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 people. There are things you can do to help cope with them:
Headache
Headaches usually only last for a few days after you start using vaginal oestrogen as your body gets used to the medicine. Try taking a painkiller such as ibuprofen or paracetamol.
If headaches last longer than a week or are severe, speak to your doctor. You may need to change your dose or switch to a different type of HRT.
Unexpected vaginal bleeding
This is common for the first 3 to 6 months after starting HRT, but usually settles down.
If you get heavy bleeding or unexpected bleeding after you've been using vaginal oestrogen for 6 months, talk to your doctor.
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 doctor 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 (including raised temperature, urgent need to pee, local pain and itchiness), check with your doctor.
Pain or discomfort in the abdomen
Try taking a painkiller such as ibuprofen or paracetamol for a few days. If the pain does not go away, check with your doctor.
Speak to a pharmacist or doctor if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
Serious side effects from vaginal oestrogen are rare.
See your doctor if you:
- find 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
- experience any changes in vaginal bleeding after you have been taking oestrogen for more than a few months – this could be a sign of womb cancer
Call a doctor or call 111 for advice now if you have pain, redness or swelling in one of your legs – this could be a sign of deep vein thrombosis (DVT).
It's important to attend your breast screening (mammogram) appointments while you're taking HRT.
Immediate action required: Call 999 or go to A&E if:
- you get a pain in your chest and breathlessness – this could be a sign of a blood clot in your lungs (pulmonary embolism) or heart problems
- have difficulty speaking, or moving your arm or leg, or your face has dropped on one side – this could be a sign of a stroke
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to vaginal oestrogen.
Immediate action required: Call 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
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
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.
Other side effects
These are not all the side effects of vaginal oestrogen. For a full list, see the leaflet inside your medicines packet.
You can report any suspected side effect using the Yellow Card safety scheme.