Menopause, which means 'the period when menstruation stops', is a very normal and natural part of a woman's life. However, some of the physical changes that occur during this time can be a bit uncomfortable. Many people do not like to talk about things like vaginal pain and dryness during sex, especially because they are a little embarrassed. One of the drugs that doctors recommend as a solution to such problems is the Estradiol Vaginal Insert, which we are talking about today.
Simply put, what is this Estradiol?
Estradiol is a member of the hormone estrogen. As you may recall, estrogen is a hormone that is very important for the functioning of the female body. With menopause, the level of this estrogen hormone in the body naturally decreases. This decrease can cause the vaginal area to become dry, thin, and lose elasticity. This can cause pain during sex.
So what this Estradiol vaginal insert does is deliver a small amount of the hormone estrogen directly into the vagina, reducing that dryness and pain. This is a pill that is inserted into the vagina, not taken orally. This pill can come under different brand names like Vagifem and Yuvafem.
Things you need to tell your doctor before taking this medicine
Okay, now this is very important. Before your doctor prescribes this medicine to you, he or she should have a clear understanding of your complete health condition. So, if you have any of the conditions below, be sure to tell your doctor .
- If there is abnormal vaginal bleeding, not normal.
- If you have had blood clots or blood vessel problems in the past.
- If you have had or currently have cancer of the breast, cervix, uterus, ovaries, liver, or the lining of the uterus (endometrium).
- If you have dementia.
- If you have diabetes.
- If you have gallbladder disease.
- If you have heart disease or have recently had a heart attack.
- If you have high blood pressure.
- If you have high cholesterol or calcium levels in your blood.
- If the uterus has been surgically removed (hysterectomy).
- If you have kidney or liver disease.
- If you have migraine headaches.
- If you have had a stroke before.
- If you have an autoimmune disease like systemic lupus erythematosus (SLE).
- If you are a smoker.
- If you have an allergic reaction to the hormone estrogen, other hormones, other medications, foods, preservatives, or dyes.
- If you are trying to get pregnant, are pregnant, or are a breastfeeding mother.
It is very important for your own safety to tell the doctor without hiding these things.
How exactly do I use this medicine?
This is very easy to use, but it has to be done correctly.
1. Wash your hands: Wash your hands thoroughly with soap before and after using the medicine.
2. Insert correctly: Read the instructions that come with the medicine carefully. Usually, this comes with a special applicator. You should use it to insert the medicine into the vagina.
3. Best time: Usually the best time to use this medicine is at night before going to bed . Then, since you are lying down, the medicine has time to absorb well and take effect.
4. Dosage: Do not use more than the doctor recommends. Also, do not stop taking it suddenly without his advice.
What if there is an emergency?
If you suspect that you have overdosed on this medicine, or if someone has ingested it, immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
This medicine has been prescribed for you only. It is tailored to your condition and health. Therefore, never share it with others.
Side effects and other things to watch out for
There are some things we need to be careful about when using this medicine. Let's look at them in the table below.
| Side effect/symptom | What to do |
|---|---|
| Serious side effects that should be reported to the doctor immediately | |
| Allergic reactions Skin rash, itching, swelling of the face, lips, tongue or throat. | Seek medical advice immediately or go to the ETU. |
| Blood clot Leg pain, swelling, redness, difficulty breathing, chest pain. | This is an emergency. Go to the hospital immediately. |
| Stroke Sudden numbness/weakness of the face, arm or leg, difficulty speaking, difficulty walking, sudden severe headache. | This is an emergency. Go to the hospital immediately. |
| Changes in the breasts New lumps, redness, pain, and discharge from the nipple. | Inform your doctor immediately. |
| Abnormal vaginal discharge/bleeding Bleeding, heavy discharge, itching, or bad odor even after menopause. | Inform your doctor immediately. |
| Symptoms of liver injury Pain in the upper right abdomen, nausea, yellowing of the skin or eyes, dark urine. | Inform your doctor immediately. |
| Things that are usually not serious, but should be reported to the doctor if they persist | |
| Bloating, breast pain or tenderness, nausea, vomiting. | If these persist or are bothersome, talk to your doctor. |
Other important points
- Regular check-ups: Stay in touch with your doctor regularly to see how your treatment is progressing. You will need to have a breast exam and a pelvic exam at regular intervals. Also, talk to your doctor about whether and how to get a mammogram , and follow his or her instructions.
- Smoking: As we mentioned earlier, smoking greatly increases the risk of blood clots and stroke. This risk is especially high if you are over 35 years old. Therefore, we advise you to avoid smoking completely.
- Surgery: If you have a planned surgery (elective surgery), you may need to stop taking this medicine for a while before it. Talk to your doctor about this and get advice.
Take-Home Message
- The estradiol vaginal insert is a local hormonal treatment for vaginal pain and dryness that occurs after menopause.
- It is essential to tell your doctor about all your medical conditions (especially cancer, blood clots, heart disease) and other medications you are taking before using this.
- This medication is for vaginal use only. Use the prescribed dose at the prescribed time (usually before bedtime).
- Seek immediate medical attention if you experience any serious side effects, such as breast lumps, leg swelling and pain, difficulty breathing, or sudden severe headache.
- Do not miss scheduled medical exams (e.g., breast and pelvic exams). Avoid smoking completely while using this medication.
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