Vagifem Low - not happy about the amount of packaging and plastic!

(I was going to reply to an existing thread which I found very interesting, but apparently threads more than 180 days old get closed for comments. So I'll try to contextualise...)

Various people were discussing their experiences using the applicator to insert the Vagifem pessary, and one person said she used her finger instead - washing her hands beforehand - and had no problems. This sounds eminently sensible to me - after all, most women of an age to use Vagifem have been managing the safe insertion of tampons or body parts for some time. I'm coming at this from a slightly different angle (so to speak). I haven't started using Vagifem yet - but having picked up my first box, I'm appalled at the idea of using a new plastic applicator for every single dose, and at the amount of extra packaging this entails. I'm trying to generate less plastic waste, not more, for obvious environmental reasons.

I know this kind of over-engineered delivery isn't required for the fairly similar use of suppositories, having had the joy of being advised to use Scheriproct for a while back there (again, so to speak).

So I can't see why it's necessary for a vaginal pessary, either. I do understand that hygiene is important, and that the medication has to be packaged so as to be sterile. But tampons come with and without applicators, for people who are less or more comfortable with DIY, so why not pessaries? Am I missing something?

Does anyone know of an alternative system for Vagifem - or an alternative brand - where you get to sterilise and reuse an applicator for a number of doses, or for those who are cool with it, just buy the pessaries and insert them digitally?

Interested to know, especially as I travel a fair bit and can do without the bulk of all that packaging as well.

cheers,

Meg

I've never had to use Vagifem, but wanted to comment on insertion in general. I remember when tampons without applicators first came out. There was quite the discussion. Some people found the idea of inserting a tampon with their finger to be gross, unhygienic, etc.

Common alternatives at the time were the lollipop stick and the cardboard tube. I believe that there are now plastic tampon applicators as well? Keep in mind that tampons are sold in huge numbers. The manufacturers can afford to produce a range of options for women with a range of preferred application methods.

Pessaries are sold in lesser numbers, which means it's not as economical to produce a range of options. I suspect that manufacturers figured that any woman *would* use an applicator, even if it wasn't her preferred method, while women who preferred applicators would simply refuse to use pessaries that didn't have them.

All of that said, I'm looking at a photo on Vagifem's website. The "pessary" in question appears to be a 10 mcg estradiol tablet. I'm wondering what would happen if you asked your pharmacist for a bottle of generic 10 mcg estradiol tablets?

For comparison, before my hysterectomy I needed a hysteroscopy/D&C. My gyn prescribed four tablets misoprostol. Two went up my vagina the evening before, the other two the morning of. No applicator provided or necessary.

Thanks, SurprisedInNB, good point about the economies of scale - hopefully the balance of opinion in the Marketing department will eventually fall on the side of avoiding unnecessary consumption of resources... great idea about asking the pharmacist about alternative forms, since they already offer a choice of generic or brand name when available.
Cheers :-)

An oral tablet may not dissolve or persist long enough in the vagina. How about estrace cream? One tube and reusable applicator that could last several months depending on dose.

True,Therese - I'd like the pessaries to be available without the applicator, and although they are like tablets in size and shape, I wouldn't try to substitute an oral form of the medication, as you're right, it might not be absorbed. I should think something designed to be broken down in the GI tract would take much longer to dissolve in the less acidic environment of a vagina - if it stayed put long enough! The pessaries are supposed to 'stick' to the vagina wall and may still be there in softened form many hours later.