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[Jules]

I've had 3 weeks break from vagiifem or equivalent. Decided to start again as I can tell I'm dryer. Do I need a loading period? I'm mindful not to do to more than is necessary as along with ovestin externally nightly, I had breast pain and a bleed and don't want to trigger symptoms again. It's a bit of a minefield managing VA.

[Minusminnie]

Given that you have had a bleed and have an scan coming up soon i would be inclined to use the mimimum vagifem for now that you think necessary.  You may feel more confident doing a 2 week reload after the scan results which will give you a baseline to go from. 
Just my thoughts.

[CLKD]

Managing VA shouldn't be a minefield if 1 continues with regular applications.  Initially I stopped when my vagina felt better and the need2P symptoms eased.  Wrong. 

I can't remember if you have an appt for the scan 

[Jules]

I have an appointment on the 18th. I'll avoid a reload and use minimum till then but I don't think that will do the trick but I suppose its better than none

[Ayesha]

I agree minimal until you have your scan. It will be very interesting what the results are and if it was caused by regular use of Vagifem and Ovestin.

[Dierdre]

Yes, I'll be very interested in the outcome too.  I'm prescribed Ovestin nightly and vagifem 5 x week from gynae, with the understanding  it's ok to do so. Last scan a year ago was ok.

[Jules]

I hope that's all it is and nothing worse. Ive had no more blood and no more breast pain. My doctor said I'm not the only one with that reaction. She wasn't referring me for scan because my September one was ok and everything was OK on questioning and examination. I asked for one

[CLKD]

Usually if results are 'within normal limits' a patient is unlikely to be accepted for NHS scans so soon ...... let us know how you get on.

The vagina will bleed if the tissues are thin and delicate whether anything is pushed up or not.  Fortunately 4 me 'ovestin' has worked well as long as I manage symptoms.  I do get niggling feelings under my belly button region as a warning to do an extra treatment mid-afternoon. 

[Minusminnie]

I hope that's all it is and nothing worse. Ive had no more blood and no more breast pain. My doctor said I'm not the only one with that reaction. She wasn't referring me for scan because my September one was ok and everything was OK on questioning and examination. I asked for one

Good for you sometimes if you don’t ask you don’t get.  September was then this is now. 

Hope you get some reassurance.

[Jules]

Usually if results are 'within normal limits' a patient is unlikely to be accepted for NHS scans so soon ...... let us know how you get on.

The vagina will bleed if the tissues are thin and delicate whether anything is pushed up or not.  Fortunately 4 me 'ovestin' has worked well as long as I manage symptoms.  I do get niggling feelings under my belly button region as a warning to do an extra treatment mid-afternoon.

I'm not sure what you mean by normal limits. I've  been referred for a scan previously. The tissues weren't thin, she checked, it wasn't vaginal bleeding

[CLKD]

Jules: She wasn't referring me for scan because my September one was ok and everything was OK on questioning and examination. I asked for one

Your September scan was 'within normal limits' ......

[Jules]

Okay. But I have been on an increased dose since then. I wasn't using ovestin or using vagifem so frequently until September so not sure if that's changed anything

[Dierdre]

It shouldn't which is why you're results will raise alot of questions if it has thickened the lining and in such a short time. Usually when you first use it, until everything inside is rehydrated some estrogen will go systemic, but even then it's an acceptable dose. This is why progesterone is not needed with topical estrogens, even years ago with the 25mcg  dose per tablet it wasn't needed and everyone was using 50mcg a week in two 25mcg doses safely. The Estring vaginal ring is 50mcg (approx) per week.
It does say on the leaflet side effects that bleeding is one of them but why? If it was from thickened lining that would be a problem so it must be caused by something else that's not a problem.

[Jules]

I don't know but when I was exasperated and commented about why I'm unusual,  she said I wasn't, that other patients had that reaction and it does list those symptoms on the side effects. I've had nothing since I stopped nearly 4 weeks ago. I read an article by a pharmacist about it and he cited statements over the decades which all said topical estrogen is well absorbed, it's only recently they're saying something different.

[Dierdre]

I think some definitely gets absorbed but maybe the fact it's a very small amount and not enough to thicken the lining makes it ok not to need progesterone. It probably is still enough for some to disrupt hormones enough to cause a bleed. Was your bleed just spotting or a like a period that lasted a few days?
Sometimes our own hormones can fluctuate, even after the last period you can have a rogue ovalation a year later. I did 15 months after what I thought was my last. They changed the timing to 12 months no periods then you're post meno, it used to be 2 years.