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[Platespinning]

Hi

I'm hoping someone can offer some advice please.

I've been having a rough time with vaginal dryness for the last 9 months. It started as discomfort around my perineal scar and then progressively got worse to a feeling of awful dryness and soreness around my vulva and vaginal opening and UTI type symptoms.

I was initially prescribed Vagifem which was effective initially but then benefits seemed to wear off. I tried all the creams but they contain sodium hydroxide which caused an awful burning reaction. I then had an Estring inserted in August which again seemed to help at first but less so now.

Last month the duty GP prescribed systematic HRT (2x pumps of estrogel and 200mg utrogestan) as I was at my wits end with the UTI symptoms (burning). I didn't want to go on it as peri and not really experiencing any other symptoms but I felt bullied into it as she wouldn't offer me any alternative. Despite me asking about Qlaira then she was dismissive and said they only offer HRT. (Unfortunately the Sister with specialist experience at the practice is retiring so appointments with her are like rocking horse poo.) The GP advised I start straight away despite me being mid cycle which I did then had a period so started the cycle again on day one.

Initially the estrogel did seem to help at least with the burning but I wasn't convinced it was really helping with the dryness however I started taking utrogestan 3 days ago and dryness and burning have returned. I skipped last night's dose as it had got so uncomfortable and used a leftover Vagifem to try and relieve things. At a previous appointment with the Sister she did express concern that the utrogestan might make things worse so had avoided putting me on systemic earlier. I'm worried about using the estrogel alone as essentially that's what happened last month cos I started mid-, cycle so think I'm going to try using the utrogestan vaginally tonight just to know if it's something I can tolerate or not but I am confused about his much as I've read 100 or 200mg on here.

I am waiting for an NHS appointment at a menopause clinic but in the meantime I got a private prescription for interosa which I'm really keen to try but I am sexually active and in the patient leaflet it says you can't use with latex condoms. In the UK the only other option seems to be polyisoprene ones but they say don't use with oil based lubricants and interosa is mixed with coconut oil and palm oil (assuming only small amounts). Does anyone know if they can be safely used as not on any other contraception? I've tried asking a pharmacist (who didn't know), the online clinic where I got it from and also the company who make it and neither have responded.

I have an appointment scheduled with the only GP at our practice with some knowledge of menopause but it's not for another few weeks. I'm thinking of asking to go on Qlaira as hoping that the hormones in that will override my own and provide contraception so I can start using the interosa but am also worried that will exacerbate things 🤦🏻‍♀️

Has anyone had experience of interosa and/or Qlaira who could offer some advice on how long the interosa will take to work (do I do the HRT and start it and just avoid sex)? Or if Qlaira well make the dryness worse?

Sorry for the long winded post but very confused and it seems like you all know more than most of the doctors out there!

Thanks in advance!

[CLKD]

Morning.  Having skimmed through your thread, how often are U using the VA treatment?  Every night is fine, for months if necessary.  Vagifem internally plus 'ovestin/estriol' on the outer areas as often as necessary.  Some find 'sylc' or 'yes' products on the vulva/vagina help.  When symptoms niggle I swallow two nurofen 3 times a day to ease the nip as the urine flow shuts off.

[Platespinning]

Thanks. I've still got my Estring in and use Vagifem to top up when I think it's needed but that's just cos I have some left over. Not sure the Dr will prescribe any more 😔

[CLKD]

Use every night and if your GP refuses then ask for a referral to a dedicated menopause clinic.  Without regular treatment this condition may become worse which then takes longer to settle symptoms.

Why would your GP. not prescribe?  Is there a Nurse Practitioner to speak with?  The details in the leaflet are out of date.

[bombsh3ll]

Why don't you just pay for the Qlaira which you wanted anyway and will avoid the need for special condoms as it provides contraception?

Qlaira also provides a healthy dose of systemic estrogen which might just fix or at least massively improve your vaginal symptoms as well.

[Platespinning]

Thanks both. My doctors seem particularly clueless when it comes to menopause!

I've looked into paying for Qlaira but most online won't offer it unless you've been prescribed it before.

[bombsh3ll]

What about The Lowdown? Or wherever you got the private prescription for intrarosa?

Also there might be a local NHS family planning clinic that you could try.

I would just say you need it for contraception, maybe don't mention any perimenopause symptoms. You could say that you are aware that 17 beta estradiol pills are likely to have a lower thrombotic risk than their synthetic cousins, that you are really keen to avoid unintended pregnancy, and other birth control options that are invasive or result in poor cycle control are not suitable for you.

I can't see them having a problem in the absence of any medical contraindications.

[Platespinning]

Thanks I'm going to try the local sexual health clinic and see what they say