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[Iwona]

Hello,

I am "in the end of my coping". I am 62 years old. Have been on HRT, Sandrena and Utrogestan. In May I tried to decrease Sandrena from 1 to 0.5...and in August my problem started. Apart from sweating, depression and lack of sleep, started having more and more severe itching and burning. GP surgery was useless, prescribed Fluconazole that as a trial and error, Metronidazole vaginal, without even checking if I had a bacterial infection. The itching and burning started to be really severe and it also included anal area. Managed to get privately to Gynecologist, Vagifem was prescribed. It helped with symptoms, but then I had another gynecologist appointment, as I was referred, so I thought would be good to have a specialist accepted by my surgery. He prescribed Ovestin, after one week of taking it the symptoms have been back! I stopped it, got back to Vagifem, unsure if I really can take it again...but I cannot cope anymore...I also got back to my Sandrena, increasing the dose to 1.5...
Unsure what to do anymore. The itching and burning interferes with everything, I cannot concentrate at work, cannot do much, also wake up often with itch. It includes anal area as well. I had an appointment with Proctologist and waiting for colonoscopy...
I am really worried that this will never go away and the rest of my life will be in pain and discomfort...
Iwona

[Joaniepat]

If Vagifem suited you better, I would go back to that. Perhaps do the loading dose again, then reduce to every other day and see how you get on. Not everyone can tolerate Ovestin at first, as it can sting if the tissues are inflamed. Ultimately, the best combination might be Vagifem internally and a small amount of Ovestin mixed with a vaginal moisturiser on the labia.
It is common for the "undercarriage" to be affected in a figure of 8 pattern in menopause, hence the perianal skin being affected. Maybe you could try an emollient on the whole area to protect and moisturize. There are many (eg, Epaderm, Hydromol, Cetraben) but impossible to recommend as you need to find one you like. You can also use these to wash with.
If you are going to see another specialist, the best would be a vulva dermatologist.
The private Vaginal Atrophy Facebook support group is a good resource and well worth joining.
JP x

[Iwona]

Thank you. Just joined the Facebook group...
I reinstated Vagifem, feeling a bit better today. Perhaps because it is weekend. I have noticed that I am worse if there is any additional stress, such as going to work...
I use aqueous cream to wash, it does not irritate me additionally.
I bought "yes" lubricant and this irritated me as well. Seems I respond really sensitively...

I think I made mistake by trying to decrease HRT in may, but it also makes me wonder if I will be ever able to decrease and stop it. My GP keeps telling me that I am well over the limit and should consider stopping...I think there is a new NICE guidance on HRT...

[Gracie]

I'll just mention that you have to be very patient for VA treatments to take effect.  For me it took four months using Vagifem and Ovestin on a daily basis before my symptoms cleared up.
From what you say your symptoms are classic VA and with time you will feel much better if you persevere with the Vagifem and Ovestin.

[VictoryV]

Hi Iwona,
Sorry things are tough right now.
Your GP and many like yours make my blood boil. You don’t have to stop HRT and you are nowhere near the limit never mind well over it!
Have a look at the NICE guidelines and take them to your next appointment.
I hope you get this under control soon so that you’re not in pain.
Victoria xx

[Iwona]

I'll just mention that you have to be very patient for VA treatments to take effect.  For me it took four months using Vagifem and Ovestin on a daily basis before my symptoms cleared up.
From what you say your symptoms are classic VA and with time you will feel much better if you persevere with the Vagifem and Ovestin.

I will try to be more patient with Vagifem. I think ovestin did not suit me, so I will share this with my gynecologist.
This is a new experience for me. I wish I had never decreased Sandrena!

In feel exhausted today after my recent relapse. I felt so good and then crashed back to the symptoms after adding Ovestin...

[Iwona]

Hi Iwona,
Sorry things are tough right now.
Your GP and many like yours make my blood boil. You don’t have to stop HRT and you are nowhere near the limit never mind well over it!
Have a look at the NICE guidelines and take them to your next appointment.
I hope you get this under control soon so that you’re not in pain.
Victoria xx

Thanks Victoria, yes I read a new guidelines, but they (GP surgery) keep repeating the former one...
I am on Sandrena and Utrogestan, if this was stopped I would be depressed and they would start antidepressants!
I hope I will manage to persuade them...

[Gracie]

"In feel exhausted today after my recent relapse. I felt so good and then crashed back to the symptoms after adding Ovestin..."

If it helps my regime is to insert a Vagifem tablet every morning and in the evening a half pea sized amount of Ovestin mixed with Sylk moisturiser used locally around the outside. 
I also didn’t get on with Ovestin at first but tips on here about mixing with moisturiser has made all the difference, no more stinging! I also use Sylk during the day if needed.

After six months I am happy to say my lower half is back to normal. I got to the stage where I couldn’t even sit down my symptoms were chronic. 

[Iwona]

"In feel exhausted today after my recent relapse. I felt so good and then crashed back to the symptoms after adding Ovestin..."

If it helps my regime is to insert a Vagifem tablet every morning and in the evening a half pea sized amount of Ovestin mixed with Sylk moisturiser used locally around the outside. 
I also didn’t get on with Ovestin at first but tips on here about mixing with moisturiser has made all the difference, no more stinging! I also use Sylk during the day if needed.

After six months I am happy to say my lower half is back to normal. I got to the stage where I couldn’t even sit down my symptoms were chronic.

I will probably stay with just Vagifem at present on top of my usual HRT. It seems that any creams, including ovestin just irritate me more. I think this is because of all the other ingredients. Vagifem does not have a lot of other fillers...
I already spend so much money on some products...
As I have never been in situation like this I am unsure what next...and I am aware that this is very individual...
My sensitivity at present is severe. But I always have had problems with cosmetics, have to be very careful...
I have a phone call to my gynecologist on Tuesday, need to ask him to write a letter to my GP and request Vagifem, also need to ask him if I can take it daily until a full improvement...

They also suggested some assessment/biopsy for lychen sclerosis if I don't respond to treatment...hope I don't have it...

Today has been a bit better, perhaps because I am resting ...it is worse during the week, when at work...

Thank you.

[Iwona]

I am much worse today and unsure why, woke up around 3am with itching both vaginal and rectal. Don't know what to do anymore...Feeling exhausted and with no hope...

[Gynaikeíos]

Hello Iwona, I am sorry for you having such trouble. I had very bad burning   feelings when my VA treatment was new. It is rotten feeling which affected  my sleep. Everything  stinging as  dryness  is reversing.

Have you tried  an ibuprofen for the pain?  I found long acting ibuprofen after  my last meal before bedtime helped. If you  cannot take ibuprofen  then perhaps  your gynaecologist will give advise  for an alternative.

I hope your gynaecologist will give you a suitable cream to use with vagifem. It can take combination of treatments to make VA  improve. For a few  times when  I  really fed up I used a very little of Vagisil  (it is off the shelf cream for what  it calls  intimate  itching) on the  *outside only* and  followed the instructions  carefully.  Also I  tried  a  test patch  on my  wrist  firstly in  case of sensitivity to the  local  anasthetic in it or anything else. It helped reduce  stinging feeling  overnight and  on days   when I sat  at a desk  or in car  for  a  long  time.  I have  not  needed to  use for  more than  just  a few  times over  the whole year  I have had VA GSM but it is something.

I hope today will  improve  for you. X

[Gracie]

I know you think it will never get better but it does. I was at the stage you are now when I thought Vagifem wasn’t working fast enough, I mean how can two little tablets a week make a difference to treat such a chronic condition, it doesn’t.

I phoned my doctor and told her Vagifem wasn’t making a difference to my symptoms, it was then she said use it every day, I was so surprised that it was safe to use on a daily basis.
It took a long time to work but six months on I am symptom free and I am sure you will be too.

You mentioned an appointment with your gynae, I hope it all goes well for you, do keep in touch and let us know how you get on.

[Dierdre]

I am much worse today and unsure why, woke up around 3am with itching both vaginal and rectal. Don't know what to do anymore...Feeling exhausted and with no hope...

You definately need to be checked for Lichens sclerosis, preferably by a vulva specialist or dermatologist. In the meantime ask your GP for Dermovate cream and use this twice a day for a least a month. Also use alongside this vagifem and Ovestin externally. 

[Iwona]

I am much worse today and unsure why, woke up around 3am with itching both vaginal and rectal. Don't know what to do anymore...Feeling exhausted and with no hope...

You definately need to be checked for Lichens sclerosis, preferably by a vulva specialist or dermatologist. In the meantime ask your GP for Dermovate cream and use this twice a day for a least a month. Also use alongside this vagifem and Ovestin externally.

I actually have dermovate cream at home, but I felt it was really strong...I will restart this as the itching is so severe...
My Gynecologist said he will test my, but wanted to try with vaginal estrogen first...

Last night I almost did not sleep...

[Iwona]

I know you think it will never get better but it does. I was at the stage you are now when I thought Vagifem wasn’t working fast enough, I mean how can two little tablets a week make a difference to treat such a chronic condition, it doesn’t.

I phoned my doctor and told her Vagifem wasn’t making a difference to my symptoms, it was then she said use it every day, I was so surprised that it was safe to use on a daily basis.
It took a long time to work but six months on I am symptom free and I am sure you will be too.

You mentioned an appointment with your gynae, I hope it all goes well for you, do keep in touch and let us know how you get on.

My gynae was really helpful. He will write to GP and request daily Vagifem until I improve...

Last night was very difficult...I feel exhausted, but still have to go to work next day...
Tend to go to sleep around 8pm, as I need some sleep...