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[AngCho]

Hello all. I am new to the site and have been learning about my condition - VA with irritable bladder symptoms. I am quite uncomfortable with soreness and burning, mainly in my urethra and clitoris. I am on my 3rd week of Vagifem every night, as directed by my urologist. Next week I will step down to twice a week.
I have seen some improvement with Vagifem, my vagina is less sore, but I am still very uncomfortable and so decided to ask my GP for Estriol cream to rub on my sore areas. She agreed but now I am unsure how to use both together. Please can you tell me how I should use both together in the loading phase (every day), and also when I move to the twice a week program. I do not seem to find any official guidelines. I realise that this treatment is going to take some time to show results and am trying to be patient, but I long for my old life back where I never had any bother with my nether regions. Thank you for your input. I have learned a lot from this site. A few weeks ago I never knew VA was a thing! Thank you.

[CLKD]

Yep.  Vagifem internally, as far inside as is comfy with a smear of estriol on the outer labia/vulval areas.  Every night for ever if necessary.  Do not lessen the applications until you are completely comfortable.

   VA also mimics urine infection-type syndrome really really well.  Many of us as well as a lot of medics have no idea about vaginal atrophy.  "Me and My Menopausal Vagina" should be read by every trainee - written by a lady who was on the Forum.

There is little official guidelines about VA diagnosis and treatments, each 1 of us is different.  Occasionally I need to do a re-load for 5-7 nights to ease symptoms.  When I get the need2P I swallow 2 Nurofen 3 times a day to ease the nip as the urine flow shuts off. 

Don't be in a rush to go into twice a week, U may find that alternate nights suits you better.  The info in the leaflet in the box is way out of date ;-)

[AngCho]

Thank you CLKD, that’s really helpful. I don’t really have any side effects from the Vagifem so I will use it more often if I have to. I am worried that my GP will not prescribe me enough medication to do this though. (It was quite hard to persuade her to give me the cream as well). You are quite right about VA mimicking urine infections. I have had a few unnecessary courses of antibiotics and urine tests that come back as normal.

[CLKD]

It really can be Trial and Error with the occasional blip = another reload 

[Ayesha]

These are the latest guidelines in treating GSM (Vaginal Atrophy) and can be used in discussion with a GP or nurse if you have resistance in your request for more treatment.
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

I am over 70 and use Vagifem and Estriol cream every day to keep my symptoms under control. I had a review recently and had no trouble from the surgery keeping at this dosage, you shouldn't either.  As already mentioned, don't rush to go down the 2 a week route, it rarely ever works and you will soon be back to every day.

[CLKD]

   I do feel too that having a 'family doctor' makes a huge difference because I don't have to keep repeating symptoms as well as the correct questions R asked = appropriate treatment.

[AngCho]

Good advice thanks both. I’m glad to have found this site and grateful for your help.

[CLKD]

Let us know how you get on.  Ask away.