Estradiol Vaginal Inserts
Estradiol Vaginal Inserts

Get your Imvexxy medication filled online

With Felix, you can get Imvexxy prescribed by a licensed healthcare practitioner and delivered to your door for free.

At a glance
Estradiol Hemihydrate
4mcg and 10mcg softgels
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Prescribed by a Canadian healthcare professional
Support and resources along your journey
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What is

Imvexxy is a vaginal insert containing the active ingredient estradiol.

Imvexxy is used to treat postmenopausal symptoms associated with vulvar or vaginal atrophy, in women who are experiencing pain before, during, or after having sex.

For more resources, including a full list of the risks and benefits of Imvexxy, please review the product monograph.

How does

Imvexxy contains the sexual hormone estradiol, which is a type of estrogen.

After menopause, a person’s body makes less or stops producing estrogen naturally. This can lead to symptoms like dryness and discomfort in and around the vagina.

Imvexxy works by helping to replace this missing estrogen, and in turn, reduce these types of menopause symptoms (i.e., associated with vulvar and vaginal atrophy).

What is
used to treat?

Imvexxy is a postmenopausal medication known as an estradiol vaginal insert.

It’s used to treat specific symptoms that are associated with postmenopause and vulvar/vaginal atrophy, such as:

  • Vaginal dryness
  • Pain before, during, or after sex
  • Vaginal discomfort

It’s important to note that Imvexxy dosing has only been studied for safety and efficacy in use cycles of 12 weeks or less.

How do you take

Imvexxy is given as a vaginal insert, which means that it needs to be taken by inserting Imvexxy dosages directly into the vagina. Imvexxy 4 mcg and 10 mcg dosages are taken the same way.

Start by thoroughly washing your hands, before handing the medication. Then follow the exact application instructions that will be provided alongside your prescription.

Always be sure to follow the application directions exactly as instructed, and never take Imvexxy more often than is prescribed by your healthcare practitioner. Don’t ever change your dosage or dosing schedule, without first talking to your healthcare practitioner.

Imvexxy is NOT to be taken orally.

Remember: Imvexxy has only been studied for safety and efficacy in 12 week cycles or less, so you shouldn’t take this medication any longer than this, without first discussing possible risks with your practitioner to ensure your safety.

How long does
last after you take it?

What are the common side effects of

There are some side effects that can present when using a Imvexxy suppository, such as:

  • Headache
  • Dizziness
  • Memory loss
  • Vision changes
  • Abdominal, back, or pelvic pain
  • Nausea
  • Diarrhea
  • Feeling bloated
  • Fatigue
  • Changes in appetite or body weight (up or down)
  • Excessive sweating or body odor
  • Changes in vaginal discharge (i.e., discomfort or odor)
  • Anxiety or nervousness
  • Loss of scalp hair
  • Hair growth on the fair, chest, abdomen, or legs
  • Breast tenderness, pain, or swelling
  • Acne
  • Rashes or itchy skin
  • Pain during sex

Also, Imvexxy can sometimes cause abnormal blood test results. Your practitioner will be able to determine if this means you require another treatment.

Also, there are some more serious risks that can apply to both Imvexxy, as well as oral estrogen, including:

  • Nasopharyngitis (a cold)
  • Urinary tract infection
  • Vaginal bleeding changes
  • Stroke
  • Pulmonary embolism
  • Deep vein thrombosis or thrombophlebitis
  • Breast abnormalities
  • Coronary thrombosis
  • Cystitis
  • Depression
  • Endometrial hyperplasia
  • Endometrial cancer
  • Erythema multiforme
  • Erythema nodosum
  • Eye disorders
  • Gastrointestinal disorders
  • High blood pressure (hypertension)
  • Liver problems
  • Migraines
  • Neuritis
  • Ovarian cancer
  • Heart palpitations
  • Peripheral edema
  • Urinary tract disorders
  • Vaginal yeast infection

If you start to experience any of these other side effects, be sure to talk to your healthcare practitioner right away. They may want to suggest an alternative medication that could work better for you, based on your health, symptoms, and medical history.

MHT is the most effective treatment for menopausal symptoms and has been shown to prevent bone loss.

In menopausal women who start appropriately-dosed MHT prior to age 60 OR within 10 years of their last period, the health benefits outweigh the risks.

Risks of MHT are considered very rare (~1 case per 1000 to 10,000 women on MHT per year) and may include:

  • risks of stroke or blood clots in legs or lungs with oral estrogen (much lower risk with estrogen gel or patch)
  • risks of dementia in women older than 65 years,
  • risk of breast cancer (less than ~1 case per 1000 women on MHT per year)  

These conditions are all rare, but they highlight the importance of having a full discussion with your healthcare practitioner; especially if you’re experiencing moderate to severe side effects.

Individualization is key, and your MHT treatment plan should be reassessed (at least) once a year to monitor your health, as well as ensure that you are on the correct dosage and formulation.

Your practitioner can help you find balance between treating your symptoms safely, and avoiding increased risks.

Who shouldn't take

There are a number of people that shouldn’t take Imvexxy, including:

  • People who are allergic or have an intolerance to estradiol or any of the other ingredients in Imvexxy
  • People who are or may be pregnant
  • People who are breastfeeding
  • People who have or have had liver problems, and blood tests to measure liver function haven’t returned to normal yet
  • People who have, might have, or have had estrogen-dependent cancers
  • People with endometrial hyperplasia (an overgrowth of the lining of the uterus)
  • People who have, have had, or are suspected to have breast cancer
  • People with unexplained bleeding from the vagina
  • People that have recently experienced a heart attack, stroke, or a blockage or narrowing of the arteries around the heart (coronary heart disease)
  • People with blood clotting problems (i.e., deep vein thrombosis, pulmonary embolism, thrombophlebitis, or protein C, protein S, or antithrombin deficiency
  • People with eye problems that are caused by low blood flow to the eye

In addition to these people, there are some others that need to be extra cautious about taking Imvexxy, such as people who:

  • Have or have had uterus problems (i.e., fibroids, endometriosis, a history of endometrial hyperplasia, or have had a hysterectomy)
  • Have a history of allergies or intolerances to any other medications or substances
  • Have or have had a history of abnormal vaginal bleeding
  • Have a history of liver problems, jaundice (yellowing of the skin or eyes), or itching
  • Have symptoms of a blood blockage to the brain (i.e., migraines, headaches, difficulty speaking, paralysis, loss of consciousness)
  • Have or have had hypertension (high blood pressure)
  • Have or had asthma
  • Have kidney problems
  • Have epilepsy (seizures)
  • Have or have had bone diseases, including conditions or cancers that affect the levels of calcium and phosphorus in the blood)
  • Have diabetes, or have a family history of diabetes
  • Have or had high levels of fat in your blood (i.e., cholesterol, triglycerides)
  • Are pregnant, may be pregnant, or are breastfeeding
  • Smoke
  • Have or have had an autoimmune disease
  • Had or will be having surgery
  • Have porphyria (a blood pigment disease)
  • Have low or high levels of calcium
  • Have thyroid problems
  • Have biliary problems (i.e., gallbladder disease, bile problems)
  • Have eye problems

If any of these conditions apply to you, be sure to talk to your healthcare practitioner about them, before starting Imvexxy. They may want to suggest an alternative dosage schedule or different medication that may work better for you.

There are some medications that shouldn’t be used alongside Imvexxy. Be sure to tell your practitioner first if you’re currently taking:

  • Medications to treat diabetes (i.e., glyburide and insulin)
  • Medications to prevent or treat blood clots, also called anticoagulants (i.e., warfarin)
  • Medications for high blood pressure (i.e., verapamil, diltiazem)
  • Medications that impact liver enzymes (i.e., barbiturates, hydantoins, carbamazepine, meprobamates, phenylbutazone or rifampicin)
  • Medications used to treat epilepsy or seizures (i.e., phenobarbital, phenytoin, carbamazepine)
  • Medications used to treat HIV (i.e., ritonavir, nelfinavir)
  • St. John’s wort, which is used to treat depression

If you’re currently taking any of these medications, your practitioner may want to suggest an alternative medication that will work better for you, alongside the other medications you’re already taking.

What happens if
is taken regularly by men?

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We’d love to tell you more

Health Canada regulations require us to confirm your patient status to access further information on Imvexxy.
The drug identification number (DIN) is easy to find. It’ll be printed on your Imvexxy packaging and the receipt from your pharmacist.

Sorry the DIN you entered is incorrect. Please verify the number and try again.

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Trusted by over 500,000 Canadians

Very easy and professional experience. Quick response from the doctor and easy ordering, billing and shipped and delivered on time. Hassle free.
Great service and products. Everything always arrived in a timely manner.
Simple, respectful, professional with good follow up and guidance, and fast service and delivery.
Best place to get birth control. No more annoying doctor visits
Within an hour . . . a doctor contacted me to make sure that particular medication was what I wanted. Doctor was friendly and knowledgeable. Within minutes . . . being confirmed my order was put through and I received my medication after 2 days.
Great service! I really appreciate being able to put my auto-refill on pause.
Easy and simple.
The best service!!! So happy I never have to try and get myself to the pharmacy anymore. This is the future!!!
The whole process of signing up with Felix, the online visit, and getting my prescription in the mail was very easy and very convenient.
Super convenient, and amazing customer service! The team always responds +++ fast and answers every question and concern. Very pleased with Felix!
Discreet, quick, very professional, and feels totally safe. This is such a convenient service and I'm a huge fan already.
Sign up was a breeze, and items shipped faster than expected. A positive, painless experience from start to finish!
Felix gets you into contact with doctors discreetly online to address personal matters that you'd rather not go to a doctor in person to see, you get the prescription best suited to your needs, and they'll deliver it to your local pharmacy or even your house!
Very quick and easy to do. Can ask the doctor any questions about the medication.
The process was a whole lot easier and faster than I imagined. And the doctor was absolutely helpful and answered relatively fast. I highly recommend Felix.
Super convenient and affordable! Much easier than having to book a doctors appointment and wait to get a prescription filled.

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Frequently asked questions


Felix 101

What is Felix?

Felix is Canada’s first truly integrated healthcare platform. We provide on-demand treatment for everyday health needs like weight loss, mental health, sexual health, and more. Founded in 2019, our digital-first approach to healthcare includes everything from diagnosis to prescription — all accessible from the comfort of home.

Who can use Felix?

Anyone who is 18 years or older older (16 or older for acne and birth control prescriptions), and is located in Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Prince Edward Island, Saskatchewan or Ontario. We cannot ship medication outside of these provinces at this time.

Does Felix replace my doctor?

No. Felix provides a faster, hassle-free way for you to get a prescription to certain medications but our service does not replace your primary care provider. For matters that extend beyond obtaining a prescription lifestyle medication safely and easily, we encourage you to consult your primary health practitioner in person — whether for checkups, personal health concerns, or to inform them about the medications you are currently using.

Can I be accurately assessed remotely?

Absolutely. Our online assessments have been designed to ask all the necessary questions required for diagnosis. We've worked with specialist to create an assessment process that can provide sufficient information for the healthcare practitioner to determine whether or not you are eligible for a prescription and craft an appropriate treatment plan.

It's an emergency. What do I do?

Call 911 or proceed to your nearest emergency room immediately. Felix is not intended for medical emergencies. Once the emergency has been addressed or resolved, contact your prescribing practitioner to inform them of your experience as this may impact your current treatment plan.

Online Visits

How does this visit work?

After creating an account, you will complete a medical assessment for evaluation by one of the Felix healthcare practitioners. 

During your assessment, you will have the opportunity to send your practitioner questions via secure messaging.  

In most cases, practitioners will complete your assessment with secure messaging alone but sometimes they may determine you require an audio or video visit and/or further diagnostic testing to help determine the best treatment plan for you. 

If your practitioner has determined a prescription treatment is appropriate, they will approve your visit and write you a prescription. Our pharmacy will then ship your prescription to your home.

You’ll be able to message your healthcare practitioner if you have questions about your medication or want to make changes to your treatment at any time.

Do I need to complete my online visit at a scheduled time?

No. We use an asynchronous telemedicine model so you can complete your online visit in your own time and we save your progress so you can come back later to finish it.

If you are completing a visit in the mental health or weight loss categories, your healthcare practitioner may require a phone or video call to discuss your medical profile further during the assessment process.

Does the online visit require a phone or video appointment?

Most assessments do not require a phone or video conversation. Once a prescriber has reviewed the info in your assessment they will respond to you via secure instant messages that you can access within your Felix account.  

If you are completing a visit in the mental health or weight loss categories, your healthcare practitioner may require a phone or video call to discuss your medical profile further during the assessment process.

How quickly will a healthcare practitioner review my online visit?

You can expect to receive a response from a healthcare practitioner within 24 hours of submission. If you’ve been waiting longer than this, please email and we’ll look into it.

Can I just get the medication and skip the online visit?

No. A prescription written by a licensed healthcare practitioner is required for all medication currently provided through Felix’s service. If you already have a prescription with at least one refill remaining, you can transfer it to the Felix Pharmacy network.

Please email our Customer Support team at and they will be able to assist you with the transfer.


How long will it take to get my medication?

Not long. After completing your assessment, a practitioner will generally respond within 24 hours, and often much sooner.

The pharmacy will process and fill your prescription within 2-3 business days of your prescription approval date if there is nothing blocking them from doing so.

All packages are shipped via Express Post, which usually takes 2-3 business days. You will receive an email with your tracking number once your treatment has been shipped.

Is your packaging discreet?

Absolutely. All Felix shipments arrive in a nondescript blister package so you can have your medication shipped wherever makes sense for you as long as there is someone there to sign for it.

Do I have to be home to receive my package?

A signature upon delivery may be required.

How much does it cost for shipping my medication?

There is currently no cost to have your medication sent to you from our Felix Pharmacy network.

What courier do you use for shipping?

Our pharmacy partners use Canada Post and/or Purolator for shipping.

Privacy and Security

Is my information private and secure?

Yes, your security is paramount to Felix’s mission. Personal health information provided during your medical assessment is strictly and legally confidential between you and the Felix healthcare practitioner.

Beyond that, all your account information (including the medical assessment, credit card, and shipping information, etc.) is also stored safely and securely. Felix is compliant with all federal and provincial health privacy legislation. It is our duty to protect your data with comprehensive security infrastructure and stringent data policies to ensure it stays private and secure.

Read more on our Privacy Policy.

Is this legal?

Yes! In Canada, only a licensed healthcare practitioner can write a prescription, and only a registered pharmacist can fill that prescription. We are supported by leaders in the Canadian pharmacology and specialized medical fields. Felix adheres strictly to all the regulations set forth by all applicable Colleges of Pharmacists and Colleges of Physicians and Surgeons in which we operate.

Is this safe?

Absolutely. All prescriptions obtained via Felix are provided by licensed Canadian healthcare practitioners—the same as you would get at a hospital, doctor’s office, or clinic. These practitioners do not provide prescriptions unless they deem it medically safe and appropriate to write them based on your medical profile and assessment answers. Our assessments have been crafted by the experts on our medical team. Finally, all Felix Pharmacies are provincially accredited just like any retail pharmacy.

How is my privacy protected?

Your privacy is our top priority. All your data is 256 bit SSL/TLS encrypted, and we take significant steps to keep your data secure. You can read our Privacy Policy for more information. 

Pricing and Payment

How much is the online visit?

Felix charges a fee for the online visit, but only if and when you are approved by the healthcare practitioner. In most cases the fee is $40 but varies by treatment category. The visit fee includes a prescription valid for up to a year (depending on the condition) and on-going support from the healthcare practitioner or pharmacist.

How much will my medication cost?

It depends. Medication costs vary from treatment to treatment but will be in line with what you would pay at a pharmacy in person. You will see the estimated cost of your medication before insurance, during the online visit but will only be charged once approved. Once approved, your prescription will be sent to the pharmacy and we will process the payment and fill the prescription within one to two days.

Keep in mind that you won’t necessarily need to pay the full price yourself. If you have insurance, Felix’s partner pharmacies will bill your insurer directly. You may also be eligible for financial support in your province.

What payment methods do you accept?

We accept all major credit cards for any aspect of your treatment not covered by insurance or other financial support

When am I charged?

You will be charged for the online visit as soon as it is approved by the healthcare practitioner. From there, and after your prescription is activated by the pharmacy, you will be charged the medication cost for each shipment based on your chosen refill schedule. If you have provided insurance or benefits coverage details, it will be applied according to your plan.


Am I covered by my insurance?

Medication coverage varies greatly between different insurance plans.

The good news is that if you are covered, Felix can bill your insurer directly, and then ship your medications right to your door at no additional cost to you. We recommend that you upload your private and/or provincial benefit card during the online visit so that our pharmacy partner can apply any coverage you are eligible for before shipping your meds.

Insurance coverage for medications through Felix doesn't include the cost of your visit.

Is the online visit covered by my insurance or provincial health plans?

A Felix online visit is considered asynchronous since it is conveniently completed through a secure chat bases system. Currently, asynchronous visits are not covered by insurance or provincial health plans so you will be charged a visit fee, depending on the category of treatment you are requesting.

Is the medication covered by my insurance or provincial health plans?

Medication coverage varies greatly between different plans, provinces, and has specific criteria that determine eligibility. For private insurance, we recommend contacting your benefits administrator with your details and the Drug Identification Number (DIN) and the drug name to determine your coverage.

For more details on provincial health plan coverage see below:

Alberta: Learn more about AHCIP here. Search for covered drugs here.

British Columbia: Learn more about MSP here. Search for covered drugs here.

Manitoba: Learn more about MHSIP here. Search for covered drugs here.

Newfoundland and Labrador: Learn more about MCP here. Search for covered drugs here.

Nova Scotia: Learn more about MSI here. Search for covered drugs here.

Ontario: Learn more about OHIP+ here. Search for covered drugs here.

Prince Edward Island: Learn more about Health PEI here. Search for covered drugs here.

Saskatchewan: Learn more about Saskatchewan Health Coverage here. Search for covered drugs here.

Is birth control covered by OHIP in Ontario?

OHIP+ covers some birth control for eligible residents of Ontario who are under 25 years old and do not have private insurance. You can check if your birth control medication is covered here. Make sure to upload your Ontario health card during your online visit so our pharmacy partners can apply your coverage directly.

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