Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Ms_london76 on February 26, 2025, 03:17:48 PM
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Hi friends
I have been on Imvexxy 4mg 2x a week for almost 4 months (next week) I was using estragyn cream a couple of times a week. But I developed a red irritation and stopped for a week and was put on a steroid. Back to using the cream only once a week on the area the dr told me too. (Not all over)
The area is only on my right side, the wounds look like they are healing with new loose skin forming (Gyneo said it was normal)
However lately, some bothersome symptoms are persisting. Sometimes when I pee there is a post pee burn which lingers. And my bladder is still not up to snuff (wake up at least twice to pee) when I sit in a car I am very uncomfortable.
I am learning I am hyper sensitive to things for instance yes wb stings the crap out of me, versus yes ob which can sting depending on what I do but mostly can function.
I am understanding that there is new skin and that skin can be uber delicate just like it was in the beginning before being on anything.
So at what point do I discuss changes to my medications or continue to stick it out. The Gyneo was adamant about it can take up to 6 months.
Visually the area looks a lot better. And often have great days but lately it seems I went backwards a little bit.
I am losing my patience at this point. As I feel I should be so much further ahead at this point.
Any thoughts, I just want to be pain free but with having such delicate area down there. When I mess around with medication and self dosing things get worse for me (like using the cream more often than prescribed ended up on a steroid)
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2 a week of any VA treatment probably isn't enough , many require nightly applications for many years. How about upping the Imvexxy?
A steroid should probably not have been the first choice of treatment on an already damaged area of skin, increasing appropriate VA treatment may well have improved symptoms.
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I was having redness and itchiness which started when I was using the cream more frequently and all around the vagina. I was supposed to use it one area. The redness appeared on the opposite side of where the wounds is. But I thought I could use it everywhere.
I made the same mistake with vagifem and used it too much which ended up causing crazy burning. When prior to that I just had dryness issues. Too much too soon.
Since stopping the steroid (only one week) the redness is completely gone.
At this point downstairs is just hyper sensitive possibly cuz of the wound that does look like it’s healing. But terrified too do too much too soon and suffer more
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It’s very unfortunate for you that you are super sensitive to the treatments for Vaginal Atrophy and that situation will make it an uphill struggle to get your symptoms under control. It probably will take longer for you to feel any better, I know that my symptoms were straight forward but it still took a year before I felt I was completely symptom free.
For someone like you it will be lots of trial and error and taking things slowly until you eventually find some relief.
I am sure I have read posts here of ladies using steroid cream to help with severe soreness and in the short term this is fine to do but someone will correct me if I'm wrong.
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It's Trial and Error - have U tried something as simple as KY Jelly several times a day to keep the area moist? I find that helps when the labia are dry, even with the use of 'estriol' every 3/4th night.
Or mayB stop everything to see how well the steroid has worked? If the skin around the vulva, vagina etc. is thin anything that touches it may well sting so little and often may ease that. I have successfully applied LIVE yoghurt which is soothing, internally and externally.
When I had steroid treatment following radiation on a breast I was told 'not to use anything bigger than a pea ' and was restricted to no longer than alternate days for a week.
4 me VA was like razor blades :o up there !
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It’s very unfortunate for you that you are super sensitive to the treatments for Vaginal Atrophy and that situation will make it an uphill struggle to get your symptoms under control. It probably will take longer for you to feel any better, I know that my symptoms were straight forward but it still took a year before I felt I was completely symptom free.
For someone like you it will be lots of trial and error and taking things slowly until you eventually find some relief.
I am sure I have read posts here of ladies using steroid cream to help with severe soreness and in the short term this is fine to do but someone will correct me if I'm wrong.
You're not wrong Ayesha, steroid cream is fine to use, I've been prescribed it for years for VA flare ups and Lichens Sclerosus by a consultant at the hospital's vulva clinic. Thankfully Lichen Sclerosis hasn't appeared now for a few years so mainly for VA flare ups. Safe dosage of Dermovate is twice a day for up to 4 weeks, then a maintenance dose of twice a week with a weaker cream, Daktacort Hydrocortisone cream. I never actually had to use for that long as Dermovate is quite strong and I'm usually sorted within a week now as I don't ever let it get to the state I was in years ago. Estriol cream was also prescribed at the same time by the consultant to use externally every night with the steroid cream for Lichens Sclerosus and VA and Vagifem was upped to 5 per week. The combination of all these has been life changing for me as I suffered for a year on just 2 a week vagifem from the GP and was in a right mess.
Sometimes you have to throw everything at it to work but then for others less is more. We're all so different and what suits one won't another.
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:thankyou: Dierdre.
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Hi everyone
Thank you for all your replies.
The steroid was prescribed for one week thin layer 3 x a day. I stopped using it last Tuesday and the area is no longer red or itchy. I also wondered if it was the coconut oil I was using externally which seeped internally creating a burn as well. Stopped using that and now use cerave healing ointment.
She told me to stop everything except for Imvexxy. The last few days I have been using yes Ob but would also sting the area. If I moved around it would seep around.
I used Imvexxy last night and used yes Ob at 4pm yesterday. Today I didn’t use anything but have a good day today 🤷♀️.
I can see the wound when I look internally, meaning I see the loose skin (healing I guess) like the skin is growing over it. So that is a positive.
I did try yogurt once didn’t agree with me. I do have ky gel but if it is water based may have an issue.
I have a phone consult with the Gyneo tomorrow to go over my medication of maybe upping Imvexxy 4mg to 3x a week versus using 10mg. I need to go slow apparently as I am reactive :-\
Will ask about changing from estrone to something milder. But apparently estrone is not as potent as estradiol. And only contains one estrogen versus others. But will ask
The post pee sting is just so annoying and I would love for that to go away.
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So just an update:
Gyneo was not willing to increase my Imvexxy at all. Nor wanted me on the cream.
But last night I used the estragyn cream anyways but this time mixed in my hand both pea size amount of estragyn cream and yes ob together. Than I applied and had no burning over night. I learned that I cannot “rub” things in versus lightly applying.
I have learned to really space out when I apply yes ob and either Imvexxy or the cream (few hours between).
I could take it with her knowing but the scripts are only for 2 times a week, meaning I will run out of scripts for Imvexxy.
I don’t feel twice a week is enough of Imvexxy and I am not sure why she is not willing to increase it for me
I have sensitive skin. She recommended replens but it’s water based and I already reacted to yes WB.
Yes OB is more soothing
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I've come to the conclusion that we have to find our own way of discovering what regime works best for us as individuals, because that's what it requires and I don't believe a doctor or meno specialised knows any different, GSM is a completely individualised condition.
I have had great conversations with my GP and Practice nurse and they concur with everything I say because what I am doing is working for me, full stop.
Treatments are safe, if you can buy them to go along with what you can get on prescription then great, do it.
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I agree. The next day after using Imvexxy or the cream I feel great. It’s those in between days.
My fsh is stating I am post menopause which is slightly early at 48. When I said to the Gyneo she was like well those numbers don’t mean anything. So one dr says my period is mostly done so all the blood panels and another dr said panels are useless.
I learn everything from Dr Kelly Casperson and Dr Mary Claire Haver from social media.
So it’s frustrating to not have the consensus on things. I will be fighting for systemic estrogen today to add to my tool box cuz I think I need it.
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I was the drs office on Friday, to talk about systemic estrogen (started divigel on sat) got some blood work. And had to get an ultrasound of my shoulder. (Pulled a muscle 2 months ago has not gotten better)
Anyways, during the appointment on Friday, I almost passed out. Got really dizzy, lightheaded, sweaty, and could feel that I would hit the floor. They had to stop so I could lie down. My blood pressure was normal. The thing is I was fine when I left the drs office and went to a store walked around. The ultrasound place was right next door to my dr where they took me right away.
I have had these episodes in the past few years. Not sure what causes it. I have had all my blood work done (now checking for iron or b12).
I worked out in the morning, i did have some snacks before the appointment. The room was small with two technicians, i was fairly calm that morning.
I am not sure if it was low blood sugar, low blood pressure, low estrogen? Been tested several times for diabetes.
And of course after all that sitting my drive home was painful. Apparently the body goes into flight or fight mode and goes into reserve mode when it comes to oxygen and blood flow. So the vagina was not happy plus all the sitting.
I feel now but not sure what happened
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Although you have reactions to things, I still think you would benefit from more than 2 per week. I know you're having a hard time to get more than that prescribed though :(
I hope the systemic HRT helps :)
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I used estragyn cream the night before mixed in with yes OB. Than in the morning I did another round of yes OB.
Maybe that was too much and I should just leave it the next day.
I made the same mistake with Imvexxy, where the next day I applied yes OB and had some issues during the day. So last Tuesday I did not use yes OB the next day and I felt fine. Something about the sensitive tissues from estrogen the next day etc.
I wonder if it was from that?
Or stress of almost passing out reducing blood flow to the area (cuz I was sitting so much on hard chairs)
I have the cream so I may try to up that to 2 times a week. While Imvexxy is at 2 times a week.
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Hi
I am suffering from very similar issues after trying all of the different types of topical oestrogens and now thinking I will mix my oestrogen cream with my YES VM - are you on low dose systemic HRT - I am going to try the lowest dose HRT patch to try and help my bladder which has caused me constant discomfort ( frequency / pain/ pressure ) and anxiety for a solid year now - it’s just awful - I may try Mirabegron to see if it helps calm my very sensitive bladder …. we should PM somehow - we are the same age and stage by the sounds of it !
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Correct VA treatment is unlikely to cause extreme reactions Ms_london76. Your GP should follow up these 'sessions' correctly. We shouldn't blame everything on menopause. Also U may be putting too much preparation into and around the vagina/vulva - I suggest from my experience to stick to dedicated VA treatment internally. When I am dry I use KY Jelly or a smear of estriol on the outer labia.
It have been a panic attack. Or hot flush. At which point of the examination did U experience these symptoms? Drawing blood can cause wooziness.
Kaz78 - U can ask away on here, mayB start your own thread? That way responses are unlikely to become lost. There are a lot of threads about VA etc. so U R not alone. How often do U use VA treatment internally, every night is necessary for many sufferers!
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@Kaz78 I just started divigel (systemic estrogen) in Saturday. I only have been on that for 5 days. But literally noticed an improvement in my overall mood and mental clarity. I have been already on progesterone (bio identical) for a few months. I feel sharper and less foggy, more energy. The dr said this just means my body needed estrogen. I feel like a new person overall.
I often suspected my episodes (of almost passing out) were due to something. I have been tested for everything diabetes, iron, d, b12, nothing has shown up in my blood work.
@CLKD it was not a hot flash. It was I was going to pass out. It happens very quickly light headed, exceptionally dizzy, than I start sweating things got visually swirly and at that point I knew I would hit the ground. I have had hot flashes before it was not the same. Low blood sugar maybe. It was not right after the blood draw, I walked out of the office. Went to a store and circled back for the ultrasound, sat in waiting room for a few minutes. Than went to room for ultrasound. I felt pretty relaxed as it was just my shoulder. So maybe just low blood sugar.
As far dedicated treatments it is just estragyn cream (estrogen) Imvexxy and yes OB for lubricant. I cannot seem to use water based at the moment.
I suspect all the sitting in hard surfaces plus the table for ultrasound (where my feet were not touching the ground and put all the pressure on my pelvis. Those tissues are still healing in chairs I can lean to one side and prop a leg up. But in the table I had no option to do that. During the episode the body went into flight or fight mode and prob just made my symptoms 100% worse.
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When had U last eaten? Years++ ago we would have a cooked breakfast B4 setting out on cycles, within 20 mins I would be on the floor. Gut couldn't digest breakfast and cycle :o ::)
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I guess I had eaten early and modified work outs. I thought I had enough in me meaning I had a banana and a small granola bar on the way to the drs office.
I have always been mindful to have snacks with me due to past episodes. And being now gluten dairy free and vegetarian and bladder sensitivities
It makes it harder to stop and grab food. The blood draw may have been the reason….
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So at the 4 month mark I am still experiencing discomfort, especially after I pee or sit too long.
I do get the tissues are healing and this can take time. And most likely in the rebuilding phase which can take the longest .My Gyneo was unwilling to change the frequency of use neither did my GP want to change it from 2 x week.
I will give divigel 2 weeks before I play with my dosing.
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Could the lightheaded episode be linked to your shoulder injury? I overstretched a tendon in my neck/shoulder area a couple of years ago and it kept making me come over dizzy, sweating as if I would pass out. I did weekly sessions with osteopath which helped reduce the episodes but they didn’t go until a few months had passed when the tendon healed and tightened back up.
Could also have been your brain adjusting to the higher dose oestrogen.
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It’s a shoulder strain, the ultrasound didn’t hurt. Seeing that I have been dealing with since December.
This most likely was the blood draw and low blood sugar.
I did not start divigel until the next day so it was not that.
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Hi friends.
I started divigel last Saturday only .25mg daily on my thigh. I started divigel because I was not sleeping well, night sweats, hot face. Brain fog low energy, depression, severe mood swings and vaginal issues.
I am also on Imvexxy twice a week and estragyn cream once a week plus progrestrone. For about 4 months now.
Last Sat Imvexxy all was good Sunday with mild discomfort pockets.
Tues night Imvexxy was okay on Wednesday.
On Thursday I had a good day no burning at all just using yes OB all day (have not had that at all since I started)
Thursday night, I used estragyn cream mixed in with yes OB. Woke up to pee at night and had burning which took awhile to settle.
Friday I had some mild discomfort thru the day.
Sat, I had severe discomfort. Eventually settled. I used Imvexxy at night.
Sun am I was okay and used yes OB in am, but went to the bathroom again I had severe discomfort. To a point where I felt I was back at the beginning. I washed the area down and did a sitz bath. And used a little yes OB. I didn’t leave the house at all
I have no idea what is causing the flare up?
I read in ChatGPT that the addition of systemic estrogen can actually overload me with estrogen!? Or too many things down there. The dr had advised to stop using the cream but I thought I would try one more time. (There was a time in Feb where I used estragyn cream and the next day I felt great) but have not had that since. I am learning that estragyn can actually delay the release of estrone cuz it gets converted to estrodial. And it can release a few days later which is something I did not know. So combine that and used Imvexxy last night it’s very angry today.
I already did one sitz bath and may do another if it doesn’t calm down.
So I am not really sure what is wrong? I know the tissues are still healing but what I experienced today terrified me cuz I felt like I back at the beginning again.
Any thoughts? Too much product at once? Too much estrogen? The cream? I have not had a flare like this over two days ever.
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Just use one product at a time to identify which is causung the burning. It seems to have started with the cream but was that because it interacted with the oil base YES? Try using everything on its own or at least a few hours apart. Anything oil based is going to cause a barrier and make it hard for the cream to absorb into the skin.
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According to my diary I seem to have reactions post estragyn use. I do space everything out but maybe the cream is the issue.
I will try something milder by the naturopath who can give me a script for a compounding pharmacy. With estriol as the base that way I can use it more often
For the time being I will shelve the estragyn cream. And stick with Imvexxy 2x a week plus I added divigel this week. And yes OB for the time being.
It was terrifying to have that experience I could not walk, could not drive. Had no idea what triggered it
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Hopefully the divigel will start to make a difference and you might not need the cream. Just been looking at the side effects of estragyn cream and it mentions irritation. It's also estrone not estriol or Estradiol, I've not heard of estragyn before, is it new?
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I am in Canada. It is supposed to be a milder form of estrogen. But also learned that estrone can have delayed release of estrogen which I felt is why I had irritation the next day and even two days later. Estrone converts to estradiol and lingers longer in the vaginal tissues due to this conversion and slower release.
Which I found rather interesting…
I have tried this cream for quite sometime only once a week at a small dose (pea sized) my body may not agree with it or I have allergy to something in it.
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Estriol is milder than Estradiol so perhaps just use that for a while on its own and see how it goes. I use Estriol cream every night externally.
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Dierdre,
When you have flare ups of atrophy pain,
what number on a scale of 1-10 would you say they are?