Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Dierdre on February 08, 2020, 11:24:14 AM
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I was looking back on old posts on Vagifem and found a post by scriv who had been using the 10mcg vagifem without success. She had been fine on the old 25mcg dose so had decided to use 2x10mcg twice a week with 1x10mcg in between, totalling the old 50mcg per week with success. Has anyone else tried this and had better results?
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Yes, I use Vagifem daily, so a total of 70 mcg per week. The Estring gives approximately the old dose too, at 7.5 mcg over 24 hours so 52.5 mcg per week.
JP x
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A female GP at my practice said she was happy for her ladies to use Vagifem 5 x a week, she said when the dose was reduced many of her patients couldn't manage their VA. I use it every night and my GP is happy for me to do so.
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Ditto joaniepat and tinkerbell. Another daily user here. GP insisted I use it daily.
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My GP wont up the dose to 7 per week without my gynae's recommedation so waiting for appointment for that but also waiting for scan on thickened lining, suspected fibroid (on another thread) so doubt they will up the dosage yet. Im officially 5 per week but even when i tried taking one every day for a while i was never 100%. I thought I'd try the 2x10mcg dose twice a week with the 1 x 10mcg in between to see if it gives a better hit.
I'm not sure how long this forum has been going but it seems there's alot of people not happy with the 10mcg but cant find many posts when it was 25mcg twice a week, or is that because there wasnt any problems with that dosage!
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I use every day on consultants recommendation. What I would be interested to know is if using it everyday there is still the same need for progesterone to stop any thickening of the womb lining if no other HRT is used.
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I doubt it, taking Vagifem everyday is 3,650mcg per year, thats 3.65mg or 3 to 4 oral HRT tablets per year.
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Joaniepat and Tinkerbell, are you both also on full HRT with progesterone and is that why your doctors are happy for you to take Vagifem everyday? I wonder if thats why mine and others just using Vagifem wont allow more than the maximum of 5 per week?
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I am not on progestrone (well into menopause for 15 years) and my GP says Vagifem used daily to control symptoms is just fine. I still have my womb. Vagifem takes a very, very long time to work. Some ladies give up when they don't get substantial relief within the 12 weeks Vagifem claims. I am on 6 months of vagifem use and still have some discomfort. My GP said it could take up to a full year before relief is at 80 to 90% better. Keep in mind VA is chronic and as with any chronic condition, there will be great days, good days and some bad days. That is our new normal.
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Dierdre and Nairncat, I am on oestrogen only patches, no uterus. The daily Vagifem was prescribed by a NHS menopause clinic and my GP just goes along with their recommendations. I also have Estriol Cream for the vulva. Whatsupwiththis is right about it taking a long time. Whether or not you have a uterus isn't relevant to using local oestrogen as there is no systemic absorption once the tissues are plumped up, thus endometrial protection would not be required for those using local products alone.
JP x
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Deidre....i now have a Mirena but the meno specialist was happy to prescribe Vagifem everday without progesterone and she informed my doctor of that, also adding that even everyday use only amounted to 3 HRT tablets a year. I did use Vagifem everyday for a year before i got the Mirena.
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I really need everyday so im hoping the gynae will instruct my GP to up the dose. Im managing at the moment by using Ovestin as well externally and on the 2 days i dont use Vagifem i use this inside as well as outside.
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I think you're right whatsupwiththis, this is our new normal, after 5 years on Vagifem I'm still expecting things to improve to 100% all the time. I think I'm still in a bit of denial this is forever. I get 100% at weekends and the weeks I'm on holiday I feel totally normal again and i know once i retire and I'm not sitting all day at my desk I'll improve but still got a couple of years yet. Had a bit of a stressful week so had a flareup again, it kinda knocks you back and makes you realise its never going away. Roll on summer, i always feel better then and the sun and vitimin D helps everything.
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Hi Dierdre, another 5x Vagifem/week user here, plus Estriol 0.01% on external area. This combination was prescribed by a well-respected NHS menopause clinic. However, I need systemic HRT on top to help manage VA (plus other meno symptoms). My Endocrinologist, who prescribes my HRT, suggested I go to Vagifem 7/week a while ago if need be. As the other ladies have said, systemic absorption of topical oestrogens is said to be minimal once the integrity of the vaginal mucosa has been restored. :)
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I did try full HRT for 6 months a couple of years ago but to be honest it didnt make any difference to my VA, the side effects I had made me decide to stop and I had no other meno problems other than VA. I'm 63 now so not really a good time to start again. If I subsidise with Ovestin I do manage with just 5 a week but sitting all day is not ideal.
Wrensong, do you take your 5 every other day or just miss 2 days?
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I definately dont think a 2 week load is enough, then going down to 2 a week! I struggled with this dosage the first year and it was awful. I think you should be on every day, then when ready, go to a dose that is right for you. Also be given Ovestin for external use from the start too.
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Stellajane...I think that is what us VA ladies fear is that we will never be 100%. There are some days where lady bits feel much better and then there are some days where it's 'oh no not again'! I only wish that when the younger women reach this stage in their lives, they will have a simple cure for VA (we can dream)...
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I have been on Vagifem twice weekly for over 2 years now. I have post episiotomy lumpy scarring just inside the vaginal entrance, which since the menopause 10 years ago has become loads more painful due to VA. Intimacy hurts just where the scarring is!!
I have recently decided to increase it to every third night, but wonder should I use it more often than this - will it help the scarring?
I started on 2 pumps Estrogel and 100mg utrogestan daily (with Tostran gel added later by meno clinic) last October. (went up to 3 pumps recently which made nipples sore again so may go back to 2??) HRT seems to have got rid of hot flushes and had no bleeds, but still have the severe VA and also global anxiety which am hoping will improve as time goes on?? Yes I agree Whatsupwiththis, we'll never have our bits right again??!!
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Julia Dizzy...I tried with twice a week with very little relief. My GP insisted I use it daily as I have severe VA. As many ladies have posted, Vagifem contains such a tiny amount of estrogen and for me, quality of life is far more important than quantity. There should be no need for us VA ladies to live in such discomfort and if Vagifem (or reasonable facsimile) helps if needed daily, then so be it.
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Dierdre, The 2 nights a week I don't use topical HRT are those when I apply a new patch. I have probs with Vagifem in that they don't dissolve very quickly, so that sometimes they are expelled virtually intact when I go to the loo the next day, or on a couple of occasions 36hr after insertion. This became evident given I have some nights Vagifem-free. I can't use the internal creams though & Estring is also out for me, so there's no alternative. That's where systemic HRT has helped I think - it's taken a long time as I'm on very low dose, but topical alone is simply not enough for me. I'm post-BSO, very skinny, so probably lacking the sources of buffering oestrogen women with a healthier amount of body fat are said to go on producing postmenopause & indeed bloods showed my oestradiol was too low to be measurable before systemic HRT.
The menopause clinic's suggestion I supplement Vagifem with the very low dose Estriol made a big difference to the comfort of the external area. I would not want to be without either.
I agree with Whatsup - perseverance is key - it's an ongoing maintenance project ::). So thank goodness there are products out there we can use. :)
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Have you tried using some YES waterbased lubricant a couple of hours before inserting your vagifem so to help it dissolve and not drop out dry. The small 5ml vials might work best. I suffer worst on the outside and need Ovestin for this as Vagifem doesn't seem to reach there.
I took 2 vagifem last night to see if the old dosage might work better twice a week but it caused cramps and the chalky discharge today from the fillers has irritated, I wont be trying that again.
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Dierdre, thanks for that reminder - a meno specialist also suggested that & I did try with Yes WB, but forget to do it regularly as I was using Vagifem for a long time beforehand on its own - old habits die hard. I don't seem to have lost a tablet recently & other signs are that area is improved now I'm back on systemic HRT as well.
I don't know whether you've tried varying insertion depth. That was another tip given to me at a meno clinic, as Vagifem's effects are apparently very localised. The advice is to alternate deeper insertion with shallower. Apparently its common for women to be especially sore just inside the entrance. So inserting Vagifem not too far inside is more likely to help that area.
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Hi Wrensong,
I tried doing Vagifem lower as all my pain is external. I tried on a Wednesday night, on Friday I had virginal atrophy flare up. And was in pain all day. And that was the only reason I could think of that the tablet got inserted too low about 3cm. Now I'm still struggling to get over my flare up and too scared to try again :'(
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Hi Lyncola, ooh that sounds very uncomfortable. Have you tried one of the oestrogen creams instead of Vagifem? They can be very soothing. They can be used internally & externally. I use the weaker form of Estriol cream for the external area. It's the 0.01% formulation & I find that really helps & leaves me very comfortable. Not sure, but I have in mind that you are in Oz & if so I don't know what's available over there?
Wx
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Wrensong ive tried inserting low but the fillers then irritate the outside bits so i have to place it higher and then use the Ovestin cream for the outside. This normally works but not all the time as we all know. Even the cream sometimes stings and burns if im sore so ive got Dermovate cream to use then and thats soothing but i cant use all the time as it contains steroids. Im sometimes better on the day i dont use the Vagifem and just the cream and vice versa, there's no pattern to any of it, i can do exactly the same routine as the day before but then have a blip,. Its just a constant battle.
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i?m young went through this at 39 ! VA is not fun thankfully i?m managing on twice a week although i?m not sitting all day as gave up work and was doin mg a desk job
how do u have intimacy with partner if using everyday ? is it ok for him to be exposed to it just asking incase in the future i need this although i?m on ovestin cream internally and externally x
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Hi Sammiejane,
I'm glad I'm not the only younger person going through this, I was 45 when virginal atrophy started. I think am I going to have a sore virgina all my life :'(
With sex, as I am at the moment using something every night. I just asked my husband if he wants to do something before i use Vagifem or Ovestin externally. Takes the romance out, but I tell he once I use something that's it, no sex.
And I'm sure your not supposed to have sex after use Ovestin and I assume it's the same with Vagifem.