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[linfit]

Hi all

Does anyone have any knowledge on roughly how long Vaginal Atrophy should take to clear up?

I have been on Vagifem for around 4 months, 10mcg 2 x weekly. Although I have had some improvement, I still get very painful flare-ups of my symptoms. My GP surgery are at best vague & don't really seem to be able to either advise me or make appropriate referrals.

Is this normal in terms of recovery & when should I expect to be more or less symptom-free?
Should I push for an increased or more frequent dose of vagifem?

Also, can anyone explain why symptoms flare up the way they do?

Any help very gratefully received as it's badly affecting my life.

[Annie0710]

Twice a week wasn't helping me so gynae told me to double up to 4x vagifem a week.  This still didn't help the tearing and soreness , since I started testosterone it's lubricated me inside but outside was still sore so now I'm rubbing on sylk, only on day 2 and definitely not as itchy today x

[CLKD]

Unless you use regular treatment symptoms will return.  This condition is usually for ever.  As oestrogen levels drop so the skin thins and the body dries.  Inside and out  - VA for me was like razor blades up there  .  Nostrils itch, eyes, deep in the ears …… skin …….

[Dancinggirl]

linfit - Hi and welcome.  Vaginal atrophy doesn't clear up exactly but the Vagifem should help to restore and maintain a healthier urogenital area.
You haven't told us how old you are or where you are in the menopause? What VA symptoms are you getting?
If you have had VA for some time then it will take longer to get relief from symptoms and many women need full systemic HRT alongside to really tackle the problem.  Most of us who get bad VA do find that a range strategies ar needed to help keep things comfortable.  Vaginal moisturisers e.g. Sylk can really help and some basic things like never using scented washes or shampoo near the ‘lady bits'  etc.
I use Sylk at least once a day and Vagifem 2-3 times a week and I will have to maintain this regime for the rest of my life if I wish to remain comfortable - I'm 60 now and have had VA since my early 40s!!!
There are lots of threads on this forum that cover VA and other urogenital issues so do a search. Do increase Vagifem to 3 times a week to see if that helps and start using some Sylk or Replens or YES vaginal moisturisers alongside.
Dg xxx

[grumpyjane]

Sulk! ha ha Dg, I need that! 
But seriously, yes coping strategies needed. I used to think I had a STD before the ladies on this site educated me. I use vagifem twice a week and Oestrogel, progesterone and have just started testosterone.
Jx

[Hurdity]

Hi linfit

You definitely should have seen a difference by now - 4 months is a long time!  What are the symptoms which flare up and are they related to anything eg intimacy or your cycle if you have one?

I agree that you should ask to increase Vagifem - the old dose was 25 mcg twice a week max and then reduced to 10 mcg twice a week - less than half - so for many women this is not sufficient! Also I suggest you also ask for estriol cream 0.01 % - the generic one, in addition - not Ovestin which is stronger. The estriol cream you can rub onto the outer areas of vagina and entrance and really helps this area - it's a different type of oestrogen and many of us use this as well as Vagifem and systemic HRT.

Hurdity x

[ancient runner]

Did you start with the two-week loading (one a night) phase?
Did it improve then? Has it got worse again now you're on 2 a week?
The dose you are on simply isn't enough for lots of us. I use something called the Estring which gives roughly 49mcg over a week (you pop it inside and it stays there for around 3 months delivering a continuous dose of oestrogen). Others on here use up to 5 vagifem a week, or use vagifem/ovestin and full HRT.
There is a thread called The Burning Club which has lots of our discussions on it.
Hope that's helpful. 

[ancient runner]

You asked about flare-ups - forgot to answer that. It might be that the oestrogen is wearing off between doses and your tissues are complaining, but it could also be that your vaginal pH isn't right (because of the lack of oestrogen) so you're getting thrush or BV coming and going. Thanks to Dancing Girl quite a few of us swear by Multigyn Actigel which gets your pH right and is soothing (though it can sting like mad - probably when the tissues aren't as healthy as they should be)

[dap5645]

Hi...  I had VA for ages. Tried estrogen creams, patches and vagifem. Vagifem did not suit me at all was giving me thrush all the time and went sorer down there. In the end I went on hrt tablets and that helped no end. I went on Premique but it as now been withdrawn and was great on it. Had to change last week to kliofem but don't feel too well on it. I have asked for Indivina similar to Premique
It will take some time but gradually you will go better and better. I know how bad it is. Mine was constantly there and so bad. To be honest if I was youI would give the hrt tablets a try  because this VA causes depression as well. I was glad I went on the tablets. All the best.       

[dap5645]

Linfit... I think really you have to try a few hrt tablets first to see which suit. I posted the other day and Hurdity informed me that Indivina was similar to Premique.  I think sometimes you have to tell your Doc which you may want to try. It's tiring I know xxx

[Hurdity]

Hi dap - just to say that it was the progestogen in Indivina which is the same as in Premique - the oestrogens are totally different (Premique contains a mix of horse oestrogens, whereas Indivina contaisn estradiol which is bio-identical with the oestrogen we make in our bodies). Since it is the progestogen which often the problematic part of HRT if you were changing from Premique then Indivina would be a better one to go for initially.

Hurdity x

[dap5645]

Thanks Hurdity. Yeah i'm sure i'll be better on indivina because of the same progesterone. xx

[ancient runner]

Here for a little whine and a moan. Mine's flaring up again two months into the Estring.Thrush? VA? Who knows? Chucking all sorts at it and wondering whether to reload with vagifem yet again or tackle the packet of Femoston which has sat waiting for me for the last year. Couldn't get back to sleep last night after waking for a wee, dry eyes and miserable for first time in months. Sigh.

[Dancinggirl]

ancient runner - 'nothing ventured, nothing gained'.  The Femoston is there waiting for you to try and if you don't try it you'll never know whether it will help or not.  You can always stop using it as you won't go back to the beginning again (your current situation will simply return). The menopause is not a race you have to get through - there is the perception that one puts up with a time of flushes etc. and then emerge OK when the body supposedly gets used to the lack of oestrogen - many women never get to the end of this race to find they are ‘OK' in the end; for some of us the meno symptoms carry on for years and the oestrogen deficiency carries on doing it's damage for the rest of our lives - one could argue that HRT can help the race run more smoothly.  I suspect you see using the systemic HRT as a weakness, whereas I see it as a weakness if one doesn't do everything you can to improve your quality of life.
DG x

[CLKD]

It is personal choice.  If someone sees taking medication as a 'weakness', then don't moan about symptoms?  World wide Chemists spend hours in Labs. working on medications which may help various conditions, so the choice in the First World is there.  Sometimes medication can ease/cure symptoms.  Unless we try we won't know what suits or what actually helps.  I tried not to take ADs but had to 'give in ' eventually, now Himself and I have a Life together  .

Those in 3rd or War Torn countries have less choices.  Even for pain relief, Hospitals are crying out for medication in Syria to aid pain relief in theatres.  Some Religions don't agree with medication but for those of us with the option, it can be worth while trying. 

Also, because sometimes it can takes months to find something that eases symptoms and suits, it is better to try B4 one becomes despondent