This is curious. So if you've been on Vagifem "for a while", how long is that? Supposedly estradiol helps with the vaginal health, drying out and utis. The inserts are supposed to be safer because they do not go into the system. If you are bleeding, I would see a doctor pronto. Latest theories are encouraging postmenopausal women to use hrt for osteoporosis and cardiovascular as well as vaginal health. Do they really know?