For me I’ve had to cut back on the external Ovestin as it was making me burn, and I also needed a thrush treatment (I always take the oral pill for that). I think for my body it was too much (and it seems getting VA under control is a very individual experience) alongside the Intrarosa pessary I am using daily that melts and treats the external tissue too. I have now even managed to heal those wretched painful fissures with Dermovate. It is all very weird this VA how it can come on so suddenly, wreck your life for months, and then settle as quickly as it came!
Patchsmama, I understand your fear concerning systemic HRT, but I am thinking that if you have had a surgical menopause then you no longer have the tissues in your body that may pose a risk. Perhaps you could be referred to a menopause clinic, or if you could afford it then make an appointment with Newson Health (they do online as well as in person appointments)? Wishing you some peace from this. X