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[CLKD]

Where did I suggest that years of work and experience is 'worthless'?   There have been many dangerous assumptions made by 'experts', many of whom were widely acclaimed in various 'fields' until: i.e. MMR caused autism  .  Studies relating to HRT being dangerous for women .....

I would never have learned about vaginal atrophy had I not been diagnosed years ago.  Which means that I would not have required VA treatments.

 

[CLKD]

Nix - have U made any decisions?

[Nix]

Let us know how you get on, will U use for 2 weeks to plump up the vaginal tissues?

Hi there, doctor said to use daily for one week and then 3 times a week thereafter but I might see about going longer as I’m still really uncomfortable.

[Nix]

This is a matter of debate among experts.

Whilst it is absolutely ok to use vaginal estrogen alongside systemic, my personal view is that if someone has a healthy level of estrogen in their body, their vagina shouldn't be atrophying, unless there is another condition eg neuropathy or poor blood flow due to previous surgery, radiotherapy etc.

Studies were done in the 1990s on plasma estradiol and VA by Sarrell et al, which found it was much more prevalent below a threshold level of 50pg/ml, and less common as women got above this.

(Note US units used. UK measures in pmol/L)

I find it biologically implausible that my vagina would be uniquely withering whilst every other tissue in my body thrives, and the likelihood is if one organ is protesting, my bones, heart and blood vessels etc are probably not optimally estrogenised either.

Whilst I realise that some of the very small risks associated with systemic estrogen are avoided with vaginal therapy, I am also slightly uncomfortable with the practice of only treating, or only treating adequately, the part used to potentially have penetrative intercourse with men, rather than the woman as a whole.

My view on this may be coloured by personal experiences and I am in no way suggesting vaginal estrogen isn't an extremely valuable therapy or that anyone shouldn't use it.

At the very least though I believe the ongoing presence of VA despite systemic therapy should prompt a review of the dose/absorption, that way you can make an informed decision whether or not to increase, with or without vaginal estrogen.

This was my thinking to be honest. If my levels are good why the atrophy.  I’m using the cream and Vagifem have also added a top up dose of Oestrogel to my HRT.  I’ll be checking levels in 6 weeks but if my memory serves me right, I was at the 350 mark when last tested, I need to double check that though. Just to add, my doctor agreed to the increase, it’s not something I decided alone.

[Ayesha]

Unfortunately the ageing process carries on even though you are using systemic HRT its not always enough to protect the vagina from dryness and the subsequent symptoms of it. Some need both systemic and topical oestrogen to control symptoms and some don’t, its all very much trial and error when it comes to getting the right regime that suits and its not easy.

[CLKD]

   Ayesha