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[matildamouse]

"Vaginal E2 should not be inserted deep into the vagina but rather delivered to the anterior vaginal wall. From a pharmacokinetic perspective, the vagina has two compartments. The posterior component has vascular and lymphatic connections with the uterus and so E2 placed in the posterior vagina, if used for long periods of time, could theoretically induce endometrial hyperplasia. The anterior compartment has connections with the urethra, clitoris and bladder and so placement of E2 in this region best reduces atrophic symptoms".

The above is quoted from the article below, and based on this info, I have decided to do my own "test run" by making changes to my twice weekly Vagifem insertion by NOT putting it in as deep as possible. I rather aim for a shallow and anterior placement with the applicator only one third inserted and the direction sort of aimed upwards to my tummy...if that makes sense. What I am aiming for is to try and put my Vagifem as close as possible to my urethra to assist with bladder issues which can also be a sigh of vaginal atrophy. I use Progesterone vaginal on alternative days and this might add to my bladder irritation and frequency and insert the Vagifem on their own on the nights I do not use progesterone. I used to get up a minimum of two times a night, sometimes 3-4 times, to urinate which disturbed my sleep. Since I have changed my way of insertion I now get at least 6 hours sleep and sometimes even more before I need to go to the toilet. I am pleasantly surprised by this and feel so much better when waking up in the mornings.

http://www.whria.com.au/wp-content/uploads/2016/08/HRT-Micronised-Progesterone-2016.pdf

[Optimist]

Thanks for this matildamouse. Really interesting read. I'm trialling vagifem again with everol conti, first few nights slept really well now seems to be back to waking few times for loo! Will definitely trial low insertion as have been inserting high up.
Not sure if the progesterones are causing these side effects.
Will let you know how I get on.

[Dancinggirl]

I am also trying this method - it makes sense to me. Not had any real improvement with nighttime toilet visits but I do think I have less urethral discomfort.  DG x

[matildamouse]

Optimist and Dancing Girl, please keep us updated if anything changes please.

[Optimist]

Update: matildamouse have been trialling as you described not sure it's benefitting me but just into 2nd week of loading dose. Tonight I was asleep by 10 awake at 2 to go to loo and wide awake since! Last night I slept 11-5 then wide awake and up at 630! So frustrating, so tired. Wondering if due to conti progesterone. Frequencyand urgency increased since on conti (trialled 4 full months of femoston 1/5) really bad side effects, switched to everol conti patches by meno specialist who said wasn't progesterone build up but wasn't this bad on sequi. I'm exhausted. Is it still working better for you? Xx

[matildamouse]

Hi Optimist, I find continuous progesterone (vaginal) nightly too much as well. I cope with alternative nights progesterone (vaginal) and go for regular scans and so far so good.  The same article in my original post above actually discuss the alternative nights regime.

Good luck, it also took me a while to get something that works...it is still not perfect but the best of all I have tried.

[dahliagirl]

Hi - This is worth giving a go - drink plenty of water during the day.  Have a glass by you and drink it whenever you feel like it, in addition to your normal tea and coffee breaks etc.  Best done on a day when you have easy access to the loo 

It gives your bladder a good stretch which takes some of the irritability out of it and dilutes urine which helps too.  Then you should be able to accommodate a little more during the night.  For some reason it helps you make less urine at night too.  A nurse at the Enuresis clinic told us to try this when my daughter was having problems getting dry at night.

This works for me if I am going through a bad phase.

I seem to need to drink quite a lot when I compare myself to other people.  Someone I was talking to said she didn't go much/at all during the day,  and when she went out with her friend, the friend was having to pop off to the loo every 2-3 hours      She is much older than me - I can't understand why she has no problems 

[Maryjane]

I only drink hot water and my bladder really likes it . No other liquid at all.

[matildamouse]

Will definitely try that trick thanks Dahliagirl.

[Optimist]

Update: have just finished the two week loading dose of vagifem. Urinary frequency and volume much much improved (3-5 x daily instead of 10-15 x) have also been sleeping for stretches of 7+ hours which is an absolute godsend.
However I stopped the femoston conti to start on the everol conti which I stopped after 4 days due to insomnia like I'd never experienced before, plus urinary problems, chronic constipation & bloating/weightgain (all of which had been building from 2-4 months on femoston). I've been on oestrogen only (75 everol) to give my body a break from progesterone buildup and to see if I would improve and it's been a blessing, I can't begin to tell you how much better I feel.
No longer constipated, urinination completely back to normal & the best of all sleeping again!
The menopause specialist said I wasn't reacting to the conti progesterone and that I was simply having a very difficult time with the menopause and that I needed to accept I was getting older!!
I'm sorry but I beg to differ as the change in me since no progesterone is brilliant.
However I'm aware I still need progesterone so will attempt the everol conti for a while as I'm very reluctant to trial Mirena due to constant progesterone and previous pelvic infections, one leading to peritonitis from invasive vaginal procedures.
The specialist basically told me that would be my last option!!
I was wondering if I should ask my gp to trial femoston 1/10 or 2/10 firstly as two weeks sequi progesterone has surely got to be better than constant? Any ideas anyone? Xx
Hope all had a lovely Christmas.

[Brownie]

Will take what you say onboard Maltildamouse, I had been put on estriol vaginal cream but one of my GPS said to try + come off it which I did but problems started again a couple of months later so other GP has given me Vagifem. Does anyone think cream is better than pessary or other way round ? Most of my problems seem to be bladder related. Also I read that estradiol was stronger than estriol don't know if this is correct or not or if it is to do with the dosage.
Any help would be good, thanks