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[linz57]

Two years ago I was diagnosed with severe urogenital atrophy and prescribed Vagifem. It worked a treat, but after 12 months my doctor wouldn't prescribe it anymore and put me on systemic , combined hrt....Femseven Conti.

Again, this worked great and I felt better than I had in ages. I had energy,slept better, no hot flushes, no aches and pains and it even calmed my anxiety to a degree. However,just after Xmas  I realised I wasn't feeling quite as good anymore and then, five weeks ago I started with lower back pain and general aches and pains. Last week the dreaded increased urination symptoms started to reappear  and so I started to wonder if maybe my patch isn't working on the atrophy quite so well anymore. I have read that systemic hrt may not be as effective as topical estrogen for atrophy and so I'm now wondering what to do.My doctor hasn't been much help, other than to do a urine dipstick test and tell me to take anti inflammatories for my back.I do not have a urine infection.

I don't know if the increased urination is due to the backache or lowering estrogen levels in my body. So, I'm thinking of maybe reintroducing the Vagifem alongside the patch (but cutting the patch in half) and doing a 14 day reload of the Vagifem, to see if it helps.

Has anyone else found this happening after being on systemic hrt  for urogenital atrophy?

[Hurdity]

Many of us use local oestrogen as well as systemic HRT.

Yes sounds like a good idea to re-start the Vagifem - but I wouldn't cut the patch in half though as you will defeat the object of increasing oestrogen. Your doc is hopelessly out of date if s/he would not prescribe Vagifem long term.

This is what it says on this site:

Local estrogen can be used for vaginal and bladder symptoms, when systemic treatment is not desired or appropriate. For some women, vaginal estrogen may be required along with systemic HRT.

http://www.menopausematters.co.uk/local.php

I have been on both for many years - probably most of the time I've been on systemic HRT I've been using vaginal oestrogen as well.

Hurdity x

[Taz2]

I used FemSeven Conti plus Vagifem for three years linz57 as the hrt on it's own was no longer enough to keep the atrophy symptoms at bay.

Taz x

[Midnight Shadow]

Sorry to appear ignorant but what is systemic HRT? Can't quite get my head round it all. Now on Vagifem and Kliovance for severe Atrophy. Have only been on the Kliovance for a week so probably not long enough to have made a difference. Did have a better weekend though, but then bang, back to stinging and burning like nettle stings with the sitting at work. Four days off soon and then a fortnight's holiday so hope that makes a difference.  Hope others are improving.

[linz57]

Very interesting replies, thanks.
Taz2, how long after starting the FemSeven Conti  did it take before you felt the VA returning and what were your first indications that  it was doing so? I'm just presuming its the VA again as this is how it started off before, it was only later all the other symptoms such as burning, itching and internal stabbing pains kicked in.

How much Vagifem a week did you both take alongside the systemic hrt?

As far as I understand it Midnight Shadow, systemic is a form that works throughout the whole body and tackles vasomotor symptoms like hot flushes, along with anxiety, palpitations etc whereas something like Vagifem is  topical, meaning it just works locally in the vagina. Less absorption throughout the whole body  takes place with topical. Hope I've explained that ok