anderina - I really do not think you need to stop the vagifem because of fibroids.
What the leaflets/patient information about vagifem say is that there are certain effects from taking all oestrogens. The information that relates to fibroids is quoting the standard cautionary words that all oestorgen taken in any form will say. I looked closer at the detailed information and it says that (as expected) enlargement in fibroids is an effect of oestorgen - this is well known and is stated on this web site under health conditions.
http://www.menopausematters.co.uk/atoz.php#GlossFFibroids
Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT. The information in the leaflets is applying the results from systemic HRT to advise caution with any oestrogen, and states that there is no information about the effect of local oestrogen on fibroids.
All effects of oestrogen are dose dependent - which means that the higher the dose the greater the effect. Even allowing for the fact that we are all different, any effect of vagifem on fibroids is likely to be negligible, because the oestrogen dose is so small.
As above some progestogens have been shown to have the opposite effect ie shrink fibroids, especially if introduced directly as in the Mirena.
As I said please do use Orthogynest 0.5 mg pessaries instead if you really don't want to use Vagifem - they are a very weak oestrogen and will prevent your VA getting worse, without affecting your fibroid.
I understand that hysterectomy is now a last resort for treating fibroids so don't be pushed into it if you don't have to have one - and see what else is recommended when you've had the results of tests and hysteroscopy etc
http://en.wikipedia.org/wiki/Uterine_fibroidGood luck!
Hurdity x
