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[poorlittlefish]

I've been suffering from vulval irritation for several months. It's making me really stressed and uncomfortable because nothing is working.

I've tried Hydromol and Yes. I wash with unscented E45 emollient shower cream. I've self-medicated with Canesten and multiple doses of oral fluconazole in case it's thrush (no symptoms other than external burning and soreness).

I've been using Estriol cream since July and it's not made a scrap of difference. The GP was very flippant, saying it usually is very good and could only suggest booking an appointment with a female GP for a vaginal exam (no appointments are available; I waited 5 weeks for that one). I don't really have any other menopause symptoms that are bothering me.

I've now ordered Gina to try out of desperation. I don't know what else I can do, but months of this is really getting me down. Does anyone have any other suggestions?

[Minusminnie]

Just a few initial thoughts. Which Estriol cream have you been given 0.1% or 0.01% in strength ?

How often are you using it ?

It may need longer than 3 months of so to start taking effect.

Are you washing underwear in just water or very little soap powder & rinsing really well as residue can cause irritation. Breathable cotton underwear helps too.

[Dramy3]

Sorry you're struggling with this. It drove me mad for 2 years before anyone mentioned it might be oestrogen-related. FFS.

I use vagifem (same as Gina) twice weekly and estriol cream (0.1%) nightly on the labia majora and minora and entrance to vagina. Plus all the bathing and moisturiser things you mention. But I'll add that I only saw about a 25% improvement in my symptoms until I added a systemic oestrogen (estradot patch 50mcg) in the mix. This was after 18 months of trying just the localised oestrogen.

It does take months to really see the difference though so don't despair. Stick to the regimen and up the cream if you feel it might help.

Good luck!

BTW--I saw even more improvement with a bit of testosterone. My dose was too high so had to come off and now reintroducing it because it really helped the VA

[Pixie]

Salcura topida spray really helped me. It smells quite strongly of tea tree oil and to start with it can feel a bit burny but it was the only thing that worked for me.

[CLKD]

Hi!  Have U read the various threads about VA and bladder issues. 

How R U using the estriol?  How often?   Some find that they require 'vagifem' internally as well as estriol/ovestin externally, every night if necessary.

Some GPs still don't seem to understand the effects of VA.  Is there a Nurse Practitioner at your Surgery?

Canastan made me burn    I had to sit in a cool bath for ages.  Never again!

Give the GINA a try, is that for internal use?  As well as the estriol on the out labia/vulva. 

[bombsh3ll]

How often are you using the estriol cream?

I would suggest using it daily, as well as a daily gina/vagifem pessary until your symptoms are controlled.

Definitely get an appointment booked for examination to exclude other diagnoses requiring specific treatment.

If vaginal estrogen isn't effective you could consider vaginal prasterone - I am not sure if this is available on the NHS.

Also what about systemic estrogen? Topical treatment can only achieve so much.

[Suziemc]

Hi

Is the irritation external only? Or internal, within the vagina? If its external only there is a chance that it could be Lichen Sclerosus. This condition presents in a very similar way to thrush in that it itches and/or burns, it can also cause white patches on the vulval skin and around the anus.

If it is LS it needs treating with a steroid cream so needs diagnosing by a GP, but not many are aware of the condition and it is often undiagnosed. Many women get a better 'service' by making an appointment at a sexual health clinic so it might be worth seeing if there is one near you.

I'd definitely make an appt with the female GP, even if it is several weeks away, you can always cancel if you manage to get seen elsewhere.

It is also possible that's its vaginal atrophy and Gina should help with that. Try it whilst you're waiting for GP appt, it can't do any harm to do so.

Definitely make that appt!

Suzie

[Suziemc]

Is the irritation external only? Or internal, within the vagina? If its external only there is a chance that it could be Lichen Sclerosus. This condition presents in a very similar way to thrush in that it itches and/or burns, it can also cause white patches on the vulval skin and around the anus.

If it is LS it needs treating with a steroid cream so needs diagnosing by a GP, but not many are aware of the condition and it is often undiagnosed. Many women get a better 'service' by making an appointment at a sexual health clinic so it might be worth seeing if there is one near you.

I'd definitely make an appt with the female GP, even if it is several weeks away, you can always cancel if you manage to get seen elsewhere.

It is also possible that's its vaginal atrophy and Gina should help with that. Try it whilst you're waiting for GP appt, it can't do any harm to do so.

Definitely make that appt!

Suzie

(I've just realised that the forum duplicated your post and I replied to the other one, copied my response here so you have them all in one place)

[CLKD]

  for reposting

[poorlittlefish]

I've been using the Estriol cream since July. It just says there's 1mg per gram, so does that make it the 0.01% strength? I did the initial 2-week 'load', then twice weekly for the 3 months, then started using a pea-sized blob daily instead, just externally. It's just the vulva area that is irritating the hell out of me, but it looks completely normal - no white patches.

I shall start the Gina and pray that it helps.

[Minusminnie]

1mg per gram is 0.1% estriol so you are using the stronger estriol.

If you are switching to Gina then that will also need time to work & you may find that it alone does not help the vulva area.

Would it be worth trying the estriol internally & both externally for a bit longer before starting the Gina ?

As suggested the sexual health clinics are a good option to get checked out further.