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I use Vagifem every night and have done for about three years now, my meno specialist said even when used every day it was only equivalent to two systemic HRT pills a year, she sent that info to my GP too. A female GP at my surgery also told me she was happy for all her ladies to use five Vagifem a week if needed as that was equivalent to the old dose. A few years ago the dose was 25 mcg per pessary it is now 10 mcg.