Vaginal estradiol is estradiol, the main estrogen, used inside the vagina to treat dryness, irritation and thinning of the vaginal tissue after menopause. It comes as Vagifem 10 mcg vaginal inserts (generic versions include Yuvafem) and as Estrace vaginal cream. Some of it is absorbed into the body, so the labels carry the same warnings as other estrogens.
Also known as: Vagifem, Yuvafem, Estrace cream, vaginal estrogen.
Vagifem is a 10 mcg estradiol vaginal insert in a disposable applicator. Estrace vaginal cream is 0.01% (0.1 mg estradiol per gram) in a 42.5 g tube with an applicator marked for 1, 2, 3 or 4 g.
The Vagifem label approves it for atrophic vaginitis due to menopause: 1 insert a day for 2 weeks, then 1 insert twice a week (for example Tuesday and Friday). The Estrace cream label approves it for moderate to severe vulvar and vaginal atrophy due to menopause: usually 2 to 4 g a day for 1 to 2 weeks, then about half that for a similar time, then a maintenance dose of 1 g one to three times a week. Both labels say to use the lowest dose for the shortest time that meets the goal, and to recheck periodically.
The Vagifem label says systemic absorption occurs, so the warnings for estrogen taken by mouth apply. Both labels carry the estrogen boxed warning (endometrial cancer, and the Women's Health Initiative findings on stroke, blood clots, breast cancer and probable dementia). In November 2025 FDA said it is starting to remove the boxed warnings about heart disease, breast cancer and probable dementia from menopause hormone products, but not the endometrial cancer warning for systemic estrogen-alone products. The label versions we read on DailyMed still carry the full boxed warning. See also oral estradiol.
The vaginal estradiol labels we read do not give a single half-life or time to peak we could list for these products, so we do not list one. The Vagifem label notes that some estradiol is absorbed into the bloodstream.
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