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[Shoefreak]

Hi all.
First time posting.
I've been taking vagifem since 2021.GP who prescribed it said to use as needed. So I've done 2 week loading on a few occasions. I'm also on evorel conti 75...so a patch and a half.
For the last month I've noticed my bladder symptoms returning, so I've just finished another 2 week reload, but symptoms still there. Also quite sore at vaginal opening.... So I've tajen it upon myself to carry on with daily use.
Can't speak to GP for another 2 weeks.
Using yes vm externally as well.
My question is, can I double up and use 2 x daily?
One in the morning one before bed?
Main symptom is feeling the need to pee, even when I've just been.
No uti.

Thanks all

[CLKD]

Yes, yes, yes.  What ever it takes to remain comfortable, despite wha the leaflet in the box suggests: this seems to be where medics/pharmacists get their idea that twice a week is 'enough'.  Wrong!

When symptoms niggle for me I put estriol into the vagina mid-afternoon along with swallowing two Nurofen to ease the nip as the urine flow shuts off.  It also helps with the feeling of a full bladder.  Plus using the estriol every night for 5 [which suits my body these days] whereas some do require nightly for years.

Does the YES VM help?  Some find 'vagifem' plus a smear of 'estriol' also works, it's a bit swings and roundabouts.

Let us know how you get on?

[Shoefreak]

Thanks for your reply.
I haven't been prescribed any cream and the yes helps a little.
It's the 'after going' niggle that irritates me.
I've also noticed, today that my labia have gone really thin... They were quite plump at one point.
Thankfully my surgery just reissue prescription when need, so I think I'll try 2 x daily.
Is 2 at once better or one in morning one at bedtime?
Strangely there's no irritation when I wake up and go, it starts during the morning 🤔

[CLKD]

It is a personal choice.  I would add 1 in the morning ....... so that there is a gradual moisture replacement unless you get sticky, then mayB 1 in the evening and the 2nd B4 bed?

Sadly as oestrogen levels drop so skin may thin, which is why some get very fragile body skin.  When I took my PAT-dog to one home a resident asked me not to let her jump up as she feared breaking the skin on her legs which might result in infection.  My dog didn't jump ;-)

 

[Shoefreak]

Thanks for the advice 😊

[Minusminnie]

Hi all.
First time posting.
I've been taking vagifem since 2021.GP who prescribed it said to use as needed. So I've done 2 week loading on a few occasions. I'm also on evorel conti 75...so a patch and a half.
For the last month I've noticed my bladder symptoms returning, so I've just finished another 2 week reload, but symptoms still there. Also quite sore at vaginal opening.... So I've tajen it upon myself to carry on with daily use.
Can't speak to GP for another 2 weeks.
Using yes vm externally as well.
My question is, can I double up and use 2 x daily?
One in the morning one before bed?
Main symptom is feeling the need to pee, even when I've just been.
No uti.

Thanks all

Could you not carry on with daily dose and see how that goes until you can speak to a GP and then perhaps ask for estriol cream where you are sore at vaginal opening.
Increasing to 2 vagifem a day means 20mcg a day = 140mcg a week.
Just seems too much of a leap to me and may leave you nowhere to go to try at different levels.

[Borchesterlass]

I’ve been using victory oil as a moisturiser as well as the vagifem . It’s not messy and has been a great help . I also cut out caffeine and alcohol . This really helps bladder issues .

[Ayesha]

I've been on daily Vagifem for five years and recently had a flare up due to sciatica.
I increased to two daily, one in the morning and one in the evening, I am also using Estriol cream twice daily to smear on the outside, a tube will last me three to four months. I will add that I am not on systemic HRT but you might find the addition of the Estriol cream beneficial.

You should find the information in this link helpful.
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[Shoefreak]

Hi all.
First time posting.
I've been taking vagifem since 2021.GP who prescribed it said to use as needed. So I've done 2 week loading on a few occasions. I'm also on evorel conti 75...so a patch and a half.
For the last month I've noticed my bladder symptoms returning, so I've just finished another 2 week reload, but symptoms still there. Also quite sore at vaginal opening.... So I've tajen it upon myself to carry on with daily use.
Can't speak to GP for another 2 weeks.
Using yes vm externally as well.
My question is, can I double up and use 2 x daily?
One in the morning one before bed?
Main symptom is feeling the need to pee, even when I've just been.
No uti.

Thanks all

Could you not carry on with daily dose and see how that goes until you can speak to a GP and then perhaps ask for estriol cream where you are sore at vaginal opening.
Increasing to 2 vagifem a day means 20mcg a day = 140mcg a week.
Just seems too much of a leap to me and may leave you nowhere to go to try at different levels.

I know it seems a lot, but it would only be until symptoms got under control.
The loading dose used to be 175mg a week for 2 weeks.... So 140 isn't that much 😊

[sheila99]

If it's the outside that's the problem you might use estriol 0.1%cream on the outside as well as vagifem. Vagifem does nothing for me outside (v. painful urethra).

[Shoefreak]

If it's the outside that's the problem you might use estriol 0.1%cream on the outside as well as vagifem. Vagifem does nothing for me outside (v. painful urethra).

It's both tbh. The constant feeling of needing to pee and the soreness at the opening.
😊

[Shirazette]

After 9 years on Vagifem (twice a week) which worked beautifully, things started going wrong again (was 13 years post meno) I did a 3 week reload which barely made any difference, and also briefly tried 2 twice a week. Meno specialist (private) saw that atrophy had returned and suspected that the pessaries weren't melting. She swapped me over to Imvaggis (estriol) which is a bullet shaped waxy pessary which melts readily. I did a 3 week load and then twice a week. It did take quite a while to get completely back to normal and I did increase it to every other night to speed things up a bit but it's worked for me.  GP wouldn't change my prescription from Vagifem so I had to pay for it, however, happily, a year later (3 months ago) had lovely gp for my prescription review and she changed it straight away even though she'd never heard of it!

It has made me wonder sometimes whether this could be happening to other women who have difficulties with the tablet pessaries.

[bombsh3ll]

Absolutely you can.

Even those who believe incorrectly that systemic estrogen is dangerous can be reassured by the absolutely negligible absorption of vagifem.

In fact the standard dose of vaginal preparations used to be much higher, and has been progressively shrinkflated over time without regard to maintaining efficacy.

Two other points I would make are a) that it is still possible to get an actual UTI or thrush, and these should be considered if symptoms not responding.

b) if you are experiencing pronounced urogenital atrophy as suggested by the loss of your labia on your current regime, I would think about whether other estrogen responsive tissues in your body are receiving adequate treatment as well and maybe review your systemic therapy.

My personal view is that urogenital atrophy should prompt a review of systemic treatment, as the vagina is like the canary in the coalmine and gives a helpful indicator as to whether the individual is well estrogenised as a whole.

Of course there will be those who cannot or choose not to take or increase systemic treatment, however it is far better that this is considered and an informed decision made, rather than subtherapeutic treatment just accepted as the default.

[Minusminnie]

If it's the outside that's the problem you might use estriol 0.1%cream on the outside as well as vagifem. Vagifem does nothing for me outside (v. painful urethra).

Sorry to read in your recent posts that you are now in the burning club that noone really wants to join.

Did this start happening to you with having to use Estraderm rather than Estradot because of the shortage ?  I have this homespun theory that changing HRT lets the VA start up. 
I have never been on systemic myself my VA came about with age and lack of oestrogen.
Don't reply if you don't wish to.

Feel all round that VA/GSM needs more research .....

[sheila99]

If it's the outside that's the problem you might use estriol 0.1%cream on the outside as well as vagifem. Vagifem does nothing for me outside (v. painful urethra).

Sorry to read in your recent posts that you are now in the burning club that noone really wants to join.

Did this start happening to you with having to use Estraderm rather than Estradot because of the shortage ?  I have this homespun theory that changing HRT lets the VA start up. 
I have never been on systemic myself my VA came about with age and lack of oestrogen.
Don't reply if you don't wish to.

Feel all round that VA/GSM needs more research .....

I had it mildly before but it got very much with the change to estraderm along with other meno symptoms returning. I don't think I absorb very much from estraderm but even 100mcg estradot isn't enough now to control either va or meno symptoms. Having resorted to 2x100mcg estraderm patches (still not enough) I'm now using 2xestradot and finally I can walk without wetting myself.  I have an appointment with Newson soon as the only option for a decent quality of life seems to be going private. The NHS meno clinic thought they'd replace 100 patch with 2 pumps lenzetto