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[Eddie]

I have suffered this vulvodynia now for a couple of years, used full hrt for over three years, then changed to sequi to try and eliminated my cycle. I am 49. So for nine months now have been on femoston sequi and more recently 4months vagifem too. My symptoms are unbearable around when I bleed and about a week after, only to feel better for maybe a week in the middle. Lower back pain is also linked with this cycle. Doc at meno clinic has told me to increase estrogen to 2mg but will that lead to estrogen dominance? Any advice welcome. Eddie. X

[Dancinggirl]

If you up the dose to the 2mg Femoston the progesterone will have increased as well so it balances out.
I have had discomfort and burning with my lady bits for many years even on full HRT so clearly the oestrogen wasn't getting to my vagina and bladder. Started local oestrogen about 7 months ago - I'm just starting to get more comfortable. - I'm now using a Estring as the other options Ovestin/Vagifem) caused more burning.
Probably worth upping your HRT dose as well as using Vagifem and see if things improve.
DG x

[Eddie]

Hi Dancinggirl, I would need a different hrt, as femoston sequi I think is only this dose. Which is only 5mg prog. But I agree with you about balancing it out. I also was on 2mg femoston conti, oh wait I've got this wrong. Was on sequi (with a bleed) for three years. Now on no bleed, which is lower dose. So just really want to eliminate the cycle to see if it helps. What is estring? Eddie. X

[Hurdity]

Hi Eddie

I am a bit confused about what you are on?

You are on no bleed HRT but you are getting symptoms around your bleed 

Perhpas you can clarify? If you are on Femoston conti then why are you bleeding? Maybe you are still peri, in which case perhpas you should still be on sequi?

The progestogen doses in HRT are always calculated to oppose the oestrogen dose so there should be no worry about too much oestrogen causing the womb lining to build up - this only happens in some women. If you were only feeling OK for a week of the 4 weeks on HRT then this suggest to me you may be progesterone intolerant, and the way round this is to have a longer cycle or shorter course of progesterone - under the supervision of your doc, with regular checks of the womb lining. This can be achieved with separate oestrogen and progesterone eg Utrogestan.

Estring is a ring with slow release vaginal oestrogen and is changed every 3 months - more convenient than Vagifem, and higher dose.

Hurdity x

[Eddie]

Hi Hurdity. I probably am still peri, but the monthly cycle is causing so much pain with vulvodynia. Now I've been on conti for nine months but bled almost constantly at first but now have a light bleed almost monthly. Meno specialist is trying to stop bleeds altogether to see if it helps vulvodynia. So she is adding elleste solo 1mg to the mix, but I feel that may not be balanced anymore.
Interesting about progesterone intolerance, I never considered that but when I started hrt yrs back I didn't get on with norethisterone? And also the natural capsule one can't mind the name? But she said if this doesn't work she suggests the merina coil.
Hope this makes more sense. Eddie. X

[Dancinggirl]

I struggled with painful breakthrough bleeds (with Sequi HRT) and progesterone intolerance (when using conti HRT) so ended up with the Mirena which was the best option for me. If you try this you only need to use Oestrogel or Oestrogen patches alongside and use the amount that keeps your symptoms at bay. Dg x

[Hurdity]

Thanks yes Eddie!

The Mirena often stops bleeding altogether and keeps the womb lining thin, which means you can have as much oestrogen as you like (well within reason) to keep it thin. There may still be odd bleeds during peri due to your own cycle though - I gather.

Yes it does sound odd to add extra oestrogen to a conti HRT preparartion as surely this will stimulate the lining? Not sure why you can't just double up the Femoston conti - if you can tolerate that much progesterone? Quite a few women don't get on with norethisterone. The natural capsule one would be Cyclogest ( pessary/suppository) - but not generally prescribed for HRT, or Utrogestan - which many of us use.

Hurdity  x