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[Nxdavies]

Hello all,

I've had bladder issues - soreness, irritation - plus soreness around my urethra for a few months.
A Urogynaecologist has diagnosed vaginal atrophy and has prescribed vagifem with a 14 day, daily loading dose followed by 3 tablets per week after that. I'm due to go back and see him after 3 months to check progress.

I started to see an improvement in symptoms during the first 14 days but I've been on the three time per week dose for two weeks and symptoms are getting a bit worse again. Do I need to persevere for longer with the three times per week dose or go back and see him sooner to increase the dose or try something different?

He's also recommended the Juliet treatment which involves lasers in your vagina to rejuvenate it all. Does anyone have any experience of this? He only been doing it for a year and has only treated 25 patients so I'm a little wary.

[commercial link removed]

Thanks in advance.

[Joaniepat]

Some people need to use Vagifem daily to keep symptoms under control. The dosage in the pessaries nowadays is only 10 mcg estradiol, whereas it used to be 25 mcg. I would try upping your dose, maybe see if 5 per week does the trick, and if not try daily.

I don't know anything about the Juliet treatment, but it sounds a bit like the MLT (Mona Lise Touch) which a few MM members have had. Maybe someone else will be along to answer this part of your query.

JP x

[Nxdavies]

Thank you JP x

[CLKD]

I too would be wary.  Give the atrophy treatment a good trial first.  As Joaniepat mentions, the dose is much lower these days so ladies may need to use it nightly.  For ever.

I use Ovestin, same idea different delivery.

Have a read round of the various atrophy, bladder and Mary Janes [I think  ] thread about laser treatment. 

[Nxdavies]

OK makes sense thank you.

I just don't know how long to persevere with the three times per week before increasing it again myself or going back to the Gynae. I want to give it a chance but I'm also concerned that the atrophy will worsen (and need longer to recover) in the mean time.

[Tinkerbell]

I need to use Vagifem every day along with systemic HRT to control my VA.

[CLKD]

Increase yourself.  Every night if necessary.  Some ladies use other products as well as, i.e. Sylc and Yes - do a 'search' here to see what is suggested.

[Katejo]

Hello all,

I've had bladder issues - soreness, irritation - plus soreness around my urethra for a few months.
A Urogynaecologist has diagnosed vaginal atrophy and has prescribed vagifem with a 14 day, daily loading dose followed by 3 tablets per week after that. I'm due to go back and see him after 3 months to check progress.

I started to see an improvement in symptoms during the first 14 days but I've been on the three time per week dose for two weeks and symptoms are getting a bit worse again. Do I need to persevere for longer with the three times per week dose or go back and see him sooner to increase the dose or try something different?

He's also recommended the Juliet treatment which involves lasers in your vagina to rejuvenate it all. Does anyone have any experience of this? He only been doing it for a year and has only treated 25 patients so I'm a little wary.

https://juliet-laser.com

Thanks in advance.

Did you try  increasing the frequency  of vagifem?  I am in the same.e position now. Took it daily for 2 weeks with positive results  and then reduced to twice a week but now have burning and increased loo visits.

[Dierdre]

I messed around for a couple of years on two, three a week, then every other day, it didn't work for me and I struggled all that time. Now I just use everyday, morning or night, makes no difference whichever you prefer. I also use Ovestin on the outside daily too, but use this at night so it has chance to absorb better as not going to the loo all day. Use the YES water based moiturisor, this is organic and don't sting at all and I am super sensitive. You have to keep this up all the time but it will get better and then becomes routine.

[Nxdavies]

I emailed my gynaecologist and asked him what to do and he said keep to three days. I did that and gradually things have got better and better over the weeks. It's not completely resolved as I'll get the odd day of soreness. I'm going to see him next week for a 3 month review so I'll see what he says then about how to fix that.

[Nxdavies]

Oh and an important aspect for me is to try to relax the whole area by deep breathing and trying my best to unclench! I think I hold a lot of emotional tension in that area as well as clenching against the discomfort. There are a whole host of muscles and nerve endings there so relaxation techniques can't hurt.

I hope you feel better soon. X

[Katejo]

I don't really understand why anyone with atrophy would hesitate to use Vagifem daily. Your body gives out very accurate distress signals I find! Its all about quality of life ladies.

Yesterday I searched for the NICE statement which says it is safe to use every day but didn't find it. I want to have it available before I speak to the GP. She was helpful but didn't appear to know much about it and I suspect that she might resist. Do you happen to know? I can't search now because I am at work.

[Nxdavies]

I haven't increased it myself as it is oestrogen after all, all be it a small amount, so I would prefer the dosage to be medically prescribed taking in the overall view of the other HRT I'm using rather than me deciding myself.

Also those of you taking more than your doctor has prescribed - how do you get enough for you to use, say 7 days per week, if your doctor has only prescribed 3 times per week?
Don't you run out of vagifem too soon or does your doctor give you a new prescription regardless even though it's much sooner than they would expect?

[Katejo]

I haven't increased it myself as it is oestrogen after all, all be it a small amount, so I would prefer the dosage to be medically prescribed taking in the overall view of the other HRT I'm using rather than me deciding myself.

Also those of you taking more than your doctor has prescribed - how do you get enough for you to use, say 7 days per week, if your doctor has only prescribed 3 times per week?
Don't you run out of vagifem too soon or does your doctor give you a new prescription regardless even though it's much sooner than they would expect?

I am not using any other HRT but suspect I will have problems convincing a GP that I might need to use it more frequently. That's why I am looking for NICE guidelines to support my argument. I had a previous encounter some time ago with a GP (whom I have since avoided) who shouted at me for suggesting that it was safe to use Estriol cream for more than about 3 months.

[Emma]

This might be the guidelines you're looking for
https://www.nice.org.uk/guidance/ng23/evidence/full-guideline-559549261
(page 120)

There are also other links on our homepage
https://www.menopausematters.co.uk/index.php#nice