Vaginal atrophy

Prescribing Notes:

• Local oestrogen treatment can improve vaginal and bladder symptoms caused by menopause; systemic therapy is necessary for vasomotor symptoms.
• Vagirux is a more cost-effective preparation than Vagifem, however, local expert recommendation is to use Vagifem in patients who have difficulty using the Vagirux applicator or have dexterity problems.
• Estradiol vaginal tablets may be useful in women who find creams difficult or messy to use.
• Women using long-term vaginal oestrogen treatments do not need to add in cyclical progestogen therapy.
• Most women with significant vulvo-vaginal atrophy will require long-term treatment particularly if sexually active.
• Symptoms recur when local vaginal oestrogens are discontinued; there is no fixed duration of use and each woman should be assessed individually.
• The lowest effective dose should be used for shortest duration possible.
• Some intravaginal creams contain arachis (peanut) oil and are therefore not suitable for patients with peanut allergy. For patients with peanut allergy select a formulation without arachis oil and specify the manufacturer and/or brand name on the prescription. Full details of the excipients can be found in the manufacturers Summary of Product Characteristics at www.medicines.org.uk or MHRA Products | Home.
• Vaginal creams may damage latex condoms and diaphragms.