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[Abc123]

Hi, first I'll give a bit of history.

I've been on Ovestin for a couple of years (starting around 2 months after starting patches as I suddenly became very dry and bleeding internally and externally as the tissues were so delicate). Until the beginning of this year, after the loading dose, I was managing it fine with 2-3x a weekl application internally and externally.

From January my bladder became irritable (not painful to pass urine, but it would take a long time to start passing urine and very stop start and not emptying properly). I did a 2 week loading of every night and things improved and I managed to drop to 4x a week. Gp was OK with that but wanted me to use as little as needed.

I then started vaginal utrogestan because we thought oral was affecting my mood negatively. I find this to be quite irritating to the tissues and burns if any touches the outer area.

My GP has said to use Ovestin in the morning and utrogestan in the evening. When I rang Yes about using their VM product alongside Ovestin, they told me not to use within 12 hours of each other.

So I'm not really sure what I can use? Is it normal for utrogestan to make things sore or is it more likely that what I presume is VA is not controlled and that's why the area is so delicate?

Sorry for such a long post and thank you for reading!

[CLKD]

Hi.  Did your GP give a reason why she wanted you to use 'as little as needed'?  Another ignorant GP.  We can use VA treatments every night if necessary along with moisotisers [sp].  I would use 'ovestin' in the morning for the next few days as well as every night ......... and would stop anything that irritates the very delicate vaginal area.  If very sore don't insert too high up initially, allow the vaginal walls to absorb the product. 

How is your diet overall?   Did U need to P more often even though the stream was slow?  How is the urine output in general?

[CLKD]

NHS:

Why is Utrogestan taken at night?
Utrogestan is a natural sedative so can cause drowsiness in some women. It is therefore recommended you take it at bedtime. It is best to take Utrogestan on an empty stomach because eating food can actually increase its absorption.

[sheila99]

I think it's to do with va. I used it vaginally for a number of years but now it makes me sore and I'm just starting with va. I've started using it rectally now but this is very much off licence.

[bombsh3ll]

If you are sensitive to utrogestan vaginally and really keen to take it that way, you could ask to try cyclogest pessaries instead. They are specifically designed for vaginal use.

That's aside from treating the VA adequately, which is important in it's own right, but may or may not stop the progesterone burning.

Personally I believe that if genitourinary symptoms are severe or persistent, this is an indicator that systemic treatment is probably not adequate, rather than assuming all the other tissues you can't see such as bones, blood vessels etc are all fine and dandy and the vagina is somehow uniquely withering whilst the rest of the body thrives, however I am aware that not everyone in the field shares this view.

[CLKD]

As oestrogen levels drop the body may become dry: inside and out; nostrils, deep in the ears, skin, vagina, anus, between the toes ......... whereas on the arms, legs etc. we can see when the skin requires a mositorisor, internally of course we aren't aware until symptoms become difficult.  I use 'ovestin' regularly which has kept symptoms under control for over 5 years.  Along with KY jelly or a smear of 'ovestin' on the outer labial area.

[Abc123]

Thanks CLKD, I may have misspoken. I believe my GP was saying the same as the Ovestin data sheet, to use as little as effective. I have to use it in the morning and not at night for the 2 weeks I take the utrogestan vaginally. As for my bladder, my other health problems have meant liver and kidney bloods and I drink 3l water a day so I have good flow most of the time. There are times it's stop start, but when I take enough Ovestin it's well controlled. Thabks for checking on that though! Ans thanks for your replies.

Sheila, thanks for your reply and that's interesting to know. I think it's likely uncontrolled VA too. I'll contact my GP to reevaluate things.

Thanks Bombsh3ll, I had been wondering the same. I don't feel I'm on enough oestrogen yet and things got worse when I changed to oestrogel from patches in January due to adhesive allergy. From reading another thread, it seems lots of people's symptoms returned on oestrogel and my oestradiol level tested low for someone on HRT so I have moved to Sandrena. However I'm not convinced it's a high enough dose but have been trying to give the change a chance to balance before contacting GP again. Reading all your replies makes me realise I need to do so soon rather than giving it too much time.

Thanks too Bombsh3ll for your cyclogest recommendation. My GP did say there were other options when she prescribed the vaginal utrogestan usually used for IVF.

Thanks muchly xx

[CLKD]

Dr Louise Newson is trying to get the information leaflet in VA treatments altered.  You might like to tell your GP/s to contact her if they are at all worried.  The data sheets are WAY out of date!

Let us know how you get on.  3 litres of water a day is a lot if 1 has a good diet as the kidneys take liquids from everything that goes through the gut.  Which do you think is the most important issue here, using 'ovestin' at least every night for 3 weeks as you say that symptoms are well controlled: or continuing with the 'utrogestan' vaginally? 

[Abc123]

Thanks clkd, I'm going to maintain the status quo currently, or increase the Ovestin to daily in the morning. The affect oral utrogestan had on my mood is more deleterious to me than the irritation currently. Then when I can speak with my GP we'll make a plan.

[CLKD]

Let us know how you get on!

[Abc123]

I will do, thanks again!

[chopsuey]

Utro does seem to irritate some women's bladders - there are several historic threads about it on this forum. It certainly irritates mine and I'm counting the days each month when I can just take Oestrogel on it's own for 14 days, when everything calms down again. This is despite having good oestrodial levels (which I'm sure does help)  and using Ovestin internally.

I don't know if it's the progesterone itself that irritates, or one of the ingredients.

[Abc123]

Thanks Chopsuey.

Sheila, I hope you don't mind me asking you this and I won't be offended if you don't want to answer....

How do you use it rectally? How far do you insert and do you use some form of lubricant?

I'm thinking of trying it rectally before contacting the GP so I know if the irritation goes away and how it affects my mood etc. Thank you so much!!

[chopsuey]

Just to add, I saw a new specialist yesterday and she endorsed most of what has already been discussed on this thread; the need to fiind out whether it is VA that hasn't been adequately treated or a genuine reaction to utro. I am going to try a month of Cyclogest. She does say many of her patients seem to tolerate it much better and it is designed for vaginal use.

[Abc123]

That's really good info Chopsuey, thanks so much for sharing. I really hope the cyclogest works for you and doesn't cause more discomfort. Please let us know how you get on.

On a personal note, I'd love to find a progesterone that's not vaginal so I can then treat the VA night and morning when necessary. Having to not treat night for the 2 weeks I use utrogestan definitely doesn't help things, aside from the gritty irritation the utro itself delights us with!!