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Understanding Estradiol Dosage: Comparing Vagifem Low-Dose Tablets to Oral Estradiol

Updated: Jun 14


Introduction:

Estradiol (estrogen) supplementation plays a vital role in managing menopausal symptoms and promoting women's health.


Two common methods of estradiol delivery are Vaginal estrogen low-dose tablets and oral estradiol tablets. In this blog, we'll delve into the dosage differences between these two forms of estradiol therapy and explore how the low dose of Vaginal estrogen low-dose tablets compares to oral estradiol.


Please note, it is far safer to use estrogen through the skin. The action of estrogen by mouth can cause liver cells to increase production of clotting proteins which leads to an increase in the risk of blood clots or strokes . Everything that we take by mouth, other than pure water, has to go through the liver. Estrogen through the skin goes direct into the blood, hence zero clotting risk. The patient information leaflet is outdated and has not been updated to reflect what we now know about estrogen. Estrogen doesn't cause breast cancer, and vaginal estrogen will not cause blood clots.


vaginal estrogen Low-Dose Tablets:

Vaginal estrogen low-dose tablets are designed for localized treatment of vaginal symptoms associated with menopause. These tablets contain a low dosage of estradiol, typically around 10 micrograms per tablet. The low dosage allows for targeted relief of symptoms such as vaginal dryness, itching, and discomfort during intercourse.


Comparing Vaginal estrogen Low-Dose Tablets to Oral Estradiol:

To appreciate the low dose of Vaginal estrogen compared to oral estradiol, let’s examine the typical dosage of oral estradiol. Oral estradiol tablets are available in various strengths, with a common dosage being 1 milligram (mg) per tablet.


Now, let’s break down the dosage comparison:


1. Vaginal estrogen, Low-Dose Tablets:

- Dosage: Approximately 10 micrograms (mcg) of estradiol per tablet.

- Administration: Inserted vaginally using an applicator.

- Purpose: Provides targeted relief for vaginal symptoms with minimal systemic absorption.



2. Oral Estradiol Tablets:

- Dosage: Typically 1 milligram (mg) of estradiol per tablet.

- Administration: Taken orally, absorbed through the digestive system into the bloodstream.

- Purpose: Provides systemic relief for a broader range of menopausal symptoms.

Understanding the Difference:

The dosage disparity between Vaginal estrogen low-dose tablets and oral estradiol tablets is significant. While Vaginal estrogen delivers only 10 micrograms of estradiol per tablet, oral estradiol tablets typically contain 100 times more estradiol, with a dosage of 1 milligram per tablet.


To compare a year's supply of Vaginal estrogen low-dose tablets to a 1 mg dose of oral estradiol, we need to calculate the total amount of estradiol in each.


Let's start with Vaginal estrogen low-dose tablets:

Each Vaginal estrogen low-dose tablet typically contains approximately 10 micrograms (mcg) of estradiol.

If a woman were to use vaginal estrogen low-dose tablets daily for a year, the total dosage of estradiol for that year would be:

10 mcg/tablet * 365 days = 3,650 mcg


Now, let's compare this to a 1 mg oral dose of estradiol:


1 mg = 1000 mcg

So, a 1 mg dose of oral estradiol contains 1000 micrograms (mcg) of estradiol.


Comparing the two:

- A year's supply of vaginal estrogen low-dose tablets (3,650 mcg) is equivalent to 3.65 mg of oral estradiol (3650 mcg ÷ 1000 mcg/mg). This means that a year's supply of vaginal estrogen pessaries is equivalent to 4 days dose of estrogen by mouth!


Conclusion:

The low dose of estradiol in Vaginal estrogen low-dose tablets highlights the precision and specificity of vaginal therapy for menopausal symptoms. When compared to the higher dosage of oral estradiol tablets, Vaginal estrogen offers a gentle yet effective approach to managing vaginal atrophy and discomfort. It is safe to use daily if necessary. Use it as often as you need to, to control your symptoms. Aim for no dryness, no discomfort with intercourse, no frequency of urination. No itching, no leakage when you cough or sneeze.



By Dr Purity carr

Menopause Doctor & GP

Harvey, WA #drpuritycarr

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