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[alibeau]

So I just took a phone call from a Nurse.
Apparently I was referred to the Menopause clinic in 2022  and they have a cancellation appointment on Thursday and she was asking if I still wanted to see someone 
I don't even remember being referred 

Anyway, I have accepted the appointment as thought it might be worth going for a chat about VA and weak bladder??!!
Kinda feel like I am wasting their time though?  The GP has okayed me to use oestrogen pessaries 3 times a week instead of 2 - whoopie do... this isn't controlling my symptoms and so I was going to have to approach GP again to see if they would up my usage to daily.

So as I would prefer to use daily so I guess I can talk this through with the Dr?

Am I right in saying the Dr will not prescribe Testosterone on the NHS?  I am mainly interested in this due to my severe dry eye syndrome and wondered if it might help?

Any thoughts on whether I should attend, don't want to take up an appointment that someone else could use? I may well be able to convince my GP to up my oestrogen pessaries to daily but just thinking it might be quicker and easier to sort with Dr this week?

Thanks.

Ali x

[bluebird68]

If I were you I'd take the appointment. Something good may come out of it. If you decide afterwards that you don't feel it will benefit you then at least you have tried. I suffer from dryness and VA and it is a miserable condition. I have not found GPs very knowledgeable but the menopause team are probably better versed. Good luck and I hope you get the right support.

[alibeau]

Thank you.

Yes, after I posted, I started thinking, I’d be mad to pass up the chance to talk through my current issues….

Thanks for replying x

[sheila99]

Your GP may be different but mine won't prescribe vagifem more than twice a week and if I have vagifem I can't have estriol cream for the outside. Menopause clinic can advise your GP to increase it. If you want testosterone it would help if your libido is non existent. Very unlikely your GP will prescribe testosterone except if the meno clinic says you can have it. Many will do a phone consultation now if you don't want to sit in the waiting room for hours.

[Ayesha]

Going by your post you still have issues that they will be able to help you with, you won't be wasting their time. There are too many posts on here about medics not prescribing what we need when it comes to topical oestrogen, it always seems to be a fight and your feedback will be helpful.

[alibeau]

Thank you all.

I think the call took me so much by surprise I just questioned it in my mind.

I have several issues that I would like to discuss with them so having had a moment to reflect, I’m really happy this appointment has come through now.

I think you can sometimes just get a place where you unknowingly accept some symptoms as your new normal…. When they might not have to be.

I’ve made a list of my top six major symptoms and I’ll see if they recommend a new approach to any of them.

Thanks again.

[Snowcat]

My GP gives me 28 vagifem pessaries a month and just says use as much as you feel you need as it’s perfectly safe.  She knows I use estrogen cream too that the practice nurse prescribed and she’s happy about that too - she said do everything you can to keep that area plumped up and healthy.  I’m just hoping it’ll all start working soon but reading posts like this I do wish all GPs were as sensible - VA is hard enough to cope with without a battle - there should be a consistent response - not just a case of happening to be registered at a helpful surgery.  My GP did say that that my info was more up to date than hers but at least she read what I gave her and agreed that my request was reasonable. 

[Talli]

Thank you all.

I think the call took me so much by surprise I just questioned it in my mind.

I have several issues that I would like to discuss with them so having had a moment to reflect, I’m really happy this appointment has come through now.

I think you can sometimes just get a place where you unknowingly accept some symptoms as your new normal…. When they might not have to be.

I’ve made a list of my top six major symptoms and I’ll see if they recommend a new approach to any of them.

Thanks again.

Hi just wondering if you’ve had your appointment and how it went?

I’ve got one booked for next week (after a two year wait…like you Id forgotton about the referral lol) and I’m terrified they’ll tell me to stop using Vagifem internally x4 a week and Ovestin x3 a week externally.
I can barely function on that but using it any less would be horrific!
I also have LS,

[MrsMitch]

Talli there is no reason for you to be told to stop Vagifem & Ovestin. I'm prescribed both for daily use, it's perfectly safe. I also buy Gina online to use 2 pessaries a day when I get a flare up. Maybe print out the GSM guidelines for treatment options so you're armed with the facts just in case you're fobbed off, some of us get it easily some don't. You absolutely do not need to have this condition not sufficiently controlled. Hopefully you'll have a good appointment & can get what you need. Will you update us once you've been?

[Talli]

Thank you @MrsMitch 💖

I will definitely do my best to update this thread once I’ve been.
Just really don’t want to upset the Apple cart so to speak as the referral was made years ago and since then other diagnoses have been made like LS and things are a lot calmer than they were. The last thing I need is something that helps being taken away! Xx

[alibeau]

Thank you all.

I think the call took me so much by surprise I just questioned it in my mind.

I have several issues that I would like to discuss with them so having had a moment to reflect, I’m really happy this appointment has come through now.

I think you can sometimes just get a place where you unknowingly accept some symptoms as your new normal…. When they might not have to be.

I’ve made a list of my top six major symptoms and I’ll see if they recommend a new approach to any of them.

Thanks again.

Hi just wondering if you’ve had your appointment and how it went?

I’ve got one booked for next week (after a two year wait…like you Id forgotton about the referral lol) and I’m terrified they’ll tell me to stop using Vagifem internally x4 a week and Ovestin x3 a week externally.
I can barely function on that but using it any less would be horrific!
I also have LS,

Hi Talli,

I have mixed feelings about my appointment....

The Dr raised an eyebrow when I said I was using vaginal estrogen three times a week as opposed to the recommended two but did not tell me to stop or mention it in his letter to my GP.

He recommended that I use a vaginal moisturiser more regularly. He recommended Yes but I have tried this previously and not found it to help.

He said he would see me again in six months!

So I came away a little disheartened, however, I have stuck with the estrogen three times a week and introduced Dr Wolffs V-San moisturiser and I am already feeling an improvement in dryness but not so much the bladder leaks.

He also talked about testosterone but said we could discuss further next time if my symptoms have not improved which I thought was a little odd given I thought this was only given for low libido which we didn't discuss.  However I am interested in trying it to see if it helps my severe dry eye syndrome..

So he's happy to prescribe testosterone 'off label' but raised an eyebrow about using Estrgoen?!?

So all in all, the appointment was ok, I guess the problem is if you see someone who is 'against' your current regime where does that leave you? Yes, you can ignore them but the Dr I saw sent a letter to my GP covering everything we discussed so could that possible become an issue for you?!

I would also print out the GSM Guidelines as MrsMitch recommends. I had them ready in my handbag 

Sorry I can't be more helpful and wishing you luck!

[Ayesha]

A moisturiser is not going to help a wasting vagina from atrophy, its there to work alongside topical oestrogen to keep everything moist and nothing else.
I cling on to anything written to help the cause because there is such a lack of knowledge from medics about the dose of oestrogen needed to keep symptoms under control, we also need to be treated as individuals.

A post from Dr Currie on a thread recently which I found to be very helpful and more ammunition when given knockbacks from those who should know better.

"The dose increase for vaginal estrogen tablet as mentioned is reasonable because of the following--
Many years ago, we had a preparation Vagifem 25mcg--every night for 2 weeks then twice weekly. When it was taken off the market, we then used the lower dose Vagifem 10mcg (Vagirux is the same)--nightly for 2 weeks then twice weekly. So the maintenance dose of Vagifem 25 provided 50mcg of estradiol over a week, for which there was no concern about significant circulating absorption affecting the womb lining. Therefore, if needed, this can be achieved by using Vagifem 10 of Vagirux up to 5 times weekly. For many, twice weekly is enough and can be continued long term, for others using it 3 to 4 times weekly or maximum 5 times weekly works better.
If vulval and vaginal treatment needed, some find using the large volume estriol cream 0.01% applying half with a finger to the vulva and remainder into the vagina can be useful. However, other vulval conditions and sensitivity may need to be considered.
I hope that this is helpful
 

[sheila99]

So I came away a little disheartened, however, I have stuck with the estrogen three times a week and introduced Dr Wolffs V-San moisturiser and I am already feeling an improvement in dryness but not so much the bladder leaks.

There is another way to stop leaking. I gave up and went private. I'm now on more than the NHS allowed amount of systemic hrt and 'down below' is back to normal. No pain, no dryness, no incontinence and I no longer use local oestrogen as I don't need it. The only negative is the cost. It really annoys me that the NHS thinks it's ok for me to wet myself when treatment is available.

[alibeau]

Thank you both, it's all so mind blowing....

Sod's law, I am feeling a little sore again today 

I've got so much going on in my life I honestly just feel like giving up at times (I mean in regards to trying to control my symptoms, not life itself!)...

Shelia99 - I am on 3 pumps of Oestrogel and Utrogestan 12 nights out of 28, 2 capules orally. Are you saying that if my systemic HRT dose was increased if might sort out my dryness and bladder leaks without the need for topical treatments?

Thanks.

[sheila99]

Va isn't something we suffer from when we're younger and producing gallons of our own oestrogen so it stands to reason it can be controlled by sufficient systemic oestrogen though perhaps unlikely you'll get it on the NHS. I'm on 200mg estradot but on 100 I had all my oestrogen deficiency symptoms again not just va - anxiety, insomnia, bad mood etc etc. I have a mirena so no issue with a thickened lining. You can go up to 4 pumps on the NHS so that might be worth a try.