Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: Jules on February 14, 2024, 11:11:56 PM
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I've posted something about this on the main board but I'm trying to find out if anybody else has had any bleeding whilst using vagifrm or similar when they're post meno. I seem to be the only one. I'm not on systemic HRT. I was using it alternate nights and ovestin externally every night since August. Previous to that just vagifem twice a week since maybe autumn 2022. I've had breast pain and one small bleed, size of a 10p. My last scan was October and lining was normal. My gp has done an internal examination and breast exam and everything felt normal. She's not referred me for another scan, feels its because I increased the doseage and has asked me to stop the vagifem for 4 weeks to see if I get any more bleeding. If nit she will check again and I can restart on lower dose. I was upset about having to stop as it's made a lot of difference and I'll be back to square one, but reassured that she wasn't concerned. I currently have bad health anxiety and now worrying that I should have more investigation, at least a scan. I note Vagifem say breast pain and bleeding are side effects. Am I unique in this situation with topical estrogen? Has anybody else had problems? Can anybody recommend any non estrogen vaginal product I can use in the meantime?
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I've been taking vagifem since August last year, twice weekly, but then upped the dose to everynight in October.
I had some bleeding, a bit like a light period, had a scan but all okay, was told probably the last bit of hormones (I'm post meno 2 years in May).
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I've been taking vagifem since August last year, twice weekly, but then upped the dose to everynight in October.
I had some bleeding, a bit like a light period, had a scan but all okay, was told probably the last bit of hormones (I'm post meno 2 years in May).
My periods were so long ago I don't remember when. Would you be worried not having a scan if you were me? Obviously I had one in October but I've had 5 more months of it.
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I've been taking vagifem since August last year, twice weekly, but then upped the dose to everynight in October.
I had some bleeding, a bit like a light period, had a scan but all okay, was told probably the last bit of hormones (I'm post meno 2 years in May).
Did you have to stop the vagifem until after your scan?
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My worry would be that if you stop the vagifem for 5 weeks and things get really dry quickly, then you could bleed because of that. Given your health anxiety that is likely to make you worry more.
I personally don't think anything is likely to have happened between October and now but, given your health anxiety, I don't think you'll be reassured until you get further checks done.
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My worry would be that if you stop the vagifem for 5 weeks and things get really dry quickly, then you could bleed because of that. Given your health anxiety that is likely to make you worry more.
I personally don't think anything is likely to have happened between October and now but, given your health anxiety, I don't think you'll be reassured until you get further checks done.
I've asked about another scan given that I'd only just increased the frequency when I had the last one. I've also asked about continuing with a reduced dose of vagifem as long as the symptoms don't reappear as I don't want the discomfort etc to return. It's really difficult. I could continue anyway without a gp say so but if I then have symptoms again she will say I should have followed her advice
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My worry would be that if you stop the vagifem for 5 weeks and things get really dry quickly, then you could bleed because of that. Given your health anxiety that is likely to make you worry more.
I personally don't think anything is likely to have happened between October and now but, given your health anxiety, I don't think you'll be reassured until you get further checks done.
I've asked about another scan given that I'd only just increased the frequency when I had the last one. I've also asked about continuing with a reduced dose of vagifem as long as the symptoms don't reappear as I don't want the discomfort etc to return. It's really difficult. I could continue anyway without a gp say so but if I then have symptoms again she will say I should have followed her advice
Could you pay for a private scan at somewhere like ultrasound direct? I think they are around 140. Then you would know if it's an issue or not. I see you predicament but I can also see (and know from your previous posts) how much this is triggering your health anxiety. No matter how much reassurance people give you it'll always come back.
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My worry would be that if you stop the vagifem for 5 weeks and things get really dry quickly, then you could bleed because of that. Given your health anxiety that is likely to make you worry more.
I personally don't think anything is likely to have happened between October and now but, given your health anxiety, I don't think you'll be reassured until you get further checks done.
I've asked about another scan given that I'd only just increased the frequency when I had the last one. I've also asked about continuing with a reduced dose of vagifem as long as the symptoms don't reappear as I don't want the discomfort etc to return. It's really difficult. I could continue anyway without a gp say so but if I then have symptoms again she will say I should have followed her advice
Could you pay for a private scan at somewhere like ultrasound direct? I think they are around 140. Then you would know if it's an issue or not. I see you predicament but I can also see (and know from your previous posts) how much this is triggering your health anxiety. No matter how much reassurance people give you it'll always come back.
I think I'm more anxious about stopping the treatment. I've no reason to doubt the GPs assessment but I feel a scan would have given the answer, instead I'm being asked to stop treatment for weeks to wait and see. I will see what she comes back with. I wish I didn't have to use anything. I don't know anybody else with this problem.
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I wonder if your body is over sensitive to any changes, I think you mentioned you ended up in hospital with acid reflux when the rest of us can get by on PPI's and a bottle of gaviscon. It seems very unfair on you that everything you try bites back at you, no wonder you have very high health anxiety.
It must feel like you are knocking your head against a brick wall all the time but will say that a lot of research must have gone on to allow topical oestrogen to be available to buy over the counter in the UK (restrictions are so high here) and deemed safe to use, I think your body protests too much.
I hope you find a happy medium with your VA treatment eventually.
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I got a brief message telling me if I start using it again she will have too refer me under the 2 week rule. It feels like a threat. And it doesn't make sense. If that's the case why am I nit being being referred at all? I feel so distressed by it all
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I wonder if your body is over sensitive to any changes, I think you mentioned you ended up in hospital with acid reflux when the rest of us can get by on PPI's and a bottle of gaviscon. It seems very unfair on you that everything you try bites back at you, no wonder you have very high health anxiety.
It must feel like you are knocking your head against a brick wall all the time but will say that a lot of research must have gone on to allow topical oestrogen to be available to buy over the counter in the UK (restrictions are so high here) and deemed safe to use, I think your body protests too much.
I hope you find a happy medium with your VA treatment eventually.
No I was diagnosed with Barratts Oesophagus, cell change from chronic acid reflux. That's a different thing. It's likely some people who are self medicating also have disease and don't know
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My worry would be that if you stop the vagifem for 5 weeks and things get really dry quickly, then you could bleed because of that. Given your health anxiety that is likely to make you worry more.
I personally don't think anything is likely to have happened between October and now but, given your health anxiety, I don't think you'll be reassured until you get further checks done.
I've asked about another scan given that I'd only just increased the frequency when I had the last one. I've also asked about continuing with a reduced dose of vagifem as long as the symptoms don't reappear as I don't want the discomfort etc to return. It's really difficult. I could continue anyway without a gp say so but if I then have symptoms again she will say I should have followed her advice
Could you pay for a private scan at somewhere like ultrasound direct? I think they are around 140. Then you would know if it's an issue or not. I see you predicament but I can also see (and know from your previous posts) how much this is triggering your health anxiety. No matter how much reassurance people give you it'll always come back.
I think I'm more anxious about stopping the treatment. I've no reason to doubt the GPs assessment but I feel a scan would have given the answer, instead I'm being asked to stop treatment for weeks to wait and see. I will see what she comes back with. I wish I didn't have to use anything. I don't know anybody else with this problem.
Ive had a look at places that do ultrasound scans. Ive asked again via the secretary for a scan and asked for a second opinion from another GP but quite honestly it would be easier to break into the Royal Mint. I just dont understand the logic - stop using HRT (though she is letting me continue with ovestin externally) for 6 weeks as she claims is the guidance, or she will have to refer me to hospital under the two week rule. If that's the case, shouldn't she be asking for further checks anyway though? How can it be a choice between wait and see for 6 weeks or be seen at hospital on fast track pathway?
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I’d be inclined to continue using the vagifem and let her refer you. At least you will be seen and get sorted out quickly instead of faffing around.
I think some gps just make things up when it comes to hrt.
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I've been taking vagifem since August last year, twice weekly, but then upped the dose to everynight in October.
I had some bleeding, a bit like a light period, had a scan but all okay, was told probably the last bit of hormones (I'm post meno 2 years in May).
My periods were so long ago I don't remember when. Would you be worried not having a scan if you were me? Obviously I had one in October but I've had 5 more months of it.
I would be worried, but because it's natural to worry. I do however feel that as you had a scan 4 months ago that was clear it's only a short time so a lower risk for anything to happen.
I had a scan & hysteroscopy in July due to bleeding, then bled again in December, so had another scan which was clear, although doctor wasn't expecting anything due to my scan & hysteroscopy in July 5 months earlier.
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I’d be inclined to continue using the vagifem and let her refer you. At least you will be seen and get sorted out quickly instead of faffing around.
I think some gps just make things up when it comes to hrt.
Same! That's what I'd do to, accept the 2WW referral. She needs to explain her logic to you. Keep using the vagifem and let her refer you, or ask for a second opinion. Sounds like she is threatening you into a course of action you don't want to take.
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My son said the same. It's strange because when I had a previous episode 4 years ago, I was just booked in for a scan. I've not had any bleeding since Monday, it was as much as a 10p piece. I really don't want any invasive investigation. I've heard on here that it's painful and also I'd be waiting ages. I've dpent all last year waiting for endoscopies and biopsies. I'll see what the reply is tomorrow then and decide. If there's a chance something is going on I don't want to make it worse with estrogen. I'm really disappointed as I finally felt I wasn't having to think about the VA
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I've been taking vagifem since August last year, twice weekly, but then upped the dose to everynight in October.
I had some bleeding, a bit like a light period, had a scan but all okay, was told probably the last bit of hormones (I'm post meno 2 years in May).
My periods were so long ago I don't remember when. Would you be worried not having a scan if you were me? Obviously I had one in October but I've had 5 more months of it.
I would be worried, but because it's natural to worry. I do however feel that as you had a scan 4 months ago that was clear it's only a short time so a lower risk for anything to happen.
I had a scan & hysteroscopy in July due to bleeding, then bled again in December, so had another scan which was clear, although doctor wasn't expecting anything due to my scan & hysteroscopy in July 5 months earlier.
Did you have to stop using your treatment whilst waiting for tests? I wonder if I've been using too much ovestin externally and along with the alternate nights of vagifem it's been too much estrogen.
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Did you have to stop using your treatment whilst waiting for tests? I wonder if I've been using too much ovestin externally and along with the alternate nights of vagifem it's been too much estrogen.
No I didn't.
At the first bleed the gynaecologist even insisted on taking vagifem, to help with the hysteroscopy I was going to have.
At the second bleed she didn't mention stopping, only that she couldn't see that the vagifem would cause the bleeding, or any potential womb problem, as i'd not been taking it long enough.
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Okay. I've been using it about 18 months maybe. My last scan was towards the end of September but I was on a lower dose then. And she said she'd examin me again in 4 weeks. I doubt she'll manage it by then. I will definitely get back to her
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I've checked NICE guidelines updated this year. It isn't very reassuring. I've not found anywhere about stopping fir 6 weeks but I'm going to ask for a check up. https://cks.nice.org.uk/topics/incontinence-urinary-in-women/prescribing-information/intravaginal-oestrogen/
- What advice should I give to someone prescribed intravaginal oestrogen?
Advise the woman that:
Topical oestrogens should be used in the lowest effective dose to minimize systemic absorption.
Medical advice should be sought if she experiences breakthrough bleeding or spotting at any time during treatment-
This is still the advice despite some of us being told we can use it every night.
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Just an update. After waking with a mini panic attack I decided I'm in charge of my own body so have messaged the GP outlining what I've found out, what I think and what I want eg a scan and second opinion. I've pointed out her ultimatum isn't helpful, has no logic and feels like a threat and that discontinuing the vagifem for longer than a week will cause a return of my symptoms and make any necessary future investigation harder. I know I've health anxiety but dealing with the inept NHS this last year has contributed 50% of it.
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Good for you Jules. That’s great. Let us know how you get on x
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Good on ya Jules. I woke up with the intention of ringing the hospital this morning and demanding an update on biopsy results. I've rang 18 times already and left messages can't get through to speak to anyone....I give up honestly!!!
I too am absolutely fed up with waiting around for the NHS....staff are great but system is well and truly broken at present
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Good on ya Jules. I woke up with the intention of ringing the hospital this morning and demanding an update on biopsy results. I've rang 18 times already and left messages can't get through to speak to anyone....I give up honestly!!!
I too am absolutely fed up with waiting around for the NHS....staff are great but system is well and truly broken at present
Have you tried ringing the histology lab? I did that last year after a 4 months wait and ringing round everyone else. They didn't give me results but confirmed they'd received them and explained how they prioritise samples and told me my GP could expedite them. It did reassure me that they'd nit found anything urgent in initial inspection. I was told they are shirt staffed and are outsourcing to other labs. The nhs should be renamed the DIY-HS
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I’d get straight onto PALS Northerngirl. You should find their number on the hospital website or ring switchboard and ask for it. The way you’ve been messed around is ridiculous and it needs sorting.
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I've had a message with an appointment with the same doctor on Monday. I'm not sure what the point of that is. By then I will have missed a week of treatment. I don't really want to go over it all again with her. I tried making a private appointment for scan, they wanted a GP referral even though I would have been self funding.
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I've posted on the other thread but just wanted to post on this one aswell that my results are back with the medical secretary now but haven't been seen by the consultant yet so he couldn't tell me anything...so annoying but I was told 2-3 weeks so hopefully it should be the next few days. I am going to ring every day now so they get fed up with me.
I'll keep you posted and thanks ladies x
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I've posted on the other thread but just wanted to post on this one aswell that my results are back with the medical secretary now but haven't been seen by the consultant yet so he couldn't tell me anything...so annoying but I was told 2-3 weeks so hopefully it should be the next few days. I am going to ring every day now so they get fed up with me.
I'll keep you posted and thanks ladies x
At least there's some progress but it shouldn't take so long nor require pestering. Keep pestering though.
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I've got that feeling of needing the loo a lot. I don't know if it's been triggered by the painful examination, I did have cramps yesterday, or its because I'm not using vagifem. I can't think in less than a week it's deteriorated so much. I get similar symptoms after sex. I'm really fed up though. I wish I had a doctor friend
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Hi Jules
The feeling of needing to pee a lot is a symptom of both va and uti, therefore it could be either a uti due to the examination or a flare up of va due to stopping the vagifem.
Take a urine sample with you to the doctors on Monday and ask her to check for a uti. If it's all clear it is probably your va that has flared up.
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Maybe but I've only missed 3 doses and am still using ovestin externally. I do tend to get pelvic discomfort and bladder urge when I've had anything like that and she was quite rough and hurt me. I'm holding out till Monday but after that depending on what's said I might resume.
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The discomfort has subsided so I think it was the rough internal examination that triggered it. Is there anything weaker than vagifem that I could suggest to the GP? Though it might not then do the job but I'm trying to get prepared for the appointment
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As you're feeling a bit better today, it probably was due the internal examination you had, especially if you've suffered similar before.
Regarding a lower dose of vagifem, sorry idk, but your gp should know this so ask them on Monday.
You could also ask the pharmacist, as otc ones will be lower dose I would have thought.
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Blissel gel is quite a weak dose of estriol. There is also 0.01% Estriol cream.
JP x
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Blissel gel is quite a weak dose of estriol. There is also 0.01% Estriol cream.
JP x
Thanks. I wish I knew where this guidance is that says if I don't stop the vagifem she would have to refer me under the 2w thing. Hopefully I'll find out tomorrow
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Update. The guidance apparently is that any bleed in post menopausal women on hrt has to be a break from the hrt for 6 weeks to make sure that's the cause. She's agreed to refer me for a scan and if I've had no more bleeding in another 3 weeks I've to message her, let her know and I can start again but only on the twice weekly. That wasn't enough for the extent of things but I didn't have discomfort at least. She doesn't think the bleeding is anything sinister, she said it's likely to be the hrt but we need to be sure and can't be if I carry on using it. So I've agreed. She wouldn't prescribe moisturiser though, she said most isn't available and they advise to get it over the counter. She didn't even check. Just saving money I think.