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[annie79]

Hello,
I am new here. I was wondering if anyone has any advice. I am 43. I have been on HRT for about 6 months (I suddenly started getting thrust constantly/hot flushes/palpitations/no sleep last year). I have the Mirena coil (for heavy periods) - although have hugely erratic cycles now, some 70 days long, some 22 days long, very light now. One of my worse and most persistent symptoms is vaginal dryness. I have been prescribed Vagifem and Ovestin and I have to use Vagifem 5 to 6 times a week. I use Ovestin on the outside.

I cannot get this under control. The HRT doesn't touch it - why? I thought it would help this (and one of the selling points of HRT on-line seems to be it helps VD) but it does not feel right or look right without anything. It is like tending to a difficult pet, that constantly needs attention. I just can't face the thought of dealing with this amount of up keep forever. Please tell me that there is a certain dose/type of HRT that will fix this - even just a little.

I was on 3 pumps of gel but was still getting break though symptoms (hot flushes). If I go to 4 I feel nauseas and overly tired and just ill. I have just tried patches (75) but my skin has reacted so badly to the glue and I got insane headaches. So I am now back on the gel. The dryness is going nowhere. I am feeling increasingly sad about this. Any advice?

Thank you in advance!

[CLKD]

Hi!  'like tending a difficult pet' - love it!

It can take a few weeks for the vaginal skin to absorb treatment enough to feel less sore/itchy/heavy.  If necessary put an extra vagifem pessary up there mid-afternoon as well as one at night, plus the ovestin.  After 3 days of the extra treatment the vagina should begin to feel better.  If not alternate an extra pessary in the afternoon until you feel comfortable. 

How does the vaginal area fell overall, labial region etc.?  When did you begin the VA treatment?   When I get the need2P I take two Nurofen 3 times a day to ease the nip as the urine flow shuts off.

MayB 3 pumps is too much every night, have U tried every 3rd or 4th night so that the bother isn't over whelmed. 

[annie79]

Thank you for your reply! I started the VA treatment about 5 months ago... my question is, really, will the HRT (pump/patch) ever fix the dryness on its own?

It just seems to me that it's drying out every day... despite using a Vagifem every night and the cream. Otherwise the whole thing feels/looks ok and I don't think there is thinning, its just really dry and very uncomfortable if I don't put the cream on, or use the Vagifem everyday. I don't know if this is right/normal?

[annie79]

Also - there is no thinning... but the central ball looks like a dehydrated brain - you can see these two vertical lines on it and every ridge (so just really dry). I am very overly familiar with the whole thing now

[CLKD]

How far internally are U able to insert the pessary?  Is there any of it popping out of the vagina, i.e. not absorbing?  With 'ovestin' one can smear the treatment around the vaginal walls with a finger to coat the 'walls'.  ..........


5 months may be a long while to wait, some vaginas however do take a while - hopefully someone will be along with more advice.  Do try the extra 'vagifem' in the afternoon, or perhaps stop that and pop 'ovestin' internally - which is what I use.  Some use these on atlerante nights. 

Do U have a prolapse? 

[Amazing grace]

Hi annie79, sorry to hear you are struggling with this horrible problem, I too had a similar issue I was on 3 pumps of estrogel for 4 years started at 43 but it didn’t stop the awful vaginal ,vulva and bladder issues to develop , I also couldn’t go to 4 pumps as it caused unwanted side effects also can’t use patches due to reaction of glue, I started on vagifem but after months on it with everyday doses it just didn’t do anything for me although lots of women do really well on it , I use ovestin internally and externally, I also use yes vm in and out , I also use hydramol ointment (not cream) my gp told me ointments are better than creams as the contain less fillers to wash with and apply after a shower it took around a year of doing this to feel some what normal again, but I still get flare ups , so using the patch or gel doesn’t stop the dryness for me but for some it does , I guess it’s about finding what will work for us because we are all different and respond differently to medications , do you use any vaginal moisturisers ? It can really help and make a difference to the dryness xx

[annie79]

Thank you all for your replies. I was kind of hoping the Gel/patch/something - would completely take this problem away and there would be no need for local treatment daily, but it looks like it doesn't help this issue for some.

I can insert the Vagifem all the way up and tend to kind of put it on the 'shelf' on the front wall, if that makes any sense. It doesn't fall out. No prolapse. The doctor examined me (after a thrush episode - before I started using Vagifem/Ovestin daily) and said it looked fine. I had 4 c-sections (back in the day), so everything looks ok at first, but it is just this persistent dryness.

Amazing grace, you sound very similar to me. I guess I am preparing for the long hall with this. I do have Yes VM too but find that stings a bit. I might ask the doctor for the hydramol ointment. Thank you the suggestion!

[Hurdity]

Hi annie79

Sorry to hear about your vaginal problems.

There are other vaginal treatments listed here:
https://www.menopausematters.co.uk/local.php

One of them is a coconut oil (I think) based estriol pessary (imvaggis) and might help instead of the vagifem? I have never heard of inserting extra vagifem in the afternoon. I think the advice is daily use if twice a week does not work. Also you will see there is the Estring - which delivers the same amount amount estradiol ( approx) as daily vagifem if I recall corrrectly - so you don't have to keep on inserting stuff.

Yes you should have seen a difference after 5 months especially as you are using systemic HRT too. Many women though do need both - systemic and local oestrogen. I have used vagifem/estriol cream for years alongside HRT patches.

   and I hope you find a solution soon

Hurdity x

[CLKD]

Because VA treatment is such a low dose, the occasional 'extra' insertion won't do any harm.  Certainly I use 'ovestin' in this way to get relief when symptoms are bad.  Although 'not licensed', as with many drugs, it can be Trial and Error to find something that gives relief.  Also, the leaflets in VA treatment are way behind the times!

Let us know how you get on.

[Ayesha]

Vaginal Atrophy is a beast to get under control and can take months to start to feel better and it does need a lot of patience. Shame that your systemic HRT is not helping you!

Apart from the Vagifem and Ovestin its trial and error when it comes to what moisturising products work best for you. Also important not to use soap for washing, I use Aqueous cream which is easily available from the supermarket if you didn't want to wait for a prescription.

[Kirstychase1974]

Out of interest do you get itching everywhere down there? I’ve had the same problem for well over a year with same thrush type symptoms on top of it all. I’ve just started using the oestrogen cream you insert and so far after 3 weeks not noticed much difference.

[Ayesha]

Just to say, Kirsty, you won't find a difference after just 3 weeks, it takes months to make a difference.
Best advice is search Vaginal Atrophy here, its a mine of information and extremely educational! 

[Kirstychase1974]

Thanks 

[CLKD]

Yep.  The itch is high up    due to dryness. 

[Amazing grace]

Hi annie79, just to add you don’t need to get hydramol on prescription you can buy it from any chemist or Order it online I buy it from Amazon you can get in 500g tubs or 100g tubes , might be better if you wanted to try it to buy the tube first to see if it suits you , good luck I hope you find something that will bring you some relief xx