Print

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

[Shoefreak]

Hi I've been using vagifem since 2021, with great success. I sometimes have to do a reload for two weeks which helps with a flare.
This last flare has been going on for about 5 weeks and taking vagifem every day hadn't helped
GP has changed me to Estriol cream and I'm doing the 3 week load atm. My question is, if this is a lower dose of estrogen, how is this going to help?
Not uti as had urine sent to lab. Have another gp telephone appointment on Friday, but not sure what to ask for.
I know I've only just started with the cream, but surely after 5 weeks of vagifem I should see some improvement 🤷🏻‍♀️
I'm also on evorel conti, patch and a half
Thanks for listening

[bombsh3ll]

Why not use the cream in addition to the vagifem?

I would also think about your systemic estradiol levels as the state of the vagina is a good barometer regarding the health of other estrogen responsive tissues throughout the body that you can't see or feel.

Studies in the 1990s by Sarrell et al showed vaginal atrophy was uncommon when plasma estradiol was above 50pg/ml. (Note US units)

[Shirazette]

Hi, a similar thing happened to me. I was happily on Vagifem for 9 years when my va reared its head again. I did a 3 week reload which barely made any difference. The specialist thought that the Vagifem wasn't melting and put me on Imvaggis which is an estriol waxy pessary which melts easily. This did the trick for me but did take a while to get back to normal.

I believe the pessaries are weaker than Vagifem but because they are estriol instead of the estradiol of Vagifem they target different oestrogen receptors (well that's my basic understanding, please correct me somebody if I've got that wrong) if so it will be the same for the cream.

For me it could be a combination of the melting issue and/or the different type of oestrogen, but it's all a bit of a guessing game.
,

[Dandelion]

Why not use the cream in addition to the vagifem?

I would also think about your systemic estradiol levels as the state of the vagina is a good barometer regarding the health of other estrogen responsive tissues throughout the body that you can't see or feel.

Studies in the 1990s by Sarrell et al showed vaginal atrophy was uncommon when plasma estradiol was above 50pg/ml. (Note US units)

Thank you this is useful. I go to pick up oestrogen cream off the chemist tomorrow, dunno what it is. I assumed it was instead of vagifem 2 x a week, but I might use it in addition.
I hear prasterone is the best, as there's testosterone receptors down there as well. Dr Rachel Rubin the US urologist is the guru of this, apparently, I know of her and she's good.

[bombsh3ll]

Yes, prasterone (vaginal DHEA) is reported to be more effective than estrogens alone, however cost is prohibitive for many. I don't think it is easily or widely available on the NHS, if at all.

Anatomically this makes sense given the presence of androgen receptors.

I personally take oral DHEA which I am very happy with, and gets everywhere it needs to go in the bloodstream.

[juliaC]

Dandelion and Bombsh3ll, I'm interested in DHEA, can you recommend a good place to purchase it?  Thanks 

[MrsMitch]

If you have a look on the forum there are quite a few recent threads that cover this topic. A number of us, myself included, currently have the same issue you do & whatever treatment we use doesn't help the issue. You can see all the different things we've tried.
I've just started Intrarosa, which is prasterone, but had to buy it online as my GP claims it isn't licensed for UK use. We're all at the stage where we've been using as much estriol/estradiol in the area as we can, some 2 products daily some 2 products twice a day.
It does seem very common to have flare ups unfortunately.

[Dierdre]

I use both Vagifem and Estriol cream every day as they do seem to target different receptors. Vagifem didn't reach the outer vulva area but Estriol does.  Although Estriol is a weaker hormone it's effectiveness is not less than Estradiol in the treatment of VA.

[Dierdre]

Just a thought, have you had a swab for thrush? I've mistaken a flare up before that ended up being thrush, I didn't have the tell tale cottage cheese discharge and the thrush caused bladder spasms as was well established and took months to resolve.