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[joziel]

It can take months to get your vagina estrogenised again. I really wouldn't be expecting to notice an improvement yet. You need to commit to many months of treatment and the long term. You do NOT want to reduce down from every day until your symptoms are well under control.

Hopefully your doctor supports that... It is very safe to use loads of local estrogen, every day, forevermore....

[Minusminnie]

So at Day 13 of the loading phase. I have been on vacay so not
teaching hot yoga and the burning has even subsided. I have not had to use the vaginal moisturizer other than Sunday. 

Have you seen a women’s pelvic physiotherapist who could assess you internally & give an opinion ?
Tight muscles can cause burning also & im just wondering if your very regular workouts are causing anything.

[Ms_london76]

Ok.

The real test will be in the hot room when i am teaching 2 classes back to back. Post class i always take a shower and fresh clothes.

I had dryness last summer and it cleared up and went away. I was using the vaginal moisturizer but no hormones. My period also went missing last summer. Dryness went away on its own.

Now I am 120 days or more from the last period, and the dryness has not disappeared. Hence taking hormones. I am only 47 yrs old but due to extreme stress in the last two perhaps menopause came early?

I am under alot of stress caring for two needy elderly parents. Which has been time consuming and my own self care gets put aside. I am hyper stressed from that almost all the time.

Still learning

[Minusminnie]

I am sorry that you are under a lot of stress as that will not be helping.

There is a thread on here for those looking after elderly parents I will find it if I can & bump it for you.

Are you able to find down times for yourself ? as your vacation seems to have made a temporary difference.

I mentioned the physio in order to not only find out anything but also to eliminate any other reason. Any/all knowledge around this helps. Take care.

[joziel]

Are you on systemic HRT? Besides helping the VA (for many women), it sounds like you might need it by now if your own periods are irregular.

Usually they get closer together before longer, so if you're already at the longer part, sounds like you might want to be thinking about some HRT.

[Ayesha]

When you are under a lot of stress it's difficult to think straight and too much information can be overwhelming. You are certainly at an age when your body is changing and you have to learn how to adapt to the changes. The most pressing thing right now for you is to relieve the burning and the easiest solution is topical oestrogen and when the symptoms have eased then perhaps think about the long term to what treatment is best for you, systemic or topical HRT or both.
Keep us updated as you go forward down the rocky road that is menopause, it can be a bumpy ride!

[Ms_london76]

Day 14

Taught a class in the hot room, was okay. Took a shower post class started to notice the dryness.

Here is something new I did last night. I have always worn unscented pantyliner daily, change it a few times a day etc. Last night, I came home and did not wear a pantyliner at bedtime or overnight. I did not have anymore pain inserted the vagifem. This morning so far it has been normal.

Now, maybe letting the V breathe made a difference? I will be going on my run this morning and will do the same thing.

So now i am in no mans land meaning, do i keep taking this for another week everyday or flip to every other day? I am quite nervous to drop down to twice a week especially when i have go teach 4 more classes in the hot room.

As far as systematic hrt, i have read that vagifem works better than the estrogen pill to help with the downstairs issues. Without releasing estrogen into the blood stream.

Or maybe not ready to take both estrogen and progesterone mentally.

[joziel]

We've already answered these questions above...

You definitely should not reduce to twice a week just yet. You don't actually ever need to, but you should get symptoms well under control in a consistent/ongoing way - and then experiment to see what your body can manage.

As for systemic HRT, it depends. If you take a decent dose of systemic estrogen, it means your body usually doesn't need any at all locally. That's what happened to me. I can't tell you what a total fcking pain in the ass it is to be applying moisturisers, estrogen creams, pessaries, avoiding sex, having things leaking out of you blah etc. I am ecstatic that on a decent dose of estrogen, I no longer need anything locally at all.

As for 'without releasing estrogen into the blood stream' - why would you want to avoid that? You want to release estrogen into the blood stream because it will decrease your risk of dementia, diabetes, insulin resistance, bowel cancer, osteoporosis, cardiovascular disease and more besides. It's not a bonus to avoid estrogen in the blood stream, it's a drawback. The number one killer of women worldwide is cardiovascular disease.

Your whole body needs estrogen, not just your vagina.

[Ms_london76]

Hi

I have had unique reactions to birth control in the past. Meaning it was not working for my body. I would get bleeding on my white pills days and my monthly got so messed up that i stopped taking them.

So my hesitancy is what will my body do with estrogen and progestrone? I am very sensitive to medications in general.

At the moment my only annoying symptom is the dryness. I do not suffer from hot flashes. Disrupted sleep due to waking up to pee yes, vaginal dryness yes. I understand what you mean i am just worried how my body will react plus the cost of monthly up keep (the pills and vagifem) i do not have insurance.

But yes i am not ready to go off the vagifem until i notice any difference and consistent difference.

[Ayesha]

Joziel, you make it sound as if taking systemic HRT is the holy grail, the magic youth pill when we know full well that for some women it can be an absolute minefield, reading some of the posts on here and the struggles women have from the side effects of taking HRT and finding a regime that works, can be very problematic. I am glad MsLondon76 is taking baby steps here in controlling her symptoms.

I use Vagifem, Estriol smeared on topically and a moisturiser, its a regime that has become second nature, a part of my life now and a very welcome part because it controls the most horrendous symptoms that GSM causes.
I am not on systemic HRT but lead a healthy life, I am very old and I am not falling apart because of lack of oestrogen in my bloodstream and I would like other women to know that its not all about systemic HRT that keeps you healthy in old age its also about how you live your life and how you manage any symptoms if and when they arise.

[joziel]

Ayesha, it is the holy grail - when you get the dosage and product right for you. It is the very small minority of women who would disagree with that. Most women who end up on forums like this are women with problems looking for solutions. We are not representative of most women on HRT. They get on it and it's great and that's that - they don't waste hours looking for answers online - because it's working for them.

For sure, how you live and lifestyle is very important for aging healthily. But research shows everything I listed above: Menopause (and the loss of estrogen it causes) increases the risk of cardiovascular disease, osteoporosis, bowel cancer, dementia, arthritis - and probably more I've left out. It's astounding how cognitive dissonance sees people object to this. It is imperative that women are given this up to date information so they can make a fully informed decision about whether to take HRT.

[CLKD]

I am as old as I feel - each morning it's about 90  by mid-morning about 16 unless anxiety takes over 

I don't know why any1 would wear a panty liner  .  If a discharge is such that 1 needs to use them then a check up with the Nurse Practitioner should be arranged.  Both Mums used them: we found packets++ in the drawers when turning the houses out. 

VA treatments can be for ever.  Even used occasionally it may be necessary to keep to a regime that works: don't think "Oh it's better" and stop  sometimes I need to do a re-load for no particular reason.  I wear cotton knickers, no liners and they are changed daily.  I sleep naked.  [nighty to hand when staying away from home  ]

Some ladies find that using a moisturiser externally as well as 'vagifem' or 'estriol' internally works. 

I believe that Birth Control is different to that prescribed during our peri-menopause years.  Ms_london76 - R U Stateside?  Disrupted sleep due to waking up to pee yes, vaginal dryness yes. this is typical of VA .  Do read the thread again, as well as 'the bladder issues' and other VA topics: make notes 

[Ms_london76]

Yes I know all about the research but it is safe to say hrt is not a fix for everyone. I know many ppl who have not used hrt and are fine.

It’s a trial and error journey, we all experience such unique symptoms. Some worse than others some not at all.

I am taking baby steps and trying to find the right answer for my body. Which may be different from every single person on this forum.

We can support each other and share what worked for them but there is no absolute.

I am pretty sure I am not ready to let go of a daily regime of vagifem. But curious if my body would respond without for a twice a week regime. But scared for that awful dryness to return.

[Ayesha]

I recently did an experiment to see if I could do without the twice daily smear of Estriol thinking after 4 years of daily Vagifem I might be ok but within 4 days of not applying the cream the GSM symptoms came back. For me its obvious that the Vagifem is working well inside but not reaching the outside and its only through trial and error we find this out for ourselves.

[joziel]

I think, if you're not on systemic HRT, you probably will need more local estrogen - but by all means experiment and see what works best.

As for 'many people who have not used HRT and are fine'... That is just looking at this in terms of symptom control. Not disease prevention.

Many of these people who are 'fine' now will fall and break a hip when they are 80 and then go into a nursing home for the rest of their lives. Or develop dementia when they are 70. And so on. As I said, the number one killer of women is cardiovascular disease. Many of these women who seem 'fine' without HRT, will (statistically) go on to die of cardiovascular disease. Not all of them, of course. But statistics are all we have to base decisions on.

So it's not just about treating symptoms. We will probably get to a future where almost all women are routinely and preventatively put on HRT at the first sign of peri-menopause, unless they have a strong preference not to. But at the moment the health system would collapse if we did that, it is already struggling to cope.