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[Jules]

I'm not entirely sure what you are all meaning but I'm presuming low estrogen which I also presumed was a normal part of aging eg estrogen levels falling. I know people in their 40s who have the effects of that. I don't think I'd have wanted systemic HRT for my vaginal atrophy, at that time there were too many scary stories about any estrogen treatment. I do wish I'd had better advice about the VA so that I'd used it earlier. I literally had no idea things could start wasting away down there till it was too late.  But just imagine being in your 30s and being told that's what could happen as you age. Life can be scary enough!

[CLKD]

Lowering of oestrogen is natural.  Many do not have symptoms, others feel aches and pains as the muscles become lax - oestrogen being our elastic ;-) along with vaginal atrophy.  The body may dry: inside and out 

[bombsh3ll]

If your genital tissues are atrophying, you have low estrogen (and also often low testosterone as well).

If you are in your mid 50s or beyond, the presence of vaginal atrophy is not telling you anything you don't already know - unless you are on replacement, your estrogen levels will be low.

Whether you choose to treat systemically, locally or not at all is a personal choice.

But when someone in their early 40's or even younger has symptoms of vaginal atrophy, rather than just treating the symptoms this should prompt a clinical assessment as to whether that individual is heading into early menopause. Most guidelines recommend testing FSH in women under 45 and certainly below 40 with symptoms suggestive of ovarian failure, which include GSM.

If endogenous ovarian hormones are going away at this age, this means the individual has potentially many more years ahead of them to live in a hypoestrogenic state, which we know has negative health consequences across multiple organs and systems such as bones heart brain etc, than someone who loses (and doesn't replace) their ovarian hormones at the usual age of menopause or later, which in developed countries is around 51.

This is why it is particularly important at any age but especially the younger you are, to have a holistic assessment with a menopause informed specialist.

[Jules]

My sister had an early menopause, she used systemic hrt for about 5 years then stopped. She has no VA at 66. I didn't notice until my mid 50s. Pain with intercourse. Funnily, after we'd separated and I met someone else, I had no problems with pain so it wasn't all to do with menopause. At that time VA was not talked about so I was in the dark, as I'm sure many others were. It's just a case of managing it now for comfort. And I'm comfortable for the biggest part. I do tell my younger friends though. https://healthinmenopause.co.uk/how-your-vulva-changes-during-menopause-what-to-expect/

[bombsh3ll]

I think VA in postmenopausal women is like haemorrhoids in the general population -

90% have/had them
50% admit to it 😂

[Jules]

I think VA in postmenopausal women is like haemorrhoids in the general population -

90% have/had them
50% admit to it 😂

You're probably spot on there 😁. 

[Minusminnie]

I look forward to not having to use my standing desk at work so much when I can start sitting with less discomfort!!!!

I had a 2 bespoke U cushions made one for home and one for the car.  This was done at a mobility/disability place where they had an upholstery service.  They were very patient in getting the shape, depth and amount of stuffing right.  Any other bought cushions i tried had less stuffing, the shape wrong or the hole not clearing the vaginal area.

One member on here had a chair done by her work is it worth you asking ?

2 rolled up towels can work under each butt cheek but you need the right type of chair to use them in. I also bent a draught excluder to a U shape and sewed webbing across to hold it but my bespoke cushions now serve me well and have lasted.

[Jules]

I think VA in postmenopausal women is like haemorrhoids in the general population -

90% have/had them
50% admit to it 😂

I don't know how Cher manages!

[Fuzzwhizzer]

I’ve been to the nurse practitioner once, and  twice to doctors appointments this year. Other symptoms and problems have had to be investigated, but also each time I’ve mentioned to three separate professionals that I think atrophy might be occurring due to several different symptoms down there. Each time they’ve just looked mildly vague and either embarrassedly grinned and moved the conversation on or gone quiet and ignored it. I was hoping they’d offer me something for it. I can’t believe they wouldn’t I’m 56 for goodness sake, it should be part of the whole menopause discussion. The whole of my year has been dogged by abdomen wide symptoms of varying description. Slowly going through the test by test scenario trying to get somewhere it’s like a hamster wheel.

[Jules]

I can relate to that. One of my GPs reacted the same when I mentioned changes, she also looked embarrassed. Ironically since, things have moved on and she told me she'd already noticed changes at 45 and wouldn't hesitate to use hormone treatment if she needed to. But my treatment was too late in some respects. Is there a different GP you can see at your surgery or even an appointment at a sexual health clinic. They have walk in clinics at our local one.

[Climbingthewalls]

Quick update. I’ve completed my two full weeks of vagifem and one week of every 3 days. The first week I saw improvement and the white tissue discharge that remained from using replens just slipped, which felt like a sign my vagina was producing normal discharge/moisture. I was very happy and then I seemed to go backwards. The last two weeks I’ve gotten progressively worse each day. The scratchy itch inside has come back and I feel sore and swollen, bruised when sitting. I stopped using replens as soon as I started on the vagifem but wondering if to go back to twice a week of replens. I’ve tried YES moisturiser and that does nothing and now I’m even wondering if that is make me more sore. Anyone found a combination of vagifem and replens works?

[Ayesha]

The only thing that will work is the oestrogen, the moisturiser just makes the area moist nothing else.

To keep myself symptom free I have to use Vagifem daily, with a smear of Estriol cream twice daily alongside Yes moisturiser.
This regime took four months to take affect then a whole year to be completely symptom free, even now flare ups will happen but always on the mild side. I am not on systemic HRT and is probably the reason why I need this amount of treatment.

You can't pussy foot around with this condition, use the oestrogen consistently until you are free from symptoms then like me experiment to check if you can reduce the dose, after five years I still need daily treatment.