Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: kathryn22 on December 14, 2023, 02:19:42 PM
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New to this site so no idea if this will even post, or if it’s the right place, not finding the site very easy to use.
Am suffering from horrendous Atrophy, which has crept on over the last year or two and been given Estriol cream x 2 weekly and Replens x3 weekly. But nothing is helping I do get the occasional good day, but mainly every day is miserable and depressing I dread waking up, my GP says it might get better but not very reassuring and not that interested to be honest.
Is this it ?? I’m just 65 and the thought of suffering for another 20 + years is sending me into such a dark place Does anyone have any suggestions that might help. Maybe different meds? it does seem that there is a generic prescribed list of meds, which if they're not successful then nothing else is tried. Hoping this post arrives in the right place
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AAAHHHHH. .......... ::) :welcomemm: Sounds like another GP who needs to stick his/her head down the loo and flush. Several times >:( ::)
Lots of info about 'bladder issues' and vaginal atrophy on this site. Browse round. U don't have to suffer.
Who has offered the regime you have been using?
GPs usually prescribe either: "vagifem" which is delivered by a think a small tablet into the vagina to stick on the 'wall' to release slowly; or 'ovestin' which I use delivered into the vagina in a measured dose in an applicator. The advantage with that is that 1 can use a smear on the vulval area too. Some find that using a moistorisor such as 'sylc' or 'yes' can help too.
There is a product available OTC from Boots called I think, 'gina'.
There is a book called 'me and my menopausal vagina' which is worth a read. Written by a Forum Member and her daughter a few years ago ...... to educate women who can they pass on the book to their GPs . I did, several times.
Up the estriol to every night for as long as is necessary, 2-3 weeks at the very least. Ditch the Replens and use KY Jelly if suitable or 1 of the mositorisors that can be useful.
When I get the need2P I swallow two Nurofen 3 times a day to ease the nip as the spincter shuts off the urine flow. It relaxes those muscles.
Let us know how you get on. It's 1 subject that we know a lot about.
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Welcome Kathryn22
Do as much research as you can by using the search box here, and yes I know not an easy site to navigate but if you put Vaginal Atrophy in the box there are lots of helpful posts.
You will get better but you must use the treatment every day until you feel better and that can take weeks or even months. Vagifem every day, with Ovestin cream used on the outside and a moisturiser like the Yes products are very good. Replens is not a good one to use and some GP's have stopped prescribing it.
Some links to help you:
https://www.menopausematters.co.uk/forum/index.php/topic,64837.msg895647.html#msg895647
https://www.menopausematters.co.uk/forum/index.php/topic,22886.0.html
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Thanks for your advice
It’s a really isolating condition although I’m sure so many women have it and suffer in silence
My GP hasn’t prescribed either of your advised meds so I will try to get hold of her again as I’ve been on the regime for about 6 weeks
So difficult to get an appointment so have to use an E referring system, which is a pain and very long winded
Coincidentally I was also told I have a double prolapse when the atrophy was diagnosed and am due to see a gynaecologist in early January, so am hoping he might be a bit more proactive The joys of being a woman Periods Childbirth Menopause Prolapses Atrophy
Who knew what was coming Thank you again
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All of the meds for VA are oestrogen based so don’t worry you are not being given the right medication, it all depends on how often you use it to ease the symptoms. Some of us don't tolerate the meds given so we try another that might suit, that's the problem with VA, its all trial and error at first.
When you throw other conditions into the mix with VA, it makes it all the more complicated a situation that has to be worked on. I am glad you have an appointment in early January which should put you in a good place going forward. But in the meantime, do all the research yourself on Vaginal Atrophy, knowledge is power when you have your appointment with the Gynae.
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A prolapse may well increase the 'need2P' sensations - take a list of your symptoms to the appt. in January.
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So sorry your suffering 😔 it can be a very awful place when this all starts. It will get better but unfortunately can take some time. Be consistent with the esteogen and as others have said use more often than 2 x week. You're not alone 🥰 xx
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I would abandon the Replens, awful stuff it made my soreness worse. Ask for some Vagifem and Ovestin cream and use every day for two weeks. I need to use both every day and have never managed on twice a week.
It will improve but will take time.
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Hello kathryn22. I am so sorry to hear about your VA. I see you have been prescribed an estriol cream; was this Ovestin or the weaker generic one? You can use either daily as twice a week won't be enough. Initially you should do a 14 night loading dose, and only then should you consider reducing the dose. As well as using the cream internally with the applicator, you can apply some directly to the labia at night. An emollient such as Epaderm or Hydromol applied externally at other times can also be soothing. If you do a Google search for Vaginal Atrophy Facebook Support Group, you can join this and find plenty of knowledge and support. It is a totally private group. Hope this helps.
JP x
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Thank you all so much for the latest replies and advice
Joaniepat you asked if I was using the generic cream or Ovestin it’s the generic one I used everyday for 4 weeks and then told x 2 a week with Replens in between
Replens seems to get negative reviews but as it’s gone off the shelves I have now been given YES VM so maybe better?
I think the mental trauma has been almost as difficult to cope with as the physical symptoms The idea that this will never go away is, to me, unbearable As I have said, I see a gynaecologist after Christmas and hopefully he may also have some thoughts . I do wonder if a lot of the pain and discomfort is to do with the prolapse as if I don’t rest enough I’m in real trouble with burning pain and discomfort and I know I am fortunate that I have no issues peeing or going to the loo like I see so many people But the whole situation makes me so sad. Can I ask, did anyone have any tests to confirm VA I’ve heard there’s a PH test. My GP just said Oh you’ve got a prolapse and a bit of atrophy So I just wonder ??? Again thank you all so much
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I've never heard of a test to confirm VA. Mine was found when I thought I had a prolapse, during the examination I was told no prolapse but that I need oestrogen down there, GP's obviously seeing the wasting away down there.
My symptoms were chronic to the stage I couldn't sit down but I am sure there is no test to determine if VA or not, unless someone knows different!
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I've never heard of a test to confirm VA. Mine was found when I thought I had a prolapse, during the examination I was told no prolapse but that I need oestrogen down there, GP's obviously seeing the wasting away down there.
My symptoms were chronic to the stage I couldn't sit down but I am sure there is no test to determine if VA or not, unless someone knows different!
Me too. Diagnosed on examination though it wasn't given a name at first. The doctor can see the change in the tissues. Coupled with symotoms, It's like diagnosing measles from a rash.
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Hello All
Just wondering
Has anyone had a reaction to Estriol??
Been using for a few months and now down to X2 weekly with a moisturiser in between Last few times used I’ve noticed what I can only describe as heightened discomfort over the next 48hrs. Wondering if it’s being caused by the sheer amount used blocking things up it doesn’t absorb very well and mostly comes away on the first pee of the day next morning I know other meds require you to use a lesser amount. just wondering (or clutching at straws)
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You're not using it often enough. Initially when I put in a dose I would have the need2P feelings the next day: at the time I was using every 3rd and every 6th night.
How high are U inserting the product? A certain amount may well discharge however, it could be 'excess' - which the vaginal walls haven't absorbed = needs more to soften the vaginal tissues. It's a bit Trial and Error ::)
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Hello All
Just wondering
Has anyone had a reaction to Estriol??
Been using for a few months and now down to X2 weekly with a moisturiser in between Last few times used I’ve noticed what I can only describe as heightened discomfort over the next 48hrs. Wondering if it’s being caused by the sheer amount used blocking things up it doesn’t absorb very well and mostly comes away on the first pee of the day next morning I know other meds require you to use a lesser amount. just wondering (or clutching at straws)
Is it cream? Can you try a pessary? I use alternate nights, vagifem or equivalent
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Thanks CLKD
Couldn’t get it any higher🤣
It’s a nightmare.Will try to use more often see if that helps.
Trouble is drives you crazy having the “fidgets” all the time doesn’t it. Like a brain worm, can’t think of anything else till it stops
So on we go, as you say trial and error
Big Thanks again
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Get it up there ;)
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@CLKD how far up do you put it? I put the applicator in to halfway up - is that high enough?
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It depends on how sore, itchy, dry the vagina might B. I push the ovestin applicator as far in as possible. Sometimes it's more comfortable to start with a gentle push which should, as the preparation work it's magic and softens the skin, allow a deeper insertion. If U find that half way suits your symptoms, then stick with it. It's the amount of nights per week that is important for many, some require treatment every night others vary depending on how the vagina feels.
When my belly begins to feel full: around the surgical bikini line: I know that symptoms are trying to be problematic so up the dose immediately; sometimes in the middle of the afternoon then at night.
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Hello All
As Happy a Christmas as possible to all So as my thread has mentioned earlier, I have a prolapse as well as atrophy I see a gynaecologist in January and just wondering if anyone has any thoughts if I’m offered corrective surgery. I’m worried that obviously I won’t be able to use the vaginal route of medication so will the atrophy go into a tailspin? does anyone think that I could maybe have patches and,if atrophy causes a thinning of the walls, will this make repairs more difficult??? Yes I’m sure the gynaecologist will have some answers, but if he’s one of the unhelpful variety.. we’ve all met one .. then I would value other input
Big thanks
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Make a list between now and the appt - which mayB cancelled so don't stop any atrophy treatment.
Remember too that this is your body so you don't have to agree to any surgical intervention without giving it a lot of thought. The 1st appt is for advice followed by consideration and if necessary, a 2nd opiiion with another surgeon.
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HI CLKD
Yes going to have a list with me .. memory useless since Covid .. Luckily have a private consultation as have a small health plan,otherwise would have waited till sept 24 just to be seen!! Thing is,none of the non surgical options have worked.. rings and things, all fell out ☹️.. so I’m actually hoping I do get offered something else while I’m young enough to recover and have some quality of life, which I don’t have now. Hopefully the gynaecologist will be clued up on the atrophy issue
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Let us know how you get on!
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I would abandon the Replens, awful stuff it made my soreness worse. Ask for some Vagifem and Ovestin cream and use every day for two weeks. I need to use both every day and have never managed on twice a week.
It will improve but will take time.
I can’t manage on twice a week either. You (probably) need to use it every night. I do at least :)
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I may have said that when symptoms threaten I push 'ovestin' up in the afternoon and again in the evening, leaving about 5 hours between.
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I am doing my best to reduce my Vagifem dose to 5 a week but sometimes its a lost cause and end up back to 7 days, it really goes to prove that some of us need daily treatment and its no point trying to fight against VA, its a demon that has to be controlled.
Just to mention I am not on any other form of HRT.
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If it ain't broke don't fix it? Once a regime was settled on, I didn't consider altering it.
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Just me hoping I can have a break from every day poking an applicator up inside me, a wish to feel normal again. Wishful thinking though! ::)
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I tried to reduce to five a week Ayesha, but it won't quite do! Six a week is OK. Currently I'm doing three nights on, one night off.
JP x
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I manage alternate nights, I'm not currently sexually active though so no idea how that would be. I'm using ovestin externally every night. That's very slow improvement, the vagifem was quicker
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I started on vagifem but some nights it would fall out half dissolved - so changed to ovestin so at least I know it stays there and hopefully works - any suggestions as to why the vagifem would have fallen out half dissolved?
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MayB your vagina skin was too thin to grip the pessary/capsule? However, what goes up ......... had the capsule dissolved at all 50+?
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I started on vagifem but some nights it would fall out half dissolved - so changed to ovestin so at least I know it stays there and hopefully works - any suggestions as to why the vagifem would have fallen out half dissolved?
That was due to the vagina being dry. The Vagifem should stick to the vaginal wall. Coating the applicator in a moisturiser such as Sylk or Yes VM helps. Or switching to Ovestin as you did.
JP x
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How long does it take to dissolve?
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I started on vagifem but some nights it would fall out half dissolved - so changed to ovestin so at least I know it stays there and hopefully works - any suggestions as to why the vagifem would have fallen out half dissolved?
The pessary is rock hard and very dry in consistency, which makes it no surprise that some of us require the added help of Ovestin for the outer area, and because of this it takes a long time to dissolve.
Once inserted high enough, like inserting a tampon far enough that its comfortable and you don't feel it, it should never fall out. But we are all different and it could be a muscle issue that's ejecting it.
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@CLKD most of them stayed up fine it was just a couple that fell out half dissolved which put me off them as I wondered if the others had stayed put. Perhaps they weren't put up far enough as it was just at the start when I was a novice at it. I don't think it has shrunk very much as at my smear recently the doctor had to look for a longer speculum to get to what she needed to and she said the muscles up there were tight and no chance of a prolapse which sounded good to me x
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I don't insert mine right up. I did do but read on here something about the best place being lower so that it's away from the cervix, less absorbed into the uterus.
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Thanks for that Jules - have you ever had any that have fallen down/out? x
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Thanks for that Jules - have you ever had any that have fallen down/out? x
Not that I'm aware of. I insert at bedtime so I'm not vertical for a few hours. I'm not sure that the placement is right either. It was on another thread, someone posted some research.
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Thanks for that Jules. I had inserted half way up until I felt resistance which was what was on the instructions but hey ho it's a minefield isn't it but so far so good with the ovestin so I will go with that but I am learning new things on here all the time - I couldn't tell you what I looked like before "down there" and still haven't had a look and don't think I will but as long as I am not in pain or uncomfortable that is all that I am bothered about.
You had mentioned earlier that this had put you off your man friend and I suspect you have lost confidence with all of this as had I but I had asked my husband if he had felt things any different or had he thought I looked different "down there" and he had said no, so please don't be so hard on yourself were men are concerned as I don't think they are really too fussy or notice what it looks like if you know what I mean - I think as long as they are "getting it" they are quite happy and also as men age they have their problems too so you could be surprised how understanding they are - I was ... I hope this makes you feel a bit better about yourself. Take care and be good to you x
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Thanks for that Jules. I had inserted half way up until I felt resistance which was what was on the instructions but hey ho it's a minefield isn't it but so far so good with the ovestin so I will go with that but I am learning new things on here all the time - I couldn't tell you what I looked like before "down there" and still haven't had a look and don't think I will but as long as I am not in pain or uncomfortable that is all that I am bothered about.
You had mentioned earlier that this had put you off your man friend and I suspect you have lost confidence with all of this as had I but I had asked my husband if he had felt things any different or had he thought I looked different "down there" and he had said no, so please don't be so hard on yourself were men are concerned as I don't think they are really too fussy or notice what it looks like if you know what I mean - I think as long as they are "getting it" they are quite happy and also as men age they have their problems too so you could be surprised how understanding they are - I was ... I hope this makes you feel a bit better about yourself. Take care and be good to you x
Thanks for the thoughtful words. Yes it has deterred me. The change that I noticed happened while I wasn't paying attention I think. And it was actually when I was having a physical exam after some spotting that I started being aware as the doctor gave a running commentary. I felt like an old woman and also had no idea those things happened. So I started paying more attention and it actually worsened quite quickly at that point and that's when I read an account on here about someone using ovestin. Thing is I wasn't using it often enough so now on nightly. I was apart from my friend for a couple of months due to his work and I didn't resume after that because I felt different. It feels so vain or selfish to be troubled by appearance but when it's your female bits it's hard. And now 3 months on I've lost confidence. I enjoyed sex before, i can't face getting my kit off now.
I'm just hoping the estrogen will help. I just wished my doctor had suggested it at the same time she prescribed vagifem. We women don't half have some rubbish to put up with
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bloody GPs!!! It’s like they are allergic to offering any type of reassurance. It’s as if they sign a contract at medical school not to ever give anyone any hope. I get don’t over promise but I feel like they go too far the other way and that can make you feel totally hopeless.
I’ve found this forum really useful for correcting my (pretty useless) GP. I didn’t get on with Vagirux or Vagirux plus estriol cream on the vulva but touch wood thanks to this forum I persuaded my GP Ovestin isn’t exactly the same as the generic estriol that wasn’t working for me (and I think maybe also making me more sore). From what I’ve read there is hope. I got a cancellation with the gynaecologist and she said it’s ok to use Ovestin x 2 a week internally and externally and also externally on the vulva every other day.
I also find using v magic vulva balm after I wee, using black free toilet paper and sanitary pads and only washing with aqueous cream helpful
X
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Well I'm using vagifem alternate nights and ovestin externally every night so I must be over dosing but with the progression of the atrophy, anything less would make no headway. Anyone else using my dosage?
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Thought I would post a quick update for anyone interested
Saw the gynaecologist this morning and as expected he confirmed the Atrophy (so all my prayers have gone unheard and it wasn’t a mistake 🤦♀️ I do have it) … but on the positive he says my medication routine is suitable suggested a few tweaks which he said “might”help including a mild steroid cream for external use and thinks it all should start to kick in soon. He’s arranging for me to see the physiotherapist to make sure I’m doing the pelvic floor exercises properly. Also, the double prolapse my GP said I had,is in fact a single one , bowel only grade 2 and bladder is fine,so it’s the Atrophy causing the symptoms
So I suppose that’s a good thing. He has offered to surgically repair the prolapse if I want and told me to have a think and let him know as if it’s not causing a problem at the moment there’s no rush and it’s a bit of a long haul operation. So at least I know more today than yesterday. It wasn’t the resolution I wanted, I clung onto the hope that I had raging thrush and a UTI, but that’s life. I have to concentrate now on getting the beast under control and at least I know my bits are not going to fall out if I cough. So not a good day, but not a bad one either :-\ :-\
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Thanks for the update, Kathryn.
To be honest I would be cheered by the news, you now have something to work on and hopefully an operation won't be necessary in the future.
Seems to me you are getting well looked after and VA once under control is no problem to have to live with.
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Kathryn - VA is far better if 1 has to choose, than thrush!
He should have suggested upping the VA treatment to every night which will work, rather than applying a steroid 'down there'. VA treatments can be applied around the labia/vulva areas. I slar either KY Jelly or 'ovestin' if the area itches to keep it supple.
VA can mimic repeated urine infection-type symptoms really really. Once a regime works, then it's best to stick with it for at least 3 years. VA treatment can be for ever to stop the area becoming dry = itchiness.
Bella247 - Gynaes often don't know enough about VA treatments and many medics are scared that we can 'overdose' on oestrogen, however: if your symptoms haven't settled on twice a week, those of us who have tweaked and experimented would probably suggest every night for at least 2-3 weeks.
Both: let us know how you get on.
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Kathryn - VA is far better if 1 has to choose, than thrush!
Really ? odds on with treatment you can get rid of thrush whereas VA has to be managed.
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Many people have on-going problems with thrush including a Member of the Forum.
Most of my day2day living is managed. Atrophy is simply another aspect of carrying for my body.
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Hi Ayesha, CLKD, Minusminnie,
Thanks for your support and replies to my post
CLKD, know exactly what you meant with your thrush comment 🤣
Minusminnie… I think it was a irony comment not said to say thrush is something anybody wants but hey ho sometimes you get thrush, sometimes it’s atrophy
Thanks again ladies
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He’s arranging for me to see the physiotherapist to make sure I’m doing the pelvic floor exercises properly. Also, the double prolapse my GP said I had,is in fact a single one , bowel only grade 2 and bladder is fine,so it’s the Atrophy causing the symptoms
You may find Prolapse Excercises Inside Out book by Michelle Kenway useful.
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Will Amazon that one 👍