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Estradiol Vaginal (Local)

Generic name: estradiol vaginal (local) [ES-tra-DYE-ole-VA-jin-ul]
Brand Names: Estrace Vaginal Estring. Imvexxy Maintenance Pack, Imvexxy Starter Pack Vagifem. Yuvafem. Imvexxy Local.
Dosage forms:  vaginal cream (0.1 mg/g), vaginal insert (10 mcg; 4 mcg), vaginal ring (2 mg), and vaginal tablet (10 mcg).

Classification of drugs: estrogens and vaginal agents

What is Estradiol Vaginal?

Estradiol, also known as estrogen or female hormones that control many bodily processes, is one form.Estradiol placed in the vagina is used to treat "locally'' vaginal menopause (such as irritation, dryness, and burning). Some vaginal estradiol is used to treat vaginal symptoms of menopause and other symptoms (such as hot flashes). The "systemic" nature of this type of vaginal estradiol can cause effects in other parts of the human body than the area where it is applied.The information in this guide is intended to help you understand the use of estradiol vaginal as a local treatment for vaginal symptoms associated with menopause, such as vaginal dryness and irritation (itching).This medication guide does not list all possible uses of estradiol vaginal.

Side effects of Estradiol vaginal (local)

If you experience any of the following symptoms of an allergy reaction, seek immediate medical attention: Hives, difficulty breathing, swelling in your lips, face, throat, or tongueIf you experience nausea and vomiting with diarrhea, severe muscle pains, dizziness and fainting, or a sunburn-like rash, remove the vaginal rings and get emergency medical help. This could be a sign of toxic shock syndrome, a potentially life-threatening condition.

Estradiol vaginal may cause serious side effects. If you experience:

  • Symptoms of a heart attack: chest pressure or pain, discomfort in your shoulder or jaw, nausea, sweating
  • Signs of a stroke: sudden numbness (particularly on one side), severe headache; slurred or shaky speech.
  • Signs of blood clots: sudden vision loss, chest pain that stabs, shortness of breath, blood in the cough, or pain or heat in both legs.
  • You may experience swelling in the stomach or tenderness.
  • Jaundice
  • Memory problems, confusion, and unusual behaviors;
  • Unusual vaginal bleeding and pelvic pain
  • A lump on your breast,
  • High levels of calcium are accompanied by nausea, vomiting, diarrhea, and increased thirst. Other symptoms include muscle weakness, pain in the bones, fatigue, or a lack of energy.

Some of the common side effects associated with estradiol vaginal include:

  • Nausea, vomiting, bloating, and stomach cramps;
  • Headache;
  • Weight gain; swelling of the hands and feet;
  • Breast pain
  • Breakthrough bleeding.

There may be other side effects. For medical advice on side effects, call your doctor.Report any potential adverse reactions by calling the FDA at 1-800-FDA-1088.


Estradiol should be avoided if: you are pregnant, have undiagnosed vaginal blood, have liver disease or bleeding disorders, will undergo major surgery, or have had heart attacks, strokes, blood clots, Cancer of the breast, uterus, cervix or vagina is a serious threat that must be dealt with as soon as possible.Avoid using it if pregnant.Estradiol can increase the risk that you will develop a condition that may eventually lead to cancer of the uterus. Do not ignore any abnormal vaginal bleeding.Estradiol is not recommended for the prevention of strokes or dementia.

Before you take this drug

Estradiol should be avoided if:

  • Unusual vaginal bleeding not checked by your doctor
  • Liver disease
  • A history of heart attacks, strokes, or blood clots;
  • An increased risk for blood clots as a result of a blood disorder or heart disease;
  • A history of cancers of the breast, uterus, cervix, or vagina

Avoid estradiol during pregnancy. Inform your doctor immediately if you are pregnant while on treatment.This medicine increases your risk of blood clots and strokes. This medicine can increase your risk of blood clots, strokes, and heart attacks.This medicine should not be taken to prevent strokes, heart attacks, or dementia. The medicine can actually raise your chances of getting these diseases.

If you've ever:

  • Heart disease
  • If you have liver disease or jaundice due to pregnancy, taking hormones, or being pregnant,
  • Kidney disease
  • Gallbladder disease
  • Asthma;
  • Epilepsy
  • Migraines;
  • Lupus;
  • Endometriosis or uterine fibroid tumors;
  • Hereditary angioedema
  • Porphyria
  • A thyroid disease;
  • Calcium levels in the blood can be high or low.

Estradiol can increase the risk of breast cancer, uterine cancer, or ovarian cancer. Speak to your doctor regarding this possibility.Estradiol may slow down the production of breast milk. Inform your doctor that you are breastfeeding.

How to take Estradiol Vaginal?

Read all the instructions or guides that come with your medication and follow all the directions. Follow the directions on your prescription label.Estradiol can increase the risk that you will develop a condition that could lead to uterine carcinoma. A progestin may be prescribed by your doctor to lower this risk. If you experience any abnormal vaginal bleeding, call your doctor immediately.Before and after inserting the estradiol vaginal, wash your hands.The applicator supplied is used to accurately measure out the dose prescribed of the vaginal cream, estradiol. After each application, wash the applicator with warm, soapy water and mild detergent.The applicator for each vaginal estradiol tablet comes in single-use packaging. After one application, throw the applicator tablet away.Once it's in place, you shouldn't be able to feel the vaginal band. Remove the ring after 90 days. You may be asked by your doctor to get a replacement ring. It is not necessary to remove the ring during sexual activity. You can remove the ring, wash it in warm water, and then reinsert it after sexual activity if it bothers you.

Remove the ring by gently pulling it out of the vagina. Loop a finger around the ring. If you are having trouble removing the ring, call your doctor.You should have your doctor check on you regularly to see if this is a treatment that should be continued. While using estradiol, self-examine your breasts monthly for lumps and get a mammogram once a year.You may have to temporarily stop using vaginal estradiol if you are going through major surgery or if you will need to be in bed for an extended period of time. You should let any doctor who treats you know if you use estradiol.Keep away from heat and moisture. Store the vaginal rings in their protective pouches until ready to use.

What happens if I miss the dose?

If you are almost due for the next dose, skip the dose that was missed. Never take two doses of the same medicine at once.As soon as possible, remove the vaginal band and replace it with a fresh one. Use an extra vaginal band to compensate for the time missed.Rinse the ring with warm water if it falls out. Then, re-insert it. Use your finger to press it further into the lower vaginal area if it falls down.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention.

What should be avoided?

Smoking is harmful. Estradiol can increase the risk of heart attacks, blood clots, and strokes.Do not use other products for vaginal care without consulting your doctor.Avoid grapefruit products, as they may cause unwanted side effects. Use grapefruit-based products as little as possible.

Interaction with other drug

It is sometimes not safe to take certain drugs at the same time. Some medications can cause side effects that increase or decrease the effectiveness of another drug you are taking.Estradiol can be affected by many drugs. These include prescription drugs, over-the-counter medications, vitamins, and herbal products. This list does not include all interactions. Inform your doctor of all medications you are currently taking and those that you will stop or start using.