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[Snowcat]

Ok, so I went to the GP the other day as I was in so much pain.  While she was examining me she kept saying ‘oh dear - you poor thing!’ (slightly alarming!) then she said the vulval skin was so raw and thin it was tearing - she said it looked like trauma!

She asked me how often I was using the estriol cream (I’ve been using it for about a month) so I said I was using it every day (in line with the practice nurse’s advice - she deals with women’s health issues) and the GP said ‘oh no, you should only use it twice a week!’ Why would she say this having just seen the state I was in? Then, while I was still in there I got a text from the practice nurse saying she’d just prescribed me 3 extra tubes so I could use liberally as often as I liked!!! I’m assuming there’s no harm in using it every day until it improves? - not from the point of view of the amount of estrogen but from the point of view of the damaged skin. It seems every GP you see has different opinions.  One said I couldn’t use that AND vagifem (I’m only using the cream on the labia) so I soon put her right about that.  Then the pharmacist asked what I was doing with all the cream and the pessaries! She was fine about it when I told her I was under gynaecology but it seems you have to fight all the time just to get better when you least feel like it.  I wish they could change places with me for a day then they might have a different view! All of them are very kind and sympathetic- no dragons lol! But I wish my old GP was still there - he used to say ‘just tell me what you want and you can have it!’ 😂

[Dierdre]

I use Estriol every day on the labia and have done for years. A tube lasts me 3 weeks on repeat prescription, I get 2 tubes every 6 weeks. I also use vagifem every night. Your practice nurse has given good advice and you need to use every day until you are better. You may be able to reduce the amount used to a lower maintenance dosage when it's under control but you will know your needs by then, some will always need it daily.

[Ayesha]

Don't be confused anymore, listen to your practise nurse, she knows what she's doing. Mine is exactly the same, an absolute diamond and well trained in menopause and HRT matters.
Such is the state of women's health in the UK, some GP's have no idea of the treatment for GSM symptoms and it seems the nurses are doing all the training and are wonderfully up to date.

As for my GP when he questioned my use of both treatments and the dose I was using, once I explained what I needed and what is allowed he was fine with it. My treatment is Vagifem daily, a smear of Estriol twice daily and the tube will last me 3 months.


 

[Snowcat]

Thank you all for your kind support and encouragement- I don’t know where we’d be without a forum like this - seems like we should all set up our own practice.

 A wise Gynae once told me that ‘when you have a chronic condition you become your own expert and it’s a wise doctor to listens to such patients as they will undoubtedly know more!’ Sadly I live too  far away to see him now!

[Ayesha]

A wise Gynae once told me that ‘when you have a chronic condition you become your own expert and it’s a wise doctor to listens to such patients as they will undoubtedly know more!’ Sadly I live too  far away to see him now!

I love this quote, its exactly the response I got from my new GP when I was discussing what I needed and not what he was going to prescribe. After five years of treating my GSM symptoms, he knew I knew best.

[Snowcat]

Hi Ayesha, I know.  It’s such a relief when you come under the care of someone who’s humble enough to know that the patient isn’t stupid! It should be a partnership. 

Another quote I like is one where a patient was told by a doctor ‘don’t confuse what you know with my 5 years at medical school learning about your condition!’ and she replied ‘and don’t you confuse your few moments learning about it at medical school with my 25 years of living with it!’ 

[Ayesha]

Another great quote. I also think this kind of assertiveness comes with age and how long you have suffered with a particular condition, experience and knowledge here of the subject is everything and a good GP knows and understands that.

[Snowcat]

Absolutely right Ayesha- I don’t always find it easy to be assertive especially when I’m in pain as you feel so vulnerable and desperate for help.  But definitely being forwarned is being forwarned! I’m better if I know what I’m going to say if challenged.  I just wish we didn’t have to fight those who are meant to be on our side.  Having said that my surgery and local hospital is excellent so I shouldn’t really complain - others have much worse experiences. 

[CLKD]

Morning.  Your GP needs    The info in the leaflet in the box of VA treatments is out of date, Dr Newson is trying to encourage manufacturers to alter it. 

The active ingredient is very small so we can use every night when necessary.  When my symptoms niggle I use an 'extra' application mid-afternoon then do a  5-7 reload every night.  Once I found a regime that works for me I have stuck with it.

[Snowcat]

Morning.  That’s good to know.  My GP is newly qualified so I thought she might be more up to date in these things.  She’s very kind and sympathetic though so I have great hopes for her! 

I’m in a lot of pain this morning.  After she examined me and looked more stressed afterwards than I did, I’ve been Using the Ovestin twice a day and a little hydromol ointment but I woke up in agony at 3am with the usual left sided labia pain, raw, stinging, mild itch feeling.  I’ve been a bit dehydrated over the past couple of days so maybe that’s why, or ot could be trying out these so called vulva relief cushions - I just don’t know - I wish I did as then I could avoid it! I also missed a couple of doses of Gabapentin yesterday - I’m akways trying to manage on the least amount of drugs as I can - I’m meant to be on amitriptyline as well but that seems too much and I’ve take that drug for my fibromyalgia & bladder pain syndrome before.  and it didn’t do anything then. The only thing that works is oramorph but that gives me migraines!!

I’ve got to drive to the hospital on Tuesday and I’m dreading that plus a hair appointment I’ve postponed on so many occasions that I is resemble rapunzle with roots! Something needs doing! I know it’s still early days but I was very disappointed that the skin is still tearing 2 months in to treatment ..

[CLKD]

I use KY Jelly to moisten any extra sensitive areas or a little estriol gently applied.