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[Treehouse1]

Good Morning
I have had vulvodynia for 12 years now and it destroyed my career, my finances and my life due to the incessant pain.

It grows to about level 9 pain and subsides to about 4 , but the 4 is only for a couple of days per month).

I am now post menopausal and have been using vagifem for abut 5 years which helps with the bladder and a bit of a everol conti patch as m weaning off it and doing ok. (I’m 60 now)

Anyway am due for a pudendal nerve block in Jan but chap at hospital has suggested and given me ovestin cream instead of vagifem to try. I had tried it before on the outside years ago but it stung like hell so didnt really fancy it.

However, eventually gave it a go twice this week as directed and blow me the pain has reduced quite a bit, the last week i’ve been from a high of 5 to a low of two!

Now because my vulvodynia increases and decreases through the month its hard to tell whether its a coincidence.
But lets sayit isnt , and if i dare to dream that this is going to work for me( and i darent hope incase i am crushed again), is it safe to use long term re endometrial lining etc?

Because i se a bit of a sequi patch i am getting abit of progestin from that i guess but if i come off the patch will the cream be safe?
My gp is less than useless so no point asking them. They have misdiagnosed that many people i dont trust them one iota, so any advice would be gratefully accepted.

Thankyou very much.

[CLKD]

Use every night for as long as necessary!  Get a dose up there this afternoon and again B4 going to bed.  When symptoms niggle I find this helps as well as swallowing 2 nurofen 3 times that day.

Some use 'vagifem' internally with a smear of 'ovestin/estriol' on the vulva etc. every night.  There are no issues of safety using vaginal atrophy treatments.  These may sting initially due to the tissues being very thin and dry, as the skin plumps up, these symptoms ease. 

Many medics have little or no idea about vaginal atrophy, including some GPs and Gynaecologists.  There are dedicated menopause clinics.  May I ask why the pudendal nerve block?

[Ayesha]

Its perfectly safe to use topical oestrogen without the need for progesterone to protect the womb, it doesn't reach that far and is not necessary.
I do think you would have benefitted from using two treatments because the pessary doesn't always reach as far down as it needs to. A lot of women need both Vagifem alongside using Estriol cream to fully cover all of the outside area and again a lot of women need daily treatment, its safe to do this. Also a daily moisturiser helps if there is any stinging from the fillers in the cream, they can be mixed together.

You might find this link helpful:
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[Treehouse1]

Hi . First of all thanks for the replies. I thought i had rad it can cause thickening/endometrial cancer  when unopposed so this has put my mind at rest. The pudendal nerve block is ‘last resort’, or close to, to numb the nerves around there so less sensitive to pain, as some suspicion the nerve is compressed or damaged  which may be adding to the problem, xxx

[CLKD]

All I can say to that is OUCH !  Have U suffered a prolapse ever? 

VA is due to a loss of oestrogen causing the body to become dry, inside and out.  As well as laxity of muscles = aches and pains.  Up that VA treatment quality of Life is important.

[Feather]

Hi Treehouse1, I had never heard of vulvodynia. May I ask when does the type  of vulval discomfort you get with VA actually become vulvodynia? Is it to do with how long it lasts?

[Treehouse1]

Hi there, no i have not had a proplapse but many years ago it literally felt as though i had, such was the heaviness in the pelvic area.
Re symptoms, pretty similar to va. It produces a burning stinging pain most of the time, inability to sit for any length of time as this irritates it. Even the slightest touch, dabbing yourself after urination is like torture, The pain management people say it may be the pudendal nerve. It sits near the sciatic nerve and comes out the pelvis and forms a hammock of lots of tiny nerves underneath the vagina . Its horrible.