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[linfit]

Hi
I have posted on here a few times but am feeling so worried and frustrated now, I need help. I am 53, post menopausal. Had VA symtoms since August, on Vagifem twice a week since Sept and Evorel conti patches since November.

I feel like my life is sprialling out of control; the symtoms are sometimes better, sometimes not. My work is affected, I am not the same person. I have anxiety in the morning and am obsessed with symtom checking.

I have seen a urologist who wants to do a cystoscopy to eliminate bladders problems.

Please please tell me that this isn't my life now?! It's nearly 5 months and I am still in discomfort and pain. Is this normal, where will it end?

I am going to see a gynaecologist on Friday but so worried, I am loosing hope and I just need to know I can get my life back on track.

[CLKD]

Do you use the Vagifem often enough!  The initial 2 week loading as recommended should improve symptoms, some ladies find that they need to use the product every other night rather than spreading a distance of every 3/4th and 5/6th.  I would encourage you to up the doseage, do a 2 weeks reload and maybe use another product to keep the vaginal lips moist: KY Jelly does it for me, others use Sylk on a regular basis.

Keep hydrated.  Toilet hygiene is important, i.e. wipe front to back ;-).  Light cotton panties, go without when possible.

Anxiety can be eased by an emergency 'as necessary' tablet or by taking anti-depressants as some can ease symptoms :  since I upped the one I take I have felt so much better, I now take 10mg at night and 5mg in the morning.  Add to that a beta-blocka  .  It really can be Trial and Error.

Do take a list of symptoms etc. to your appt..

[Dancinggirl]

lnfit - I wish I could tell you that your VA problems will clear up completely but, has I think I've mentioned before, urogenital issues have to have ongoing management.  I am comfortable most days but now know what to do if symptoms flare up.  It does require discipline and staying relaxed and calm is vital - I do think stress makes everything worse. 
I would certainly have the cystoscopy for peace of mind and talk through your symptoms with the gynae - write everything down so you don't forget what you want to discuss.
Don't dispair - I've struggled with these problems for many years and now feel I have thing vaguely under control - you just need two find the strategies that work for you.  The local and systemic HRT you are using will take 6-9 months to really restore things in your whole urogenital area.  Keep using the SYLK.
DG x

[Elizabethrose]

Hi linfit

I'm no expert but the wonderful ladies here offered excellent advice re my recently developed VA just a couple of months ago. I started Vagifem in November which I use along with a small blob of Sylk every morning following my shower. I've found that the twice a week maintenance dose following the two week every day loading wasn't enough to keep everything comfortable. I saw my utterly brilliant GP again today for an update, explained that I had had to increase the weekly frequency and she shrugged her shoulders and said fine, I could take what I need to keep me comfortable. I'm using the Vagifem every other day which works well. We are going to review again in a month and if needs be we'll add to it. Could you suggest to your GP that they increase your weekly dosage which may calm things more for you? As my doc said, the old dose of Vagifem was 25 mgs twice a week before it was reduced to 10mgs twice a week.

I wish you well.

[Annie0710]

My gynae said to use double vagifem twice a week for ever.  That and Sylk externally really does work wonders x

[Tinkerbell]

I am the same age as you, last period nearly two years ago and have battled to get VA under control, mostly due to lack of knowledge by GP and even a gynae!
But since being on Estrogel since August, I did use Estradot prior to that for four months and using Vagifem every day, plus Ovestin on the outside bits 4/5 times a week I am comfortable most of the time. I would say I have only been like this for about 3 months, so please don't despair yet, although I have had times in the past when I thought the same as you.
I would up your Vagifem to five times a week, that is equivalent to the old dose.

[Hurdity]

Hi linfit

I answered about VA in your other thread about systemic HRT and what you could do:

Most HRT types come in different strengths so one delivery method is not stronger per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.php

Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (whereas Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.php

Have a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.

Hurdity x

So to summarise:

-Maybe do another 2 week daily "re-load"
-Look to increase frequency of vagifem per week
-Get hold of some estriol cream in additiom - for external areas
-Consider Estring if still no improvement after given length of time
-read Maryjane's posts
-Read the Burning Club (very long thread in Private Lives)
-Use moisturisers when not using local oestrogen (I have no experience!)

+ anything else in this thread that hasn't already been suggested in your other threads!

Let us know how you get on with the gyane on Fri and hopefully you will gradually see an improvement - but be patient - you will get better!

Hurdity x

[linfit]

Hi linfit

I answered about VA in your other thread about systemic HRT and what you could do:

Most HRT types come in different strengths so one delivery method is not stronger per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.php


Thank you (and all the other ladies who replied). I will try all you recommend and will let you know what the gynae says. I appreciate your help.

Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (whereas Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.php

Have a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.

Hurdity x

So to summarise:

-Maybe do another 2 week daily "re-load"
-Look to increase frequency of vagifem per week
-Get hold of some estriol cream in additiom - for external areas
-Consider Estring if still no improvement after given length of time
-read Maryjane's posts
-Read the Burning Club (very long thread in Private Lives)
-Use moisturisers when not using local oestrogen (I have no experience!)

+ anything else in this thread that hasn't already been suggested in your other threads!

Let us know how you get on with the gyane on Fri and hopefully you will gradually see an improvement - but be patient - you will get better!

Hurdity x

[CLKD]

 

[Hurdity]

linfit - no problem - and really hope you get some relief soon

CLKD - linfit answered but her answer has appeared inside the blue box quotes which sometimes happens with multiple quotes!

Hurdity x

[CLKD]

Well, so it does  .......

[linfit]

linfit - no problem - and really hope you get some relief soon

CLKD - linfit answered but her answer has appeared inside the blue box quotes which sometimes happens with multiple quotes!

Hurdity x

Hi there
I saw the menopause specialist today who advised me to use vagifem five times a week. Plus she said get the cystoscopy done.

In addition she said use an emolient when washing/bathing.

Her opinion was that systemic hrt doesn't hep that much with vaginal/urinary  symptoms and topical is better there. I am on patches so not sure what to do. She said it was up to me if I felt better on them. I have found it hard to tell. I have become tearful a lot lately but don't know what's cause or effect?!

I asked about Amitriptyline but she said that was for chronic pain and wasn't really able to say much about my feelings of anxiety etc.

Any thoughts?

[CLKD]

She seems to know what she is talking about! 

Systemic HRT is surely for symptoms other than VA?!? ........ Vagifem is for use in the vagina as the dryness is due to thinning of skin due to a drop of oestrogen.  The two types of HRT can be used as necessary at the same time to help ease the various symptoms.

Anxiety can be caused by a drop in blood sugar so eating on a regular basis is imporant; not eat more but spread out the daily diet across 24 hours, even in the night.  Every day.  Anxiety can be eased by certain types of anti-depressant medication if it becomes overwhelming.  I used Rescue Remedy with some success as well as relaxation therapy.

[dahliagirl]

I didn't find the local enough on its own.  Systemic does not seem to help on its own either.

I had my last complete deluge bladder-wise, on the day I was prescribed elleste.  It seems to help even out the ups and downs of the vagifem, and I am not sure the vagifem is enough on its own if your own hormones do a nose-dive (am still peri).  Also, using the vagifem for quite a while seems to have helped iron out my problems.

I found dermol (an emoilent wash/moisturiser for skin problems) useful for washing when I was suffering thrushy symptoms.  Plenty fluids helps too - stops my bladder getting over-excited 

For me, it seems to take a bit of everything.

[linfit]

She seems to know what she is talking about! 

Systemic HRT is surely for symptoms other than VA?!? ........ Vagifem is for use in the vagina as the dryness is due to thinning of skin due to a drop of oestrogen.  The two types of HRT can be used as necessary at the same time to help ease the various symptoms.

Anxiety can be caused by a drop in blood sugar so eating on a regular basis is imporant; not eat more but spread out the daily diet across 24 hours, even in the night.  Every day.  Anxiety can be eased by certain types of anti-depressant medication if it becomes overwhelming.  I used Rescue Remedy with some success as well as relaxation therapy.

Thanks for your practical and supportive comments, really help