Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: linfit on January 11, 2017, 05:51:57 PM
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Hi
I have posted on here a few times but am feeling so worried and frustrated now, I need help. I am 53, post menopausal. Had VA symtoms since August, on Vagifem twice a week since Sept and Evorel conti patches since November.
I feel like my life is sprialling out of control; the symtoms are sometimes better, sometimes not. My work is affected, I am not the same person. I have anxiety in the morning and am obsessed with symtom checking.
I have seen a urologist who wants to do a cystoscopy to eliminate bladders problems.
Please please tell me that this isn't my life now?! It's nearly 5 months and I am still in discomfort and pain. Is this normal, where will it end?
I am going to see a gynaecologist on Friday but so worried, I am loosing hope and I just need to know I can get my life back on track.
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Do you use the Vagifem often enough! The initial 2 week loading as recommended should improve symptoms, some ladies find that they need to use the product every other night rather than spreading a distance of every 3/4th and 5/6th. I would encourage you to up the doseage, do a 2 weeks reload and maybe use another product to keep the vaginal lips moist: KY Jelly does it for me, others use Sylk on a regular basis.
Keep hydrated. Toilet hygiene is important, i.e. wipe front to back ;-). Light cotton panties, go without when possible.
Anxiety can be eased by an emergency 'as necessary' tablet or by taking anti-depressants as some can ease symptoms : since I upped the one I take I have felt so much better, I now take 10mg at night and 5mg in the morning. Add to that a beta-blocka ::). It really can be Trial and Error.
Do take a list of symptoms etc. to your appt..
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lnfit - I wish I could tell you that your VA problems will clear up completely but, has I think I've mentioned before, urogenital issues have to have ongoing management. I am comfortable most days but now know what to do if symptoms flare up. It does require discipline and staying relaxed and calm is vital - I do think stress makes everything worse.
I would certainly have the cystoscopy for peace of mind and talk through your symptoms with the gynae - write everything down so you don't forget what you want to discuss.
Don't dispair - I've struggled with these problems for many years and now feel I have thing vaguely under control - you just need two find the strategies that work for you. The local and systemic HRT you are using will take 6-9 months to really restore things in your whole urogenital area. Keep using the SYLK.
DG x
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Hi linfit
I'm no expert but the wonderful ladies here offered excellent advice re my recently developed VA just a couple of months ago. I started Vagifem in November which I use along with a small blob of Sylk every morning following my shower. I've found that the twice a week maintenance dose following the two week every day loading wasn't enough to keep everything comfortable. I saw my utterly brilliant GP again today for an update, explained that I had had to increase the weekly frequency and she shrugged her shoulders and said fine, I could take what I need to keep me comfortable. I'm using the Vagifem every other day which works well. We are going to review again in a month and if needs be we'll add to it. Could you suggest to your GP that they increase your weekly dosage which may calm things more for you? As my doc said, the old dose of Vagifem was 25 mgs twice a week before it was reduced to 10mgs twice a week.
I wish you well.
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My gynae said to use double vagifem twice a week for ever. That and Sylk externally really does work wonders x
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I am the same age as you, last period nearly two years ago and have battled to get VA under control, mostly due to lack of knowledge by GP and even a gynae!
But since being on Estrogel since August, I did use Estradot prior to that for four months and using Vagifem every day, plus Ovestin on the outside bits 4/5 times a week I am comfortable most of the time. I would say I have only been like this for about 3 months, so please don't despair yet, although I have had times in the past when I thought the same as you.
I would up your Vagifem to five times a week, that is equivalent to the old dose.
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Hi linfit
I answered about VA in your other thread about systemic HRT and what you could do:
Most HRT types come in different strengths so one delivery method is not stronger per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.php
Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (whereas Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.php
Have a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.
Hurdity x
So to summarise:
-Maybe do another 2 week daily "re-load"
-Look to increase frequency of vagifem per week
-Get hold of some estriol cream in additiom - for external areas
-Consider Estring if still no improvement after given length of time
-read Maryjane's posts
-Read the Burning Club (very long thread in Private Lives)
-Use moisturisers when not using local oestrogen (I have no experience!)
+ anything else in this thread that hasn't already been suggested in your other threads!
Let us know how you get on with the gyane on Fri and hopefully you will gradually see an improvement - but be patient - you will get better! :)
Hurdity x
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Hi linfit
I answered about VA in your other thread about systemic HRT and what you could do:
Most HRT types come in different strengths so one delivery method is not stronger per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.php
Thank you (and all the other ladies who replied). I will try all you recommend and will let you know what the gynae says. I appreciate your help.
Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (whereas Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.php
Have a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.
Hurdity x
So to summarise:
-Maybe do another 2 week daily "re-load"
-Look to increase frequency of vagifem per week
-Get hold of some estriol cream in additiom - for external areas
-Consider Estring if still no improvement after given length of time
-read Maryjane's posts
-Read the Burning Club (very long thread in Private Lives)
-Use moisturisers when not using local oestrogen (I have no experience!)
+ anything else in this thread that hasn't already been suggested in your other threads!
Let us know how you get on with the gyane on Fri and hopefully you will gradually see an improvement - but be patient - you will get better! :)
Hurdity x
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???
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linfit - no problem - and really hope you get some relief soon :)
CLKD - linfit answered but her answer has appeared inside the blue box quotes which sometimes happens with multiple quotes!
Hurdity x
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Well, so it does ::) .......
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linfit - no problem - and really hope you get some relief soon :)
CLKD - linfit answered but her answer has appeared inside the blue box quotes which sometimes happens with multiple quotes!
Hurdity x
Hi there
I saw the menopause specialist today who advised me to use vagifem five times a week. Plus she said get the cystoscopy done.
In addition she said use an emolient when washing/bathing.
Her opinion was that systemic hrt doesn't hep that much with vaginal/urinary symptoms and topical is better there. I am on patches so not sure what to do. She said it was up to me if I felt better on them. I have found it hard to tell. I have become tearful a lot lately but don't know what's cause or effect?!
I asked about Amitriptyline but she said that was for chronic pain and wasn't really able to say much about my feelings of anxiety etc.
Any thoughts?
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She seems to know what she is talking about!
Systemic HRT is surely for symptoms other than VA?!? ........ Vagifem is for use in the vagina as the dryness is due to thinning of skin due to a drop of oestrogen. The two types of HRT can be used as necessary at the same time to help ease the various symptoms.
Anxiety can be caused by a drop in blood sugar so eating on a regular basis is imporant; not eat more but spread out the daily diet across 24 hours, even in the night. Every day. Anxiety can be eased by certain types of anti-depressant medication if it becomes overwhelming. I used Rescue Remedy with some success as well as relaxation therapy.
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I didn't find the local enough on its own. Systemic does not seem to help on its own either.
I had my last complete deluge bladder-wise, on the day I was prescribed elleste. It seems to help even out the ups and downs of the vagifem, and I am not sure the vagifem is enough on its own if your own hormones do a nose-dive (am still peri). Also, using the vagifem for quite a while seems to have helped iron out my problems.
I found dermol (an emoilent wash/moisturiser for skin problems) useful for washing when I was suffering thrushy symptoms. Plenty fluids helps too - stops my bladder getting over-excited ::)
For me, it seems to take a bit of everything.
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She seems to know what she is talking about!
Systemic HRT is surely for symptoms other than VA?!? ........ Vagifem is for use in the vagina as the dryness is due to thinning of skin due to a drop of oestrogen. The two types of HRT can be used as necessary at the same time to help ease the various symptoms.
Anxiety can be caused by a drop in blood sugar so eating on a regular basis is imporant; not eat more but spread out the daily diet across 24 hours, even in the night. Every day. Anxiety can be eased by certain types of anti-depressant medication if it becomes overwhelming. I used Rescue Remedy with some success as well as relaxation therapy.
Thanks for your practical and supportive comments, really help
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I didn't find the local enough on its own. Systemic does not seem to help on its own either.
I had my last complete deluge bladder-wise, on the day I was prescribed elleste. It seems to help even out the ups and downs of the vagifem, and I am not sure the vagifem is enough on its own if your own hormones do a nose-dive (am still peri). Also, using the vagifem for quite a while seems to have helped iron out my problems.
I found dermol (an emoilent wash/moisturiser for skin problems) useful for washing when I was suffering thrushy symptoms. Plenty fluids helps too - stops my bladder getting over-excited ::)
For me, it seems to take a bit of everything.
Thank you, that's hopeful for me, appreciate your constructive support
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Do you feel that you now have a plan to work with?
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I had bad VA that was helped with Vagifem use every day, but since I have been on systemic HRT there has been a big improvement.
So from my personal experience I would say systemic HRT does help VA...I am on Estrogel..3 pumps a day. I still need Vagifem every day as well, but I no longer spend every day aware of my down below bits!
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Pleased you had a good appointment linfit. I still think it's well worth using both local and systemic HRT as I believe local oestrogen doesn't fully benefit the bladder and the systemic may well help - simply cover all the bases.
Good luck and keep us posted. DG x
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linfit - Yes local oestrogen targets the vaginal area but some women need both - simple as that - as you can see from the responses.
I started with just local oestrogen - when I was in early peri. Then in late peri symptoms (flushes and sweats) got too bad so started systemic HRT and doc stopped the local oestrogen. Then after a while ( can't remember how long) I went onto local again too as the systemic wasn't cutting it re VA. I have been on this combo ever since - patch HRT, local oestrogen, and estriol cream for external parts.
Personally if you are feeling better generally I would stay with it - glad you have been given the increased local oestrogen anyway and let us know how you get on :)
Hurdity x
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Do you feel that you now have a plan to work with?
Hi
Yes, certainly going to try with the 5 times a week. So hoping I get an improvement. I will report back in a week or two so I can see if it works. Thank you
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I had bad VA that was helped with Vagifem use every day, but since I have been on systemic HRT there has been a big improvement.
So from my personal experience I would say systemic HRT does help VA...I am on Estrogel..3 pumps a day. I still need Vagifem every day as well, but I no longer spend every day aware of my down below bits!
Thanks, so hard isn't it. Good to know you were helped with both. I am going to increase vagifem and see how I go!
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Pleased you had a good appointment linfit. I still think it's well worth using both local and systemic HRT as I believe local oestrogen doesn't fully benefit the bladder and the systemic may well help - simply cover all the bases.
Good luck and keep us posted. DG x
Thank you DG, I will increase vagifem and let you know how I get on.
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linfit - Yes local oestrogen targets the vaginal area but some women need both - simple as that - as you can see from the responses.
I started with just local oestrogen - when I was in early peri. Then in late peri symptoms (flushes and sweats) got too bad so started systemic HRT and doc stopped the local oestrogen. Then after a while ( can't remember how long) I went onto local again too as the systemic wasn't cutting it re VA. I have been on this combo ever since - patch HRT, local oestrogen, and estriol cream for external parts.
Personally if you are feeling better generally I would stay with it - glad you have been given the increased local oestrogen anyway and let us know how you get on :)
Hurdity x
Yes that makes sense, I will let you know how I get on and am hoping for further improvement.
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Hi Linfit,
I got VA four years after going through the menopause. I know how you feel with it. It's debilitating and I got obsessed with thinking about down there all the time. I tried Evoril conti patches first but bled on them. Then tried vagifem, got thrush all the time. Non of these eased my symptoms though. Also had the estriol cream eased a bit. Eventually I asked my doctor for hrt tablets and to be honest since I've been on them. No problems touch wood. Went plumper down there and felt comfortable. It took ages though to feel like that.
I went on Premique low dose at first but did nothing. Then went on the higher strength and it worked for me. The thing is I couldn't get these near Christmas because was told they have been withdrawn and then went on Indivina. I've had some digestive issues though recently, not sure if it's this hrt or not. But my VA seems still sorted on this hrt
Hope you feel better soon xx
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Hi Linfit,
I got VA four years after going through the menopause. I know how you feel with it. It's debilitating and I got obsessed with thinking about down there all the time. I tried Evoril conti patches first but bled on them. Then tried vagifem, got thrush all the time. Non of these eased my symptoms though. Also had the estriol cream eased a bit. Eventually I asked my doctor for hrt tablets and to be honest since I've been on them. No problems touch wood. Went plumper down there and felt comfortable. It took ages though to feel like that.
I went on Premique low dose at first but did nothing. Then went on the higher strength and it worked for me. The thing is I couldn't get these near Christmas because was told they have been withdrawn and then went on Indivina. I've had some digestive issues though recently, not sure if it's this hrt or not. But my VA seems still sorted on this hrt
Hope you feel better soon xx
thanks for your reply, it's so interesting how different things help different women. Glad you got sorted, that's good to hear.
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linfit - Yes local oestrogen targets the vaginal area but some women need both - simple as that - as you can see from the responses.
I started with just local oestrogen - when I was in early peri. Then in late peri symptoms (flushes and sweats) got too bad so started systemic HRT and doc stopped the local oestrogen. Then after a while ( can't remember how long) I went onto local again too as the systemic wasn't cutting it re VA. I have been on this combo ever since - patch HRT, local oestrogen, and estriol cream for external parts.
Personally if you are feeling better generally I would stay with it - glad you have been given the increased local oestrogen anyway and let us know how you get on :)
Hurdity x
Yes that makes sense, I will let you know how I get on and am hoping for further improvement.
Hi there
Me again. Since I increased the vagifem to everyday (or at least the last five in a row) since being told to do so, I am burning much worse than usual today. I have also been bathing in oilatum emolient morning and eve) though not for long and also applying aqueous cream as recommended by the specialist I saw last week. Is this normal to have an initial reaction like this when increasing or is it a sign that it's not suiting me?
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be careful with the aqueous cream, I used to use it until I discovered that it can contain SLS, a chemical detergent used widely in a lot of washes, shampoos and toothpastes and can cause skin irritation.
I no longer use anything that contains this ingredient and my skin, scalp and nether regions are a lot happier. I never use anything on my lady bits except water and I use oestrogen cream externally and vagifem internally.
Perhaps check the ingredients on your emollient/aqueous cream to see if it contains SLS
SLS = sodium lauryl sulphate, also used in some household cleansers!!
Just googled, aqueous cream does contain SLS but Oiltum does not but it contains other chemicals and additives.
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Linfit, I'm pretty sure acqueous cream is no longer recommended for eczema as it has something irritating in it - I'm not convinced it's the best thing for you to wash with. Also I have VA and I very rarely go in the bath - it just doesn't do me any good. I might hop in husband's bath for a treat for five minutes (before him!) if things are really going well. Showers all the way otherwise.
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ancient runner you are correct (see my post)
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I use YES vaginal wash x
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Linfit - don't use the Oilatum emollient or aqueous stuff - it made me sore. I find either a very little unscented vegetable soap or a vaginal wash like Femfresh are the best. You could just wash the area with lots of water or saline solution. The fillers in Vagifem can also irritate slightly until the urogenital area is plumped up and more resilient.
For me, Vagifem 3 times a week and SYLK every day, are still the best ways to reduce irritation and keep things comfortable.
I was once told to use Sudacrem on my ‘lady bits' !!! It made me burn like hell!!!!
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Yes - aqueous cream has SLS and is no longer recommended for eczema and skin conditions. My husband has Demol, which I borrow if I feel I need it, but otherwise a quick swoosh with the warm shower is enough.
I use Yes vaginal wash as shower gel ;) on the basis that everything ends up in the nethers in the shower (my hair certainly does). It feels really nice - skin on my arms feels really smooth.
Occasionally, I have used Yes oil lubricant between inside and outside labia which gets very dry and itchy (an improvement on the Hemp handcream I first used ;D - I also used Shea butter but it is good to get something that has been tested for the right parts!)
When I first started using vagifem, I would still used to get feelings that I was just about to get thrush, so I used multigyn actigel every day then. Before that, I used thrush cream, but one day it started to burn, then got worse and worse :o and I couldn't get it off fast enough! (Which is when I tried the Dermol, which I later saw recommended by a vulval dermatologist)
Now things are much more stable, I just use these things if I need them.
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linfit - I know I keep on about this - and I have never used it - but using Vagifem several times a week may be an irritant at first for women with severe VA as well as having the fillers there more or less continuously, so have you thought of Estring - the ring you insert and which delivers oestrogen at approx 50 mcg per week. Perhaps this could be tried for 3 months ( this is how long it lasts) or 6 months and once VA is hopefully under control, possible switch back to the Vagifem say 3-4 times per week maybe? I don't know if anyone has done this, but there are a few who have tried Estring....
By the way I'm defo not the one to ask about moistruisers etc as I have never used them and no very little about them! - Dancinggirl, ancient runner have answered well. Also Maryjane's posts :)
Hurdity x
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Estring user here - yes, Hurdity's suggestion is a good one. The Estring is fabulous - put it in and forget it, with no side effects.
I've used it for the past two years.
It's worth noting that it can run out of puff in the last few weeks and symptoms can return. I sometimes find myself doing a vagifem reload at that point... which is where I am now... which is another thread in itself.
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Go on then ancient runner - you start, we'll follow ;)
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Go on then ancient runner - you start, we'll follow ;)
Thanks to you and everyone who has replied to me so promptly. I guess it's no surprise to you all that I was advised by a 'menopause specialist' who I paid to see, to use Oilatum and Acqueous cream only last Friday. She also felt that systemic hrt wouldn't help with VA I know that's a different question and thread but this is all so hard but I know how I feel and my symptoms are worse since Friday so the potions she advised can't suit me. I know it's trial and error but it's exhausting me and not to mention the financial repercussions of all the potions that I am trying. I will stop the use of the emolient and cream, feel I still need to give the vagifem a go and then may ask for the Estring when I next see my GP which is next Monday. Thanks again all.
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I found that things had definitely improved after the 2 weeks start, so it is probably best to get there first. :)
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linfit - it may be that the 'specialist' you paid to see sells those products? Some ladies find that systemic HRT certainly does ease VA ...... get that Vagifem up there ;)
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I just want to add my thanks here too to all of you who have shared helpful comments on this thread - the advice is invaluable to me too as I try to figure out ways of dealing with VA...
Eternal gratitude to the moon and back
Kkay
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You will get there, just don't take any notice of medical professionals who try to fob you off with nonsense and out of date advice!
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As tinkerbell said stand your ground .
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linfit - it may be that the 'specialist' you paid to see sells those products? Some ladies find that systemic HRT certainly does ease VA ...... get that Vagifem up there ;)
Hi
I have been using the vagifem for nine days in a row now (previously using it twice a week). I have had a couple of really good days but bad burning during last night and uncomfortable today. I stopped the emolient and acqueous cream and started using vagisil intimate wash which seemed OK but now I am wondering what to use on the outside in terms of a moisturiser. And how long do you think it should take for the increased vagifem to work?
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I find that KY Jelly keeps the outer lips moist, others use Sylk ....
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Sorry to hear you are having ups and downs.
Maybe you could ask your GP for an estrogen cream for the outer bits.
I've read that Vagifem sometimes doesnt work on the outside as well as it does on the inside of the vagina.
If you increase your patch, that might help too.
Good luck