What does it do?

As you go through menopause, you produce less of the hormone oestrogen. MHT pessaries contain oestrogen, which helps treat vaginal symptoms of menopause.

Before you start

• Tell your doctor if you have heart, liver, or gallbladder problems, migraines, diabetes, or if you smoke.
• Women taking MHT may have a small increased risk of breast cancer, blood clots, stroke and heart attacks. Tell your doctor if you, or someone in your family, has ever had any of these problems.

How should you use it?

Remove the wrapper before inserting the pessary into the vagina as directed.

What if you forget a dose?

If it is nearly time for your next dose, skip the missed dose and insert your next dose at the usual time. Otherwise, insert the missed dose as soon as you remember. Do not insert two doses at the same time.

Can you take other medicines?

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. St John's wort) or recreational drugs.

What side effects might you notice?

When the pessary is used at usual doses for a short time, the more common side effects are vaginal itch or discharge, or some bleeding when starting. Other side effects below may happen with oestrogen from the pessary being absorbed into the body.

Side Effects	Recommended action
Symptoms of a blood clot including: sudden shortness of breath, swelling or pain in one leg Symptoms of a stroke including: sudden weakness of the face, arm or leg, especially on one side, face drooping, sudden changes in vision or speech, sudden loss of balance Severe headache Chest pain	Tell your doctor immediately
Unexpected vaginal bleeding	Tell your doctor
Headache, mood changes Sore or enlarged breasts Weight gain, swollen feet or legs Dry eyes, brown patches on the face Stomach upset, stomach cramps, bloating Vaginal itch/discharge	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• If you are having surgery, it is important to tell your doctor that you are taking MHT.
• MHT does not protect against pregnancy. You can still get pregnant up to 1 year after your last period if you are older than 50, or up to 2 years if you are under 50. Talk to your doctor about contraception options.
• MHT is also known as hormone replacement therapy (HRT).