What is Imvexxy?
Imvexxy is a vaginal insert containing the active ingredient estradiol.
Imvexxy is used to treat postmenopausal symptoms associated with vulvar or vaginal atrophy, in women who are experiencing pain before, during, or after having sex.
For more resources, including a full list of the risks and benefits of Imvexxy, please review the product monograph.
How does Imvexxy work?
Imvexxy contains the sexual hormone estradiol, which is a type of estrogen.
After menopause, a person’s body makes less or stops producing estrogen naturally. This can lead to symptoms like dryness and discomfort in and around the vagina.
Imvexxy works by helping to replace this missing estrogen, and in turn, reduce these types of menopause symptoms (i.e., associated with vulvar and vaginal atrophy).
What is Imvexxy used to treat?
Imvexxy is a postmenopausal medication known as an estradiol vaginal insert.
It’s used to treat specific symptoms that are associated with postmenopause and vulvar/vaginal atrophy, such as:
- Vaginal dryness
- Pain before, during, or after sex
- Vaginal discomfort
It’s important to note that Imvexxy dosing has only been studied for safety and efficacy in use cycles of 12 weeks or less.
How do you take Imvexxy?
Imvexxy is given as a vaginal insert, which means that it needs to be taken by inserting Imvexxy dosages directly into the vagina. Imvexxy 4 mcg and 10 mcg dosages are taken the same way.
Start by thoroughly washing your hands, before handing the medication. Then follow the exact application instructions that will be provided alongside your prescription.
Always be sure to follow the application directions exactly as instructed, and never take Imvexxy more often than is prescribed by your healthcare practitioner. Don’t ever change your dosage or dosing schedule, without first talking to your healthcare practitioner.
Imvexxy is NOT to be taken orally.
Remember: Imvexxy has only been studied for safety and efficacy in 12 week cycles or less, so you shouldn’t take this medication any longer than this, without first discussing possible risks with your practitioner to ensure your safety.
How long does Imvexxy last after you take it?
What are the common side effects of Imvexxy?
There are some side effects that can present when using a Imvexxy suppository, such as:
- Headache
- Dizziness
- Memory loss
- Vision changes
- Abdominal, back, or pelvic pain
- Nausea
- Diarrhea
- Feeling bloated
- Fatigue
- Changes in appetite or body weight (up or down)
- Excessive sweating or body odor
- Changes in vaginal discharge (i.e., discomfort or odor)
- Anxiety or nervousness
- Loss of scalp hair
- Hair growth on the fair, chest, abdomen, or legs
- Breast tenderness, pain, or swelling
- Acne
- Rashes or itchy skin
- Pain during sex
Also, Imvexxy can sometimes cause abnormal blood test results. Your practitioner will be able to determine if this means you require another treatment.
Also, there are some more serious risks that can apply to both Imvexxy, as well as oral estrogen, including:
- Nasopharyngitis (a cold)
- Urinary tract infection
- Vaginal bleeding changes
- Stroke
- Pulmonary embolism
- Deep vein thrombosis or thrombophlebitis
- Breast abnormalities
- Coronary thrombosis
- Cystitis
- Depression
- Endometrial hyperplasia
- Endometrial cancer
- Erythema multiforme
- Erythema nodosum
- Eye disorders
- Gastrointestinal disorders
- High blood pressure (hypertension)
- Liver problems
- Migraines
- Neuritis
- Ovarian cancer
- Heart palpitations
- Peripheral edema
- Urinary tract disorders
- Vaginal yeast infection
If you start to experience any of these other side effects, be sure to talk to your healthcare practitioner right away. They may want to suggest an alternative medication that could work better for you, based on your health, symptoms, and medical history.
MHT is the most effective treatment for menopausal symptoms and has been shown to prevent bone loss.
In menopausal women who start appropriately-dosed MHT prior to age 60 OR within 10 years of their last period, the health benefits outweigh the risks.
Risks of MHT are considered very rare (~1 case per 1000 to 10,000 women on MHT per year) and may include:
- risks of stroke or blood clots in legs or lungs with oral estrogen (much lower risk with estrogen gel or patch)
- risks of dementia in women older than 65 years,
- risk of breast cancer (less than ~1 case per 1000 women on MHT per year)
These conditions are all rare, but they highlight the importance of having a full discussion with your healthcare practitioner; especially if you’re experiencing moderate to severe side effects.
Individualization is key, and your MHT treatment plan should be reassessed (at least) once a year to monitor your health, as well as ensure that you are on the correct dosage and formulation.
Your practitioner can help you find balance between treating your symptoms safely, and avoiding increased risks.
Who shouldn't take Imvexxy?
There are a number of people that shouldn’t take Imvexxy, including:
- People who are allergic or have an intolerance to estradiol or any of the other ingredients in Imvexxy
- People who are or may be pregnant
- People who are breastfeeding
- People who have or have had liver problems, and blood tests to measure liver function haven’t returned to normal yet
- People who have, might have, or have had estrogen-dependent cancers
- People with endometrial hyperplasia (an overgrowth of the lining of the uterus)
- People who have, have had, or are suspected to have breast cancer
- People with unexplained bleeding from the vagina
- People that have recently experienced a heart attack, stroke, or a blockage or narrowing of the arteries around the heart (coronary heart disease)
- People with blood clotting problems (i.e., deep vein thrombosis, pulmonary embolism, thrombophlebitis, or protein C, protein S, or antithrombin deficiency
- People with eye problems that are caused by low blood flow to the eye
In addition to these people, there are some others that need to be extra cautious about taking Imvexxy, such as people who:
- Have or have had uterus problems (i.e., fibroids, endometriosis, a history of endometrial hyperplasia, or have had a hysterectomy)
- Have a history of allergies or intolerances to any other medications or substances
- Have or have had a history of abnormal vaginal bleeding
- Have a history of liver problems, jaundice (yellowing of the skin or eyes), or itching
- Have symptoms of a blood blockage to the brain (i.e., migraines, headaches, difficulty speaking, paralysis, loss of consciousness)
- Have or have had hypertension (high blood pressure)
- Have or had asthma
- Have kidney problems
- Have epilepsy (seizures)
- Have or have had bone diseases, including conditions or cancers that affect the levels of calcium and phosphorus in the blood)
- Have diabetes, or have a family history of diabetes
- Have or had high levels of fat in your blood (i.e., cholesterol, triglycerides)
- Are pregnant, may be pregnant, or are breastfeeding
- Smoke
- Have or have had an autoimmune disease
- Had or will be having surgery
- Have porphyria (a blood pigment disease)
- Have low or high levels of calcium
- Have thyroid problems
- Have biliary problems (i.e., gallbladder disease, bile problems)
- Have eye problems
If any of these conditions apply to you, be sure to talk to your healthcare practitioner about them, before starting Imvexxy. They may want to suggest an alternative dosage schedule or different medication that may work better for you.
There are some medications that shouldn’t be used alongside Imvexxy. Be sure to tell your practitioner first if you’re currently taking:
- Medications to treat diabetes (i.e., glyburide and insulin)
- Medications to prevent or treat blood clots, also called anticoagulants (i.e., warfarin)
- Medications for high blood pressure (i.e., verapamil, diltiazem)
- Medications that impact liver enzymes (i.e., barbiturates, hydantoins, carbamazepine, meprobamates, phenylbutazone or rifampicin)
- Medications used to treat epilepsy or seizures (i.e., phenobarbital, phenytoin, carbamazepine)
- Medications used to treat HIV (i.e., ritonavir, nelfinavir)
- St. John’s wort, which is used to treat depression
If you’re currently taking any of these medications, your practitioner may want to suggest an alternative medication that will work better for you, alongside the other medications you’re already taking.
