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[Therese83]

Hi all, I'm new here! And also new to perimenopause and HRT. I sought help mostly for irritation/rage, among other things. As part of the consultation the Dr asked if I had any problems with vaginal dryness and I replied "I think I've always had a problem with that". So because of this and also bladder prolapse from childbirth, she prescribed vagifem. The problem is though, they keep falling out whole. I read another thread about this where someone suggested maybe too much dryness but I don't think that's my issue. Possibly relevant here is that I've been spotting or having my period since I started using them (so maybe it can't stick?). They mostly don't fall out right away but rather after a few hours. I never got the same vagina back after childbirth (there were complications in my first birth) so I'm not sure if it's all just too lax or if the bleeding is relevant. If anyone has any advice I'd appreciate it. Obviously I'll ask the Dr too but just wondered about experiences.

[chopsuey]

Hi Therese83

When I tried Vagifem, it never dissolved, perhaps because I was too dry, so I switched to cream. When are you inserting it? I would have thought it would be less likely to fall out during the night, if you insert it high up, unless you need to get up for the loo of course. I'm not sure how long it takes for the oestradiol to get absorbed, but I seem to remember reading somewhere it is a couple of hours but I can't vouch for it's accuracy.

[Therese83]

Thanks for this! My doctor had been quite insistent I insert it in the morning, so it wouldn't get in the way of sex at night! However if it persists I might try nighttime. It's also good to know it should be absorbed quite quickly although I wonder if that's still the case if it doesn't dissolve. I was actually able to ask the doctor about it today and she seemed to think it was quite likely to fall out if bleeding. I had been spotting since starting Evorel patches and then had period so hopefully it might improve soon.

[CLKD]

Your GP    ..........  . gravity may well alter how the dry vagina holds onto the pessary 

[Therese83]

Haha I'd have to agree with you, the simplest explanation tends to be the best!! Can I ask though, what DO you do about evening sex, presumably you have to know it's going to occur and do the vagifem afterwards?! As if my life wasn't already scheduled enough 

[CLKD]

We use a lot of lube anyway, any medication I insert after - rompies ;-).

Also what has your sex life got to do with the GP anyway ..........

[sheila99]

You could try the cream instead of the tablet. I thought the tablet was supposed to stick to the wall so a lax vagina or gravity shouldn't mean it falls out. I've had no problems using it on the morning. My GP must have thought I'm past it, she didn't mention sex 

[CLKD]

sheila99 - her time will arrive 

[Dierdre]

Definately insert at night and as high as possible, especially if you still have the prolapse.  If you have sex insert it afterwards. It should stick to the vagina walls but if you are really dry it can fall out but less likely at night unless you're going to the loo alot or having sex.  Ask for Estriol cream as well and use a little inside and also all around the vulva.  The vagifem pessary takes about 24 hours to completely dissolve so it really makes no difference when you have sex. You should beable to use in the morning once you're not so dry.. I had to place it high up when I had a prolapse as it would work its way out.

[CLKD]

   Dierdre

[SundayGirl]

If you switch to nightly insertion the pessary will have more chance of staying put and dissolving as you're not moving around.
I understand where your GP is coming from with inserting in the morning as regards sex but the pessary is obviously not sticking to your vaginal wall, possibly due to dryness, and is just getting washed out with the help of gravity.

[Therese83]

Really appreciate these replies. I do find it tricky to insert because of the prolapse so I basically have to use a finger and pave the way for the applicator with that 🙈 I do think I'm getting it high enough but it is easier some days than others. She seemed to think it was falling out because I had been bleeding, which I guess might have essentially washed them out! I didn't use one at all today as I had mirena inserted yesterday and decided against. I think I'll give it another day or two of trying the morning now that I'm not bleeding and if it doesn't work, I'll just go with nighttime. I have to agree with all those who said it'll get more chance to dissolve that way!

[Therese83]

Ok just in case someone else has this problem in future, who has similar issues to me with prolapse and vagifem falling out - inserting at nighttime has totally solved this for me. Who'd have thought the written instructions could be right after all?!

I did briefly freak out that my prolapse had suddenly got worse then realized... You're comparing first thing in the morning to last thing at night.

[Dierdre]

Really appreciate these replies. I do find it tricky to insert because of the prolapse so I basically have to use a finger and pave the way for the applicator with that 🙈 I do think I'm getting it high enough but it is easier some days than others. She seemed to think it was falling out because I had been bleeding, which I guess might have essentially washed them out! I didn't use one at all today as I had mirena inserted yesterday and decided against. I think I'll give it another day or two of trying the morning now that I'm not bleeding and if it doesn't work, I'll just go with nighttime. I have to agree with all those who said it'll get more chance to dissolve that way!

To insert easier with a prolapse, I used to lay on my back with knees up and lift my bottom up. The prolapse would fall back and out the way.

[SundayGirl]

Thanks for the update Therese 

It's worth asking about these things as just sometimes the lived experiences of women can be more effective than the theoretical ideas of GP's

You may be able to switch to morning use once your vaginal walls are plumped up enough for the vagifem to stay put if that's what you'd prefer.