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[CLKD]

Devon66 - a little on the end of a finger inserted inside the opening and as the walls get plumped up you will find it easier.

[Devon66]

Thank you - I’ll give that a try tonight.
It feels like broken glass at the moment.

[CLKD]

That's a good description: for me it was like sitting on razor blades 

[Northerngirl]

Sorry for jumping on your thread ladies but I've been taking note of this for the last few days.
Sprush1 did you try the vagifem? If so how are you going ....early days I know.
I've been suffering with the VA like you and many others on MM . I've just been to see a lovely GP and she's prescribed Vagifem. I like you am still a bit apprehensive to try it ....especially with last years scare for endometrial thickening.  I was given the all clear but still worry about using anything, especially something so close to my womb.
I know how safe it is supposed to be....but how long has it been around to make these claims etc. I've looked at Ayesha's link and it's very interesting but my stupid brain is still stressing as usual.
Ladies advice please 😊

[Ayesha]

It doesn't go near the womb, its topical only and not systemic, so safe you can now buy it over the counter.

[sprush1]

Northerngirl I haven’t tried the Vagifem yet.
I’ve been using vitamin e capsules ( piercing the capsule to release the liquid first) and this has taken the edge off my burning and aching.

I’ve recently watched a very interesting You Tube video about VA/GSM.
It’s by a Dr Kelly Casperson MD who is a urologist working out of Washington DC. The video was broadcast about 3 months ago so it’s up to date.
You might have to freeze frame whilst watching to read the references to treatment etc.
she regularly posts under the name of Grand Rounds in Urology.
She makes an interesting statement about not feeling it necessary to do the holding dose regime when starting vaginal oestrogen. Also she says that it is acceptable to insert the tablets/pessaries lower down the vagina which might help with any possible side effects.
Maybe someone could watch it and post their thoughts?

[Northerngirl]

Northerngirl I haven’t tried the Vagifem yet.
I’ve been using vitamin e capsules ( piercing the capsule to release the liquid first) and this has taken the edge off my burning and aching.

I’ve recently watched a very interesting You Tube video about VA/GSM.
It’s by a Dr Kelly Casperson MD who is a urologist working out of Washington DC. The video was broadcast about 3 months ago so it’s up to date.
You might have to freeze frame whilst watching to read the references to treatment etc.
she regularly posts under the name of Grand Rounds in Urology.
She makes an interesting statement about not feeling it necessary to do the holding dose regime when starting vaginal oestrogen. Also she says that it is acceptable to insert the tablets/pessaries lower down the vagina which might help with any possible side effects.
Maybe someone could watch it and post their thoughts?

Thanks Sprush1 , thanks for your reply. I've not started the vagifem either.
I will give that video a watch for sure.

[Devon66]

I’ve just watched the video - very interesting. Thanks Sprush1
https://www.youtube.com/watch?v=nb1tjdXLVec

I’m thinking of not doing the 4 week nightly and going straight to twice a week. It does make more sense. It evens it all out. And if there is no reason for the high dose start then I would rather not do it.

I’ve used the Estriol twice and I’m  feeling very uncomfortable. I managed to get the plunger in but must have gone too far on the 2nd night because there was blood on the end of the plunger!
And this might be too much detail but today it felt like my front bits had swelled up and then dropped. I went for a walk and felt discomfort.
I woke up with a headache too - I expect to have side effects but the effect on my front bits was a shock. Is that just part of post menopause or is that over use of oestrogen, I wonder 🤔

[Devon66]

I’ve just checked and I’ve been diagnosed with atrophic urethritis. And thinking about it all, rereading the posts on this thread….I think I’d better continue with my 4 weekly nightly dose of oestrogen as prescribed by my GP. But I’d really welcome any thoughts on this.

[Ayesha]

I watched the video and my thoughts are GSM (Vaginal Atrophy) is a very individualised condition, it can and does affect us all differently. When I was first diagnosed I followed the instructions in the leaflet, I did the two week loading dose of Vagifem then reduced to two a week.
After a few weeks this dose was having no effect on my symptoms, I phoned my GP and she said use the Vagifem daily and also gave me a prescription for Estriol to use on the outside, a tube will last me three months or more.
Four years on I am still on a daily dose, I have experimented with reducing but the symptoms immediately come back, it seems GSM symptoms are always on the surface ready to flare up at any time and sometimes for some of us a daily dose is the only way to keep it under control.

I was lucky that I didn’t have any side effects of the oestrogen when first started to use it but I know some do, my advice is to find your own regime, you have the ammunition to fully take control of the condition and It’s safe to use.

Listening to doctors like this in the video can make it all sound like its all a big deal, its not, the solution is simple we are not talking systemic HRT here just  topical oestrogen to relieve a very nasty condition, a condition that will get worse if not treated and is for life.

[Devon66]

Very good point Ayesha. It could take a while to find the right solution for each individual.

[sprush1]

Update on my saga!

I started a UTI on Sunday ( don’t think I’ve got rid of the one since January really) and had a GP phone consult on Monday, who prescribed another 7 day course of Nitrofurantoin and this GP booked me in to see the Menopause GP at the same clinic, today. I’d dropped off a sample on Monday and an in house dipstick test showed Blood, Protein and Luecs. Sample then sent off for analysis.
At my appointment earlier the Menopause GP did an internal exam ( which was fine as I’d used plenty of Yes moisturiser). She said that my VA was fairly mild in my vagina and cervix and the vulval area was ok. I told her that I’d taken 2 of the Vagifem that was prescribed recently but had stopped as I had dreadful headaches.
She has prescribed Blissil gel. If there is no improvement after 4 months then I can try Prasterone. I asked about Ovestin/Estradiol but she said no to that.
She has also suggested I get a vibrator and recommended a company called Pelvic relief.co.uk. Her suggestion was the Kaito Sky one at a price of £49 plus delivery.
I asked her about my recent urine sample and the results back from the lab showed mixed growth and she wasn’t concerned about that as she said that’s normal.
She seems to think that my UTI’s aren’t necessarily related to VA and I could possibly need to be referred on for a Cystoscopy. I last had one of those 30 years ago when I was told that I had a birth defect in my urethra as it hadn’t grown with me.
Another interesting comment she made was that as it’s 25 years since my menopause when one introduces oestrogen to the body it can cause the side effects as the brain wants to reject it.
I’ve not looked it up but I’m guessing Blissil gel is a lower dose.
Feeling completely wrung out from it all to be honest.
I do realise though that I’ve been very fortunate to have seen this menopause GP so quickly bearing in mind she only works 2 days a week as she has her own private menopause clinic.

[CLKD]

Criky don't medics have such different ideas for the same condition.

We are talking about a loss of oestrogen = dryness inside and out.  Devon66 - whilst this is your personal choice, twice a week may not be enough for years until your vagina is plumped up with appropriate treatment.  Do B prepared if twice a week doesn't help to do a complete loading for 2-3 weeks every night.  Let us know how you get on.

I don't think sprush1 that the brain rejects menopause.  It's a naturally declining of natural hormone levels. 

Most urine samples dip stick tests show blood, protein and luecs.  It's the amount shown that is important.  DH's bloody sample came back as e.Coli. Interesting that you have a birth defect, has this been followed up over the years?  A cystoscopy will give you a base line from which to work.

As the video is from the US I won't be bothering to watch as we have plenty from dedicated menopause clinicians in the UK.  I will add that when my symptoms niggle I use an extra treatment mid-afternoon with 2 Nurofen to ease the nip as the urine flow shuts off.  I've been using treatment for many years now with good GP support and am aware when symptoms might become troublesome. Initially when restarting I did experience a repeat of symptoms the next day which went once I was back to 5-7 days reloading.

Until appropriate VA treatment is used the condition is unlikely to improve.  Rarely does a woman need surgical intervention due to the vaginal lips 'glueing' together but it has been known due to dryness, pain and the reluctance to insert anything to ease symptoms. 

[Devon66]

Thanks CLKD.
And don’t want to take over Sprush1 update - it sounds like you’ve got a lot going on.
But here’s my update:
I told GP about some side effects which I’ll list below. She said they weren’t usual side effects, but I think from reading on MM here that most are, it’s just that I seem to be experiencing a broad range of them.
GP suggested trying every three nights instead of every night. I’ve done a week of estriol every night and I’ve had two nights without and have been ok. A slight broken glass feeling last night. But much better today.
 I even managed to do a bike ride today (I usually cycle 2 or 3x a week and haven’t been able to since starting the estriol).
It’s the third evening so I do the estriol cream again tonight.
Side effects affecting me in this first week:
*Headaches (first few days only)
*Stomach ache - every afternoon worse with eating. Very bloated - set off IBS.
A lot of wind. Painful when wind gathers.
Feels like stomach or womb is bottoming out. When sit down pain shoots up inside my body. This is mostly in the morning. Need hot water bottles on back and tummy whenever I can, evening and night to ease my tummy
*Labia is swollen, or plumped up might be a better word. Also discharge. Strangely, at the same time, labia feels like it’s just hanging down as if all my front bits are hanging. Walking was uncomfortable with swollen labia and discharge but it was Ok after first week to walk again.
*sometimes, for stretches during the day, I feel like need the loo all the time. Also have this strange feeling like I have a tampon stuck in - half in half out
*I’ve felt fatigue and a general feeling of not being ‘with it’, like I can’t remember the words for things
*Internal ache right side under breast and sometimes lower down by right hip.
*Jaw ache
When I first had paracetamol it did nothing but the second time it did ease aches. I’m on daily Asprin for a heart issue so am wary of taking nurofen or ibuprofen.
I’ll carry on with this every three days and see how it goes. I’m seeing the GP tomorrow (unfortunately a male GP) about getting IBS meds again.

[CLKD]

OUCH!