Aunt Vadge: can I stop using Vagifem if my microbiome report was good?

41 year old woman holding glowing bacteria, which represents her healthy vaginal microbiome

Hello Aunt Vadge,

I am currently using Vagifem because I had BV for a long time. I also used vaginal probiotics and lactoferrin.

My recent Juno Bio test showed 98.5% lactobacillus gasseri. I stopped the probiotics, but I was wondering if I should also stop the Vagifem?

Age 41


Hey there, Denisa!

First off, mega props to you for taking charge of your health and following through with treatments. Battling bacterial vaginosis (BV) can be such a drag, but you’re on the right track. Now, let’s chat about Vagifem and your next steps.

Vagifem (vaginal oestradiol tablets) is typically used to beef up those vaginal tissues and keep them from throwing a hissy fit, especially if oestrogen levels decide to take a hike. It’s not just for kicks; it’s for helping with things like BV because a well-nourished vagina is a happy vagina, and happy vaginas are less likely to be grumpy with infections.

Seeing that Juno Bio test waving a 98.5% Lactobacillus gasseri flag is awesome news! That’s like your vagina throwing a block party because it means the protective bacteria are having a blast down there.

About stopping the Vagifem: since Vagifem is a hormonal treatment, presumably you’ve been prescribed this by a doctor. You should consult with your doctor before stopping. If your doctor thinks the treatment has done the trick, and gives you the green light, you can stop and see what happens when you don’t use any treatment at all (scary, I know!).

You can also try Fennelope or EstroBoost all-natural drug and hormone-free vaginal treatments to boost vaginal oestrogen levels. You can always restart your treatment while you seek help.

For extra understanding, if you haven’t already, download and read Killing BV, My Vagina’s extremely popular expert guide on treating BV.

If you’ve struggled with BV for a long time, it may be because there is a deeper issue going on that needs your attention, particularly if the Vagifem and probiotics worked at least temporarily. If you have genuinely low oestrogen, it’s important for you to know that and get the right support.

If you stop using the Vagifem, and after a while the BV comes back, I suggest booking in with one of our vulvovaginal specialist practitioners so we can take a look at what’s going on in the rest of your body to see if it might be contributing to this situation, including low oestrogen, which we can check. You’re clearly doing a great job in your treatments – well done! – but if it returns, we need to work out why.

Until then, keep doing you, and remember to listen to your body—it’s your BFF in this health journey.

Big hugs and healthy vibes,
Aunt Vadge 🌸

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