Imvexxy (estradiol) is a brand-name vaginal insert prescribed for use in adults to treat painful sex due to menopause. Imvexxy is used once per day to start and then typically twice per week to maintain treatment.

Imvexxy belongs to a drug class called hormone replacement therapy (HRT). Imvexxy isn’t available in a generic version.

Keep reading for specific information about the dosage of Imvexxy, including its strength and how to use the medication. For a comprehensive look at Imvexxy, see this article.

Note: This article describes typical dosages for Imvexxy provided by the drug’s manufacturer. When using Imvexxy, always follow the dosage prescribed by your doctor.

Read below for recommended dosages of Imvexxy and other details about the drug.

Imvexxy form

Imvexxy comes as a gel capsule vaginal insert.

Imvexxy strengths

Imvexxy is available in two strengths: 4 micrograms (mcg) and 10 mcg.

Typical dosages

The following information describes dosages that are commonly prescribed or recommended. However, be sure to use the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for painful sex due to menopause

Doctors may prescribe Imvexxy to treat painful sex due to menopause.

If your doctor prescribes Imvexxy for you, your starting dose will likely be 4 mcg. Typically, you’ll use this dose once per day for 2 weeks. After 2 weeks, your doctor will decrease your dosage to 4 mcg twice per week (once every 3–4 days). This is the typically recommended dosage of Imvexxy.

If this dose isn’t working for you, your doctor may recommend increasing your dosage.

For more information about your specific dosage, talk with your doctor.

Long-term treatment

Imvexxy is used short term for painful sex due to menopause. Talk with your doctor if you have questions about how long you can expect to use Imvexxy.

The Imvexxy dosage your doctor prescribes will depend on several factors. These include:

  • your age
  • how your body responds to Imvexxy
  • the type and severity of the condition you’re using Imvexxy to treat
  • other medications you take
  • side effects you may have with Imvexxy
  • your liver and kidney function

Other medical conditions you have can also affect your Imvexxy dosage.

Dosage adjustments

Your doctor may need to adjust your dosage if you take certain medications. Examples include inhibitors or inducers of CYP3A4.* These drugs can affect the level of Imvexxy in your body. To find out what drugs may interact with Imvexxy, see the “Interactions” section in this article.

Your doctor may also need to adjust your dosage if you have liver damage or kidney disease or if you’re 65 years old or older.

Be sure to tell your doctor about all medications you take and any health conditions you may have.

* CYP3A4 is a type of protein in your liver that breaks down medications.

You should follow your doctor’s directions for how to use Imvexxy. Imvexxy is a small, soft gel capsule that you insert in your vagina. You can do this while standing or while lying down.

To begin, hold the larger end of the capsule between your thumb and finger. Then place the capsule, with the smaller end up, about 2 inches (5 centimeters) into your vagina.

For more details, see these instructions on the manufacturer’s website. You can also ask your doctor or pharmacist for more information.


Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you forget your dose of Imvexxy, use it as soon as you remember. Don’t use more than one vaginal insert per day during the first 2 weeks. If you miss a dose after the first 2 weeks, use an insert as soon as you remember. Still, don’t use more than one insert once every 3–4 days. If you’re not sure what to do, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.

It’s important that you don’t use more Imvexxy than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.

Effects of an overdose

Overdose effects of Imvexxy can include:

If you use more than the recommended amount of Imvexxy

Call your doctor right away if you believe you’ve used too much Imvexxy. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are some frequently asked questions about Imvexxy.

Is the dosage of Imvexxy similar to the dosage of Vagifem?

Yes, the forms and how often you take each drug are similar. Imvexxy and Vagifem (estradiol) are both vaginal inserts used daily for 2 weeks and then twice weekly thereafter. Unlike Imvexxy, Vagifem comes with an applicator that you use to insert it.

Imvexxy is available in strengths of 4 micrograms (mcg) and 10 mcg, but Vagifem comes in only a 10-mcg strength. Your doctor will prescribe the drug and dosage that’s right for you. See the “Imvexxy dosage” section above to learn more about Imvexxy’s recommended dosage.

To learn more about how these drugs compare, talk with your doctor.

How long does it take for Imvexxy to start working?

Imvexxy starts to work after your first dose. However, it may take about 2 weeks of treatment before you experience the drug’s effect. In some cases, it may take up to 3 months of use to reach the drug’s full effect.

If you continue to have pain with sex after this time, talk with your doctor. They can help determine whether Imvexxy is right for you.

Talk with your doctor if you have questions about what to expect with Imvexxy treatment.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Imvexxy for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Imvexxy without your doctor’s recommendation. If you have questions about the dosage of Imvexxy that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Imvexxy. These additional articles might be helpful:

Disclaimer: Medical News Today 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.