Side Effects of Estradiol Vaginal Tablets

While most women do not have problems with estradiol vaginal tablets, side effects are possible. Some of the most commonly reported side effects include headaches, back pain, and vaginal yeast infections. Although most side effects of estradiol vaginal tablets tend to be minor, the medication can also cause serious side effects, such as strokes, blood clots, and dementia.

An Introduction to Side Effects of Estradiol Vaginal Tablets

As with any medicine, side effects are possible with estradiol vaginal tablets (Vagifem®). However, not everyone who uses the medication will experience side effects. In fact, most women tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or are easily treated by you or your healthcare provider.
(This article covers many, but not all, of the possible side effects with estradiol vaginal tablets. Your healthcare provider can discuss a more complete list of estradiol vaginal tablets side effects with you.)

Serious Side Effects of Estradiol Vaginal Tablets

Estradiol vaginal tablets have been studied thoroughly in clinical trials. In these studies, the side effects that occurred in a group of people taking the drug were documented and then compared to the side effects that occurred in another group of people taking a placebo (a "sugar pill" that does not contain any active ingredients). As a result, it was possible to see what side effects occurred, how often they appeared, and how they compared to the group not taking the medicine.
Some side effects of estrogen medications are rare, but are serious enough to mention. Estradiol vaginal tablets are believed to have a low risk of these serious side effects, as the medication provides such a low dose of estrogen compared to most other estrogen medications. These serious, but rare, side effects include:
Because of the serious nature of these side effects, there are a few symptoms you should watch out for and immediately report to your healthcare provider if they occur. These include but are not limited to:
  • Signs of a blood clot in the leg, such as:
    • Pain in the calf
    • Leg cramps
    • Leg or foot swelling
  • Signs of a blood clot in the lung, such as:
    • Shortness of breath
    • Sharp chest pain
    • Coughing up blood
    • Vision or speech changes
    • Weakness or numbness in an arm or leg
    • Severe headache
  • Signs of liver damage, such as:
    • Yellowing of the whites of the eyes or skin (jaundice)
    • Dark urine
    • Upper-right abdominal pain (stomach pain)
  • Migraines (or changes in your migraines, if you have had them before)
  • Breast lumps
  • Chest pain or heaviness, which may be signs of a heart attack
  • Sudden loss of vision or vision changes, which can be a sign of a blood clot in the eye
  • Heavy vaginal bleeding or unexpected vaginal bleeding
  • Signs of an allergic reaction, such as:
    • An unexplained rash
    • Hives
    • Itching
    • Unexplained swelling
    • Wheezing
    • Difficulty breathing or swallowing.
Last reviewed by: Kristi Monson, PharmD
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