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Vagifem
Estradiol
$78.00
10 mcg · 24 suppositories · 3 months supply
BrandBranded medicine· By NovoNordisk
$26.00 per month
How long a supply?
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Annual cost
$312a year at this pack size
FDA boxed warningEndometrial
CANCER, CARDIOVASCULAR DISORDERS, PROBABLE DEMENTIA, and BREAST CANCER
Estrogen-Alone Therapy
Endometrial Cancer
Cardiovascular Disorders and Probable Dementia
The Women’s Health Initiative (WHI) estrogen-alone substudy reported increased risks of stroke and deep vein thrombosis (DVT) in postmenopausal women (50 to 79 years of age) during 7.1 years of treatment with daily oral conjugated estrogens (CE) [0.625 mg]-alone, relative to placebo.
The WHI Memory Study (WHIMS) estrogen-alone ancillary study of WHI reported an increased risk of developing probable dementia in postmenopausal women 65 years of age and older during 5.2 years of treatment with daily CE (0.625 mg)-alone, relative to placebo. It is unknown whether this finding applies to younger postmenopausal women.
Prescribe estrogens with or without progestogens at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.
Estrogen Plus Progestin Therapy
The WHI estrogen plus progestin substudy reported increased risks of pulmonary embolism (PE), DVT, stroke, and myocardial infarction (MI) in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral CE (0.625 mg) combined with medroxyprogesterone acetate (MPA) [2.5 mg], relative to placebo.
The WHIMS estrogen plus progestin ancillary study of the WHI reported an increased risk of developing probable dementia in postmenopausal women 65 years of age and older during 4 years of treatment with daily CE (0.625 mg) combined with MPA (2.5 mg), relative to placebo. It is unknown whether this finding applies to younger postmenopausal women.
Do not use estrogen plus progestogen therapy for the prevention of cardiovascular disease or dementia.
Breast Cancer
The WHI Memory Study (WHIMS) estrogen-alone ancillary study of WHI reported an increased risk of probable dementia in postmenopausal women 65 years of age and older ( 5. 4)
The WHIMS estrogen plus progestin ancillary study of WHI reported an increased risk of probable dementia in postmenopausal women 65 years of age and older
About Vagifem
Overview
Vagifem contains estradiol, a form of estrogen, and is used vaginally to treat symptoms caused by reduced estrogen after menopause. It helps relieve vaginal dryness, irritation and discomfort during intercourse. It works by replacing estrogen locally in vaginal tissues, helping maintain their thickness and moisture.
What it treats
Vaginal atrophy due to menopause, including associated vaginal dryness, irritation and pain during intercourse.
Safety information
Side effects
Common side effects include headache, abdominal discomfort, vaginal discharge, and vaginal irritation or itching. Vaginal spotting or bleeding may also occur. Contact a doctor promptly for unexpected, persistent or recurrent vaginal bleeding, a new breast lump or other breast changes, or yellowing of the skin or eyes. Unusual vaginal bleeding needs assessment because it can be a sign of changes in the womb lining, including cancer. Seek urgent medical help for painful swelling in one leg, sudden chest pain or breathlessness, sudden severe headache, weakness on one side, difficulty speaking, or sudden vision changes. These may indicate a blood clot, heart attack or stroke. Swelling of the face, lips, tongue or throat, particularly with difficulty breathing, may indicate a severe allergic reaction and requires emergency care.
FDA boxed warning
Endometrial
CANCER, CARDIOVASCULAR DISORDERS, PROBABLE DEMENTIA, and BREAST CANCER
Estrogen-Alone Therapy
Endometrial Cancer
Cardiovascular Disorders and Probable Dementia
The Women’s Health Initiative (WHI) estrogen-alone substudy reported increased risks of stroke and deep vein thrombosis (DVT) in postmenopausal women (50 to 79 years of age) during 7.1 years of treatment with daily oral conjugated estrogens (CE) [0.625 mg]-alone, relative to placebo.
The WHI Memory Study (WHIMS) estrogen-alone ancillary study of WHI reported an increased risk of developing probable dementia in postmenopausal women 65 years of age and older during 5.2 years of treatment with daily CE (0.625 mg)-alone, relative to placebo. It is unknown whether this finding applies to younger postmenopausal women.
Prescribe estrogens with or without progestogens at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.
Estrogen Plus Progestin Therapy
The WHI estrogen plus progestin substudy reported increased risks of pulmonary embolism (PE), DVT, stroke, and myocardial infarction (MI) in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral CE (0.625 mg) combined with medroxyprogesterone acetate (MPA) [2.5 mg], relative to placebo.
The WHIMS estrogen plus progestin ancillary study of the WHI reported an increased risk of developing probable dementia in postmenopausal women 65 years of age and older during 4 years of treatment with daily CE (0.625 mg) combined with MPA (2.5 mg), relative to placebo. It is unknown whether this finding applies to younger postmenopausal women.
Do not use estrogen plus progestogen therapy for the prevention of cardiovascular disease or dementia.
Breast Cancer
The WHI Memory Study (WHIMS) estrogen-alone ancillary study of WHI reported an increased risk of probable dementia in postmenopausal women 65 years of age and older ( 5. 4)
The WHIMS estrogen plus progestin ancillary study of WHI reported an increased risk of probable dementia in postmenopausal women 65 years of age and older
A boxed warning is the strongest warning the US Food and Drug Administration requires on a medicine label. Text is taken from the official label, with internal section references removed.
When to call your doctor
If symptoms are severe or getting worse quickly, seek emergency care rather than waiting.
Before taking this medicine
Vagifem should not be used by anyone with an allergy to estradiol or any of its other ingredients; unexplained vaginal bleeding; untreated thickening of the womb lining (endometrial hyperplasia); known, suspected or previous breast cancer; or another known or suspected estrogen-dependent cancer. It should also not be used with a current or previous blood clot in the legs or lungs, a known blood-clotting disorder that increases clot risk, a history of stroke or heart attack, or active liver disease. Previous liver disease also requires avoidance until liver function has returned to normal. Do not use during pregnancy. Conditions requiring caution and medical review include fibroids, endometriosis, risk factors for blood clots or estrogen-dependent cancers, high blood pressure, diabetes, migraine or severe headaches, gallbladder disease, high triglycerides, lupus, epilepsy, asthma, and heart or kidney problems that may worsen with fluid retention. Breastfeeding requires medical advice before use. Any new or unexplained vaginal bleeding should be assessed.
Interactions
Drug interactions are less likely with vaginal estradiol than with estrogen taken by mouth because less reaches the bloodstream. Still, tell your doctor about all medicines and supplements you use, especially: - Medicines for epilepsy, such as carbamazepine, phenytoin or phenobarbital. - Rifampicin or rifabutin, used for certain infections. - Some HIV medicines, including ritonavir or nevirapine. - St John’s wort, a herbal supplement. These medicines and supplements can affect how the body breaks down estrogen. Also mention any other estrogen-containing medicines or hormone treatments before using them together with Vagifem.
Using Vagifem
Dosing
Dosing is set by your prescriber. Each health care professional may prescribe medication differently according to a patient's medical history and condition, so follow the directions on your prescription label and speak to your doctor or pharmacist before changing anything.
Storage
Store below 25°C in the original pack, away from heat so it does not soften. Do not freeze. Keep all medicines out of the sight and reach of children.
Clinical information on this page is summarised from the US FDA label VAGIFEM (ESTRADIOL) INSERT [NOVO NORDISK] (DailyMed, retrieved 19 September 2026).
Patient information and references
Official and supporting information to read alongside advice from your prescriber or pharmacist.
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