Local Vaginal Estrogen Medications
Vagifem (estradiol 10 mcg) is a small, dissolvable vaginal tablet delivered via a single-use applicator. It releases a low, localized dose of estradiol directly to vaginal tissue, with minimal systemic absorption. Generic: Yuvafem
Check out this website for further details regarding Vagifem
How to use it:
Insert one tablet vaginally once daily for 2 weeks, then reduce to twice weekly as a maintenance dose. Use the pre-loaded applicator, inserting as far as comfortable while lying down or standing with one leg raised.
Estrace (estradiol vaginal cream 0.01%) is an estrogen cream that delivers a small, targeted dose of estrogen directly to the vaginal tissue. Because it acts locally, very little is absorbed into the bloodstream, making it appropriate for many patients who need relief from genitourinary symptoms without systemic hormone therapy.
How to use it:
It comes with an applicator, but don't use it. Throw it out! Instead, use your finger to apply a blueberry-sized amount (0.5-1g) nightly: 1/2 intravaginally (to knuckle depth and massage it into the walls) and 1/2 externally (to the vaginal opening, clitoris, and urethra).
Apply this nightly for two weeks, then two times weekly after that.
Check out these links for videos on how to apply estradiol cream -
Video 1
It may take six weeks to see improvement.
ESTRING is a soft, flexible vaginal ring that releases a low dose of estradiol (2mg) directly into the vaginal tissues. It used after menopause to treat moderate to severe menopausal changes in and around the vagina. It works on treating LOCAL symptoms of menopause rather than systemic.
How to use it:
It stays in place continuously for 90 days (3 months), steadily releasing a low, stable dose of estrogen. After 90 days, it is removed and replaced with a new one if treatment continues. The ring can stay in place during sexual intercourse, though it can also be removed if it causes any discomfort. ESTRING may slide down into the lower part of the vagina as a result of the abdominal pressure or straining that sometimes accompanies constipation. If this should happen, gently guide ESTRING back into place with your finger.
What to expect:
It will take about 2 to 3 weeks to restore the tissue of the vagina and urinary tract to a healthier condition and to feel the full effect of it in relieving vaginal and urinary symptoms.
One of the most frequently reported effects associated with the use of ESTRING is an increase in vaginal secretions.
Step-by-step Guide:
Click here for step-by-step instructions
ESTRING INSERTION
ESTRING can be inserted and removed by you or your doctor or healthcare provider. To insert ESTRING yourself, choose the position that is most comfortable for you: standing with one leg up, squatting, or lying down.
After washing and drying your hands, remove ESTRING from its pouch using the tear-off notch on the side. (Since the ring becomes slippery when wet, be sure your hands are dry before handling it.)
Hold ESTRING between your thumb and index finger and press the opposite sides of the ring together as shown.
Gently push the compressed ring into your vagina as far as you can.
ESTRING PLACEMENT
The exact position of ESTRING is not critical, as long as it is placed in the upper third of the vagina.
When ESTRING is in place, you should not feel anything. If you feel uncomfortable, ESTRING is probably not far enough inside. Use your finger to gently push ESTRING further into your vagina.
There is no danger of ESTRING being pushed too far up in the vagina or getting lost. ESTRING can only be inserted as far as the end of the vagina, where the cervix (the narrow, lower end of the uterus) will block ESTRING from going any further
ESTRING REMOVAL
After 90 days there will no longer be enough estradiol in the ring to maintain its full effect in relieving your vaginal or urinary symptoms. ESTRING should be removed at that time and replaced with a new ESTRING, if your doctor determines that you need to continue your therapy.
To remove ESTRING:
Wash and dry your hands thoroughly.
Assume a comfortable position, either standing with one leg up, squatting, or lying down.
Loop your finger through the ring and gently pull it out.
Discard the used ring in a waste receptacle. (Do not flush ESTRING.)
Imvexxy (estradiol vaginal inserts) is a prescription bioidentical estrogen therapy used to treat moderate to severe dyspareunia, which is a symptom of vulvar and vaginal atrophy (VVA) due to menopause. They come as softgel capsules, available in 4mcg and 10mcg, inserted vaginally with a finger.
Check out this website for further details regarding Imvexxy
When to use it:
To start, you should use IMVEXXY once per day for 2 weeks. After that, insert IMVEXXY twice per week—for as long as you and your healthcare provider feel you need it. While you can use IMVEXXY at any time of day, you should use IMVEXXY around the same time each day
