Tear off a single applicator.
Separate the plastic wrap and remove the applicator from the plastic wrap as shown in Figure A. If after opening the package you see that the insert has come out of the applicator but has not fallen out of the package, carefully put it back into the applicator for insertion. Please keep your hands clean and dry while handling the insert.
Hold the applicator so that the finger of one hand can press the applicator plunger as shown in Figure B.
Next select the best position for vaginal insertion of Vagifem® (estradiol vaginal inserts) that is most comfortable for you. See suggested reclining Figure C or standing Figure D position.
Using the other hand, guide the applicator gently and comfortably through the vaginal opening (see Figures C and D). If prior to insertion the insert falls out of the applicator, throw the insert and applicator away and use a new insert-filled applicator.
The applicator should be inserted (without forcing) as far as comfortably possible, or until half of the applicator is inside your vagina, whichever is less.
Once the insert-filled applicator has been inserted, gently press the plunger until the plunger is fully depressed. This will eject the insert inside your vagina, where it will dissolve slowly over several hours.
After depressing the plunger, gently remove the applicator and dispose of it the same way you would a plastic tampon applicator. The applicator is of no further use and should be discarded properly. Insertion may be done at any time of the day. It is advisable to use the same time daily for all applications of Vagifem® (estradiol vaginal inserts). If you have any questions, please consult your health care provider or pharmacist.