Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: andius on October 19, 2013, 05:53:00 AM
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I did some research on where to put vagifem after years of iffy response and came up with this study done in Italy. I'm still looking for another similar study I read previously that was done in New York. The NY study said that deeper administrations resulted in increased uterine blood flow and DECREASED urethral/vulvar blood flow. I think I may have been having vulvar "angina" :o ....LOL!
http://www.ncbi.nlm.nih.gov/pubmed/12861138
Because of this info, for vulvar/urethral issues vagifem should thus be placed in outer 1/3 of vagina? This has helped me when switching from the more deeper administration as my burning seemed to get better. Inner 1/3 adminstration of vagifem sent more blood to the uterus and had higher serum levels. Maybe this is where the progesterone should be placed??? It's an easy thing to try for those that can't get relief.
Also found this at a different site:
"Intravaginal application of estrogen plays a unique role in hormone replacement therapy because of evidence that there is preferential delivery of hormones supplied in the vagina to the endometrium. This has been termed the “first uterine pass effect.†This phenomenon is theorized to be the result of countercurrent exchanges with vein to artery diffusion. While this phenomenon is known to occur in the upper third of the vagina; it was unclear if this occurs throughout the vagina. A recent study examined this
phenomenon. Vagifem® was applied in postmenopausal women either in the lower or upper third of the vagina. Estradiol levels along with Doppler velocity measurements were made both at baseline and after 2 hours. Application to the upper third of the vagina resulted in statistically significant higher serum estradiol levels but only a small absolute difference compared to the lower third of the vagina. Also, with application of Vagifem® to the upper third of the vagina, there was a decrease in pulsatility index and resistance index which was not seen with lower third application. Thus, the first pass uterine effect appears to be exclusive to the upper third of the vagina. With application to the lower third of the vagina there was preferential delivery to the periurethral area."
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What are "17 Beta Estradiol Tablets"? Are they the same as Vagifem?
Taz :-\
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This form of estrogen 17-beta estrodiol is bioidentical to that naturally found in the body and is used in some transdermal patches.
I am almost sure that Vagifem is estrodiol hemihydrate and also used in some patches and gels and pills.
They are all synthesised in the lab though Taz.
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Thanks SL.
Taz :)
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Hi Andius. Thank you so much for your input. How very, very interesting! Clearly there have been some studies done about our problem. :hapij:
Some ladies who have used oestrogen creams (as opposed to Vagifem) mention that they smear it all round the entrance of the vagina - which would make sense. I guess there would be no harm in trying to place the Vagifem pessary in the first 1/3 - 1/2 of the vagina - hopefully it would still stick well?
There is a post about the use of Vagifem on 'All things menopause' and I've been following that closely. Many are using double doses as they used to be on 25mg and the dose is now prescribed in 100mg doses.
My other thought would be to use Vagifem in the usual way and, alongside, add a little oestrogen cream smeared around our sore areas?
I am finding that after 2 weeks of the Vagifem, my vagina excretions seem to have improved - sorry to be graphic but I'm getting more natural lubrication and it's smelling like it used to when I was pre-meno. Still getting the burning but not as bad.
Clearly 100mg Vagifem isn't enough for many ladies so perhaps using a little extra oestrogen cream around the lower vagina area might do the trick? Your thoughts please club members.
DG x
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I think you may mean micrograms not milligrams Dancingirl.
I maybe wrong but 100mgs of Vagifem sounds an awful lot and you would need progesterone to offset it.
http://www.novonordisk.co.uk/documents/article_page/document/hrt_pro_common_questions.asp
maybe I have my Math wrong.
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You'r right SL - it's 100mcg in Vagifem. I'm that age that still thinks it pounds and ounces.
DG x
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100 micrograms still far too much for Vagifem I am sure.
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I bet clkd will have an angle on this.
Ting x
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Vagifem is 10mcg.....or for those who can get it 25mcg. 1000micrograms equals 1 milligram.
17 beta estradiol is the active ingredient in the vagifem tablet.....it is the only estradiol tablet MADE for the vagina worldwide. I think it probably is in that form when the tablet is dissolved?
Some things I copied and pasted:
VAGIFEM® (estradiol vaginal tablets) are small, white, film-coated tablets containing 25.8µg of estradiol hemihydrate equivalent to 25µg of estradiol.
The estrogen contained in VAGIFEM, 17 ß-estradiol is chemically and biologically identical to the endogenous human 17 ß-estradiol and is, therefore, classified as a human estrogen.
I have tried both the premarin vaginal cream and the estrace vaginal cream on the outside. Both burned me and caused the tissue to swell up and turn red...and they really irritate my urethra. My doctor said I am allergic to something in the creams. I cannot use any eye cream of any sort! or my eyes swell up so maybe same thing going on. I have tried some low dose estriol cream I ordered on the internet on the outside too. It did not (raw) burn me or make me swell up, but it made my skin get HOT....like a sensation of immediate warmth on the inner labia kind of like hot water ...a couple days later I had itching and peeling???
Anyone else had these things happen with the creams?
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I need to get a measure stick, how the hang do you know whether you are in the outer or inner areas lol, I kind of just put the progesterone in till it gets uncomfy to push any further but then again, it is mostly uncomfy even from not too deep in, so I would never be knowing :)
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andius I think that's what I said in my post.
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Yes SL I was just confirming your post. You were entirely correct!
When you read the studies on Vagifem, there is always a small percentage of women who still have symptoms after the study period is over. Same for the other types of vaginal estrogen. I wonder if those of us who don't get complete alleviation of symptoms have something in common with those women. I have been on vagifem for 3 years and still have symptoms pretty often.
Maybe it is a variant of our anatomy regarding blood vessel supply, maybe the VA was too far gone before treatment, possibly extra hormones in the form of HRT are needed for us or at least a higher dose of the local estrogen?
Once I flew to Europe to go on a cruise for ten days. I didn't want to be bothered with the burning during this trip. I had tried Estring in the past and it didn't work to alleviate burning but I had an extra one left. I put in the Estring and used vagifem every other day on the trip and did not have a single burning episode. I drank wine, ate what I wanted, was out running around on excursions in the heat and probably didn't drink enough water, and even then I had no problems. Bladder and urethra were ok the whole time. I only tried this because I had some progesterone that I took also, just in case the estrogen was too much for my uterus. I had no bleeding episodes or other side effects. As soon as I got home I took out the Estring and lowered the vagifem back to the 2 x weekly dose. My typical burning came back in about 2 weeks. This makes me think it really is that I need the extra estradiol so I have since started HRT. However, I still have burning with HRT and regular dosing of vagifem.
I have looked for studies with higher dose of local estrogen (no HRT) and added progesterone but have not found any. It does seem that the fear of higher doses is based on the possibility of endo CA for those with a uterus so it seems a simple solution to just add prog for those who can tolerate it. However, it is hard enough to convince docs to let you try vagifem more than 2x weekly EVEN AT the dose 10mcg in US.
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Very interesting read, thanks for this.
The article is dated 2003 and refers to the 25mcg dose - wonder if it's still current thinking.
I use Vagifem 10mcg on alternate mornings, as recommended by the meno clinic. They have said that I can take this indefinitely, even without progesterone (if/when I come off systemic HRT and no longer take prog).
I'm curious - how do you know where the inner and outer vag areas start/end? I always insert the VF to the length of the applicator, assuming this is where it should go. Would it not drop out if placed too low, more so if the whole vag/bladder area has sagged?
Wondering if the lower positioning would be better for vag Utro too, or would that irritate the bladder tissues more.
Just made a note to discuss all of this at next meno clinic appt.
The alternate days use of Vagifem 10 took away all burning, can you not push for this Andius, maybe with a yearly endo scan?
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Night owl:
I tried 3 vagifem a week for 6 months which was refused by 2 ob/gyns, but thank goodness the urologist took pity on me and prescribed it. I developed a buttock rash on both sides that was like deep seated pimples that hurt and took forever to heal and left scars but persisted on, I have no idea why? other than the increase in vagifem. Eventually even that didn't work anymore and now I am on patch, progesterone and 2 vagifem a week....and the rash went away. Since I have the progesterone, I may try 3x weekly again if the lower placement of vagifem doesn't work. I am trying for half the depth I used to do when I put it in. Haven't had one fall out yet.
I found the other site that mentioned this after much searching of my internet history.
The article from NY that I saw was actually just another published reference for the same study in Italy, so there is only one study, not two.
Regarding progesterone....since the "first pass" uterine effect they describe works in the upper vagina and not lower, I would think that you would want it in the upper so it would go to the uterus (endometrium) and not the urethra. Of course, I don't know if the progesterone effect is the same as with vagifem. But it seems to be based on the blood flow. The doppler Ultrasound they used in the studies measured the blood flow so I don't think that would change between 2004 and now. Decreased resistance means increased blood flow.
Just found this regarding progesterone....they used a vaginal gel: (it seems to work here too)
http://www.researchgate.net/publication/13942259_Transvaginal_administration_of_progesterone
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I'm curious - how do you know where the inner and outer vag areas start/end? I always insert the VF to the length of the applicator, assuming this is where it should go. Would it not drop out if placed too low, more so if the whole vag/bladder area has sagged?
Hi Night owl :)
I'm like you, I've always put it in near enough full length... and wouldn't know how they measure third way etc. I don't actually get to a point where I hit resistance as such.
the actual instructions say
Step 6: The applicator should be inserted (without forcing) as far as comfortably possible, or until half of the applicator is inside your vagina, whichever is less.
http://www.rxlist.com/vagifem-drug/medication-guide.htm
so for me it would be the half of applicator to be inserted then.. will try that next time ;)
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Andius, thanks for useful info - how annoying that you developed the rash - wonder if it would happen now. I do sympathise as I medication sensitive - and highly progesterone intolerant. One thing I know for sure with this meno is that how the body reacts varies from, say, one six month period of time to the next. Maybe worth a re-try. When my VA was at its worst, alongside systemic HRT, Vagifem with a dab of Ovestin on the outer area, I used and sometimes still do - Carlson Vitamin E pessaries (very different to normal Vitamin E capsules) and vag probiotics (from Higher Nature) which I found to be soothing. Taking a high dose fish oil and ground flax seeds daily also seem to help the VA and general skin dryness, as does only using aqueous cream to wash down below and baby soap for general washing. A many pronged approach!
R4CTOM, thanks too for useful info - yesterday I tried the lower insert, half application length - strange this - don't know if it would have happened anyway, but my bladder urgency seemed to be worse than normal. This is typical of my body, to totally over-react to any sort of change! Will persist with it though and see how it goes.
Would be interesting to share experience of how we get on with the lower application.
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Night Owl:
Thanks for your comments...it really is a multipronged approach!!!!...and it takes a long time to figure out what works and what doesn't.
I love the Carlson's e suppositories...I keep them in the fridge. I also take fish oil and was taking evening primrose also, but stopped the EPO and can't tell any difference, so now just the FO and Calcium Citrate and multivitamin and my B12 and vit D. The last 2 deficiencies I was "honored" to receive with the onset of menopause ;D, particularly the vit D which makes no sense since I am in the sun alot and it is hot here....we live 3 hours from Mexico! I tried the vag probiotics too several different times (doc recommended), but not that brand. They gave me typical cystitis.....LOL...they got confused about where they were supposed to live and even grew out on the urine sample. Since then I only take them orally. Flax seeds I haven't tried....do you grind your own?, what do you eat them on?
I still get one of those lesions on my buttocks here and there, but nothing like a year ago when I had dozens. If the lower placement of vagifem doesn't help,....I may increase it again to 3x/wk and see what happens as I have plenty of them. So far 2 doses down low and no burning episodes for me....yet.
Andius
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well I did halfway up applicator last night... I am in agony today :( feels like a hot poker right up there at the top and going through to back passage :o soz if tmi ;D
don't know if it's just coincidence or what.. i'm very confused :-\
might start a new thread
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When did you last have an examination R4CTOM? If your symptoms are changing maybe you should get them checked out?
Taz
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thanks Taz... I was examined by Gynae consultant end of May who diagnosed mild prolapse bladder.... saw physio who also examined me on 2 sep, confirmed a grade 1 cystocele. Saw her again last night and asked her about womb etc, she said everything else ok, all in place when she examined me in sep, just this cystocele. Told her that the first 2 weeks on vagifem were great but felt I may need more often, she suggested trying every other day.... now got this pain today, but I have had it like this before... I originally thought all my pain was because of the cystocele, but now realise that it probably wasn't. I hadn't put it together that it was prob to do with menopause but think it must be, although I am post meno.. As I say had this pain before and it does pass but not sure what it is, it is at entrance and feels like right at top too and goes through perineum to back.. wondering if nerve damage maybe? anyway due to see gynae consultant on 6 dec so will mention it to him ;) mind you I did feel to see how the prolapse was this morning, and I have noticed that this bad pain often comes after I have done that, as if maybe just touching the tissues sets it off :-\
not sure, wish it was straightforward and could tell what's what ::)
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took a vagifem last night, so not due another until tomorrow night, but just used one to see if it helps :-\ paracetamol does nothing for it :(
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well an hour after I took it pain had really reduced, just a bit of an ache left, so maybe I do need it more often for certain :-\
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Late to this ::) - I insert as deeply as possible so that the pessary doesn't squirm it's way out again ;)
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thanks CKLD, I think that would be best for me really..... also I wonder if by inserting it lower down you are then not getting full benefit to all the area you need it :-\
Mony xx
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CLKD - I don't think you are on Vagifem - I thought you had Orthogynest - the waxy pessaries without an applicator? Apols if I'm wrong.
These are estriol and it's the effect of concentrated estradiol (in vagifem) that is being discussed.
I am excatly the same re the Orthgynest - they need to go up as high as possible - and definitely I can't put them in in the morning otherwise they would fall out!!
Vagifem are designed to immediately stick to the walls of the vagina and the estradiol gently diffuses out.
Hurdity x
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Yep Hurdity but my opinion was asked for earlier in the thread ::) ?? and maybe a certain amount of Vagifem will leak out which may help symptoms all the way through the vaginal area ??
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The reason I said it was because you said this:
"Late to this ::) - I insert as deeply as possible so that the pessary doesn't squirm it's way out again ;)"
I wasn't implying in anyway whatsoever that you shouldn't comment!!!!! Just that the discussion was only about where Vagifem should be inserted - because of some propsective research into this.
I totally agree with your point about leaking out - that's why I like the Orthogynest because it does ooze out much more than vagifem and I definitely feel the benefit the whole length of the vag.
Yes I agree also that is the reason that Vagifem should be inserted higher - it is designed to so that more oestradiol reaches more of the vaginal area - so I imagine anyway.
Hurdity x
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I just wanted to report that I used my vagifem last night and burned all day today!! I look red too! >:(
Last two doses half way in instead of deepest I could go.
A
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Hi Andius
yes me too Andius, put it in lower down on Tues evening, it took away most of the pain I had been having that day, but I was burning and itchy all around vulval area which was somewhat uncomfy all day :( Put another in last night but high up and I feel much better this morning, much more comfortable.
I'm wondering about the effects of putting 2 in together instead of 1 more often :-\ but will start another thread about it ;)
Mony xx
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Could it be for those who've gone for the half way up option that it's having a stronger effect on the outside, making a greater blood flow (as the research quoted suggested) but it's actually firing things up too much? When I was slapping Ovestin on the outside I did wonder if the effect was actually too great.
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I put a vagifem half way up Saturday and another Tuesday and the burning I was getting was horrendous - couldn't sleep for the pain. Put another in last night higher and feel so much more confortable today, so will be sticking to higher up in future.
Katy x
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I've tried two VF half way up now - and my bladder urgency is worse - however not sure if this would be happening anyway, randomly as it does - so will have to continue to trial it ....
Suzi Q - wondering what you're thinking about the half way up method of using VF?
Andius - I grind the flax seeds in a coffee grinder and have it on cereal or mixed in with yoghurt - it's not great tasting, however it does also help maintain bowel health and I think helps relieve my meno symptoms - there's a lot of contradictory info on the web re: flax/estrogenic effect.
Hurdity - I'm interested in maybe changing to Ortho-Gynest pessaries as they're weaker than VF and possibly just as effective, however just read this - discontinued October 2013?
http://www.netdoctor.co.uk/womens-health/medicines/ortho-gynest.html
Night_Owl
x
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Nooooooooooooooooo!
Thes are really fantastic - surely they can't discontinue them? I don't know what I'd do. I;ve just gone back to them...
Need to get stocks in
Hurdity x
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Night owl...i did the 1/2 way up thing and had two decent days, but am a bit bladdery today
So next eperiment is one high up and one lower down.. Think will have to call in "the grand old duke of york" method..."when they were up they were up etc....!!!"
Luv
Tingly
Xxx
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NOOOOOOO - I feel sick with fear now :'( - will send my Surgery a query ........
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Well, it seems a handful of us have now tried this for a couple of doses with no definite improvement except maybe? Some for Tingly?
Tingly
Ancient
R4
Night owl
Katy
Andius
Anyone else?
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Sorry to be the bearer of bad news re: Ortho-Gynest UK discontinuance - hope they've got it wrong?
3rd time use of half way up the stairs - and all seems okay today. Not too 'bladdery' - Tingly, I like that expression, ha ha.
Think I'm going to try it for about a month to see how it goes. I use alternate days.
Night_Owl
x
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think I'll be sticking with higher up ;)
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Probably not a bad idea Night Owl!
I have seen evidence that capillaries can regrow into areas where they have declined....i.e. to supply blood in heart patients after heart attack once patient is on regimen of exercise and meds
Maybe those of us on long term vagifem who use it up high need to try longer to get it to work in the periurethral area better....it might taken longer for the blood supply to increase since it has been preferentially going elsewhere due to "uterine first pass-effect" from the up high placement.
Another idea....if you are do for a reload - could try one up and one down for the 14 days.
I might try the alternating also, if the pain doesn't get too bad. I am better today with patch change today.
I read somewhere in a conversation between doctors that vagifem is great for vagina and doesn't work well for vulvar atrophy and burning....they recommended creams for the vulvar atrophy and once it was fixed, vagifem will maintain it. I guess I could try the creams again in very thin application now that I have been on systemic HRT for a while. Maybe I wouldn't be so sensitive now. ;)
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That is only the headline, no where in the article does it say that the product will be discontinued :-\ ....
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You can always use Vagifem if they are discontinued CLKD. Don't worry.
Honeyb
X
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2 weeks ago my doc gave me a prescription for 25mcg vagifem but I couldn't get it because it was discontinued December 2012 :bang: :bang:
The pharmacist phoned the supplier while I was there because I wouldn't believe him. Told me they were only supplying the weaker dose (10mcg), said something about them not wanting to put so much estrogen in the system in one go (it went over my head I'm afraid.)
So now I have the lower dose to try. Why oh why don't they leave it alone & let us get on with our lives. I mean so long as we are healthy & have check ups... ooh it makes me mad.
Cazi x
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We have had lots of chats on here about this Cazi. It came about because the American health authority insisted on the lowest dose possible of oestrogen being used. After that the company also decided to discontinue the 25mcg here also. It is still available in some countries but I believe it is up to each individual health organisation to decide which they will accept.
Some docs are prescribing enough to allow women to use double i.e. 2x10mcg twice a week so it's worth asking if you find they no longer have enough beneficial effect.
Taz
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well after much to-ing and fro-ing and trying to work out when and how often to use the 10mcg dose (never having tried the 25mg), I decided after a bad afternoon with the pain that I needed to use it this evening (last one being on weds eve)... I used 1 x 10mg which helped but didn't quite take the pain away altogether, so a bit later I used another..... can't believe the difference ;) :) so thanks for the tip girls re 2 at once.... :) :)
I'll see how long this dose lasts and take it from there.... seeing as how the dr said I could use it more often than 1 x 10mg twice per week I'm sure doubling up a couple of times a week will be ok ;)
Mony xx
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R4ctom...let us know how you get on at the docs
Xxx
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Just to re-iterate that Vagifem is not an instant pain reliever - nor is any local oestrogen, but works to reduce the pain and irritation through regeneration of the vaginal cells, and reduced the ph.
They should not be used as an instant thing but the regimen chosen needs to be continued for a couple of weeks at least for there to be any lasting effect.
Hurdity x
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Thanks Tingly and Hurdity :)
That's what is confusing me, I know it is a regime, but with the dr telling me to use it more often as and when I need to, well that doesn't seem like a regime to me ??? surely a regime is a regular dose at regular intervals...
don't know what to do, the relief last night was short lived, been in pain all day today.... not even sure it is atrophy anymore but could it be something else? paracetemol doesn't do anything for it..
in fact thinking about it, don't remember having this much pain before I started using it. It was suggested I use it for dryness and some discomfort. I also wanted to strengthen tissues because of my prolapse.. It was great at first, felt really comfortable, and tissues are definitely feeling stronger, but now feel like I may have made matters worse by using it :(
don't know what to do......think I will have to start again with definite days when I take it, put up with pain in between, and see how I go for the next few weeks until I see the gynae...........pain in the bum, literally ::)
if I'm out of sync with my regime, can I just start again but without the 2 wks loading, i.e take 1 x 10mg Mon and Thurs evening for next few weeks see how I go? I don't really want to give it up because I reckon the lack of oestrogen brought on the prolapse probs :(
thanks for your help ;) :)
Mony xx
fedup.com >:( >:(
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Oh bugger, sorry its come back r4ctom, i know what u mean about the regime thing
I'm the same, paracetemol doesnt help BUT ive had clear day fri sat and up until about 4.30 today.(took vagifem on friday night)
Just used some multigyn inside me about 1/2 hour ago and thats took it off again.
I wonder what it is too... I hated it when my specialist said it was typical atrophy, but then she examined me and next time i saw her she said my vagina didnt show signs of atrophy.(but by then i had been taking super strength hormones ).
I'm hoping that the hormones had worked inside my vagina but the symptoms were then the urinary ones
( fancy hoping its atrophy!!)
She did do a pelvic exam , a transvaginal scan, i had a cystoscopy a couple of years ago, my bladders been checked my waters been checked so i cant think what else it could be
Also the fact that the vagifem has worked ninety per cent surely means it is atrophy ...doesnt it?
Also look how many people have got burning in the burning club on private lives....surely this is part of atrophy?
I dont know...it does your nut in doesnt it?
Hope the stingys go soon for you
Maybe we should all go as a group to an eminent gynae and see what they say!,,
Luv
Tingly
Xxxx
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Just a thought.....changes in estrogen level in vagina can be associated with thrush. Please check to see that this is not coming on if you are new to vagifem. In my experience the burning is quite the same and it doesn't always have a discharge although usually there is some itching. ;) With burning, the itching may not be as noticeable.
If you are using Vit E or other moisturizer type stuff.....you may not have the typical discharge.
Andius
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thanks :) I know it's not thrush....
my pain is just inside me, can go right up and through to the back exit if you see my meaning :o like a hot poker through that area, also pain at bottom of my spine area.......
also just a touch can set it all off... sometimes when I am in pain I feel like my prolapse must be worse, but check it and it isn't, but just that slight touch sets everything off...
I originally went to gynae because things didn't feel right down there when I was showering, diagnosed the prolapse, and it's only since then this pain and everything has got worse...
I'm very confused about it all now..
btw updated my last post with questions ;) thanks for any advice :)
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R4
If you have completed the 2 wk loading regimen already (within last 6 mo or so) and have been taking approx 2 doses a week since then, you should be able to pick any 2 days of the week, roughly 3 days apart and make that YOUR REGIMEN.
It can be MON-Thurs or Thurs-Sun or whatever you want for your schedule. If your doctor said you could use more....I think they mean like MON - Wed - Frid or Tue- Thurs - Sat or whatever fits your schedule for 3 doses a week. I am assuming you are on the 10mcg vagifem. I have never doubled up on doses, and I would recommend you ask your doctor before you do this to clarify if that is what they mean by using more.
If you are on the 25mcg vagifem.....please wait until someone else who uses that can advise you as I have never taken those.
Andius
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thanks Andius.. i'm on 10mg.... just going to start again with twice per week and see how that goes...
will see gynae in 6 wks, so chance to have a good run at that regime :)
thanks for your help everyone...... :) :)
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I can't find anywhere on the 'net' which states that the product will be discontinued :-\ - if I remember when I go to the Surgery later today I will ask, I have sent an e-mail to that effect .........
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R4CT - Just had a thought. Could the pain be caused by your prolapse pulling down? It could be that a muscle is aching in there or a nerve pressed on or something like that. Maybe ask the gynae at the next visit?
If it is hurting, I would not recommend you do not use the Kegel machines or vaginal probes as that may aggravate the problem. Stick to the conventional pelvic floor or kegel exercises. Just IMHO.
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I too have been tested for thrush...its not that
The fact that i have good hours some days is beginning to mak me think it is va, but hasnt quite resolved in the bladder/urethra yet
Maybe it takes longer to get there?
Tingly
Ps cant find anyone who has said vagifem sorted the symptoms out completely...i posted on this a bit ago as an experimment
Also cant find out how long you have to take it to be completely effective
Luv ting x
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R4CTOM
Re using it more often. If two a week aren't working then I would just use 3 a week and yes start anywhere as long as you don't leave it longer than 3 days without ie take more rather than less to get in sync with whichever days you choose. If this still doesn;t do the trick after a few weeks I would use two at once twice a week and see how that works, or just double up on one of th three days (depending on how you want to do it)
It really sounds like more than VA to me - a hot poker right up your insides? Sounds horrendous!! I can't help re how long it works because I am on systemic HRT and vaginal oestrogen and I really get virtually no problems at all with burning or any irritation.
Hurdity x
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Thanks Scriv, Ting, Hurdity
Yes I am wondering now if it is getting complicated with the prolapse. Was also reading about the pudendal nerve causing problems throughout the whole area if it has been damaged during childbirth.
yes Scriv, I'm only doing manual kegals :)
Thanks Hurdity.. last took Saturday evening , so will start again on Tues evening and Friday evening, see how that goes ;)
fingers crossed ;)
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Am still waiting for a reply re: "Ortho-Gynest UK discontinuance" : to my e-mail from the Surgery >:(
As this Forum is medic led, it would be helpful if Dr Curry or Emma would let us know if products are due to be altered or taken off the UK market.
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Netdoctor usually gets it right CLKD - often way before any other sites.
Taz
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We have had lots of chats on here about this Cazi. It came about because the American health authority insisted on the lowest dose possible of oestrogen being used. After that the company also decided to discontinue the 25mcg here also. It is still available in some countries but I believe it is up to each individual health organisation to decide which they will accept.
Some docs are prescribing enough to allow women to use double i.e. 2x10mcg twice a week so it's worth asking if you find they no longer have enough beneficial effect.
Taz
Thanks Taz :-* :-*
I thought I had seen some talk about it, just lost track of it. Very interesting & I shall have to tell my GP that I shall be needing double dose.
Love Cazi xx
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Apparently it is Vagifem that is being dis-continued. I never received a reply to my e-mail of 3 weeks ago from my Surgery so will be checking when I go to Lloyds Pharmacy ....... perhaps ladies you could also check?
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Vagifem 25mcg is definitely discontinued in the UK.
Vagifem 10mcg is now prescribed instead.
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:thankyou:
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Anyone ever notice that they feel worse "down there" the day after vagifem?....i.e. more irritation?
Andius
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Yes andius. I find the urethra is sore the day after - but I'm still finding the burning is still coming and going quite a bit . I'm going to try the Ovestin cream around this area externally over the next couple of weeks, as well as using Vagifem two times a week, to see if that gives relief.
DG x
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Am still waiting for a reply re: "Ortho-Gynest UK discontinuance" : to my e-mail from the Surgery >:(
As this Forum is medic led, it would be helpful if Dr Curry or Emma would let us know if products are due to be altered or taken off the UK market.
I did see this somewhere online - it said that stocks should last till the end of Nov. I've just been googling, but can't find the page now. Grr. I've got a GP appt on tues to find out, but am going to carry on investigating...
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Nillers, you are right - I saw it too. You are not imagining things..... Was it on net.doctor or something similar?
I seem to remember it was a headline on a page about vaginal oestrogens, but there was nothing more about it in the text.
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http://www.pjonline.com/discontinued_products (http://www.pjonline.com/discontinued_products)
???
The information re Ortho-Gynest is listed under 28 September. It's interesting there's no reason given for their withdrawal - I wonder whether it will be available in different sized packs/alternative strength? There is a phone number supplied for 'Medical Information'. I have a GP appointment the week after next so I'll ask about it then...
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Thanks morwenna, I might print that to take to my GP appt on Tuesday.
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In reply to Andius. Yes I feel more irritated the day after using Vagifem and then it settles down with just occasional burning. Very strange.
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Personally I think vagifem can be more potent then the lowest dose estrogen patch. The mucous membranes are a very good way of introducing hormones into the body and some women may absorb it systemically more then others.
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It is true that some women absorb more than others from all forms of HRT local and systemic, as we are all different. However I understand the main difference in the amount absorbed is due to the condition of the vaginal mucous membranes - which is why it is so important that those who only want to use topical/local oestrogen to follow the dosing instructions carefully, to minimnise systemic absorption.
As we have discussed on other threads, if a woman has VA and the vaginal tissues have thinned, then some systemic absorption occurs. After approx 2 weeks the tissues and cells have grown and systemic absorption, although it still occurs is said to be minimal, especially with the 10 mcg patch - although many have said this is not enough to keep symptoms at bay!
Morwenna - re Orthogynest pessaries: I've e-mailed the manufacturers and will post when I have a reply. I do hope it's not bad news for women....
Hurdity x