As estrogen levels decline during menopause, vaginal tissues tend to shrink and lose their elasticity—sometimes producing a condition known as atrophic vaginitis. Inserted in the vagina on a regular basis, tablets provide a local source of estrogen replacement without passing through the rest of the system. This helps relieve such symptoms of atrophic vaginitis as vaginal dryness, soreness, and itching.
Most important fact about Estradiol vaginal tablets

Because estrogen replacement therapy is not advisable if you are in any danger of developing cancer, your doctor should take a complete medical and family history—and do a complete physical exam—before prescribing E2. As a general rule, you should have an examination at least once a year while using this product.

How should you take Estradiol vaginal tablets?

Each E2 tablet comes in its own disposable applicator. Insert the applicator as far into the vagina as you find comfortable, stopping when the applicator is half inside. Gently press the plunger in the applicator until you here a click and the plunger is fully depressed. This will release the E2 tablet. Conclude by gently removing the applicator and discarding it as you would a tampon applicator.

The E2 tablet can be inserted at any time of day, but it's advisable to do each insertion around the same time.

If you miss a dose...
Apply it as soon as you remember. If it is almost time for your next dose, skip the one you missed and return to your regular schedule. Never try to "catch up" by doubling the dose.

Storage instructions...
Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using E2.

Side effects may include:
Abdominal pain, allergic reactions, back pain, genital itching, headache, skin rash, upper respiratory infection, vaginal spotting or discharge, yeast infection

Why should Estradiol vaginal tablets not be prescribed?

Do not use E2 if there is any chance that you have breast cancer or any other cancer stimulated by estrogen. Avoid E2 if there is a possibility that you are pregnant. Do not use E2 if estrogen products have given you clotting problems in the past, or if you currently have phlebitis or other clotting disorders. Also avoid E2 if you have unexplained genital bleeding or the metabolic disorder known as porphyria, and do not use this product if it causes an allergic reaction.