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[chopsuey]

I have been taking estriol 0.1% (formerly Ovestin) for several years to help with bladder pain and frequency. Although overall it does help, I almost always get a burning sensation internally (I think in my bladder but hard to tell) for a day or so after using it and my urine flow is then quite restricted, as though the tissues around the urethra have become swollen and are constricting it.

I never found Vagifem/Vagirux to be very effective and wondered if the 0.01% estriol would be less irritating. It is made by a different manufacturer and seems to have a lot fewer chemicals in it, which may be causing some irritation.

I wondered if anyone else had experienced this problem and found this to be a better option.

Thanks

[CLKD]

How often R U inserting the VA treatment?

[chopsuey]

Twice a week, usually. I might have tried using it more frequently, to see if that helped but until recently, I was using a low dose of Utrogestan vaginally and was concerned that amount of cream may have interfered with it's absorption, as I used both at night.

The Utrogestan also burned me and I was hoping I would tolerate the estriol better now I have a Mirena, but I'm not.

[CLKD]

It may simply be that the vaginal walls are so thin that anything pushed up will sting. Hence the advice to load every night for 2-3 weeks to plump up the tissues. 

When my symptoms niggle I pop 'estriol/ovestin' up mid afternoon and again for 5 nights .  MayB not put it up too high initially?  As the vagina relaxes with the treatment U can then insert a little deeper every 3rd night until the area feels more comfy.

[chopsuey]

Thanks CLKD. I'm inclined to maybe get a private prescription of the 0.01% estriol, as there does seem to be less in there to irritate and maybe try using that nightly for a few weeks and see what happens. If all goes well, I can either re-try the 0.1% after the tissues are more plumped up or try and persuade the GP to prescribe the 0.01%. It's a lot more expensive for them though for some reason, even though they are both generics.

[CLKD]

Why do U need to pay for what is available on the NHS?      Some find that vagirux which is cheaper irritates.  I wouldn't think that there is much active ingredient in 0.01% which should help at all. 

Some find that 'yes' or 'sylc' products useful on the labia soothing.  Personally KY jelly is my go-to in a hurry 

[chopsuey]

I have struggled in the past with getting my GPs to understand that there is a difference between systemic and topical oestrogen and that I need both. I will need a good case to persuade them to prescribe me something more expensive. They know about the burning I get, so if I say I have tried something that works, they may be more inclined to say OK

According to medicines.org.uk, each dose provides 0.5 mg of estriol, which, bizarrely, is the same as the 0.1%  cream. As it's based on weight, I can only think that the ingredients in the 0.01% cream, which is more oil based, are heavier, so you end up getting the same amount of estriol. 

I don't really seem to have an issue with the labial side of things, fortunately, I do think it is more in the bladder.

[SundayGirl]

According to medicines.org.uk, each dose provides 0.5 mg of estriol, which, bizarrely, is the same as the 0.1%  cream. As it's based on weight, I can only think that the ingredients in the 0.01% cream, which is more oil based, are heavier, so you end up getting the same amount of estriol.   

The active ingredients per dose are exactly the same. With the weaker cream you use 10 times the amount. It's a larger applicator.
With it being a larger amount it's easier to use less of the actual estriol but a larger proportion of moisturising ingredients.

[chopsuey]

Thanks SundayGirl. It would make sense to have a larger amount of cream to get the same amount of active ingredient, although 10 x does seem like an awful lot of cream!

On the website below, it says the dose is 5 ml, which, if that info is correct, is not too dissimilar to that for the 0.1% cream.

https://www.medicines.org.uk/emc/product/12876/smpc

Good to know that they are the same though and I think it will be worth trying.

[CLKD]

Morning. Vaginal atrophy mimics repeated urine infection-type symptoms really, really well!  Let us know how you get on.

[Ayesha]

This is a very useful document to read and it explains all the treatments available for treating GSM in particular when discussing symptoms and usage with your medical provider, puts you in the driving seat! 

https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[chopsuey]

Thanks for posting that Ayesha - very detailed and informative. I shall print that off and have a good read of it, so I can go armed and ready!

[Nain56]

Thanks for sharing that very useful document.

I started getting migraines when I was using 0.1% Estriol so my gynae switched me to 0.01 % Estriol 2x a week but I am only allowed to use half an applicator each time.
So does this mean it would be like using only half a 0.1 Estriol dose? I am a bit confused.
The idea is to lower my Estriol dose but still maintain the 2x a week to see if I can use it without getting a migraine and to deal with symptoms.

The 0.01 applicator is huge so I guess it was easier to half the dose as opposed to half the 0.1 Estriol with its red marker line.

Any help to understand the dosage welcomed.