Menopause Matters Forum

Menopause Discussion => All things menopause => Topic started by: Chickbits on July 02, 2014, 09:34:31 AM

Title: Vagifem reduction
Post by: Chickbits on July 02, 2014, 09:34:31 AM
Hi

I started on Vagifem 10mcg vaginal tablets in March after much debating whether or not it was a good idea. Once I got over the 'loading up' period and then got used to the maintenance dose of twice a week it seemed to have done the trick for the most part. However I asked for my repeat prescription a couple of weeks or so ago and the GP rang me to say she would give me the prescription but told me I should cut down to one a week and maybe then once every fortnight if possible. I have tried to do this but after the first six days all my symptoms started to return with a vengeance ie vaginal dryness, back pain and pressure over my pubic bone and the dreaded return of dashing for a wee, sleepless nights because of the burning pains. I didn't expect the symptoms to return so quickly so I was quite shocked. I don't understand why I've had to cut down as I thought that the dosage of 2x10mcg tabs was quite low. I've just got my life back on track and don't really want to revisit the bad old days. Anyone gone thru anything similar with their GP? I thought I'd garner some views before I go back to the surgery. Cheers Chickbits
Title: Re: Vagifem reduction
Post by: Dancinggirl on July 02, 2014, 12:39:35 PM
Your GP is bonkers.  If you have VA you probably need to use local oestrogen for the rest of your life. Vagifem 2x weekly is a low dose the there is little or no systemic absorption. Go back and tell her you researched this on this very good site founded by a Gynae and if need be ask for a referral to a gynae for further advice.
Oh dear, these GPs make me mad.  I bet she is young - all I can say is, I hope she suffers with VA one day because I'm sure she won't put up with it.
I'm using Estring which is higher dose - it's taken months for things to improve and there is no way I will be without local oestrogen.  DG x
Title: Re: Vagifem reduction
Post by: Chickbits on July 02, 2014, 04:49:31 PM
Hi DG

Yes, I thought it was rather strange to encourage me on to the Vagifem then suddenly say that the dosage was too high as there was no mention of this when the dosage was explained to me. Trouble is you doubt your own logic when your GP tells you something like that. She seemed to be suggesting that if I couldn't cope with cutting back to once a week I'd have to go on progesterone to balance out the oestrogen I was getting from my two a week habit - does this sound sensible? At the time I was thinking that the Vagifem dosage was so low that I didn't need to use anything else but hey, what do I know? My gut feeling was I should stay on the twice a week dose and shouldn't need the progesterone. I'm glad the Estring is working out for you - it must be a relief after suffering for months. It's encouraging to know that there's alternatives in case the Vagifem becomes less effective. By the way my GP is female and I would say she's in her late 40's. I was hoping she'd be more reassuring in view of her either approaching or in the middle of meno herself! I'll do as you suggest and ask for a referral to a Gynae if I'm not satisfied. thanks Chickbits x
Title: Re: Vagifem reduction
Post by: dahliagirl on July 02, 2014, 04:57:42 PM
The leaflet says twice a week (every 3-4 days).

On The British Menopause society tweets: https://storify.com/SAGE_News/british-menopause-society-24th-annual-conference-2  some one says 1 year of vagifem is equivalent to 1.1mg of oestrogen orally.
Title: Re: Vagifem reduction
Post by: oldsheep on July 02, 2014, 05:16:55 PM
The meno clinic at Kings in London told me every other day or every 3rd day is fine as I have problems. I am on progesterone though. A GP at my surgery - supposedly the one who "does HRT" - was concerned that vagifem was "risky" and meno clinic wrote her a note to reassure her.
I now go to see the one GP who is more sanguine about HRT to get my repeat prescriptions.
Hope you have someone else you can see?
Title: Re: Vagifem reduction
Post by: Dancinggirl on July 02, 2014, 05:19:29 PM
Chickbits
Clearly your GP doesn't understand about the difference between HRT and local oestrogen.  Vagifem used to be 25mg but unfortunately they reduced it as they claim 10mg works just as well!!!!! Well, many ladies who have been using 25mg twice a week for years are finding they now have to use the 10mg 3 or more times a week to maintain their comfort levels. 25mg is still available in other countries and women have been on it for years with no build up of their uterus.
Estring is a low continuous dose which naturally gives greater relief. You shouldn't need opposing progesterone as little, if any, oestrogen is actually absorbed to build up the uterus lining. Your GP needs to do her homework. 
If she needs info she can always check out this site - there is a section for health professionals.  DG x
Title: Re: Vagifem reduction
Post by: Chickbits on July 03, 2014, 08:08:33 AM
Hi and thanks for your replies which are reassuring to say the least. I was feeling really low after thinking that I would have to cope without the necessary dosage to alleviate the rotten symptoms that came back almost immediately. I guess I'll have to gird my loins (as long as it doesn't cause any further irritation) and tell my GP I need and must continue with the two Vagifem a week and refer her to this excellent website. I went in thinking that with a mainly female GP practice at my surgery they would be experts on HRT and all things connected to the menopause. It makes you wonder if they have been given 'guidelines' on safeguards and they err on the side of caution in this litigious age. Thanks again for your info cheers Chickbits x
Title: Re: Vagifem reduction
Post by: Chickbits on July 03, 2014, 08:44:57 AM
PS - I meant to say oldsheep that there are 4 women GPs in our surgery. You see one and the others sign the prescriptions - maybe to cross check they aren't killing you? So you can get several doctors input on your prescribed drugs - probably adding to the confusion on the advice I'm getting. Maybe they're not singing from the same hymn sheet. I wish I could find a sympathetic clued up GP and stick with them thru all my treatment/prescriptions but they don't seem to approve of this approach. Cheers Chickbits
Title: Re: Vagifem reduction
Post by: Lynne888 on July 04, 2014, 07:02:57 AM
I use more than 2 a week some weeks.  My  symptoms started to come back after about 12 months on vagifem and my GP told me to do another 2 weeks of using every day and then either use two every 3 days or one every other day.  It does the trick. If I feel any symptoms coming back I just double up again for a few days and it calms down. I DO get thickened lining though:(  I have a bleed using Provera every 3 months and I always bleed a lot so it shown there is a build up where I am concerned. My life before using Vagifem was terrible so I would be devastated if I had to stop.  I was given the Estring to try about 12 months ago. My doctor would be happier if I used this, but  didn't get on with it.  It was fine for about 4 days and I was thinking it was better than having to remember to use Vagifem, but I started to get a stinging sensation which got increasingly worse so I had to take it out. 
Title: Re: Vagifem reduction
Post by: Chickbits on July 06, 2014, 11:04:39 AM
Hi it's interesting hearing about the variations in dosage you've all been taking. I've been using the Vagifem twice a week and the symptoms I had have mostly subsided - still going to the loo a bit more than I was and the urgency is still there but nowhere near as bad. I think I will carry on twice a week and see if it kicks in. If not I will raise the problem with my GP. How does the estring work - is it something that you have inserted like the coil? Afraid I'm a bit ignorant on HRT I must read up and get clued up. Cheers CB
Title: Re: Vagifem reduction
Post by: Dancinggirl on July 06, 2014, 12:31:37 PM
Estring is a latex ring that you put in yourself - it just slides in and sits around the uterus. It slowly releases oestrogen over 3months and then you change it.  I find it great because you just forget about it.  DG x
Title: Re: Vagifem reduction
Post by: CLKD on July 06, 2014, 03:40:18 PM
I think once we find a regime that works for us we need to continue with it.  My bladder soon lets me know if I have forgotten to insert a pessary, I get the dragging symptoms and the need to pee more often.  :-\
Title: Re: Vagifem reduction
Post by: Hilary66 on July 07, 2014, 09:15:30 PM
Hi there, I'm just found this site today and felt relieved that there are others out there with symptons like my own .I have been on vagifem 10 mg since May and haven't really noticed any great difference to be honest,I still have horrible hot flushes and intercourse is painful,I had a routine smear done today and had to insert vagifem as it was due and it stung like hell.I hope I will find some answers on this site as doctors don't seem to understand how draining it all is,I am also a ms patient diagnosed in 2012 and firmly believe the menopause brought my condition to a head, looking forward to reading all you posts.take care h66
Title: Re: Vagifem reduction
Post by: Dancinggirl on July 07, 2014, 09:37:26 PM
Hi and Welcome Hilary66
It can take months before local oestrogen starts to improve the whole vaginal area.
If you are getting bad flushes have you been offered systemic HRT?  Vagifem won't help flushes and night sweats but some women find that they need both systemic and local oestrogen to help with vaginal atrophy? 
10mg Vagifem twice a week is often not high enough to help with VA - it used to be 25mg but it was deemed by the powers that be unnecessary to use that high a dose so all those women who were doing well on 25mg are having to use the 10mg doses several times week to keep comfortable.
There are number of ladies who have MS who post on this site and hopefully they'll be along soon with advice and help. I'd start your own thread so they can respond. I think some have found that HRT has helped their MS?!!
Keep posting   DG x
Title: Re: Vagifem reduction
Post by: Lynne888 on July 08, 2014, 10:35:07 AM
Hi Hilary66. I use vagifem for constant urination. It worked within a week for me.  I don't think my bladder will ever be completely  *normal* I also have Interstitial cystitis and for ages before seeing my GP, I thought I was having a bad flare of that.. it was my GP who connected it all to the menopause. The difference using Vagifem for me has been life changing. I couldn't even leave the house as I was on the loo at the very worst about every 5 minutes and at best about every 20.  I think when we start using Vagifem we are unsure about it and need advice, I certainly had to come here to look for help. Once you have been using it for a while you get  to know when you need an extra boost and how to calm everything down. Dancinggirl is right. 2 x 10 a week doesn't seem enough if you still have issues. Keep us posted.
Title: Re: Vagifem reduction
Post by: Hilary66 on July 08, 2014, 12:07:49 PM
Hi there,thanks for your comments I will discuss thus with my new gyno next week.I have more pressing matters at hand at the moment,I am booked in to have a left colonoscopy tomorrow for haemmorhoid banding and am absolutely bricking it,I am in two minds abouts cancelling it altogether,I'm usually so calm when I need to have a procedure done but for some reason I feel the total opposite,I have heard so many stories about how bad it is the recovery period etc and am concerned the stress of it will bring on a relapse of ms anybody out there any positive feedback on this procedure.   Help :'(
Title: Re: Vagifem reduction
Post by: Dancinggirl on July 08, 2014, 03:41:13 PM
My sister has had several colonoscopies and is usually ok afterwards - she has really major issues with her bowels following a car accident that resulted in her losing most of her bowel - a lot had to be cut away as she contracted MRSA after an operation for internal bleeding.  If she can cope with this I'm sure you can.  Are they giving you something for the procedure - they usually give my sister something that makes her sleep through it - some type of anaesthetic.  I would contact the clinic where they are going to do the procedure and ask advice.
These things are pretty routine so I'm sure it will be fine.  Haemmorhoids are miserable so it's bound to be worth having this done.
Good luck  DG x
Title: Re: Vagifem reduction
Post by: Hilary66 on July 08, 2014, 05:45:20 PM
Hi Dg,
Thanks for your advice ,I feel very petty now considering all your sister went through,I hope she is doing we'll now.I'm sure I will be fine I just need to keep the nerves in check.Haemmoroids have been a pain in the butt since last year when I had an emergency haemmoroidectomy due to trombosis  so your right when you say it will be worth it in the long run,keep your fingers crossed for me, take care  ;)
Title: Re: Vagifem reduction
Post by: Hilary66 on July 12, 2014, 03:55:23 PM
Hi there,
Can anybody advise me I inserted my vagifem tab again last night and once again have horrendous burning in that area today,after taking diflucan150 earlier this week after a visit to my doc who thought I had mild thrush,after inserting the tab on Monday ,could it be that I have become allergic to vagifem,I am sick of constantly being on fire down there, is it just me or is that part of the menopause.ihave an appointment with a new gyno on Thursday I have tried using a baby cream ba bantam  to ease the burning but to no avail :'( H66
Title: Re: Vagifem reduction
Post by: Dancinggirl on July 12, 2014, 04:29:29 PM
I got pretty bad burning with Vagifem.  I'm using the Estring which I find causes less irritation. I still get some burning but things have improved over the last 6 weeks or so but it's taken 6-8months to get my fanny more comfortable. Dg x
Title: Re: Vagifem reduction
Post by: Hilary66 on July 13, 2014, 08:22:55 AM
Hi there,
I ended up seeing a lady doc last night hoping she could recommend something to stop this awful burning,what a joke,she said take diflucan again and use some daktacort cream and that was without even examining me.She was a bit annoyed when I asked her would she take a look to see the irritation,and just said oh yes that looks sore,65 euro to be told what I knew already,anyway I put a little daktacort cream on and such a night I've had, it burned so much I grabbed frozen peas to try and cool down I think I will just buy a tub of natural yogurt and sit in that for the day regardless of what it smells like.......What I would give to have a monthly period and none of this crap to be dealing with,age gracefully they say at the age of 48 I feel about 60 and to be honest if this is to be the future  I wouldn't mind stepping off this train,every turn in the track  has another bloody issue to deal with,     ITS A MANS WORLD.  Bitch rant over.   Hilary 66
Title: Re: Vagifem reduction
Post by: vanilla slice on July 13, 2014, 09:33:08 AM
I use the lower dose of Vagifem on alternate days with Sylk moisturiser in between and before intercourse. This is after trying other moisturisers which caused build up and irritation. I'm 65yrs old and had to stop HRT after 22 yrs as I developed asthma. I then suffered a sudden menopause with every symptom going! Try the Sylk it helped a lot.
Title: Re: Vagifem reduction
Post by: Chickbits on July 16, 2014, 09:47:26 AM
Hi the Estring sounds interesting - I like the idea of inserting it and then forgetting about it for a few months. Since I've gone back on the twice a week regime I've not really felt as good as I did before I tried cutting down but still it's a whole lot better. Maybe I need to do a 'reload' session. I'm going to take a printout of this advice to the GP. I'm psyching myself up to go back and say I need my twice a week 'fix'. I'm just scared they tell me they won't give me the prescription for the amount I need but then again I can ask for a referal to a gynie. Coward aren't I? I hate confrontation. After reading other women's problems I feel a bit of a wimp.
Title: Re: Vagifem reduction
Post by: CLKD on July 16, 2014, 03:45:00 PM
Not 'natural' yoghurt but LIVE - it's full of 'good' bacteria, also when applied liberally on the important places it is cool and soothing.  Remember to keep the pot in the bathroom and to tell others that it ins't for eating  ;).

Take a list with you to the GP and tell her that you have found this med-led meno forum and from the info you would like to try ……… do you subscribe to the MM Magazine?  perhaps you could read it and pass to your GP  ;)
Title: Re: Vagifem reduction
Post by: Hilary66 on July 17, 2014, 06:46:25 PM
Hi everyone,
Seen my gyno today and am feeling a bit despondent ,she put me back on amitriptyline to potentially nerve block the burning sensation,hoping that it will work and in a months time if there is no improvement she wants me to have a biopsy on the vulva to see if maybe it's a skin condition.However the bigger issue is that the perenium area is practically worn away because of the way I was cut during both births and now with the thinning of skin there due to menopause,which she thinks its causing the problems with painful intercourse,it is putting pressure on the bowel,So not such good news today.Still burning there so yogurt application it will have to be I don't know how to feel about any of this news. Hilary 66