Hi Midnight Shadow,
I personally find myself to insert Vagifem as far as it goes. I too have external pain and had a flare up in January. I was on two times a week and found in January that the pain was starting to get worse, so I decided to insert Vagifem up 3cm, the next day I was in a lot of pain?
So I did a 10 days every night, about 7 weeks off 3 times a week, now I'm on Vagifem one night, followed by Ovestin externally the next night, on the third night nothing, then I repeat the cycle. I use yes externally two times a day one in the morning and one in the afternoon. Yesterday I forgot to do my afternoon as I had no discomfort.
This virginal atrophy sucks it states for me at age 45, 4 months after a hysterectomy and I still got ovaries. I would say on a good day I'm 80-90% better. Which is a lot better than all day pain.
So for some ladies insert it lower helps, but it didn't work for me, we are all different so it could be worth trying.
I hope you feel back to normal soon

Lyncola