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[Nanny2two]

Hi

I use Evorel 75 patches and asked my GP to switch me over from 100mg oral utrogestan to Lutigest pessaries with applicator.
(I have chronic gastro issues with bloating and the alternative route may help)

I have been prescribed Lutigest at 100mg.
I also use Vagifem pessaries nightly for atrophy.

Does anyone know if both pessaries must be separated, or can they both be delivered together? 

Also, does the Lutigest mg sound correct alongside the Evorel? (due to vaginal v oral absorption)

Thanks

[bombsh3ll]

You can use both together however I would insert the progesterone first, in order to get this closest to the uterus and also because the consequences of undertreatment are potentially more serious.

Inserting last thing at night when lying down helps avoid them falling back out before they dissolve.

Long term it would be unusual to require nightly Vagifem if on a therapeutic dose of systemic estrogen.

[Nanny2two]

You can use both together however I would insert the progesterone first, in order to get this closest to the uterus and also because the consequences of undertreatment are potentially more serious.

Inserting last thing at night when lying down helps avoid them falling back out before they dissolve.

Long term it would be unusual to require nightly Vagifem if on a therapeutic dose of systemic estrogen.

Thanks. Is there any reason why I shouldn't stay on daily Vagifem with my patches?
The pessary is minute in dosage and my VA is severe and has been for many years.

[bombsh3ll]

No there is no safety concern at all with using as much Vagifem as you need alongside systemic estrogen.

However vaginal atrophy is pathognomonic of hypoestrogenism, so if someone has such severe and chronic urogenital atrophy, it begs the question of whether their systemic treatment is adequate or being absorbed.