Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[JanS]

I have been on  Imvaggis pessaries for vaginal atrophy for a good two years now with no problems at all.  Over the past few months I’ve noticed that my  vulva is really sore which is something I haven’t suffered with and I am unable to urinate properly I have been using Yes moisturiser which is a godsend.  I’m wondering if anyone else has had this problem and is it related to being dry basically?  Also, I’m not sure whether I’m inserting this pessary up high enough.  I suppose I’m scared of hitting something I shouldn’t, but I would be grateful for some advice on how far should this pessary be inserted up bearing in mind I don’t have an applicator with this?  I have seen my doctor about this three times in the last week and she has prescribed me estriol 1.0 cream but the Imvaggis is 0.3 I suppose I’m a little bit worried that this is stronger and I might get some worrying side-effects.  I am willing to try anything because this is just so debilitating.   Thank you so much in anticipation.

[Ayesha]

The pessary doesn't have to be inserted too high up, just enough that its comfortable and you don't feel it.
Modified my answer because I didn't read your post properly, use the Estriol its what you need and hopefully you will be fine on it, topical treatment is low dose, no need to worry about it.

[JanS]

Thank you so much for your fast response .  I am presuming they give you all the pros and cons to cover themselves.  I did ask to go back onto HRT but because of my age I am 70 they said it’s too risky so I’m stuck with the pessaries or the cream now.   Hopefully the estriol cream will sort it

[Minusminnie]

Imvaggis is estriol 0.03% on looking it up.
Which estriol cream do you have 0.01% or 0.1% ?

There is an option there to increase the strength overall and use just Estriol cream at 0.1% internally as well as externally. A stronger internal estriol may help your urinary problem more.

[JanS]

Hi the dr has now prescribed Estriol 1.00 which i suspect is a lot stronger.  On looking at the application tube to fill to red line would be less than the size of the imvaggis.  I am going to give it a go and see if it helps.  I think the problem lies in dry skin on the vulva for which i am using Yes gel which is an absolute God send.  Cannot understand why this has now occurred.  Am so fed up with it especially with this heat.

[Shirazette]

Hi, I am on Imvaggis too. I've been on it for 18months now since Vagifem stopped working or me.

I use it every other night and push it up the length of my finger which is what the specialist said to do.

I'm also 70 and went on to systemic HRT 2 years ago (now Estradot 75 with Utrogestan 100) though it wasn't for VA it was for night sweats which I had been having for 13 years and had actually increased to about 6-8 a night. I don't think the systemic has particularly helped with the VA, though who knows what would happen if I were to stop it.

Unless you have a really switched on GP it's probably unlikely you'll get systemic HRT on the NHS because of the age factor so if you wanted to give it a go you might have to shell out and go private.

If you don't have any other bothersome meno symptoms I would give the cream and Imvaggis combinations a good go first, if that doesn't work there are other options like vagifem which are a different oestrogen. You could increase the Imvaggis if you're only using it twice a week and use the cream on the outside but I'm not sure whether the stronger cream you have is only for internal use.

[Minusminnie]

Hi the dr has now prescribed Estriol 1.00 which i suspect is a lot stronger.  On looking at the application tube to fill to red line would be less than the size of the imvaggis.  I am going to give it a go and see if it helps.  I think the problem lies in dry skin on the vulva for which i am using Yes gel which is an absolute God send.  Cannot understand why this has now occurred.  Am so fed up with it especially with this heat.

Likely further depleting oestrogen.  I'm age 70 and wonder at times how far does this all go.    I'm not on systemic HRT and use Estriol both internally and externally.  There are more oestrogen receptors internally but using just internally does not reach the vulva area so helps to rub some there.

If you have been reading the forum others have mentioned that this heat does not help. Your Estriol also needs to be stored at 25 degrees C or below.

If you want an extra or back up tube of Estriol you can buy a tube of Ovesse in Boots. Ovesse is the same as Estriol 0.1% and made by the same manufacturer.

When quizzed at the till (which is likely) i just said that i had already used estriol and was familiar with it. I did not mention that i already have it on prescription. You can also order online as well.

[Ayesha]

I am 75 and use the pessary once daily but only use a smear of the Estriol cream on the vulva twice a day, a tube lasts me three months. I find that the pessary will do all of the work inside and the cream works great on the outside.

I am mostly symptom free but if the immune system is under threat flare ups will happen, I then use two pessaries a day and increase the cream to three times daily, usually after three days I am back to being symptom free again, this is how I have learned to manage the condition. 

I haven't been confronted lately on my use of treatment approved by my surgery, but when and if I do I say you do realise that topical treatment is the equivalent of one systemic HRT tablet a year, what is all the fuss about.

I don't follow the NICE guidelines but the recommendations of the BSSM regarding GSM, my GP agrees.

[JanS]

That is so helpful.  I did try the estriol cream last night wasn’t happy!  Going back to the pessary and use the cream sparingly on the outside and see what happens!  Thank you all so much for your views.

When I saw my doctor in December, she said to me I am definitely lacking estrogen.  I have been doing a lot of research over the last day and looking into foods that mimic estrogen.  I will certainly update you on how I get on. 

[bombsh3ll]

You don't just have to accept your systemic treatment being arbitrarily stopped due to age - this is against clinical guidelines and an affront to your autonomy.

If you can't afford to see someone privately I would print out the relevant section of the NICE guidelines regarding no age based cut offs for HRT and advocating for shared decision making based on an individual risk Vs benefit evaluation, and write to your GP asking for a referral to the local NHS menopause clinic.