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[Miljea]

I’m 57, on HRT for 5ish years, Estradot 50mg patch and Mirena, but I’ve developed dry, itchy, and a bit burny areas on my labia.

I’m not prone to thrush, but I’m suspecting VA. Shouldn’t my HRT be protecting me against that?

[Joaniepat]

Many women require local oestrogen treatment as well as systemic.
JP x

[CLKD]

Get thyself some appropriate vaginal atrophy treatment and apply ;-).  Ring the Surgery and ask for a prescription, you don't need bloods or an internal examination.  The GP/Prescribing Nurse should be OK with explanation of symptoms. 

Do read the threads on bladder issues and VA ;-)

[Tinkerbell]

I need to use both systemic HRT and topical to keep VA under control, i am same age as you.

[shrosphirelass]

I use both the HRT and systemic. The vagifem seems to help more, along with estriol cream externally.

[JoJo42]

I’m 51 and been on systemic hrt 9 years or so, and then had to go onto Vagifem too a couple of years ago for VA. I also use the Yes vaginal moisturiser products (started with the Yes Vm and the switched to Yes OB) or Olive and Bee.