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[Hurdity]

Anterior wall is the front vaginal wall. Posterior wall is the vaginal wall nearest the back passage. If you imagine putting a dollop of cream on your fingertip and then inserting your finger into the vagina - it will naturally find itself the right way round to deposit on front wall. If you prefer an applicator continue to use it.

The thinking I guess is that if you shoot the stuff very high by the cervix then some will ooze into the uterus so ideally minimise that - although it is a very low oestrogen dose indeed. So - I think the suggestion is not to apply so high. I think with the cream where you apply ( anterior or posterior) - is less of an issue because it doesn't actually stick to the vaginal wall whereas Vagifem does and is designed to do so.

Hurdity x

[Hurdity]

Earlier this week I began with an 'attack' of atrophy: heavy bladder region, feeling nauseated, shivery when I peed, need to pee more often and that family feeling of needing treatment  .  So mid-afternoon I put Ovestin up there and another load at 10.30 after my bath.  Added to that Nerofen every 3 hours settled the symptoms.

To clarify - VA symptoms do not mimic UTIs in their systemic effect so if you are getting bladder and urethral symptoms, urgency etc, but also feeling shivery and nauseous - then this cannot be due to atrophy but is characterisitc of an infection. Of course at this time of year one could be getting VA coming and going + a bug unrelated to the VA/UTI making you feel shivery and nauseous.

Also to reiterate that vaginal creams should not be used as ointments as and when - if the regime you are using eg twice weekly maintenance dose - is not sufficient and is not dealing with the VA then an increase to 3 x per week should help. In between doses I presume women use the various moisturisers and remedies as recommended by Maryjane and Dancinggirl?

Hurdity x

[suzysunday]

Do you mean ointments using externally and if so why not?

[suzysunday]

Also how high in vagina would be sufficient to avoid cervix.  So sorry if I sound a bit dim about all this.

[CLKD]

I was advised to put the product as high up as possible. Initially this hurt so I coated the vagina and each night, went in a little further as the walls of the vagina became more moist.  Don't worry too much suzysunday, if you don't like using a finger maybe put it onto the tampon and insert gently ......... then withdraw it after a few moments?  It really is Trial and Error!

[suzysunday]

Yes my gp advised to put it in high.  I think I will stick with the applicator and maybe put it a bit lower. I wash the applicator really well before and after use.

[CLKD]

Not dim at all.  I have no idea of what's up there and yelp a bit when the smear test takes place. 

4 me, atrophy certainly mimics the feelings of urine-type infection - need to pee, heaviness in the bladder area, shivering and that nip in the spincter.  The reason is lack of oestrogen = dryness, as well as the over-all area: bladder, vagina, anus : being so close that the whole area is affected.  Bad design?      .    On Tuesday I had those symptoms which have been eased by using the VA treatment and Nurofen.  I have one tender area on the left inside otherwise the vagina remains generally healthy. 

I have never been concerned about how it works or why, simply that the feeling of razor blades up there  eased within days and certainly, I would have been off a cliff had those feelings continued  .  I find that KY Jelly on the outer folds keeps the area supple and less itchy.

[Katejo]

Not dim at all.  I have no idea of what's up there and yelp a bit when the smear test takes place. 

4 me, atrophy certainly mimics the feelings of urine-type infection - need to pee, heaviness in the bladder area, shivering and that nip in the spincter.  The reason is lack of oestrogen = dryness, as well as the over-all area: bladder, vagina, anus : being so close that the whole area is affected.  Bad design?      .    On Tuesday I had those symptoms which have been eased by using the VA treatment and Nurofen.  I have one tender area on the left inside otherwise the vagina remains generally healthy. 

I have never been concerned about how it works or why, simply that the feeling of razor blades up there  eased within days and certainly, I would have been off a cliff had those feelings continued  .  I find that KY Jelly on the outer folds keeps the area supple and less itchy.

The thing which causes me stress is that, given the unreliability of urine tests, you can't be sure whether the symptoms are caused by the VA or are actually an infection needing an AB. You could apply extra Estriol/Vagifem and find that it doesn't work and you actually need an AB. That is combined with the difficulty in getting an appt. at short notice.

[CLKD]

Are you prone to urinary tract infections, sorry if you've already told me but meno-brain is in full swing today 

Now that I recognise my VA symptoms I don't worry if it is an infection as the regime I use sorts it.  4 me then, it's not an infection.

ABs should not be given randomly as they are being shown not to work as effectively.  They did ease my symptoms initially [3 times in 2 years] of 'infection' but tests the 4th time showed no growth.  Does the regime you use ease symptoms at all?  A dip stick test in the Surgery shows 'nowt' usually ;-). 

If you are worried I would speak to my Nurse Practitioner in the New Year and ask what the likely hood in your Health Authority region of urine tests not being accurate.  That opens up discussion about what procedure would be useful for you.

[Shadyglade]

Worryingly you can have a UTI with little or no bladder symptoms, as I know to my cost.  It's not as simple as 'this symptom is this, and this symptom is not'.  We all know our own bodies so if you feel unwell, see your doc.

I remember bad bladder symptoms with thrush.  Anything in that area can causes irritation to the bladder.  You can also get low level UTIs which tick along, almost unnoticed, until they suddenly flare up.

It's not straight forward at all. 

[CLKD]

Have I read somewhere that the bug can stick to the bladder walls and whitter away   

[Shadyglade]

Yes, I read that too. Apparently the bladder wall is covered in creases and crevices where the bugs hide. Also, and I don't know how true this is, that cranberry juice helps to clean up the crevice bugs, even though it not really an infection killer.

[Katejo]

Are you prone to urinary tract infections, sorry if you've already told me but meno-brain is in full swing today 

Now that I recognise my VA symptoms I don't worry if it is an infection as the regime I use sorts it.  4 me then, it's not an infection.

ABs should not be given randomly as they are being shown not to work as effectively.  They did ease my symptoms initially [3 times in 2 years] of 'infection' but tests the 4th time showed no growth.  Does the regime you use ease symptoms at all?  A dip stick test in the Surgery shows 'nowt' usually ;-). 

If you are worried I would speak to my Nurse Practitioner in the New Year and ask what the likely hood in your Health Authority region of urine tests not being accurate.  That opens up discussion about what procedure would be useful for you.

  Yes I am prone to them. That is one of the main reasons why I wanted to try Vagifem to reduce the chances of getting them. The nature of my UTI's has apparently changed. I used to get a dull ache (rather like a period pain) but not cystitis. The most recent ones have been more burning.

I know that the dipstick test is unreliable but, according to the recent articles and my urogynaecologist, the lab tests are also  unreliable. I read an example yesterday of women who had been refused an AB over a lengthy period because repeated tests showed no infection. They later had to be admitted to hospital with a kidney infection.  According to her, the bugs attach themselves to the bladder wall and tests won't detect them if they aren't multiplying at the time. I suggested that this was a reason why I get them more if I am a bit anxious (eg. re. health on holiday) and she thought that this was quite  possible.

[Katejo]

Yes, I read that too. Apparently the bladder wall is covered in creases and crevices where the bugs hide. Also, and I don't know how true this is, that cranberry juice helps to clean up the crevice bugs, even though it not really an infection killer.

The NHS web advice on cystitis has recently been updated. It now says something like "It has previously been thought that cranberry juice might help but evidence no longer appears to support this".

[CLKD]

It's been known for several years that Cranberry juice has no known healing properties other than keeping the person hydrated.  I can't stand the taste myself