Like all medicines, vaginal oestrogen may cause side effects. But it's common to have no side effects or only minor ones.
Common side effects
These common side effects of vaginal oestrogen happen in more than 1 in 100 women. There are things you can do to help cope with them.
Headaches
Headaches usually only last for a few days after you start using vagina oestrogen as your body gets used to the medicine. Ask your pharmacist to recommend a painkiller.
Talk to your GP if the headaches last longer than a week or are severe.
Unexpected vaginal bleeding or spotting
Unless you've had a hysterectomy to remove your womb, vaginal bleeding or spotting is common for the first 3 to 6 months after starting HRT. It usually settles down after this.
Talk to your GP if:
- you get heavy bleeding or unexpected bleeding after you've been taking HRT for 6 months
- you've had a hysterectomy and you get any vaginal bleeding
Vaginal discomfort or itchiness
Make sure you're applying the treatment carefully and using the applicator as described in the medicine pack. If the pain or itchiness do not improve after a week, check with your GP as you may need to change to a different type of vaginal oestrogen.
Urinary tract or vaginal infection
If you have the symptoms of an infection, check with your GP.
Symptoms can include:
- raised temperature
- an urgent need to pee
- local pain and itchiness
Pain or discomfort in the abdomen
Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals.
Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, talk to a pharmacist or GP.
Talk to a pharmacist or GP if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Driving or riding a bike
Using vaginal oestrogen does not affect your ability to drive or ride a bike.
Serious side effects
Serious side effects from vaginal oestrogen are rare.
Urgent advice: Contact your GP if you have:
- a lump or changes in your breasts, especially dimpling of the skin, changes in the nipple or any lumps you can see or feel - this could be a sign of breast cancer
- any changes in vaginal bleeding after you have been using vaginal oestrogen for more than a few months - this could be a sign of womb cancer
It's important to attend your breast screening appointments while you're taking HRT.
Emergency action required: Call 112 or 999 or go to the nearest emergency department (ED) now if you have:
- pain in your chest and breathlessness - this could be a sign of a blood clot in your lungs (pulmonary embolism) or heart problems
- difficulty speaking or moving your arm or leg, or change in vision - this could be a sign of a stroke
Do not drive to the ED. Ask someone to drive you or call 112 or 999 and ask for an ambulance.
Bring all the medicines you take with you.
Emergency action required: Contact a GP or go to the nearest emergency department (ED) now if you have:
- headache, tiredness or dizziness which may be a sign of a big rise in your blood pressure
- yellow skin, dark pee and tiredness - these can be signs of liver problems
- a migraine-like headache for the first time
Do not drive to the ED. Ask someone to drive you or call 112 or 999 and ask for an ambulance.
Bring all the medicines you take with you.
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to oestrogen.
Urgent advice: Call 112 or 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Do not drive yourself to the emergency department.
The person you speak to at 112 or 999 will give you advice about what to do.
Other side effects
These are not all the side effects of vaginal oestrogen. For a full list see the leaflet inside your medicines packet.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie