Can You Mix Imvexxy and Alcohol?

Menopause marks the end of menstruation. During this time, estrogen levels naturally decline. This can lead to many different symptoms, including vaginal dryness and pain during sex. Imvexxy (estradiol vaginal insert) is one option your healthcare professional may consider if your primary menopause symptom is painful intercourse.

You likely know that medications and alcohol don’t usually mix well. But many medications that interact with alcohol are taken by mouth. But can a vaginal medication, such as Imvexxy, also interact with alcohol?

What is Imvexxy?

Imvexxy is a pink, teardrop-shaped vaginal insert (capsule). Each capsule contains either 4 mcg or 10 mcg of estradiol, a lab-made form of estrogen.

Imvexxy is a form of hormone replacement therapy (HRT). It helps raise estrogen levels in and around the vagina. And elevated estrogen can help relieve vaginal menopause symptoms, such as pain during sex.

When you first start using Imvexxy, it’s recommended to insert it into the vagina once a day for 2 weeks. After that, you’ll likely insert Imvexxy twice a week.

EXPERT PICKS: WHAT TO READ NEXT

• Comparing options: Imvexxy is one of several vaginal estrogen products. Read more about the different vaginal estrogen products used for menopause symptoms.

• Changes to alcohol tolerance: Your response to alcohol can change over time. Here, people share their experiences with how their alcohol tolerance dropped as they got older.

• Alcohol and cancer: No amount of alcohol is safe to drink. Read more about how alcohol raises your risk of several cancers and other health conditions.

Does Imvexxy interact with alcohol?

In short, no, Imvexxy doesn’t directly interact with alcohol. This means that alcohol won’t change how your body responds to Imvexxy and vice versa. So having an occasional drink while taking Imvexxy is unlikely to cause significant harm. But there’s more to consider before filling your glass.

Breast cancer risk

Combining alcohol with HRT may raise your risk of breast cancer more than consuming alcohol or taking HRT would by itself. This is mainly because of alcohol’s risks when it comes to cancer.

All estrogen-based HRT medications carry a boxed warning (the FDA’s strictest warning for medications) for increased breast cancer risk. The risk is very low with vaginal estrogens such as Imvexxy. This is one reason they’re the preferred form of HRT if you’re only having vaginal menopause symptoms.

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Alcohol raises your risk for several cancers, including breast cancer. The risk is greatest for people who consume large amounts of alcohol. But even having one or two drinks per day can increase your risk significantly.

It’s a good idea to discuss your personal breast cancer risk with a healthcare professional before deciding to drink alcohol while using Imvexxy.

Does drinking alcohol change your estrogen levels?

Drinking alcohol may change your estrogen levels, but the research isn’t conclusive. And experts aren’t sure if these changes lead to meaningful differences in menopause symptoms.

Some older studies found that drinking alcohol while taking HRT raised estradiol levels in the body. Others found that drinking alcohol lowered estradiol levels. Though, in all cases, hormone levels were unchanged for people who didn’t take HRT.

It’s also worth noting that these early studies looked at women receiving forms of HRT that are meant for body-wide menopause symptoms, such as hot flashes. Compared to vaginal estrogens such as Imvexxy, the body absorbs greater amounts of estrogen from these types of HRT. Very little estradiol reaches the bloodstream with Imvexxy. So these studies likely don’t reflect what actually happens when you drink alcohol while using Imvexxy.

Can alcohol worsen menopause symptoms?

Research doesn’t suggest that alcohol directly impacts menopause symptoms, such as hot flashes or night sweats. But some people find that alcohol triggers hot flashes. This is because alcohol can widen your blood vessels, which can make you feel warmer or sweat more. It’s not connected to lower estrogen levels.

Drinking excessive amounts of alcohol can raise your risk for developing osteoporosis (weak bones). Menopause is also a risk factor for developing this condition. So drinking a lot of alcohol during or after menopause may raise your risk even further. One of the biggest issues with osteoporosis is that it can lead to bone fractures (breaks).

Drinking alcohol can also contribute to or worsen depression. Menopause can also be a risk factor for developing depression. If you’re prone to or have a history of depression, consuming alcohol during or after menopause could negatively impact your mental health.

No amount of alcohol is considered safe to drink for anyone. But if you do decide to partake, it’s best to consume no more than one to two drinks per week. This can help lower your risk of serious alcohol-related health complications.

Does alcohol tolerance change during menopause?

Your alcohol tolerance may change during or after menopause. But this is more likely related to aging than menopause. As you get older, your body has a harder time breaking down alcohol. This means that more alcohol sticks around in your system for longer. In addition to making hangovers more likely, it can raise your risk of falls and accidental injury.

Precautions when using Imvexxy

Imvexxy is generally well tolerated. Its most common side effect is headaches. Some people also reported changes to their vaginal discharge.

Most of the warnings for serious side effects that Imvexxy carries apply to all estrogen-based HRT. But because your body absorbs very little estradiol from Imvexxy, these serious side effects are very rare. These risks are mainly linked to oral and topical forms of estrogen, which are absorbed in higher amounts. But all estrogen-based HRT products are required by the FDA to list these side effects on their packaging.

Imvexxy’s labeling includes warnings about an increased risk for:

• Gallbladder disease

• High calcium levels

• Vision problems, including vision loss

• Liver problems

• Elevated blood pressure

• Dementia

• Blood clots and stroke

• Breast cancer

• Uterine cancer

These aren’t the only possible risks with the medication. Your prescriber or pharmacist can discuss Imvexxy’s potential side effects and risks with you in more detail.

Why trust our experts?

Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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