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[flaxhigh]

Hi everyone,

Does anyone know if systemic HRT is enough to deal with vaginal atrophy/urinary pain problems or do you need vaginal oestrogen as well? I'm going to ask my doc for Ovestin (and is this the best one?) to deal with the above but don't know if I can use both. I'm currently trying to get onto patches (Evoral 25 then Evoral 50 plus utrogestan).

Thanks!

[Dierdre]

Local oestrogen is usually needed for atrophy and Ovestin and Vagifem can both be used with or without systemic HRT.

[Hurdity]

Also there are two different strengths of estriol cream - there is generic Estriol cream 0.01% or Ovestin which is 10 x stronger but you use less of it 0.1%.

I use Vagifem and systemic HRT most of the time and when I'm at the bleed stage I use estriol cream squirted round the tip of the tampon every time I insert one!

Hurdity x

[Tinkerbell]

I use  systemic HRT, Vagifem and Ovestin for my VA.

[flaxhigh]

Many thanks - that makes it clearer. Did the use of Ovestin clear up VA and how quickly? And is VA associated with more UTIs or does it just mimic the sensation of having a UTI - do you know?

[Tinkerbell]

The Ovestin really helped with the VA, at that time I was in the peri stage, I then changed to Vagifem, but once post meno I needed systemic HRT plus the topical estrogen to control the VA, so I have done it a different way round to you.
When I was peri I had a couple of UTI infections, I had never had one before and since starting the Ovestin I haven't had one since, so about 6 years now. If I have run out of Vagifem and don't use it for a couple nights I do feel the need for a wee in the night and that's not normal for me.

[flaxhigh]

Interesting Tinkerbell. I need to get on that Ovestin pronto then! I have had 6 UTIs this year already and pee so many times a night its ridiculous. It's out of control. Seeing doc in 12 days so will ask.

[Hurdity]

Many thanks - that makes it clearer. Did the use of Ovestin clear up VA and how quickly? And is VA associated with more UTIs or does it just mimic the sensation of having a UTI - do you know?

Both! With VA, following decreased oestrogen the pH of the vagina is altered (raised = less acidic) so making the area more susceptible to infections but also the fragile tissues, dryness  and associated itching as well as bladder problems and frequency can feel like a urine infection.

Good luck with the doc and you should notice an improvement after using local oestrogen.

Hurdity x

[flaxhigh]

Many thanks Hurdity for your advice. I do appreciate it. xx

[suzysunday]

I was off hrt for 3 months following a biopsy.  I was on tibolone and just used ovestin externally for VA.   I had cystisis and although the worst of it passed,  for weeks after I had UTI  symptoms that drove me mad.  It really knocks your confidence.   After a week of nightly ovestin use, things really settled down.  I just use this local hrt for VA to see how it goes.  The tibolone caused the bleeding and I'm scared of using anything again for a while.