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[Annemaria]

Hi,
My doctor switched me to Vagifem from Premarin cream at my request. Premarin dose is .625 and Vagifem is 10mcg. Now, She assures me it will be just as effective as the Premarin dosage. I'm worried trouble is ahead. Why don't I believe her? Please enlighten me. 
Annemarie 

[CLKD]

Nowt is dumb on here  - experiences are to be shared, dissected and used when appropriate.
 
Were you advised to do a 2 week nightly loading of the Vagifem ?  After that 'as necessary' as sometimes ladies need more than the 2/3 times weekly.  If you don't get on with this then Ovestin is the other product prescribed. 

Let us know how you get on.  It can be Trial and Error to find how often you need to use it to keep symptoms at bay and the whole vaginal area comfortable.

[Annemaria]

Thanks for your reply CKLD,

What I don't understand is that she assured me that the actual estrogen component in the premarin .625 vs the vagifem 10 mcg is the same. The numbers don't make sense to me. Can anyone confirm this?

Reason why I'm concerned is that after 6 months finding the right dosage with premarin to get my symptoms under control and finally successful, I'm afraid I may slide right back to the beginning with this low dosage fagifem. I want to get away from using conjugated estrogens.

 

[CLKD]

The important issue is to keep the atrophied area supple all the while!

[Tempest]

So are you back on the Premarin tablets, Annemaria or is it the vaginal cream? xxxxx

[Annemaria]

Hi Tempest,
I'm on Premarin cream. It's finally working for me every day .625mg. after many months of not. I asked to switch to a not so messy and easier to use product. She gave me Vagifem. I'm worried all the months and finally getting results that I may be back to where I started from with this 10mcg low dosage. I just don't believe her they are equal strength.

[Tempest]

It may be like comparing apples and oranges,  Annemaria. Who knows what the comparable strengths are in reality? It could be that you respond more favourably to Vagifem in any case as its bio identical. As you know, one is conjugated estrogen and the other estradiol. I guess the only real way to find out is to try. I really do feel for your dilemma! xxxx

[Hurdity]

Hi Annemaria

I don't know what Premarin cream is - apart from as Tempest says it will be a mix of horse oestrogens - same as the HRT tabs? I presume you are not in UK as we don't have this here. usually local oestrogen doses are worked out so the different types have equivalent effects. You didn't say what the units were for the Premarin ie 0.625 what? g? mg? mcg? If you look at estriol cream for example then this comes in different strengths and seems much greater in quantity than vagifem - but the vagifem tablets are designed to stick to the vaginal wall and release the estradiol very slowly,  whereas cream is a cruder way of doing the same thing and is usually given in large quantities because much of it slips out ( but gives lubrication and works on the whole vaginal area at the same time).

Also there used to be two strengths of Vagifem and presumably there are studies that compare the efficacy of Premarin vs Vagifem at various doses of each?

Hopefully it will do the trick!

Hurdity x

[CLKD]

Canadian Hurdity - looked on the Profile 

[Annemaria]

Haha..yes I'm in British Columbia.
Hurdity, I'm on Premarin vaginal cream .625 mg. You made a good point there. The fact is  that half of it ends up on a mini pad! I want to switch to estradiol to get off of the mare urine and the mess. It took around 5 months to get rid of the chronic bladder pain due to atrophy. I'm just afraid I will end up starting all over again.
Thanks for your reply.

[CLKD]

How's the weather over there?  Deep snow still ;-) ?

What is the advice over there for the use of Vagifem ?

[Annemaria]

Don't get too much snow on Vancouver Island. But spring is certainly taking it's time this year.

Premarin cream start up is daily (1mg. mark on the applicator which is .625mg dose) for two weeks. Follow twice weekly there after.
This dosage is also the same as the Premarin oral tablet.