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[kp64]

I just wanted to ask if anyone can help me.

I use Vagifem and have LS.  I have been through a very stressful time the last 16mths caring for my mum, the last 4 was very traumatic and after she left hospital I cared for her at home until she passed away in November.

Do you ladies think that stress can trigger flare ups of the LS and atrophy as I feel so bad like I was before I started the treatment and I’ve had two episodes of light pink blood on the loo paper so don’t know if the vulva skin or inside has split a bit.  Would be grateful for your thoughts.
Have made a docs appointment but to be honest I’m worrying which I don’t need on top of everything else.  Thank you so much

[Dierdre]

Stress will definately cause LS and atrophy to flare up, it's the main cause of all my flare ups. I usually do a reload of Vagifem for a week or so until feeling comfortable again. I also use Estriol cream externally and that keeps the vulva healthy. Do you use Dermovate for LS.?

[kp64]

Yes I have the steroid cream but I wasn’t told to use it for the maintenance twice weekly so basically I’ve just got the Vagifem and a moisturiser that I use.

[CLKD]

Stress can cause many health issues to flare.  How often do you use a steroid?

If VA is causing discomfort and  every night treatment doesn't help, it is OK to add an 'extra' dose in the morning for 3-5 days as well as nightly use.

Splitting skin is often a sign of lack of oestrogen - R U due a discussion about the LS?

[kp64]

I’m only ever given the steroid if I get a flare up. I only use Vagifem and a moisturiser. Are you able to use the hormone cream on the vulva with LS?
My lady doctor is very nice but never given me anything else.  I’m going to see her tomorrow as I’m uncomfortable and to check out about the pinky blood.

[Dierdre]

Yes you can use Estriol cream on the vulva with LS. I use it every night.

[kp64]

The Doctor has changed me from Vagifem to cream. She said I have a tear hence the bleeding.  She said to put some of the cream on the vulva.  Do I use the cream the same amount of times that I used the Vagifem each week.  Sorry if I sound stupid but never had the cream before. Also how often should it be used in the vulva.
Thanks ladies

[Dierdre]

I'd use it inside and outside every night initially then reduce it when you feel comfortable. The maintenance dose of twice a week is not enough for a lot of women and the doctor can up the dosage if needed.  Use the steroid cream as prescribed, mines twice a day for 4 weeks then twice a week but I've never needed to use that much,  I'm usually ok after a  week or so. I usually use the steriod cream about an hour before using the Estriol cream, not at the same time. The steroid cream will help with healing the skin, as it's so sore the Estriol might sting to start with. You can use it with your moisturiser too. Which cream have you got? The small Estriol 1mg 15g tube or the larger estriol 0.01mg. Both work but with the larger tube you can spread it on more liberally.

[kp64]

Thank you so much for replying.

Not sure what size tube it is, just waiting for text to collect prescription from chemist.

Never had the skin tear before so must be because I’ve had so much stress and got run down.  Fingers crossed it heals up. Got a follow up appointment on 15th Jan dont want anymore blood. I go to worse case scenario.  Thanks so much for all your great advice x

[Dierdre]

The skin tearing is more likely to be the atrophy as it gets dry and becomes more thinner and fragile with loss of elasticity. The Estriol cream will rehydratre and plump up the skin again.  Vagifem is good internally but it never seem to reach the outer parts for me which is why I use the estriol cream as well.