Supports bladder health – reducing urinary urgency, frequency, and infections
- Helps with mild prolapse symptoms – by improving vaginal tissue strength
- Can be used long-term – safe for extended use without major systemic effects
- Easy to apply – simple at-home use with a pre-filled applicator
Vagifem side effects
Most women tolerate Vagifem well, as it works locally with minimal absorption into the bloodstream. However, like all medications, it can cause side effects, particularly in the first few weeks of use.
Common Side Effects (Usually Settle with Time):
- Mild vaginal irritation (burning, itching, or discharge)
- Bloating or mild stomach discomfort
- Spotting or light bleeding (usually in the first few months)
Most side effects settle within a few weeks as your body adjusts. If symptoms persist or worsen, speak to your doctor about adjusting your dose or trying an alternative treatment.
There is no evidence that Vagifem causes weight gain. Local oestrogen does not affect metabolism or body fat distribution like systemic HRT.
Some women notice an improvement within a few days, but for full benefits, it may take several weeks of consistent use.
Vagifem does not reverse prolapse, but it strengthens and improves vaginal tissue elasticity, which may help with mild prolapse symptoms.
Both are effective, and the choice depends on what feels most comfortable for you.
- Pessaries deliver a precise dose directly into the vagina.
- Creams cover a larger surface area and can be used externally.
Both contain estriol (Ovestin) or estradiol (Vagifem), but Vagifem (pessary form) delivers a slightly higher dose per application. The choice depends on personal preference and symptoms.
4 tips to help you
How to use Vagifem
- 1
Insert using the applicator
One pessary is inserted into the vagina, usually daily for the first two weeks, then reduced to twice a week for maintenance
- 2
Consistency is key
It may take a few weeks to feel the difference
- 3
Wash hands before and after use
To prevent irritation or transfer
- 4
For vaginal use only
The pessary should never be swallowed
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