Is it safe to engage in sexual intercourse while using an estrogen (estrogen replacement therapy) suppository?

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Last updated: April 12, 2025View editorial policy

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From the Guidelines

It is generally safe to have sex with an estrogen suppository in place, but it's best to wait 30 minutes to 1 hour after insertion to allow the medication to be properly absorbed. According to the NCCN guidelines, vaginal estrogen is the most effective treatment for vaginal dryness leading to sexual dysfunction and has been shown to be effective in treating itching, discomfort, and painful intercourse in postmenopausal individuals 1. Products like Vagifem (estradiol vaginal tablets) or Estring (estradiol vaginal ring) are designed to remain in place during intercourse. However, some estrogen creams or gels might be partially removed during sex, potentially reducing their effectiveness.

Key Considerations

  • If you're using a vaginal applicator for insertion, remove it before intercourse.
  • Your partner should use a condom if you're concerned about exposure to the medication, though the amount transferred is typically minimal.
  • Some people may experience mild discomfort during intercourse with a suppository in place.
  • If this occurs, you might consider timing intercourse before your next scheduled dose.

Benefits of Estrogen Suppositories

  • Estrogen suppositories are typically used to treat vaginal dryness or atrophy, and the improved vaginal health from these medications often makes intercourse more comfortable overall.
  • 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 Research

Vaginal Estrogen Suppositories and Sexual Activity

  • The use of vaginal estrogen suppositories for the treatment of vaginal atrophy is a common practice, and studies have shown that they can be effective in alleviating symptoms such as vaginal dryness, dyspareunia, and itching 2, 3, 4, 5, 6.
  • However, there is limited information available on the safety of having sex with an estrogen suppository in.
  • A study published in 2011 found that vaginal estrogen therapy can provide improvement in the signs and symptoms of vaginal or vulvar atrophy, and that low-dose vaginal estrogens have been shown to be effective in treating symptoms of vaginal atrophy without causing significant proliferation of the endometrial lining 5.
  • Another study published in 2013 found that ultra-low-dose vaginal estrogen tablets can safely and effectively manage symptoms of vaginal atrophy, with minimal estradiol absorption and no increased risk of endometrial hyperplasia or carcinoma 6.
  • While these studies suggest that vaginal estrogen suppositories can be safe and effective for treating vaginal atrophy, they do not specifically address the safety of having sex with an estrogen suppository in.

Potential Risks and Considerations

  • It is possible that having sex with an estrogen suppository in could potentially disrupt the suppository or cause it to be expelled from the vagina, which could affect its efficacy or increase the risk of side effects.
  • Additionally, the use of vaginal estrogen suppositories can increase the risk of vaginal bleeding or spotting, which could be a concern during sexual activity.
  • However, without further research or guidance from healthcare professionals, it is difficult to determine the specific risks or considerations associated with having sex with an estrogen suppository in.

Recommendations for Use

  • Women who are using vaginal estrogen suppositories for the treatment of vaginal atrophy should follow the instructions provided by their healthcare provider or the manufacturer's instructions for use.
  • It is recommended that women wait for a certain period of time after inserting the suppository before having sex, to allow the suppository to dissolve and be absorbed by the vaginal tissue.
  • Women should also be aware of the potential risks and considerations associated with having sex with an estrogen suppository in, and should discuss any concerns or questions with their healthcare provider.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem) in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012.

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2015

Research

Vaginal estrogens for the treatment of dyspareunia.

The journal of sexual medicine, 2011

Research

Ultra-low-dose vaginal estrogen tablets for the treatment of postmenopausal vaginal atrophy.

Climacteric : the journal of the International Menopause Society, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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