Headache, Discharge, and More: 8 Imvexxy Side Effects to Know About

GoodRx Health

Imvexxy (estradiol vaginal insert) is a prescription medication that can help reduce pain during sex for women in menopause. It's a form of hormone replacement therapy (HRT). It provides a low dose of the hormone estrogen right where you need it for symptom relief.

Overall, vaginal estrogen products such as Imvexxy are generally well tolerated. But that doesn't mean side effects can't happen.

Imvexxy side effects at a glance

In general, Imvexxy side effects don't happen frequently. In clinical trials, the most common side effects occurred in less than 4% of all participants. And a similar number of people using a placebo (a vaginal insert with no medication) reported these issues. So it's possible they weren't related to Imvexxy.

Mild Imvexxy side effects include:

• Headache

• Changes to vaginal discharge

• Sore or tender breasts

• Fluid retention (bloating or swelling)

All estrogen-based HRT medications include several rare but serious side effects in their labeling. Some of these are boxed warnings (the FDA's strictest medication warning). Serious risks and side effects listed in Imvexxy's labeling include:

• Allergic reactions (different from a side effect but can be life-threatening)

• Raised blood pressure

• Raised triglyceride levels (fatty cells measured in a cholesterol test)

• Gallbladder problems

• Increased or decreased blood calcium levels

• Vision changes

• Liver damage

• Dementia (a boxed warning)

• Heart attack (a boxed warning)

• Stroke (a boxed warning)

• Blood clots in the lungs or legs (a boxed warning)

• Breast cancer (a boxed warning)

• Uterine cancer (a boxed warning)

Keep in mind that the FDA requires all estrogen-based HRT to list the serious side effects mentioned above. But as we'll discuss, Imvexxy has a very low risk for causing them. Below, we'll cover 10 Imvexxy side effects in more detail.

1. Headache

Headache was the most common Imvexxy side effect reported in clinical trials. This may be because of changes to hormone levels.

Headaches from Imvexxy should improve over time as your body adjusts to the medication. Staying hydrated and getting enough rest may help relieve and prevent headaches. Occasional use of over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), can also help. But talk to a healthcare professional before taking an OTC pain medication, as they're not safe for everyone.

2. Vaginal discharge

Increased vaginal discharge is another mild Imvexxy side effect. This typically isn't bothersome enough to make people stop using Imvexxy. Similar to headaches, vaginal discharge changes happen because of shifting hormone levels.

Vaginal discharge is a normal part of a healthy vagina. But when estrogen levels fall during menopause, it's common to have less discharge. Estrogen-based HRT, such as Imvexxy, raises estrogen levels to help relieve menopause symptoms. As a response, your body may start making more discharge again.

If you experience increased vaginal discharge while using Imvexxy, consider taking steps to maintain your vaginal health. Use a mild soap when cleansing, wear 100% cotton underwear, and avoid scented vaginal products. You may also find comfort in wearing a thin, unscented panty liner to absorb vaginal discharge.

If you see blood in your discharge, contact your prescriber. Vaginal bleeding after menopause is never normal. It can be a symptom of a more serious problem, such as uterine cancer.

3. Breast tenderness

Breast tenderness is another possible Imvexxy side effect. Similar to the side effect above, this is likely caused by changing hormone levels.

You may be able to manage breast tenderness at home with OTC pain relievers. Cold compresses and loose-fitting clothing or bras might be helpful, too.

Even though sore breasts are an expected Imvexxy side effect, you should contact your prescriber if it happens to you. In rare cases, breast pain can be a symptom of breast cancer. Your prescriber may want to evaluate you in person if you develop this side effect after starting Imvexxy.

4. Fluid retention

Estrogen-based HRT such as Imvexxy can cause fluid retention. This is because estrogen plays a role in maintaining fluid balance. And using Imvexxy could change this balance. But if you do experience bloating or swelling, know that it's usually mild. It should go away as your body adjusts to Imvexxy.

Make sure your prescriber knows if you have a health condition that raises your risk of retaining fluid, such as heart failure or kidney disease. Imvexxy may not be the right medication for you.

5. Raised blood pressure

A small number of women using Imvexxy have reported a rise in their blood pressure. This wasn't seen in larger clinical trials, though. Keep in mind that it's possible for all estrogen-based HRT to raise blood pressure, but the risk of this side effect is more likely to happen with oral estrogen medications.

If you notice blood pressure increases while using Imvexxy, talk to your prescriber. Depending on your risks, they may ask you to check your blood pressure at home. They may also ask you to stop using Imvexxy.

6. Risk of dementia

Imvexxy carries a boxed warning for dementia. This risk is based on a large study that found a higher risk of dementia for women aged 65 or older who took a certain form of oral estrogen. Since then, the FDA has required all estrogen-based HRT to include this boxed warning. The risk of dementia with vaginal estrogens, such as Imvexxy, hasn't been well studied.

Speak with your prescriber about your risks for dementia when using Imvexxy. For many women, the benefits of using HRT outweighs the risk of dementia. This is especially true if you're 60 years or younger, or if you entered menopause less than 10 years ago.

7. Risk of blood clots, heart attack, and stroke

Imvexxy also includes boxed warnings for a higher risk of blood clots, heart attack, and stroke. Similar to dementia, these cardiovascular warnings are based on a large study that focused on certain oral estrogens. Women in the study who took oral estrogen had a greater risk of these complications. Vaginal estrogens were not included in this study.

Experts believe that the risk of cardiovascular problems is very low for most women using low-dose vaginal estrogens such as Imvexxy. Very little estrogen reaches the bloodstream when you use this form of HRT.

Still, it's a good idea to review your cardiovascular risks with your prescriber when using Imvexxy. They may recommend an alternative if you have a history of blood clots, heart attack, or stroke.

8. Risk of breast or uterine cancer

Imvexxy's boxed warnings also include a higher risk of developing breast or uterine cancer. As with the other boxed warnings, these risks are based on studies of women taking oral estrogen. The FDA requires Imvexxy's manufacturer to include this statement on its labeling.

However, research suggests that low-dose vaginal estrogens such as Imvexxy don't raise the risk of breast or uterine cancer. Since everyone's risks are unique, it's best to discuss these serious side effects with your prescriber. They can let you know if Imvexxy is right for you.

Frequently asked questions

Public link

Please use the above public link if you want to share this noodl on another website.