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[Ayesha]

My first request for Estroil cream and my usual Vagifem pessaries from my new surgery resulted in a phone call from them stating the GP said its very rare to use the two medications together. My first reaction was to say, the trouble is doctors don't know enough about the condition and one tube lasts me 3 to 4 months, it can sometimes be a fault being assertive but life has made me this way.
I rambled on to the hapless lady on the phone giving over my point of view and she said she would explain all to the doctor but needless to say I will not be getting the Estroil cream.

But then on reflection I have decided to stop the Estroil and see how I get on, perhaps I only needed it at first but not now and the only way to find out is to experiment. If I find I need to use it again, alongside Vagifem, I will buy it as I tube will last me a long time.

At my next review if I have to, I will bring the subject up and in the meantime gather as much evidence as I can on the treatment regarding Vaginal Atrophy for each individual woman and what her needs will be.

[CLKD]

Morning.  Buy a copy of "Me and My Menopausal Vagina", read then pass on with notes in the margins ;-).  It's about time that GPs began listening to women! 

With 'ovestin' I can smear a little around the outer labia area when necessary or I use KY Jelly without problems.

[Jules]

Did they say why it is rare? I'm using them together

[Ayesha]

My immediate thought was that not enough women are coming forward when suffering this condition. I didn't think it was anything to worry about re overdosing on too much oestrogen, just a lack of knowledge on a condition that affects women in different ways and needs treating accordingly.

[CLKD]

I don't think that we can 'overdose' on hormone replacement, it's what it is: replacement :  but many medics have no idea .........

[Minusminnie]

My first request for Estroil cream and my usual Vagifem pessaries from my new surgery resulted in a phone call from them stating the GP said its very rare to use the two medications together. My first reaction was to say, the trouble is doctors don't know enough about the condition and one tube lasts me 3 to 4 months, it can sometimes be a fault being assertive but life has made me this way.
I rambled on to the hapless lady on the phone giving over my point of view and she said she would explain all to the doctor but needless to say I will not be getting the Estroil cream.

But then on reflection I have decided to stop the Estroil and see how I get on, perhaps I only needed it at first but not now and the only way to find out is to experiment. If I find I need to use it again, alongside Vagifem, I will buy it as I tube will last me a long time.

At my next review if I have to, I will bring the subject up and in the meantime gather as much evidence as I can on the treatment regarding Vaginal Atrophy for each individual woman and what her needs will be.

I for one if you don’t mind would be interested in how your experiment without using Estriol on the vulva goes.  I had a fit of pique at one time & stopped using it. The itching & burning was worse than when I started out !  So back on it.

Pity the GP just won’t accept what another GP has already given you and you’ve been ok with. 

[Jules]

I darent stop using the estriol.  I was using vagifem and it didn't stop the external atrophy

[fiftyplus]

I think they make it so hard for us to try and put us off bothering them by asking for what we need imo anyhow - sounds like my GP.  I have not had to order another cream yet but when I do I suspect it will be rejected as was the last one, although they did give me a prescription for 1 cream rather than 2 (so I will have to re-order more often) - when this does happen, I will be making a face to face appointment with my GP and discussing, sorry I meant to say educating her on this - there is no way I am having a wasting away fanny and I will say that to her, because of her ignorance/incompetence.  Honestly, I will be strong and assertive regarding this.  Too many women have had to put up with this for far too long and it's about time it changed...

[CLKD]

I have no problem with two boxes of 'ovestin' each time 

[Jules]

I think they make it so hard for us to try and put us off bothering them by asking for what we need imo anyhow - sounds like my GP.  I have not had to order another cream yet but when I do I suspect it will be rejected as was the last one, although they did give me a prescription for 1 cream rather than 2 (so I will have to re-order more often) - when this does happen, I will be making a face to face appointment with my GP and discussing, sorry I meant to say educating her on this - there is no way I am having a wasting away fanny and I will say that to her, because of her ignorance/incompetence.  Honestly, I will be strong and assertive regarding this.  Too many women have had to put up with this for far too long and it's about time it changed...

I got 3 boxes last time. They've just realised it.  I'd got so annoyed that they wouldn't repeat my prescription until id had a hysteroscopy that when I got the all clear, two of the did the same prescription  .

[Ayesha]

Pity the GP just won’t accept what another GP has already given you and you’ve been ok with.

This is what made me even more angry even when I had explained that my gynaecologist had prescribed Vagifem & Estriol to be used daily. What gives the right of another GP to over-ride another professionals treatment regime just because of a change of surgery, it shouldn't have made one bit of difference.

I will update the thread on how I get on without the Estriol as its nearly three years on from starting treatment.

[Wrensong]

Hi Ayesha, I'm sorry you're having to fight this battle.  I understand your intention to experiment to see if you can manage without the cream but personally I can't & I don't think you should have to.  I was prescribed both the weaker Estriol cream (0.01%) & Vagifem to use together 8 or so years ago by a very good specialist nurse at an NHS menopause clinic & still use both now.  However, I later had a similar problem with a Cons Gynae who didn't understand that the Estriol cream was for use on the vulva & the Vagifem internally, as the effects of Vagifem can be very localised.

If you don't have a copy of the clinic letter detailing this:-

my gynaecologist had prescribed Vagifem & Estriol to be used daily

I suggest you ask admin at your surgery to look it up in your records & let you have one.  You could also ask them to show it to the GP who's not confident prescribing both together.  Once you have a copy of your own you can also produce it should the same situation arise at any time in the future.  If they can't trace the letter in your recs (this sometimes happens with stuff at my surgery), you could ring the Gynae's sec & ask for copies to be sent to you & your surgery. 

I'm sorry it's a faff to have to do any of this & it's tiresome we should have to be our own advocates in this way, but you will also be educating the GP for future dealings with any other patients in your situation.

I hope you manage to get the cream reinstated.
Wx

[MrsMitch]

Ayesha when I saw the meno consultant I asked if I could have 2 tubes of Ovestin and month (as well as estradiol daily) and she was fine with that. I told her I used it twice a day and she said use more if I need to. If I don't, I itch like mad. If you have a look at PWHCF online (you do have to register as a health professional but it's worth it) there is a comparison table of vaginal oestrogen treatments that detail usage etc. If you find you can't do without it, you could show the GP the table.
I think we're all livid for you.

[CLKD]

?? ignorance on behalf of GPs or cost cutting ?? 

Let us know how you get on.

[Jules]

I saw my GP yesterday about something else and she mentioned the estrogen treatment as part of the discussion and seemed to have no issues with what I was using. It does vary greatly across GP services