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[Macdonz76]

I will and see those moisturisers and see, thanks for all your help, they don't tell you any of this before your surgery, they really should

[Lanzalover]

Try asking for Ovestin cream and gently rub on your episiotomy scar I find this helps you can use the cream along side the vagifem.
Unless there is a reason why you can't use systemic oestrogen you really should be using it until the normal menopause age at least.

Lanzalover x

[Wrensong]

I agree with the others that systemic HRT may be a very good idea.  Months since I looked at the forum so I am out of touch with what's been said recently, but if you have a menopause clinic nearby they are often a better source of advice than GP surgeries unless you are lucky enough to have one with a really knowledgeable GP interested in Menopause.  But I'm guessing they might not refer you there unless your bloods show you are menopausal.

Vagifem just twice a week may not be enough, with or without systemic HRT.  As already mentioned, I would ask for Estriol 0.01% cream (the weaker preparation) to use externally in addition to the Vagifem & perhaps ask whether you can increase the number of Vagifem you use per week.  Even after 2 years on systemic HRT, 2 a week were not enough for me.  It was suggested I use up to 5 per week - equivalent to the former 2 x 25mcg strength, together with the weaker Estriol cream applied thinly externally.  It took several months after increasing to 5 a week with Estriol on the same nights, before I really started to feel comfortable & robust. 

If it's approved for you to increase the number of Vagifem & you are happy with this, the advice I had from the Menopause Clinic was to either double up to keep the total number of nights' use to a minimum - i.e. inserting 2 a night - 1 high, 1 low, or carry on with just one a night if you prefer (either way up to a total of 5 per week if approved), but try varying the positioning.  Vagifem can have quite a localised effect, so inserting one lower down helps ensure more of the canal is effectively treated. 

The Estriol cream is very soothing - I can feel a difference in comfort immediately after applying, but both Vagifem & Estriol take time to return the whole area to good condition & it may need up to 3 months at a higher dose, so don't give up hope.

Also, after showering & gentle towel drying, maybe try gently pressing soft tissues onto the external area to soak up any residual dampness, that can otherwise lead to soreness & cracking when the skin is so delicate.

Just a thought - you said they checked & there's no obvious reason for the spotting - if you kept your cervix, is your smear up to date?

I hope you get some good, sympathetic advice from a Meno Clinic or knowledgeable GP & soon start to feel much better.  Good luck with it.