Imvexxy (estradiol) is a prescription drug that’s used to treat moderate to severe painful sex from menopause. The drug comes as vaginal capsules you’ll insert vaginally. The maintenance dosage is twice weekly.

Imvexxy is used to treat moderate to severe painful sex in adult females* who have gone through menopause.

The active ingredient in Imvexxy is estradiol. (An active ingredient is what makes a drug work.) Imvexxy belongs to a group of drugs called hormone replacement therapy.

This article describes the dosages of Imvexxy, as well as its strengths and how to use it. To learn more about Imvexxy, see this in-depth article.

* In this article we use the term “females” to refer to sex assigned at birth. To learn more about differences between sex and gender, read this article.

This section describes the usual dosages of Imvexxy. Keep reading to learn more.

What is Imvexxy’s form?

Imvexxy is available as a soft vaginal capsule you insert vaginally.

What strengths does Imvexxy come in?

Imvexxy comes in two strengths of 4 micrograms (mcg) and 10 mcg.

What are the usual dosages of Imvexxy?

Your doctor will prescribe the recommended starting and maintenance dosages of Imvexxy to manage your symptoms. Your doctor will prescribe the lowest dose for the shortest amount of time to treat your symptoms.

How long you’ll be on Imvexxy treatment depends on the severity of your symptoms and the risks of the medication for you. Your doctor will check you periodically to see if you need to continue Imvexxy treatment.

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for painful sex due to menopause

The typical starting dose of Imvexxy to treat painful sex in adults who have gone through menopause is typically one 4 mcg vaginal capsule inserted into your vagina daily for 2 weeks.

The maintenance dosage is one Imvexxy vaginal capsule inserted into your vagina twice a week. For example, you may insert a dose of Imvexxy on Monday and Thursday each week. You’ll typically insert one vaginal capsule every 3–4 days.

Generally, the Imvexxy strength prescribed is 4 mcg to start treatment. But your doctor may increase your dosage to 10 mcg if they feel you’ll benefit from the higher dose based on your symptoms.

Is Imvexxy used long term?

No, it isn’t. Imvexxy is usually used at the lowest dose and for the shortest amount of time necessary to manage your symptoms and minimize the risks of treatment. Your doctor will monitor you regularly to see how long you need to be on Imvexxy treatment.

If you have questions about how long you need to use Imvexxy, talk with your doctor.

What factors can affect my dosage?

The dosage of Imvexxy you’re prescribed may depend on several factors. These include:

  • the severity of the condition you’re using the drug to treat
  • other medications you may be taking

Imvexxy is available as vaginal capsules you’ll insert vaginally. Your doctor will explain how to insert Imvexxy.

Wash your hands before opening the Imvexxy packaging. Insert one Imvexxy gel capsule using your finger with the smaller end of the gel capsule pointed up into your vagina around 2 inches (5 centimeters). You can insert Imvexxy either lying down or standing up, whichever is easier for you.

For detailed instructions see the manufacturer’s website for more information.

For information on the expiration, storage, and disposal of Imvexxy, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you miss a dose of Imvexxy during your first 2 weeks of treatment, skip the missed dose and continue with your next usual dose. Don’t use more than one Imvexxy vaginal capsule in one day.

If you miss a dose of Imvexxy after the first 2 weeks of treatment, use it as soon as you remember. But if it’s almost time for your next dose, then skip the missed dose of Imvexxy. Don’t use Imvexxy more often than once every 3–4 days.

If you’re not sure what to do about a missed dose, call your doctor. They can guide you on what you should do.

If you need help remembering to take your dose of Imvexxy on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not use more Imvexxy than your doctor prescribes, as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you use too much Imvexxy

Call your doctor right away if you think you’ve used too much Imvexxy. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Imvexxy’s dosage.

Is Imvexxy’s dosage similar to the dosages of Intrarosa?

No, even though the forms and approved uses are similar their active ingredients (what makes a drug work), dosages, and strengths are different.

Imvexxy (estradiol), and Intrarosa (prasterone) are both vaginal capsules you insert vaginally for moderate to severe painful sex in adults who have gone through menopause.

Imvexxy’s active ingredient is estradiol (a type of estrogen). It’s inserted vaginally every day for 2 weeks, and then twice a week.

Intrarosa is made from a plant-based type of DHEA (a hormone your body makes naturally), prasterone, which is converted to estrogen in your body. It’s inserted vaginally once daily at bedtime.

Your doctor will prescribe the drug and the dosage that’s right for you. To learn more about how these drugs compare, talk with your doctor.

How long does it take for Imvexxy to start working?

How long it takes Imvexxy to start working may depend on the severity of your symptoms and other individual factors. In studies of Imvexxy, some people saw symptom relief in 2 weeks.

But it may take up to 3 months for you to notice the full effects of Imvexxy treatment.

If you have other questions about what to expect from your Imvexxy treatment, talk with your doctor.

The sections above describe the usual dosages provided by the manufacturer. If your doctor recommends Imvexxy for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Imvexxy without your doctor’s recommendation. Only use Imvexxy exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Can I use the lower dosage of Imvexxy more often after the first 2 weeks if it’s not managing my symptoms?
  • Will I have a higher risk of side effects with the higher dosage of Imvexxy?
  • Would my prescribed dosage of Imvexxy still work to treat my symptoms if I only use it once per week?

To learn more about Imvexxy, see this article:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.