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[Sunnyangel]

Am new here and hoping for some advice.

I am 60 and went through the menopause about 8 years ago. I have never taken either the pill or HRT and have no other medical conditions or prescriptions of any kind.

VA crept up on me over a year or two but I didn't know what it was at the time and didn't realise that symptoms were connected to one another until I finally read something that clarified it for me.

To cut a long story short, I have been prescribed Estradiol 10 mg topical vaginal hormone tablets and am just still in the loading phase of one a day at the moment. I have had a number of side-effects but they seem to be diminishing a lot and it has started to help. I'm still needing the loo more frequently than I used to but some days I have gone for hours without needing to go. The UTI feeling has mainly disappeared. I'm getting up only once in the night.

In addition I have been prescribed a 1mg Estriol cream to use on sore external areas and have bought over the counter Yes gel ( isn't prescribed) to treat sore area just inside the vagina- it seems to help a bit.
So, that's my situation, here are my questions.

GP not very sympathetic. I asked what happens when I come off the loading dose and start to take it 2x week if my symptoms start to worsen. She said that I would be on the recommended dose and would have to wait it out (even if symptoms start to worsen) for 3 months (!!) to let things settle before she would refer me. And who knows how much longer that would take?!!!
Can that be right? I know it hasn't happened yet but I wanted to feel reassured that I won't have to let the symptoms get worse , if they do, before adjusting the dose and now I just feel worried. I thought the dosage was so low that increasing it would be ok and many women require more than 2x week.

Estriol cream external application making external areas more sore at the moment. Do I continue as per doctor's instructions which are to use it 2x week?Is it too strong? I am only using an amount equivalent to half a pea.

I am confused about how I could use a non-hormonal vaginal moisturiser alongside Estradiol tablet. Before? After? The next day? GP no help at all.

I have had no examination even though I expressed my concerns that I might have a small prolapse. The GP's attitude seems to be don't bother me again until your 3 months is up.

I feel worried and demoralised now so please ladies, I'm feeling needy and I really, really want some advice or at least some sympathetic vibes coming my way if you can help me.

[Snowcat]

Hi Sunnyangel.  Firstly, I’m so sorry that your GP has been so unhelpful - I sometimes wonder if it’s because they just don’t know! You will get a lot of help and support on here, so welcome! The lovely ladies on here have really kept me going.  I’ll try to answer your questions in order.

The estradiol pessaries (I use vagifem) are perfectly safe to use for as long as needed - I’ve been using them for years. You can use them daily if needed and if your GP won’t prescribe more for you, you can buy them under the name of Gina.

The estriol cream when used for the outside bits (which is what I do too) does often sting in the early weeks of treatment - if you do a patch test on the inside of your wrist and don’t have a reaction, the soreness/stinging you experience is usually because the vulval skin is typically thin and damaged and although the cream is making it sore, it is working and as the skin heals, the stinging should lessen.  I’m finding that anything I put on it stings - imagine if you had taken the top layer of skin off your arm and then put something on it - I guess it’s like having a burn down there really.  Estriol cream takes time to restore the damaged skin so a lot of patience is needed.  As I’m discovering!   Both the pessaries and the cream are safe and can be used as often as needed - some have used both daily for years.

Maybe get some up to date info on HRT to give to your doctor - maybe send it to them for them to peruse before your next appointment.

You will get more advice on here from those more experienced in all this than I am but I wanted you to know you’re not alone and you will get there!
 

[Snowcat]

BTW it might be worth asking if there’s a dedicated menopause clinic nearby you could go to (you don’t normally need a referral) Also with the moisturisers - and there are many to choose from so it’s a bit of trial and error but I’ve learnt that the water based ones can be used anytime but the oil based ones shouldn’t be used at the same time as the estriol cream so I’d think cream at night and moisturiser in the morning.  Best to look for ones with the least ingredients and always do a patch test. Hope this helps!

[Sunnyangel]

Many thanks for sharing your experience Snowcat.
I will check out your suggestion of a Menopause Clinic later today. I just don't want to go back to my GP yet but I do need more advice.

[Ayesha]

I think your GP is doing a good job, to actually prescribe Estriol cream alongside the Vagifem, some women here have to practically beg for it, you're off to a good start at least.
The best advice I can give you is to read up on everything to do with this condition, search the forum and read posts that will be very helpful to you.
It's what I did because I also had never heard of GSM (Vaginal Atrophy) and how bad it can get, plus the fact not many medics knew about it either, that was the biggest shock.
I am at the stage where I tell my surgery what I need to control my symptoms, I've only been able to get to this stage by studying GSM myself.

A couple of links that will help:
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf
https://www.menopausematters.co.uk/forum/index.php/topic,64837.msg895647.html#msg895647
https://www.menopausematters.co.uk/forum/index.php/topic,22886.0.html

[CLKD]

 

[Sunnyangel]

Thanks Ayesha. I will read the information on the links. I can't believe I didn't know about any of this before and I obviously need to get up to speed so the links will be a good starting point.