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[sweatybet]

Hi all

I am unsure what to do. I paid to see a gynaecologist about painful sex. It has been a problem since my 30's so I was not sure it was VA.  He was really nice (I had researched him and he lived up to what I had been told). When he examined me he hit the painful spot straight off, I nearly took off from the couch.  Been sore since.

He suggested vagifem which I explained I tried for about a week and suffered headaches, abdo pain and a strong old blood smell, he asked how I felt about hrt? Said ok I had tried anglique but noticed it smothered my libido and made me very sleepy. I did say I would be happy to try either again if he felt I would benefit.  In the end he suggest dilators 20 minutes morning and evening, for three months to try and stretch me, I have a short vagina, not helping the problem. No lubricant no sex he advised.  Back to see him in three months or earlier if I need to.

I am happy to try his suggestion although feel abit odd lying there with a dilator in.  I know I will end up having to use hormones of some description to carry on having a love Life. I am only 54. Been looking at lubricants they all seem to contain unpleasant stuff like alcohol which is just going to dry things even more.

Full hrt or vagifem?


Sweatybet

[CLKD]

Your Consultant recommended no lubricants for a reason.  Otherwise you won't know if the dilator is working ........

What  a dilema.  If you had such an extreme reaction to Vagifem it seems unlikely that this would be helpful.  We need to remember that we don't need to use anything for ever particularly if we get a bad or unpleasant reaction.

You could send him an e-mail to see what HRT he would suggest so that you can ask questions here?

[sweatybet]

Hi clod

Sorry he said no sex without using a lubricant. He recommended livial but I explained my mum used it and died from pancreatic cancer although I realise there may not be a connection I would not be comfortable using it.

SB

[Taz2]

I'm so sorry that your mum had this horrible disease sweatybet. I lost a dear friend in January to it and so I know what she must have experienced.

I am a bit confused as to what choice you are trying to make if you didn't like the Vagifem and you have ruled out HRT? As fare as I can see there is no link between Livial and pancreatic cancer although the use of HRT can sometimes lead to the development of pancreatitis. The only established definite risk to developing pancreatic cancer is from smoking. This does increase your risk without a doubt. The other factors - such as heavy alcohol consumption - are thought to increase it but there seems to be no firm facts yet. I expect you have already read all the info on the internet but just in case you  may like to read the risk factors here http://www.pancreaticcancer.org.uk/information-and-support/facts-about-pancreatic-cancer/risk-factors#Age

Taz x

[sweatybet]

Hi tax

Mum neither smoked or drank, she started livial in her late 60's I just could not bring myself to take it.

My dilemma is use vagifem/full hrt or suffer painful sex as I already have done for years.

SB

[Taz2]

Ah I see. I thought that if you ruled out Livial you would also rule out the other HRTs.

I would say go for HRT to see if that will help as it must be very upsetting having this problem for so many years.  Also if your mum started Livial in her late 60's then her risks would be different to you taking it under 60. The risks of all HRTs are known to increase over the age of 60. How long did she take it for?

Taz x

[sweatybet]

Tax

I think she took it for about three or four years she was still taking when she was diagnosed she died six weeks later I just always wondered what if she had not taken it. She did suffer from bi polar so took lithium for about 18 years and AD's for the last three or four years she was alive.  Who knows if that contributed.  Don't know about a family history of pancreatic cancer either they never knew what her dad died of he just wasted away her mum had a brain tumor they both died within a week of each other, must have been terrible for mum, sister and her brother who was only 14.

SB

[Taz2]

That's so sad SB.

These cancers just develop sometimes without any cause that you can see. Consumption of processed meat, diabetes, gum disease, exposure to cigarette smoke in childhood all of these things can contribute to pancreatic cancer. I can't find any link between HRT, Lithium or AD's though.

Taz x

[CLKD]

Such a sad family history.  But there are so many factors which can contribute to developing cancers.

I can't add much to what Taz has said about lithium etc..

Why suffer when there is treatment out there  ....... having had a spell of atrophy a few months ago there is no way I could not use some form of treatment whatever the risks.

[Elena]

Would Ovestin cause you the same problems as Vagifem I wonder?

I would agree with what the others have said, give HRT a try. 

[Hurdity]

...and just to add that Orthgynest pessaries are probably very unlikely to have side effects as they are a weaker oestrogen - estriol (like Ovestin which Milliemoo suggested) but you don't have to use an applicator which I understand can also cause irritation. They are just a small waxy thing you just push up (thinner than the smallest tampon and very very easy to insert). They give more lubrication which I find really helpful too.

I would also recommend full HRT as well - but you haven't said whereabouts in menopause you are ie how frequent your periods are and whether you have any other symptoms such as flushes or sweats. If not and you are still having periods - then just vaginal oestrogen should help initially.

Hurdity x

[Limpy]

Re lubricants containing nasty stuff 
Sylk - is made from kiwi extract, don't think it's got anything artificial in it.
It seems to work really well.

I agree with what the others have said about giving HRT a go.
You can always stop if you don't get on with it.

[ancient runner]

Another one here saying give the vagifem a go -- or orthogynest or ovestin.
Three other thoughts. Yes and Sylk are both lubricants with no alcohol or other nasties in -- they are hugely different to KY which I find stings.
Second thought is that if you've had problems for years could you have an infected patch of skin? I saw a bit of an Embarrassing Bodies a few weeks ago in which a young woman couldn't have sex because it was so painful. She had a patch of skin which I think was completely infested with thrush and four months of drug treatment didn't clear it. She ended up having the skin removed and was well on the mend after that.
Third thought is that I've had little problems on and off for years and a big one now with atrophy or similar, which sounds like you.  I wonder if some people just are more sensitive to hormonal fluctuations in the vulval area?

[ann123]

What is more debilitating to you and your partner?? Is it important to have comfortable sex? Or is it more important to you that you don't take HRT?
I put up with painful sex for a few years, I was dry and sore and we both hated making love.
I now take full HRT and vagifem, I feel great, I don't even need a lubricant now. Having regular sex is important to us and I wouldn't go back to putting up with the pain again.
But, you need to work out what your priorities are?

[sweatybet]

Thanks for all the responses ladies

I am going to do what the dr suggested for three months and go back and see what he says.  Will have a look at yes and silk. Pain is a problem, OH has not been aware till just recently, will think hard about my quality of life. Do suffer hot flushes mainly when working struggle with sleep sometimes and my bladder can be a nuisance so know that full hrt would help.

Looking at Bayers USA site (they make anglique) which I took for about four months last year, stopped as it made me very sleepy, they supply much lower doses but not to the UK. I think the UK market for hrt has declined that it is not worth launching new versions.

sb