Estradiol - Vaginal

Estradiol is used as a hormone replacement therapy (HRT) in menopausal women. This medicine helps relieve symptoms associated with menopause such as vaginal dryness, itch or irritation that are caused by a shortage of estrogen in the body.

Use Estradiol exactly as directed by your doctor or according to the instruction on the label. Do not use more or less than instructed by your doctor.

Estradiol is available in various forms such as cream, tablet or ring.

If you have been given a CREAM, follow these steps:

1. Wash your hands thoroughly.
2. Screw the applicator onto the tube.
3. Slowly squeeze the tube to fill the applicator with the required dose of medication.
4. Remove the applicator from the tube.
5. Lie on your back with both knees bent and legs apart.
6. Hold the applicator at the middle portion.
7. Gently insert the applicator into the vagina. Insert only as far as it will comfortably go.
8. Slowly press the applicator plunger until it stops. This will deposit the medication into the vagina.
9. Gently withdraw the applicator.

If you have been given a VAGINAL TABLET, follow these steps:

1. Wash your hands thoroughly.
2. Lie on your back with both knees bent and legs apart.
3. Remove the wrapper from the tablet (and the applicator, if this is provided).
4. If an applicator is supplied, fix the tablet into the hole at the end of the applicator.
5. Gently insert the tablet into the vagina, either with your fingers or the applicator.
6. Insert only as far as it will comfortably go.
7. If you are using an applicator, press the plunger to release the tablet then remove the applicator.

If you have been given a VAGINAL RING, your doctor may insert it for you or you may do it yourself as follows:

1. Wash your hands thoroughly.
2. Take the ring out from the pouch. Keep the pouch so you can put your used ring in it before throwing it away.
3. Lie on your back with both knees bent and legs apart.
4. Hold the ring between your thumb and index finger.
5. Press the ring such that your thumb and index finger meet.
6. Gently insert the compressed ring into the vagina.
7. Gently push it in as far as you can reach with your fingers. The ring should be in the upper third of the vagina. When it has been placed correctly, you should not be able to feel it.
8. If you feel any discomfort, use your finger to push it in further. Do not worry that the ring may get stuck or lost, as it cannot move beyond the cervix.
9. Once inserted, the ring should remain in place for 90 days.
10. You may remove it yourself or the doctor may remove it for you. To remove it on your own, hook your finger around the ring and gently pull it out.

Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to use your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• blood clot disorder
• liver disease
• recent heart attack
• recent stroke
• cancer of the breast, womb or ovaries
• womb problems such as thickening of the womb lining
• unexplained or unusual vaginal bleeding
• porphyria (inherited disorder that may cause skin or nerve problems)

as this medicine may not be suitable for you.

Do not use Estradiol if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with this medicine, alert your doctor immediately. Estradiol may cause harm to your unborn child. You must use proven birth control methods while using this medicine.

Inform your doctor if you have the following conditions:

• epilepsy (fits or seizures)
• asthma
• migraine
• kidney disease
• heart disease
• high blood pressure
• high cholesterol
• diabetes
• gallbladder disease
• thyroid problems e.g. low activity of the thyroid gland
• low calcium level in the blood
• otosclerosis (hearing disorder due to growth of bone in the inner ear)
• systemic lupus erythematosus (autoimmune disease that causes inflammation)

Let your doctor know if you are breastfeeding.

If you are going for any laboratory tests, inform your doctor that you are using Estradiol as it can interfere with certain tests.

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly. Your doctor may need to do routine physical examination while you are being treated with this medicine.

Estradiol may cause any of the following side effects: headache, nausea, stomach pain, stomach wind, bloating, skin rash and vaginal bleeding, discharge or discomfort.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• difficulty breathing or chest discomfort
• severe headache or migraine
• visual disturbances

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• medicines for TB e.g. rifampicin
• medicines for epilepsy (fits or seizures) e.g. phenobarbital, phenytoin, carbamazepine
• medicines for HIV e.g. ritonavir, nelfinavir
• St. John’s Wort (herbal medicine)

This list does not include all medicines that may interact with Estradiol.

Let your doctor know if you are using any other vaginal preparations such as vaginal douche or other medication that is applied in the vagina.

Always notify your doctor or pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.

Ask your pharmacist how to properly dispose this medicine.