Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Tinkerbell]

I have been using Ovestin and before that Ortho gynest pessaries  for the last 2.5 years.

I suffered with 8 months of awful VA as another doctor ( older female)refused to accept that I had VA because I was still getting occasional periods and insisted that it was thrush! Anyway I saw a male doctor  and got treatment.

My doctor phoned this week and has said that I should have stopped using it completely after 2 years and also said I should have had a 4 week break every 3 months while on it
In the last year I have had 3 proper periods and after no treatment for a week it takes a further week to feel comfortable again and had to reload for 2 weeks last September ( locum suggested that)
I explained firmly but politely that my life will be unbearable again and he said he would ask advice from his female colleagues and in the meantime I could carry on using the Ovestin .
Where do I go from here?

Also I do not find even twice a week is enough and have to resort to Bepanthan nappy cream some days.
Meant to say I am 51, still getting a few periods, last one was in September. No other symptoms apart from some palpitations.

[Hurdity]

Tinkerbell - your doctor is talking absolute rubbish - yet another ill-informed GP!

He only has to read up-to-date information to know that you can use vaginal oestrogen for ever and you do not need a break and especially with estriol which is very weak. He should not need to consult female colleagues - he needs to get up to speed before other women have to suffer!

You shouldn't have to use nappy cream. When you say twice a week is not enough - do you mean you are still getting dryness/irritation that affects your daily life? It is always possible to do another "re-load" ie every day for a fortnight to plump up your tissues.

You might also want to try Vagifem and use this internally, and continue with estriol cream on the outer parts of the vagina.

If this is all you are using and you have almost reached menopause then it is likely that your oestrogen levels are now getting low. Several of us on here are on full systemic HRT as well as vaginal oestrogen - in order to keeps things healthy and to keep VA at bay.

Do look at the information on Vaginal problems on the left here.

Good luck and don't be fobbed off!

Hurdity x

[Dancinggirl]

Oh Tinkerbell - Unfortunately the leaflet does recommend a cut off of 2 years with local oestrogen treatment. Hurdity has given excellent advice and if your GP keeps insisting you should come off the Ovestin then I would ask for a referral to a gynaecologist for advice about this. You don't want the constant battle about the ongoing treatment.  Many now accept that VA needs treatment for the rest of our lives to keep us comfortable. Also many of us need to use any of these treatments more that twice a week. What Hurdity has suggested e.g. adding some Vagifem, would be very good.
You GP may well reconsider their thoughts regarding stopping this local oestrogen if you insist you see not just a gynae but also an Urologist for further tests and advice - this will be costly for the practise and they'll probably end up having to continue the treatment in the end anyway.
You could do an email consult with Dr Curry if your GP will take her advice and recommendations?  DG x

[Tinkerbell]

Thank you for your advice and sympathies!

I spoke to a locum in September after I had my last period as I was finding twice a week was not enough, had been up to then.

I was also getting the feeling of split skin, that felt like it was ripping if I bent down. I have been putting the cream that was left in applicator on outside bits and that is no longer a problem. She suggested a 2 week reload and said I could use a third one occasionally, which I have done on a several occasions .Unfortunately she has left now the practice.

i am still confused on the treatments, but is Vagifem stronger?

Yes, it affects my everyday life that is why I have resorted to nappy cream. The soreness comes back, walking too far, sitting down for too long and feeling like I need a wee in the night comes back.

[dahliagirl]

Hi

I am 51, perimenopausal have vagifem.  My instructions on the label say 'use one or two twice weekly' which confuses the pharmacists quite frequently 

I usually use 3 a week, sometimes 4.  I have never managed to get it down to twice a week, even with multiple reloads.  Ideally, every other day would be best for me.

I find that how well it works varies as to what my hormones are up to, so it is hard to keep up sometimes.  I have resumed my perimenopause diary, but not with the temp taking this time.

I also take femeston 1/10 but this does not have a huge effect on the vaginal symptoms.

If I stop taking anything, it takes weeks to get back on an even keel.

If it goes haywire, I get swollen, irritated, flabby skin, loads of wet discharge, thrush or BV or something, bad itching and feel  about my bits.  It also come with occasional bladder pain, rushing to the loo and catastrophic knicker wetting.

Thankfully, no one has suggested 'taking a break' to me.

[Hurdity]

Dancinggirl - I seem t have missed this - please can you link to the leaflet where it says this?

In any case whatever it says current recommendations are that it;s OK to continue long-term without a break - even though there are no long term studies on use of vaginal oestrogen.

Low dose vaginal estrogen preparations can be used long term without causing any known systemic effect, and without needing any progestogenic protection of the lining of the womb.
http://www.menopausematters.co.uk/dryness.php

There is also a back article from the MM magazine which says the same thing:
http://www.menopausematters.co.uk/article-vaginal-atrophy.php

Many women are only given a short course of treatment and are disappointed when the symptoms may not be fully treated, or may return when treatment is stopped. We now recognise that these changes persist and gradually worsen without treatment and therefore treatment should be continued; menopausal vaginal changes are not like menopausal flushes and sweats which will reduce or even stop in most women at some stage.

Vagifem is not stronger - it is just different. Vagifem contains estradiol, ovestin and Gynest contain estriol. They work in the same way to  plump up vaginal tissues and help prevent strophy. The treatment doses are worked out so as to be comparable. I just though you might benefit from both - one higher up and the other lower down and it is easier to use Vagifem more frequently than cream I would have throught ( though I have never used cream with the applicator - as I've still got some Orthogynest pessaries and use the cream on outer areas).

In haste

Hurdity x

[Dancinggirl]

Hi Hurdity - you are absolutely right - they have removed the recommendation that local oestrogen treatment should only be used for 2 years - the leaflets did used to state this. So why are doctors still under impression that you should stop treatment after this time!!???
In the Ovestin leaflet however it does recommend women should cease treatment ever 2-3 months for a 4 week break to see if ongoing treatment is necessary - this is absolutely crazy!!!!!
Tinkerbell - I would hotfoot back to your GP with a leaflet and ask him to show you where it says you have to stop.  I'd also mention that twice a week isn't enough and can you have some extra please. DG x

[Jenna]

Hi Tinkerbell,

I have also had your symptoms. I use 'Yes' water-based vaginal moisturiser on the five days that I do not use the Ovestin cream. You can get some free samples from the 'Yes' website. This works for me (at the moment!)

Incidentally, (and Hurdity you might be interested in this!), the gynaecologist I saw a few months ago said I could not use Vagifem and Gynest cream (similar to Ovestin) together - it was either Vagifem pessaries or Gynest cream. She suggested I used Gynest, as I could use it underneath as well, which is the area that was bothering me at that particular time. I did have one prescription for Ovestin recently, as Gynest cream was discontinued, but it now available again as Estriol Cream, which I am about to use. This is less concentrated than Ovestin, but you use a lot more of it, so it works out to be same amount of estriol.

I hope this might help!

Jenna x

[Hurdity]

Thanks Jenna

My gynae specialist GP is happy to prescribe both to me - I don't use the cream internally using the applicator - just on the outer areas, so it's not like a double dose. She trusts me to do what I need with whatever product I need! I agree that if you are using both it's best to have Gynest cream as it is lower dose so you can use more without giving yourself an extra large dose of estriol ( although this doesn't worry me at all).

Hurdity x