From the Guidelines
Yes, there are vaginal estrogen tablets available for treating vaginal dryness, and according to the most recent and highest quality study, vaginal estrogen is the most effective treatment for vaginal dryness leading to sexual dysfunction 1.
Treatment Options
- Vagifem (estradiol vaginal tablets) is a commonly prescribed option, typically used at a dose of 10 mcg inserted vaginally once daily for the first two weeks, then twice weekly for maintenance therapy.
- Another option is Yuvafem, which contains the same medication and dosing.
Mechanism of Action
These tablets are inserted into the vagina using an applicator and release a small amount of estrogen directly to the vaginal tissues. This localized estrogen therapy helps restore vaginal tissue thickness, elasticity, and lubrication by replenishing estrogen that naturally decreases during menopause.
Advantages
The advantage of vaginal tablets over systemic hormone therapy is that they primarily work locally with minimal absorption into the bloodstream, resulting in fewer side effects and risks.
Precautions
Before starting any vaginal estrogen product, consult with your healthcare provider, especially if you have a history of breast cancer, blood clots, or other conditions that might make estrogen use inadvisable.
Efficacy
Most women notice improvement in symptoms within 2-4 weeks of starting treatment, and a large cohort study of almost 50,000 patients with breast cancer followed for up to 20 years showed no evidence that there was a higher risk of breast cancer–specific mortality in those using vaginal estrogen 1.
From the FDA Drug Label
When prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy, topical vaginal products should be considered. treat moderate to severe dryness, itching, and burning in and around the vagina. If you use Estradiol valerate injection, USP only to treat your dryness, itching, and burning in and around your vagina, talk with your healthcare provider about whether a topical vaginal product would be better for you.
The answer is yes, there are vaginal estrogen products for vaginal dryness, but the provided drug labels are for an injectable form of estradiol, not vaginal tablets. The labels suggest considering topical vaginal products for treating vaginal dryness, but they do not specifically mention vaginal estrogen tablets. 2
From the Research
Vaginal Estrogen Tablets for Vaginal Dryness
- Vaginal estrogen tablets are a type of topical estrogen therapy used to manage postmenopausal vaginal atrophy, which can cause vaginal dryness 3, 4, 5.
- These tablets have been shown to be effective in alleviating symptoms of vaginal atrophy, including vaginal dryness, and are preferred by some women over other formulations such as creams or rings 5, 6.
- The use of vaginal estrogen tablets has been associated with improvements in vaginal symptoms, including vaginal dryness, and has been shown to be safe for long-term use 3, 7.
- Studies have demonstrated that vaginal estrogen tablets can increase serum estradiol levels, but the levels are usually highest during the first 12 weeks of treatment and are higher for estrogen creams than for inserts or rings 7.
- The safety of vaginal estrogen tablets has been evaluated in several studies, and the evidence suggests that they are safe for use in postmenopausal women, although long-term trials are needed to fully establish their safety 7.
Types of Vaginal Estrogen Preparations
- There are several types of vaginal estrogen preparations available, including tablets, rings, and creams 4, 5, 7.
- Each type of preparation has its own advantages and disadvantages, and the choice of preparation depends on individual patient needs and preferences 6.
- Vaginal estrogen tablets are a convenient and easy-to-use option for women with vaginal atrophy, and have been shown to be effective in alleviating symptoms of vaginal dryness 5, 6.
Efficacy and Safety of Vaginal Estrogen Tablets
- Vaginal estrogen tablets have been shown to be effective in alleviating symptoms of vaginal atrophy, including vaginal dryness, and have been associated with improvements in vaginal symptoms 3, 5, 6.
- The safety of vaginal estrogen tablets has been evaluated in several studies, and the evidence suggests that they are safe for use in postmenopausal women, although long-term trials are needed to fully establish their safety 7.
- The use of vaginal estrogen tablets has been associated with few adverse events, and they are generally well-tolerated by women with vaginal atrophy 5, 6.