Vagifem® is a local estrogen therapy.
Vagifem® (estradiol vaginal inserts) 10 mcg delivers treatment directly to the vagina. It’s a local estrogen treatment—not to be confused with systemic hormone replacement therapy.
Just what is estrogen?
Estrogen is a hormone responsible for changes in the vagina and uterus. There are several forms of estrogen, including estradiol, which is used in several LETs; another LET uses conjugated, or combined, estrogens.
What is local estrogen therapy?
“Local” means that the treatment is applied directly to the affected area—in this case, the vagina. Local delivery of estrogen:
Results in quantifiably lower doses of estrogen than systemic estrogen treatments
Limits the amount of estrogen a woman may be exposed to
Compare local estrogen therapy to other types of treatment used to treat vaginal symptoms that happen after menopause, and ask your health care provider to discuss local estrogen therapy with you.
exactly the same as what your body makes.

Types of local estrogen therapy.
There are 3 types of FDA-approved local estrogen therapy (LET) options: a vaginal ring, vaginal creams, and a vaginal insert (Vagifem® 10 mcg). They’re different in several ways. The following table highlights these LET options, showing:
How they’re taken
How often they’re taken
What form of estrogen they use
How much estradiol (if any) they contain
Local Estrogen Therapies
Brand of LET | How It's Taken | How Mucha & How Often |
Type of Estrogen | Dose Strength |
---|---|---|---|---|
Vagifem® (estradiol vaginal inserts) 10 mcg | ||||
Vagifem® (estradiol vaginal inserts) 10 mcg | Insert inserted into the vagina | 1 insert daily for 2 weeks; then twice weekly going forward | Estradiol | Each insert contains 10 mcg (0.01 mg) estradiol |
Estring® (estradiol vaginal ring) | ||||
Estring® (estradiol vaginal ring) | Ring inserted into the vagina | 1 ring every 3 months | Estradiol | Each ring contains 2 mg estradiol (releasing approximately 0.75 mcg [0.0075 mg] per day) |
Estrace® (estradiol vaginal cream) | ||||
Estrace® (estradiol vaginal cream) | Cream inserted into the vagina | The usual dosage range is 2 to 4 g (marked on the applicator) daily for 1 or 2 weeks, then gradually reduced to one-half initial dosage for a similar period. A maintenance dosage of 1 g, 1 to 3 times a week, may be used after restoration of vaginal mucosa has been achieved. | Estradiol | Each gram contains 0.1 mg (100 mcg) estradiol |
Premarin® (conjugated estrogens) vaginal cream | ||||
Premarin® (conjugated estrogens) vaginal cream | Cream inserted into the vagina | ½ gram daily for 3 weeks, then off for 1 week; repeat. | Conjugated estrogens (a combination of different estrogens) | Each gram contains 0.625 mg (625 mcg) conjugated estrogens |
Imvexxy® (estradiol vaginal inserts) 4 mcg or 10 mcg | ||||
Imvexxy® (estradiol vaginal inserts) 4 mcg or 10 mcg | Insert (softgel capsule) inserted into the vagina | 1 insert (softgel capsule) daily for 2 weeks, then twice weekly going forward | Estradiol | Each insert (softgel capsule) contains either 4 mcg (0.004 mg) or 10 mcg (0.01 mg) estradiol |
a Please see Prescribing Information for related products. The dose listed is the lowest recommended dose according to each product’s Prescribing Information. Dosing regimen may vary depending upon symptoms.
The above chart is not intended to be a comparison of efficacy and safety.