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[Maryjane]

I am asking on behalf of a friend. ( I have very bad VA ) anyway she is 62, has a whole host of pelvic pain issues including VA, her GP for years had her on estriol two times a week and still suffering when I found this out I said it was not strong enough. So she tried the Estring hurt to much. Then onto 3 vagifem a week and saw noticeable improvement but still room for improvement. So I said you can up,it to 5 xs a week and put ovestin on your outer bits as she is still sore there, but her GP refuses to up the vagifem and allow it for the outer bits. The other night she woke with pain used an extra vagifem by the morning the pain went.

How can she get her GP to allow 5 xs a week and to use the outer cream. She herself is also slightly worried about upping the vagifem dose that she will need progesterone and could cause endometrium cancer. I have told her it is quality of life , I also said the GP had given you the Estring to try and that is stronger than 5'xs vagifem a week. These GPs.

I ask said they would not restrict , diabetic, thyroid/ blood pressure patients there treatment it's no different for us.

Thank you in advance for your replays , she is at the GP this week so,I said I would direct her here to read the replays. 

[Tinkerbell]

The meno specialist I see told me that Vagifem can be used everyday and it will not cause any problems with the endometrium as it is equivalent to just one oral hrt tablet.
She pointed this out in the letter she sent to my GP.
Can your friend see another doctor at the practice?
I use Vagifem every day and ovestin cream for the outer area a couple of times a week. Since doing this I have got my VA under control after four years!
She probably should do a reload for two weeks too. I did a 2x10mg reload for two weeks as prescribed by my specialist.

[CLKD]

Nope.  It takes every night for 2 weeks before it kicks in  .  Maybe go to the Practice Nurse or back to the GP, explain that ideas have changed in that many ladies use Vagifem nightly in order to maintain relief from symptoms, quoting here if necessary!  GPs really should listen to their patients!

[MrsKPD]

I was prescribed vagifem daily for 3 months then to have 3 weeks off and then to start the cycle again. However, at my surgery they do repeat prescriptions for 8 wks at a time, so why do they only give me one box of vagifem (24) ? Really need 2/3 boxes depending. Seems the surgery don't understand this. As a result of this, I am now only using it every 2/3 days. Fed up mentioning this to the surgery. 😡😡😡😡

[Ju Ju]

Who prescribed this MreKPD? If it was a gynaecologist, then was there communication with your doctor? If it was the doctor, it should be easier to sort out so they can change the amounts on the repeat prescription.

 On my repeat prescription amounts vary. I was prescribed only 8 vagifem at a time, just for one month, which made the pharmistist grumble as he had to break open a box, but now I am prescribed Ovestin, it always comes with the instructions to use every day for the first 2-3 weeks, whether that's appropriate or not. And I get 3 months of patches at a time. So not sure what time policy is being used at my surgery! Worth a visit to see your GP to sort this out? The pharmistist can't change things, though obviously they check for doses etc for safety.

[MrsKPD]

Strange isn't it, seems to differ between surgeries. My pink repeat slip says daily, when I request my meds on line, I always say x 2 boxes. Seems to no avail. It was a GP that prescribed it, won't be seeing her again until I need to. Think only solution is to go to surgery and actually speak to Clerk dealing with the repeats, probably because the guidelines say twice a week, thats what I am getting literally.

[Maryjane]

The new guidelines say more than two a week if necessary , it's left open to common sense a lot of GPs lack. As we can get something called the Estring which is more than the equivalent of 5 a week , I am pretty certain money plays a big part in it all.

[CLKD]

MrsKPD - go to the GP that issued the prescription who may not be aware that the Surgery aren't taking his instructions on board.  I've had lots of problems recently getting the 'correct' anti-depressant  - they still didn't get it 'right'  even though my GP and I had discussed exactly what I was to have.

[anais]

In my experience, these GPs need kicking into touch. All my HRT has been prescribed by my consultant at the Endocrine Gynaecology department of my local hospital. The GP assumed that because I had started combined/continuous  Estrogel/Utrogestan that I would have no need for Vagifem so wouldn't issue it on repeat prescription. However my consultant advised me to increase my maintenance dose from 2x per week to every other day. In fact, he said there's not much oestrogen in Vagifem anyway. But then I had an uphill struggle trying to get a repeat prescription for Vagifem from the GP practice even at the original dose. 

My experience with my GPs surgery and HRT was abysmal. I couldn't have a smear test due to pain from VA and the practice nurse wanted me to sign a disclaimer to opt out of the national screening programme.  And she's supposed to be the HRT nurse!! She told me the pain was due to the menopause but she didn't even suggest Vagifem or any other local HRT.

Anyway, I'm sure many people can tell similar stories but the more I read the more I realise that many GPs are very reluctant to prescribe any kind of HRT. There's so much made of hot flushes as being the only indication that a woman might need HRT and practical zero information about VA, bladder infections, etc etc. Knowledge is power, as they say. It seems that a lot of us here have had to be proactive with our GPs in trying to get what we need. HRT isn't some luxury for pampered princesses. It's actually a very effective preventative treatment for a range of conditions and these GPs really ought to know better. The menopause does actually affect 50% of the population sooner or later.

[CLKD]

Good post Anais!

[Noodle]

I can't understand why your friend has pain with Estring.  Yes, it looks a little bulky, but it's t texture is very soft and pliable. If she'd been on vagifem beforehand then I can't imagine why she wouldn't have been able to push it up to the area where frankly, you just can't feel it. 

It is marvelous.  It is continuous. It is stronger than (the new10mg) vagifem. No waxing and waning.

x

[Ju Ju]

Oh I can understand! If your vagina gets very sore and angry, even putting in vagifem can be difficult. I had to use Ovestin everyday to re-oestrogenise the vagina. Smoother edges.Maybe she can retry estring when her vagina has calmed down.

[CLKD]

Some ladies don't like touching themselves which would mean inserting anything might be difficult.

[Hurdity]

Um - well if you have VA you have to "touch" yourself to treat it! I mean there's nothing you can do in that situation if you were so averse to doing anything there - I mean when you wash you touch yourself!!!  . This must surely be very rare - most of us have used tampons haven't we?

Hurdity x