Menopause is a natural change in a woman's life. But we don't talk much about some of the physical discomforts that come with it, do we? Especially things like vaginal dryness, itching, burning, and pain during sex. These can also cause a lot of stress. So, one medicine that your doctor may recommend to relieve these symptoms is Estradiol vaginal tablets. Let's talk about this in detail, very simply.
What exactly is Estradiol?
Simply put, Estradiol is a medicine that contains the same hormone called estrogen that is naturally produced in the female body. This comes in the form of a small pill that can be inserted into the vagina. After menopause, the body's estrogen levels decrease, which is why vaginal dryness occurs. So, when this pill is inserted directly into the vagina, that area receives the necessary estrogen hormone, and the tissues there begin to recover. Due to this, symptoms such as dryness, inflammation, and pain gradually decrease. In Sri Lanka, this medicine can be seen under brand names such as Vagifem.
Things you need to tell your doctor before taking this medicine
This is very important. Before prescribing Estradiol tablets to you, your doctor should know your complete health history. This is because using this medicine with certain medical conditions can be risky. If you have any of the conditions below, be sure to tell your doctor about it.
| Disease or condition | Why should I inform the doctor ? |
|---|---|
| Vaginal bleeding for no reason | This could be a sign of a serious condition, so the cause needs to be found first. |
| Blood clots in blood vessels or related diseases | The hormone estrogen can slightly increase the risk of blood clots. |
| Breast, cervical, uterine, ovarian, or liver cancer | Because some types of cancer are hormone-dependent, this medicine is not suitable. |
| Heart disease, recent heart attack or stroke | In such situations, special care should be taken with the use of hormones. |
| High blood pressure, diabetes, high cholesterol | It is important to control these conditions well when using this medication. |
| Liver or kidney disease, gallbladder disease | The function of these organs is important because they are involved in the process of removing drugs from the body. |
| Dementia, Migraine, SLE | The doctor should be aware of such chronic conditions. |
| Smoking (especially if you are over 35) | When smoking and estrogen combine, the risk of blood clots and stroke increases. |
| If you are pregnant, trying to get pregnant, or breastfeeding | This medicine is not suitable at all in such cases. |
| Allergies to other hormones, medications, foods, or dyes | It is important to inform us in advance about any allergies. |
How exactly do I use this medicine?
Okay, now let's see how to use this exactly. Don't worry, it's very simple. Also read the instructions that come with the medicine package carefully.
1. Preparation: First, wash your hands thoroughly with soap and water, then dry them with a clean towel.
2. Preparing the Applicator: The medicine is contained in a plastic applicator. Take it out of the packet. You should use a new applicator each time.
3. Checking the pill: Sometimes the pill may have come off the applicator and is still inside the packet. If this happens, carefully put it back into the applicator. However, if the pill has fallen out of the packet, discard the applicator and pill without using it, and get a new one.
4. Position: Lie on your back on a bed or flat surface, bend your knees, and spread your legs slightly apart. Breathe deeply and relax.
5. Insertion: Now slowly insert the applicator completely into the vagina, as deep as you can comfortably.
6. Releasing the pill: Then, press the plunger on the applicator all the way down. This will release the pill into the vagina.
7. Removal: Now carefully remove the applicator. Throw the used applicator in the trash.
8. Hand washing: Again, wash your hands thoroughly with soap.
The most important thing is to use it exactly as the doctor says, at the right time, in the right amount . Do not stop taking it without the doctor's advice or use it more often.
What if I forget to take the medicine?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
What if the medicine is used too much?
If you have any suspicion that you have overdosed on this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital or go to the Emergency Department (ETU) of the nearest hospital.
Other drugs that may interact with this medicine (Interactions)
It is very important to tell your doctor about all the medications you are taking (including vitamins and herbal remedies). Some medications can interact with Estradiol.
| Possible drug interactions with estradiol | |
|---|---|
| Medicines that should never be taken together: | |
| Aromatase inhibitors (e.g. anastrozole, letrozole) | |
| Other drugs that may interact: | |
| Some antibiotics used for tuberculosis (e.g. rifampin) | Raloxifene or Tamoxifen (medicines for breast cancer) |
| Warfarin (a blood thinner) | |
Things to be careful about when using the medicine
- Regular medical checkups: Go for regular checkups as directed by your doctor. This may include a breast exam and a pelvic exam. Also, talk to your doctor about the need for regular mammograms.
- Water retention: Sometimes this medicine can cause swelling in the fingers, hands, or ankles. It can also increase blood pressure. If you experience this, tell your doctor.
- Avoid smoking: If you are a smoker, especially if you are over 35, smoking while taking this medicine significantly increases your risk of blood clots and stroke . Therefore, it is best to avoid smoking completely.
- Pregnancy: If you suspect that you are pregnant for any reason, stop using the medicine immediately and inform your doctor.
- Surgery: If you have a scheduled surgery, ask your doctor before planning the surgery whether you should stop using this medicine.
Side effects that may occur due to medication
Like any medicine, this medicine can cause side effects in some people, but not everyone gets them. Watch out for the symptoms below.
| Serious side effects that require immediate medical attention | |
|---|---|
| Allergic reactions: skin rash, itching, swelling of the face, lips, tongue, or throat. | Symptoms of a blood clot: leg pain, swelling or warmth, difficulty breathing, chest pain. |
| Symptoms of a stroke: Sudden numbness or weakness in the face, arm, or leg, difficulty speaking, confusion, difficulty walking, and changes in vision. | Breast changes: new lumps, redness, pain, nipple discharge. |
| Liver problems: Pain in the upper right side of the stomach, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, yellowing of the eyes or skin. | Vaginal problems: abnormal bleeding after menopause, changes in discharge, itching, odor. |
| Usually not serious (but tell your doctor if it persists) | |
| Bloating | Breast pain or tightness |
| Nausea or vomiting | Slight inflammation or discomfort at the injection site. |
Take-Home Message
- Estradiol vaginal tablets are a treatment for local symptoms of postmenopausal vaginal dryness and inflammation.
- Before using this medicine, be sure to tell your doctor about your complete health history and all other medications you are taking .
- The medicine should be used exactly as prescribed by the doctor . The dosage should never be changed or stopped halfway.
- Be aware of signs of serious side effects such as blood clots, stroke, and unusual bleeding. If you notice any of these, seek medical advice immediately.
- It is very important to attend scheduled medical checkups while using this medication.
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