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[Rustysmum]

Hi everyone. I used to be on here regularly several years ago when I was struggling during perimenopause. I am now 3.5 years post and everything had settled down well until a year ago when I started having problems with VA which worsened resulting in needing a cystoscopy and hysteroscopy three months ago. The gynae I saw diagnosed VA and prescribed Estriol cream which I seemed to be ok on for the first couple of months, but for the past month I have had awful swollen, painful boobs and the day or two before I am due the cream (on it twice a week) it is like I am back in the worst of perimenopause! Heart palpitations, weepy and anxious. It is like my body is desperate for the cream before the next dose is due. I would rather have the pain of the atrophy! Am wondering if I give up are there any other alternatives or if I should be asking my GP to increase? My new prescription from the Gp last time was for OVESTIN but the symptoms started before the change so don’t think it is down to change of brand. I know they will just say that the cream can’t be causing it as it stays local to the area, but I seem to be a ‘fast absorber’ and very sensitive to hormones. I did try HRt when struggling with peri but gave up as could never get the balance right which was when I was told I was a fast absorber.. I also had worse symptoms when I tried vagifem a year ago. Am so miserable that I seem doomed to having either awful peri type symptoms or the pain and bleeding of VA and the misery of incontinence which makes me feel so ugly and disgusting. Will theses peri type symptoms go eventually if I persist? Just don’t know what to do so any advice would be very welcome.

[Dierdre]

If your VA is not getting better and you are still very dry you will absorb any estrogen you apply, which is why you're up and down as you're only using twice a week and this is causing systemic fluctuations. You need to do a reload of a minmum 2 weeks and then reduce to what works for you. Twice a week is the absolute minimum and most people need more, sometimes every night. Once you're hydrated and plumped up inside the estrogen will no longer go systemic or very little will and you wont get the systemic symptoms.

[Haydo]

I agree with Deirdre.  You need to do a reload and then find out what dose keeps your symptoms at bay.  The systemic symptoms will gradually disappear but you need to give it time. 

[CLKD]

Get that Ovestin up there, right now  !  Do read the vaginal atrophy thread.  Many GPs believe that a 2 week loading followed by twice a week application is 'enough', however!  It may. not be.

Some find that 'vagifem' inserted with 'ovestin' gently smeared around the outer vaginal area really helps. Other find that using 'yes' or 'sylc' products as a moistoiror is good.  (Pity I can't spell  ).  If there is a need2P feeling then do take 'nurofen' or similar to ease the nip as the spincter shuts off the urine flow.

I would put a dose up there now and again this evening, continuing until you think symptoms have improved enough to go alternate nights.  After 3 months, review ;-)

[Rustysmum]

That all seems to make great sense! Thank you all. Will try that. A bit frustrating as the prescribing gynae said not to do the load up as it would be too much all at once! So just to do twice a week from the very beginning! But to be prepared for it to take three months before any benefit was felt! What would I do without all of you to help me?! Thanks so much.

[CLKD]

AAAAHHH a Gynae ..  what do they know about hormones!?!

Also the leaflets in the VA treatment boxes are out of date, making it more like HRT rather than dedicated treatment for the vagina.  mayB buy a copy of 'Me and My Menopausal Vagina' from Amazon - then hand to your Gynae ;-)

Have U got that treatment up there ;-) ........

[Tiredlady]

Try not to worry you will find the right solution. I have been given an e-string (yet to use it) but it has good reviews on Louise Newsons Balance App. Good luck and all will be well in time xx

[suzysunday]

I used ovestin every night for a couple of months when my symptoms were bad and still use alternate nights. It's a slow process and you have all my sympathy as it makes you feel horrible and takes over your life.

[Rustysmum]

Thanks everyone. Tiredlady I have never heard of an e-string - what is that?

[Dierdre]

That all seems to make great sense! Thank you all. Will try that. A bit frustrating as the prescribing gynae said not to do the load up as it would be too much all at once! So just to do twice a week from the very beginning! But to be prepared for it to take three months before any benefit was felt! What would I do without all of you to help me?! Thanks so much.

This gynae is not even following ths basic instructions on the leaflet for initial usage. Very worrying that we are being referred to doctors  like this.

[CLKD]

Gynaes don't know much about hormones .......... and of course, the GP should have referred to a menopause clinic.

Let us know how you get on by using it every night.

[Gracie]

I will add by saying that it took four months of using Vagifem and Ovestin every day before I felt any relief from chronic VA symptoms.
VA treatment takes a very long time to take effect and twice a week treatment was completely useless for me.
I was very lucky to have a doctor who was on the treatment herself, consequently very understanding of my needs.

It's a shame that there is a lot of ignorance by the so called professionals regarding Vaginal Atrophy that women have to take it on themselves to take control and manage their symptoms. Its easier now as treatment can be obtained over the counter but at a cost. Women shouldn't have to keep going back and forth and hoping their doctor will prescribe the appropriate treatment for them! 

[Tiredlady]

Hi Rusty Mum an estring is this soft ring you push up there and it can stay in for 3 months it releases oestrogen every hour I believe. I am contemplating the box as I am such a wimp I’m worried about putting it in! There is lots of info on Louise Newsons Balance App x

[Dierdre]

Does this Estring support a slight prolapse also or is it just like a diaphragm, in which case I would probaly end up with it protruding out!

[Rustysmum]

Thank you Tiredlady for explaining. That sounds rather more reliable than my memory to apply the OVESTIN twice a week. I am now loading daily and haven’t had the awful dip symptoms just the agonising boobs still. Just hope I don’t get it too bad when I go back to twice a week. It is lovely to be feeling on an even keel again for two days in a row! Will keep you posted on progress. Thank you all for your help and encouragement.