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[Ayesha]

I have just had an argument over the telephone with a late night pharmacist. I have had to stop taking my usual estriol cream, as one of the ingredients is causing internal burning. However, I am now getting burning symptoms from not using it. As I am away from home, I though I would try some over the counter Gina estradiol pessaries. First I was told he couldn't sell it to me because it was for thrush. When I explained my symptoms and what I normally used for this, he said Gina was a contraceptive and I'd need a prescription for it. I tried again and said it was available over the counter for VA for women over 50 with pharmacist approval, is advertised on TV etc, he then said he didn't stock it.   

I had to give up at this point, in despair. I hope I have better luck tomorrow at Boots.

I remember when Gina first became available I popped into my usual pharmacy and asked if he had it in stock as I wanted to buy some as a back up. He said he hadn't heard of it but immediately looked on his computer and said ahh yes, I can order some for the following day. It should be this simple, what a plonker, your pharmacist just couldn't be bothered could he!

Boots should definitely have it in stock and I hope you manage to buy some tomorrow. It seems every day is a fight day, my favourite new saying!!

[chopsuey]

Managed to get some from Boots, from somebody clued up. Expiry date is 02/25 though. The pharmacist said it was only the second box she had ever sold, due to the cost. I was desperate though, so just pleased to be able to get some.

Next battle it to get some 0.01% estriol from the GP, as it's a lot more expensive, assuming I get on OK with it.

[CLKD]

Don't worry about expiry dates.  Everything has to have them at the moment.  I rarely look at the boxes, in 2023 I used 2019 tubes of 'ovestin' without problems .

[Dandelion]

It was not his greatest day when he told me that he wanted a word about the pessaries in my prescription and the fact that the leaflet in the Vagifem box says two pessaries only a week, he didn’t get the chance to say anything else, a red rag to a bull situation occurred.
I wasn’t rude in any way but I told him no, no, no that leaflet is out of date and I am tired of women having to justify themselves for what is required to control a nasty condition. I explained a gynaecologist prescribed my dose and that shouldn’t be questioned in any way.

This all taking place in front of other customers but as I explained to all and sundry that I didn’t care about what people heard me say, I will always fight for what women need and as I said this a woman patted me on the shoulder and said well done, the whole situation was surreal!

I said a lot more but in finishing I did say to him I am not getting at you but please don’t say this to any other woman about this medication as she should not have to justify herself and be left to continue her treatment without interference. He was silent most of the time but he did say he wouldn’t mention it again.  As I left I think I will always remember the dear old man sitting in the corner waiting patiently to be served with an enormous smile on his face, bless him.

As I returned to the car park a woman about my age came running up to me and asked what is the name of the pessary I was talking about, it was a brief conversation but she explained to me about invasive procedures she has endured all with great embarrassment to her, resulting in her still peeing constantly and still in a lot of discomfort. I wrote down the name of the pessary and told her to make an appointment not with the GP but with the nurse practitioner as we both attend the same surgery and I know how amazing she is.
 
What happened to that once shrinking violet I once was, oh yes she aged disgracefully 

Sorry you had this unnecessary hassle.
I am due to see my GP next week over urinary symptoms and am going to ask for a hormone for down there.
I don't mean to contradict you, it's just I am learning myself and the NICE guidelines say twice a week, is this not enough to not only get rid of the symptoms but prevent further ones?

[CLKD]

NICE guidelines and the leaflet in the box need updating!  VA treatment can be used every night when necessary.  Get a copy of 'me and my menopausal vagina', read and hand over to the Practice manager ;-)

[Ayesha]

I am due to see my GP next week over urinary symptoms and am going to ask for a hormone for down there.
I don't mean to contradict you, it's just I am learning myself and the NICE guidelines say twice a week, is this not enough to not only get rid of the symptoms but prevent further ones?

Ah, the NICE guidelines, not very nice to make women suffer because they can't be bothered to change the usage instructions in the leaflet which I believe relate back to when the pessary was of a higher dose.

I have experimented with dosage and it soon became apparent that I need to have a pessary daily and when it wasn't completely clearing my symptoms I started to use Estriol cream to apply on the outside and apart from the occasional flare up I can honestly say I am symptom free.
We are all different when it comes to treating GSM and what dosage will work for us, therefore we have to find our own way of treating this horrid condition without the interference of a lot of medics who know very little of the condition themselves.

These are the guidelines I follow:
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[chopsuey]

I couldn't believe the extensive medical questions I had to answer in my interview with the pharmacist in order to get some OTC Gina the other day - it was as though I was about to start systemic HRT! Quite ridiculous. Unless you know the 'right answer' to give, you may well be refused it when in fact it is not a risk for heart disease, breast cancer etc. No wonder they are not selling much of it. 

[CLKD]

It was never going to be easy for women to access VA treatments OTC unlike Viagra 

[Dandelion]

I am due to see my GP next week over urinary symptoms and am going to ask for a hormone for down there.
I don't mean to contradict you, it's just I am learning myself and the NICE guidelines say twice a week, is this not enough to not only get rid of the symptoms but prevent further ones?

Ah, the NICE guidelines, not very nice to make women suffer because they can't be bothered to change the usage instructions in the leaflet which I believe relate back to when the pessary was of a higher dose.

I have experimented with dosage and it soon became apparent that I need to have a pessary daily and when it wasn't completely clearing my symptoms I started to use Estriol cream to apply on the outside and apart from the occasional flare up I can honestly say I am symptom free.
We are all different when it comes to treating GSM and what dosage will work for us, therefore we have to find our own way of treating this horrid condition without the interference of a lot of medics who know very little of the condition themselves.

These are the guidelines I follow:
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

Thanks for the link.
Oh! dear, the system is bad isn't it?
There's an out of date insert in the box of body identical oestrogen patches saying they are risky. The old school synthetic ones are but not these.
I feel like women are being failed.
Some women are not getting the oestrogen they require because of a licence.
Others are being given not enough vaginal cream.
Others are refused testosterone, even though it's a game changer for many (not just talking about sex)
I think the Gold Standard is that prasterone stuff Dr Louise Newson goes on about, as it has estradiol and testosterone in, yet the NHS won't fund it.
Any mad cynic would think there is a long standing ongoing genocide programme for women.

[chopsuey]

It was never going to be easy for women to access VA treatments OTC unlike Viagra 

So much misogyny in the medical/pharmaceutical world.