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[Emzib0b]

Hello ladies,

I’ve just received my first pack of vaginal oestrogen (it’s the generic version of Vagifem). It’s been prescribed more for my urinary symptoms than dryness but I do get the occasional bout of soreness from time to time. The dispensing label says to use it every night for the first two weeks, then twice weekly for three months, then take a three month break.

I was under the impression that once on a maintenance dose, we can continue to use it for life? The letter from my Meno specialist to my GP states it’s to be used indefinitely so I’m a little confused! Has anyone else had it prescribed this way?

EDIT: Spelling (main body) and punctuation (title).

[Haydo]

Once you start with it you need to continue with it as far as I, and most of the other ladies on here, are concerned.  Some of us use it more frequently than twice a week, and if you were to stop after three months you would just go back to square one.  If your Meno specialist states its to be used indefinitely then that’s how it should be prescribed.  I hope you don’t have a fight on your hands with your GP!  Some of them have no idea. 

[Flossieteacake]

You are right but sadly the leaflet is very outdated. VA is caused by lack of oestrogen so stopping it will mean the symptoms return. I wish they could change the information on the leaflet as it is not helpful at all.

I personally would use it every single day and when you see an improvement you can try and reduce it if you wish to. I use Ovestin cream every day and have done for over two years now. If ever I try to reduce it then my VA flares back so I cannot use any less.

Luckily you have a letter from the meno clinic so your GP will continue to prescribe it for you.

[Songbird]

I’m confident that if I had a 3 month break from my vaginal oestrogen, I would quickly be in tears with the horrendous VA symptoms yet again. I suffered for years but have been using it twice per week for the past year and have had not a bit of bother..

[CLKD]

I rarely read leaflets in medication boxes  - my mind has it's own ideas 

VA treatment should be considered a life-long necessity.  If necessary every night for as long as symptoms continue to be troublesome.  I've reached a stage when I can take a break of a few weeks, when I get a niggle around my belly button I do a 5-6 night treatment. 

I would send a copy of the leaflet and your concerns to Dr Louise Newson who is I believe, trying to get the leaflet info altered.

[Emzib0b]

Thanks for all your replies. I’ve just re-read the patient information leaflet and can’t find any mention in there of taking a three month break, so this appears to be something the prescribing GP has decided upon! Very strange! Fortunately I need to go in for a review in three months so I’ll try to get it dealt with then. I see what you mean about the leaflet, though, it looks like it was copied and pasted from a leaflet for systemic HRT!

[CLKD]

Don't wait!!!!   Ring the GP Practice and ask for repeat prescriptions, a gap may make the symptoms a lot worse. If the GP is stubborn, ask for an face2face appt with the Nurse Practiioner or GP.  GPs are unaware as to how VA affects us!!

[Katejo]

Thanks for all your replies. I’ve just re-read the patient information leaflet and can’t find any mention in there of taking a three month break, so this appears to be something the prescribing GP has decided upon! Very strange! Fortunately I need to go in for a review in three months so I’ll try to get it dealt with then. I see what you mean about the leaflet, though, it looks like it was copied and pasted from a leaflet for systemic HRT!

  A GP once stood up and shouted at me when I challenged her claim that it was only safe to take local oestrogen for 3 months.

[Emzib0b]

Don't wait!!!!   Ring the GP Practice and ask for repeat prescriptions, a gap may make the symptoms a lot worse. If the GP is stubborn, ask for an face2face appt with the Nurse Practiioner or GP.  GPs are unaware as to how VA affects us!!

I’ll give them a ring on Monday and let you know how it goes. I’ve just remembered that the leaflet the practice nurse sent to me last week was a ‘Balance’ leaflet (by Dr Louise Newson) and of course says vaginal oestrogen can be used safely for a long time! I sometimes feel like the left hand doesn’t know what the right hand is doing at my surgery!

A GP once stood up and shouted at me when I challenged her claim that it was only safe to take local oestrogen for 3 months.

Oh my goodness Katejo, that’s horrific! Having said that my OH was thrown off our surgery’s books for challenging one of the GP’s very harmful opinions!

[SarahT]

Emz, you OH has just become a bit of a hero for me today! Whilst I admire the health service, I do appreciate the need to be listened to like and adult and he ' allowed ' to challenge our own treatments in a responsible and equal manner.

[misskh]

I had to stop using Vagifem/Estriol cream last October due to unexplained post menopause bleeding while tests were carried out.

I've since had a hysterectomy where everything including my
ovaries were removed and was recommended to wait until the histology report was back to ascertain exactly what the was wrong before restarting.
I've been given Oestrogel as I was feeling tired all the time and when I asked about restarting with the vaginal estrogen I was again told to wait and see if the Oestrogel  helps and we'll have a chat in 3 months time.
Four weeks on and It hasn't so far.

I'm now suffering with frequent urination, burning, stinging and itching. It's like my life has gone back 8 years to when all this initially started.

I can't wait and have now started using the Estriol cream
a few weeks ago and things settled so I stopped, it returned on Thursday I'm now doing a reload of both, vagifem in the hope it settles my bladder and the Estriol cream around the vulva area in the hope it sorts it out.

[Ayesha]

Sometimes its difficult to believe what I am reading when I come across posts like yours, EmzibOb.
I just have to miss one day of Vagifem and two days later my symptoms return, burning, peeing all day long, etc.

Treatment is for life and definitely no breaks in between. You will learn as you go along how much dosage you need, your body, your choice, your quality of life!

 

[Suziemc]

When I started on vagifem 10yrs or so ago the instruction was to take a 4wk break every 12mths. I did this for the first few years but always suffered towards the end of the 4wks.

A couple of years ago I realised it had been quite a while since I last took a break but also noticed that the instruction had disappeared from the GPs prinred instruction label on the box. I asked my GP next time I had an appt and she confirmed that it was no longer deemed necessary to take the break, hence it no longer being on the label.

So it sounds as if your GP isn't up to date with latest advice.

[Katejo]

Don't wait!!!!   Ring the GP Practice and ask for repeat prescriptions, a gap may make the symptoms a lot worse. If the GP is stubborn, ask for an face2face appt with the Nurse Practiioner or GP.  GPs are unaware as to how VA affects us!!

I’ll give them a ring on Monday and let you know how it goes. I’ve just remembered that the leaflet the practice nurse sent to me last week was a ‘Balance’ leaflet (by Dr Louise Newson) and of course says vaginal oestrogen can be used safely for a long time! I sometimes feel like the left hand doesn’t know what the right hand is doing at my surgery!

A GP once stood up and shouted at me when I challenged her claim that it was only safe to take local oestrogen for 3 months.

Oh my goodness Katejo, that’s horrific! Having said that my OH was thrown off our surgery’s books for challenging one of the GP’s very harmful opinions!

  I refused to see that GP again. I later mentioned this reaction to another GP at the practice and she was horrified.

[suzysunday]

I was advised to stop local hrt while bleeding was investigated.   I stopped for 3 months and it took months to feel right when I restarted.  Never again!