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[CLKD]

Some medics believe that after a certain age women no longer want or have sex!

[MrsMitch]

It's very easy to buy Gina from Boots online, Sunnyangel. When you complete the form, when I've bought it I put on the form you fill in that I'm already prescribed it & the dose I was on wasn't effective & I needed it nightly. It's pretty simple but worth it. Then you can find out how effectively your symptoms are manage a few months down the line & as mentioned below, email your GP with all the info & guidelines & also tell them how much improved things are for you.

[Minusminnie]

A possible other option ?

Could you ask your GP if she is just reluctant to increase the Vagifem because she has given you Estriol cream as well ?

Ask her to drop the Estriol ( "as you feel it is not doing anything"  ) and ask her to increase the Vagifem following Dr Currie's guidelines as Ayesha posted.

You can then buy a tube of Ovesse cream in Boots it is the same as Estriol 0.1% and if only used on the outside will last you some time.

Ovesse a cheaper option to buying Gina all the time.

[bombsh3ll]

Some medics believe that after a certain age women no longer want or have sex!

I actually think it's the opposite, and where a particular treatment is being sought for the female patient's quality of life it is often refused or rationed, whereas you can have as much vaginal estrogen or testosterone as you want if there's potentially a male partner not getting his oats.

It's why we can get birth control pills with no bother (which actually have higher but still minuscule health risks) but HRT is often a battle.

[Sunnyangel]

Thanks Ayesha. You may be right about the advice i.e. mentioning the impact on your partner. It's amazing to think that in 2025 that could be a factor over and above my own personal discomfort! Re the letter writing, my GP just seems to be of the opinion that if 2x estradiol tablets a week are not doing it then it is never going to work and I have to try something else. To me, this flies in the face of reason as it would seem that by far the most logical course of action is to just increase the dosage for a period of time and THEN assess if it is working or not.

Sheila99, I am worried that if I go down that route of trying the estriol, my GP will never put me back on Estradiol if the cream doesn't work for me, which I don't think it will.

Minusminnie, I think that my GP would almost certainly refuse to increase the Estradiol anyway whatever I said about the Estriol. It's clear that she really just does not want to listen about dosage increase.

Mrs Mitch,I feel like in order to access the treatment I want I am 'going behind' my GPs back but I feel desperate. She has prescribed a second 'loading dose' but following on from that it will clearly be back to a 2x week prescription and no more so I have been to Boots and got hold of some Vagirux in addition to the prescription from my GP.

Here's the question though. Do I use the prescription loading dose as prescribed (one a day for the first two weeks) and then ask for the 2x  week prescription from the GP but supplement privately with the Vagirux from Boots to see what effect say 4x week has. Obviously don't tell GP.

OR

Do I not use the loading dose as prescribed at all (one a day for the first two weeks) instead just go straight on to using say 4x week and see what happens?

I feel very confused as to what to do and would appreciate any advice as to which of the two scenarios might be better. I really don't like this cloak and dagger stuff but the alternative seems to be discomfort.

[bombsh3ll]

There's nothing cloak and dagger about self funding medical treatment that the NHS won't provide.

Millions of people do so every day.

It's really sad that women feel like they are committing some kind of crime or that they shouldn't optimise their own wellbeing for fear of offending a GP.

It sounds as if you really need the loading dose given that your symptoms have gotten out of control due to subtherapeutic treatment.

After that just buy what you need and work out the regime that suits you best.

Vaginal estrogen isn't even meaningfully absorbed into the systemic circulation and doesn't need to be handled as if it is radioactive.

[Minusminnie]

Thanks Ayesha. You may be right about the advice i.e. mentioning the impact on your partner. It's amazing to think that in 2025 that could be a factor over and above my own personal discomfort! Re the letter writing, my GP just seems to be of the opinion that if 2x estradiol tablets a week are not doing it then it is never going to work and I have to try something else. To me, this flies in the face of reason as it would seem that by far the most logical course of action is to just increase the dosage for a period of time and THEN assess if it is working or not.

Sheila99, I am worried that if I go down that route of trying the estriol, my GP will never put me back on Estradiol if the cream doesn't work for me, which I don't think it will.

Minusminnie, I think that my GP would almost certainly refuse to increase the Estradiol anyway whatever I said about the Estriol. It's clear that she really just does not want to listen about dosage increase.

Mrs Mitch,I feel like in order to access the treatment I want I am 'going behind' my GPs back but I feel desperate. She has prescribed a second 'loading dose' but following on from that it will clearly be back to a 2x week prescription and no more so I have been to Boots and got hold of some Vagirux in addition to the prescription from my GP.

Here's the question though. Do I use the prescription loading dose as prescribed (one a day for the first two weeks) and then ask for the 2x  week prescription from the GP but supplement privately with the Vagirux from Boots to see what effect say 4x week has. Obviously don't tell GP.

OR

Do I not use the loading dose as prescribed at all (one a day for the first two weeks) instead just go straight on to using say 4x week and see what happens?

I feel very confused as to what to do and would appreciate any advice as to which of the two scenarios might be better. I really don't like this cloak and dagger stuff but the alternative seems to be discomfort.

If you have obtained Vagirux from Boots you may of read on here that some have found it unsuitable when it has replaced a Vagifem prescription.


Gina is the equivalent of Vagifem which you can get in Boots.

Maybe one day this will all be off prescription & reasonably priced.

[Sunnyangel]

Hi Minusminnie, I got the Vagirux from Boots and assumed it was  Gina - the same thing but with a different name. I hope it works the same.

Bombsh3ell, I think I will do the loading dose again and take it from there. At least that way, I suppose I will know if my theory that an increased dosage will help my symptoms is correct. I'm really hoping I'm right as I don't know what comes next if not. I feel very anxious about all this; it feels like my GP is working against me not in partnership with me and is more of a hindrance. Even if I tried to change to a different surgery though, how would I know it was any more enlightened there, it might be even worse!

[bombsh3ll]

When GSM has gone untreated or undertreated for a long time, it can take up to 3 months or more of adequate treatment to resolve, so please don't be discouraged or abandon treatment if you don't see the results you are hoping for after a two week loading dose.

It is sadly common with both systemic and local estrogen for a clinician who either lacks knowledge or outright disapproves of HRT to prescribe only a tiny amount and then say "oh well it didn't work, see I was right your symptoms weren't menopause so you'd better stop taking it"

[Sunnyangel]

Thank you bombsh3ll.
I will follow through on the loading dose and then, using the Vagirux to supplement, will try and see how I go with a two days on, one day off regime for a while.

 Have now also booked privately (expensive and never gone private for anything before but am sufficiently desperate) a one hour consultation with a GP menopause specialist-this happens on 17th September- I really hope she will outline a clear way forward for me or at least set my mind completely at rest that this level of dosage is safe and would be good for me. From what I read it is safe and objectively I believe it to be so but it is a powerful thing to have your GP so against it when you consult her and I would feel better if another health professional would say it is ok.

I believe I'm right in saying that  following on from such a consultation that even if the specialist recommends increasing dosage, my own GP is under no obligation to do so and I am worried that if my GP was contacted by the specialist she might revert to the 'if it's not working on 2x week then I'll stop the prescription and you'll have to try the cream for the same number of dosages a week. I feel stuck between a rock and a hard place!!

[Ayesha]

The treatment you have had so far is just negligent and appalling.

The private clinic will tell you that topical treatment can take up to four months to start working, its why we always say its all about patience, trial and error and taking into account the odd flare up for one reason or another. That was my experience and then fully symptom free after one year. That's how long all this can take with adequate doses of topical oestrogen

You have every right to have your prescription filled on the recommendations of a private GP consultation by your own NHS GP, you are being forced into this private consultation because they are not providing the correct treatment.

[Sunnyangel]

Thank you Ayesha,
You make me feel like there might be light at the end of this very long tunnel. How wonderful that you are symptom free now.

I am beyond enraged at the attitude towards my personal discomfort, restriction of activities and ability to function normally e.g. to sit down comfortably (!!) but I am afraid to rock the boat for fear of ultimately making the situation worse for myself.

Roll on the private menopause specialist appointment and I have to hope that the GP there is more open-minded, and approachable, less dismissive and able to reassure me. It would also be nice if she could demonstrate some basic empathy and up-to-date knowledge too.

So sorry for posting on and on about this- I have become obsessed and it seems the only thing I can think about at the moment. So grateful for everyone who has taken the time to make suggestions and offer advice and be generally supportive. It has all been appreciated more than you can imagine  .

[MrsMitch]

I completely understand you feel you have 'gone behind your GPs back' however it's necessary unfortunately. I did this to get Gina & have done it recently when my GP told me Intrarosa, which I asked to try, was refused because she said it wasn't licensed for use in the UK. That is completely untrue. So I bought it online & if it works for me then I will tell her.
If we were given what we need in the first place we wouldn't have to buy online, visit private consultations, pay for our own blood test & scans etc.
It's the same old story from many of us on here & frankly it's disgraceful that we have to self diagnose, track down private health care & pay for our own medicine just to feel like life is manageable.