From the Guidelines
The dose of Vagifem (Estradiol) is 10-mg.
Vagifem (Estradiol) Dosing
- The dose is based on the evidence from the study published in the Annals of Oncology in 2020 1, which suggests that low-dose vaginal hormones, such as a 10-mg estradiol-releasing intravaginal tablet, may be safe during concurrent use with an aromatase inhibitor.
- This dose is specifically mentioned as a first-choice treatment for vaginal dryness and dyspareunia in patients with breast cancer.
- Although the study published in 2008 1 discusses the use of vaginal estrogens, including Vagifem, it does not provide specific dosing information.
- It is essential to note that the safety data for low-dose vaginal hormones is limited, and follow-up is short, highlighting the need for further research and caution when using these medications.
From the Research
Dose of Vagifem (Estradiol)
- The dose of Vagifem (Estradiol) is 10 μg, which is the lowest approved dose available 2, 3.
- This ultra-low-dose has an annual estradiol exposure of only 1.14 mg 2.
- Other studies have used doses of 25 micrograms 17 beta-estradiol administered as a small vaginal tablet (Vagifem) 4, 5, 6.
- The 10 μg vaginal tablet displays minimal estradiol absorption, causes no increased risk of endometrial hyperplasia or carcinoma, and provides significant symptom relief 2.
- The clinical evidence presented may offer greater reassurance to health-care professionals and postmenopausal women that vaginal atrophy can be treated safely and effectively with Vagifem 2, 3.
Treatment Regimen
- The treatment regimen for Vagifem typically involves daily administration for the first 2 weeks, followed by twice-weekly administration 4, 5.
- This regimen has been shown to significantly improve symptoms of atrophic vaginitis, including dysuria, dyspareunia, vaginal itching, and dryness 4, 5.