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[Nain56]

Hi everyone,
I had estrogen positive breast cancer in 2006 so cannot have systemic HRT.
I am 68.
I have vaginal atrophy. My gynaecologist put me on Ovestin cream 0.1% Estriol cream. It was amazing and really helped but sadly after using it for a couple of months I got really severe migraine with aura. I had not had migraines for about 20 years so it was a huge shock. Owing to the severity and frequency of the migraines I had to stop using the Ovestin.

In consultation with a menopause specialist my gynaecologist has prescribed 0.01% Estriol
(Gynest cream) half an applicator dose to be used 2x weekly.
I have only just started using it but am so anxious about Migraines starting again and neurotic about making sure I measure out only half an applicator dose.

I know this dosage is lower than the Ovestin  but have a few questions and wondered if anyone could help me understand:

                 ***********

1. How much Gynest would be in half an applicator dose compared to an applicator dose of Ovestin? ( The Gynest applicator is huge compared to the  red line marked Ovestin applicator)

2. Are the migraines triggered by a certain level of Estrogen in the blood stream or is it more to do with a rise and fall of Estrogen?

3. Has anyone been in a similar situation re Migraine and using vaginal estrogen?

Sorry for long post and all the questions.

[CLKD]

Migraine headaches may well become worse during peri-menopause and there is a new drug in the UK suitable to help symptoms.

How often were U using the 'estriol'?   Give this new med a whirl, it if helps ease VA symptoms without triggering migraines then that has to help.

In the meantime ask why the migraines have increased?  It mayB that U require an appt with a dedicated menopause clinic, is this something that the Gynae could arrange rather than via your GP?  After all the Gynae will be gaining info too.

A dedicated menopause clinic may know more about hormonal migraines but your GP anyway should be referring you appropriately.  let us know how you get on.

[Nain56]

Thank you. I was using the original Estriol cream 0 1% Ovestin 2x weekly.
I am under the gynaecologist who consults a menopause specialist.
I will keep you updated with progress on theb0.01% Estriol cream.

[chopsuey]

As I understand it, each dose of 0.1% or 0.01% gives the same amount of estriol. This is due to the difference in product weight and amount of cream per dose. This was discussed in a recent thread 'Estriol 0.01% vs 0.1%' on page 3 if you want to look at that.

[Dierdre]

Are you sure the migraines are triggered by the localised estrogen? Twice a week Ovestin is a very low dosage and only a very small amount of that would have gone systemic. In the first few weeks on the loading dose and until the vaginal walls are hydrated some will be absorbed but after that it's very minimal.
Could it have been caused by something else or coincidence?
If you're worried about using too much perhaps apply a small amount yourself without the applicator to begin with.
I apply Estriol (Ovestin) every night this way.

[CLKD]

A friend had background headaches when she began 'vagifem', after the 2 weeks loading when she reduced the headaches went.

[Nain56]

Thank you everyone. So far so good and keeping my fingers crossed that migraines don't  recur.
I appreciate all your comment's.