Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: Jennie on September 24, 2014, 01:02:43 PM
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Have used Gynest for three months and was advised to see if VA returned before further prescription .? Off course symptoms back as expected.I found Gynest messy but very effective for my VA.Back to practice and asked for Vagifem,have used it for two days so far.I am surprised that pessary so small and have not noticed any evidence that it has dissolved as I expected some sort of discharge which would reach labia etc to alleviate soreness/dryness.
Advice please ladies....thanks
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Are you saying the Gynest cream didn't work and that's why you have changed to Vagifem? Or was it simply too 'messy'? I started Vagifem 8 days ago following an unsuccessful trial of Gynest cream and also wondered how it works to relieve dryness etc. being as it's such a tiny pessary. Maybe the localised absorption of Oestradiol (which is stronger than the Oestriol contained in Gynest) promotes self lubrication throughout the vaginal tissue? My main issues are burning and frequency/urgency - I'm not holding my breath but it does appear to be settling a bit just in the last couple of days. Like you I haven't seen any evidence of the Vagifem once it's inserted. Also extra lubrication has been needed during 'relations' - unlike when on Gynest. I asked my GP whether I could continue applying the Gynest cream to help sooth the soreness/burning on the external part of my urethra but he advised 'no', as on top of the oral HRT I'm already taking, this would be too much oestrogen? I imagine two days is not really enough time to assess Vagifem's effectiveness, but I'm sure someone more 'in the know' than I am will be along soon to answer our questions.
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Thanks Morweena.I found Gynest far to messy and asked to try vagifem instead.My symptoms are the same as yours but I'm not taking hrt so will just wait to see if Vagifem works for me.
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I think the vagifem needs a few days use for the tissues to become moist enough to absorb it IYSWIM.
I have found lumps of sticky stuff (non absorbed tablet) on the applicator of the next tablet when re-charging. Usually it just vanishes, and I feel more normal.
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Vagifem is a small white tablet that sticks to the vaginal wall and dissolves. You need to do a 2 week once a night loading before going down to 2x a week.
After a while you may notice some white discharge coming out which is the fillers and after a while with use you may notice a more gloppy vaginal discharge such as you might of had in the past - at least that was my experience mainly when using 25mcg vagifem.
You may also notice that the whole vaginal area plumps up after a while.
These effects may be lesser on 10mcg vagifem that is now available. I used Ovestin cream 1% Estriol on the outer areas with the 10mcg vagifem.
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It just shows what different opinions there are on this, I have just come been told to use vagifem and gynest cream. My physio I have for pelvic pain uses both, and at one time also took HRT she said when she goes to conferences on all this, the lecturers say the vagifem is only working up high, and does nothing for the lower areas and you need both, when I used it last the vagifem I had no discharge, but I was told until the pain has gone I won't as the pelvic floor is ouch img all the time.
I have been recommended by my dermo to use PJUR when she examined me it was so nice , you can get it for sensitive skin, I don't know about sex as that will more than likely never happen again for me with all my problems, 34 years of marriage very sad. :'(
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Absolutely - re differing opinions!
Morwenna - you can't possibly be getting too much oestrogen by using an estriol cream on the external areas - it's a different type of oestrogen than in Vagifem which is estradiol. Sadly your GP is not well-informed.
I use Vagifem (or Gynest pessaries), and Gynest cream and I am on medium dose systemic HRT. All with the blessing of my female GP who deals with all the gynae issues. I use the Gynest for the outer areas - this is a weaker preparation than Ovestin so you could use more cream for your money (if you get me) and not be absorbing as much estriol anyway. I would insist on being prescribed Gynest cream as well if you need it. I don't yet use Vagifem all the time - just when I'm using vaginal progesterone, as I'm still using up my supplies of Gynest pessaries - which really were the biz! Outrageous that this very useful product was discontinued.
Yes Jennie - many women find estriol to be extremely effective for VA but I would agree I would not want to fiddle around with cream and an applicator, so when my Gynest pessaries run out I will be using Vagifem, but will rub cream on the outer areas the same evening that I insert the Vagifem - to keep these areas moist and plumped as well!
Hurdity x
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Hurdity I was surprised when my GP advised against using Gynest cream alongside Vagifem as he has happily gone along with everything I've asked for so far! I agree that Ortho-Gynest pessaries were the 'biz' ;D, unfortunately mine ran out at the start of this year and I have found Gynest cream to be a poor substitute. However I have two full tubes left so am definitely going to start using it to supplement the 10mcg Vagifem.
Maryjane although the instructions in the Vagifem leaflet say to insert as far as possible, I read somewhere (on this forum I think) that the positioning of the pessary in the vagina can make a difference to symptoms so for the past three nights have been experimenting with placing it on the anterior wall behind the urethra. I'm still on the two week reload so it's very much a case of suck it and see right now although last night I didn't need to get up for a wee so I'm crossing my fingers for an improvement.
I'm sorry there seems to be no end in sight for your problems :hug:
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Hurdity.......how much gynest cream do you use, a small fingers nail worth? and do you spread it on the vulva area uro/gynae said it will sort of go further than you put it so don't worry to much it will find its own way. But he said it in a far more educated way, but I can't remember :)
Many thanks MJ x
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Hi maryjane - I just squeeze some out and smear it on - I don't think about how much there is! Ovestin is more concentrated but Gynest is very weak so you really can't OD on it... Probably about the same as a toothpaste squirt maybe? It doesn't need to be precise....
Hurdity x
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Hi Hurdity.......thanks for that forgot to ask also sorry......are you the lady that also uses multigyn , as I slop that on also as and when as it is the only thing that really helps with the burning, I use it in the am and afternoon if needed, but usually just am.
It says you can only use it for thirty days do you follow that rule? As it is better for my mind/body /soul to use it anifaditem at the moment......only other option is an epidural directed to my vagina which I don't think is doable.
My PH is spot on, but it does something to soothe.xx
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Hi ladies, I also have vagifem and gynest cream. For me they are a winning combination, one in and one out :)
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This year I have had ongoing problems with urgency, frequency and burning urethra. The start of it coincided with a new regime of tetracycline antiobiotics prescribed for my rosacea. Despite stopping taking them the symptoms continued. (It took me a long time to realise that the flare up would also have been around the time my Ortho-Gynest pessaries ran out and were replaced with Gynest cream). In the meantime I had been unsuccessfully treating with Canesten cream too as I wondered if the symptoms were Thrush related.
Just recently, deciding it perhaps wasn't strong enough, I stopped using Gynest cream and asked my GP for Vagifem. After 8 days of the initial two week loading, things were definitely feeling more comfortable but I experienced difficulties with dryness during 'relations' which never happened with Gynest. As per my previous post on this thread I decided last night to add in Gynest cream as an additional measure. During the night my urethra started to burn. By morning the discomfort of a full bladder sent me rushing to the toilet and it has been like that all today. (I definitely meet the criteria for Interstitial Cystitis). Am now wondering if it's Gynest cream that triggers it all off? :o
Oh and the Vagifem pessary dropped out this morning, (undissolved ???) into the toilet. Of course this may have been because I didn't insert it high enough, guess I need to stop experimenting with the position of it until it's had a chance to work...
I never had any previous problems with burning when on the Ortho-Gynest pessaries and didn't realise up until now that Gynest cream isn't exactly the same stuff - in fact on reading the ingredients, now wonder whether the peanut oil that's used as a carrier, is irritating things down below?
I experienced a lot of bladder trouble when I was younger - infections and irritability, but over recent years managed to find a regime that settled it down (which I pontificated about on the 'My Bladder' thread - Karma???!!) I'm getting really fed up now as nothing I do seems to help and I feel it's taking over my life (also I still have a spotty face but that's another issue!) :(
Does anyone have any thoughts on this? Are there really only three hormone preparations available for local use? Is Ovestin cream any different? I'm going to revert to the Vagifem only for now and just use my trusty old coconut oil for dryness when required. Watch this space....
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Morwenna, I too had lots of bladder issues when younger --cleared up mostly when I started having children. I now think lots of it was hormone-related.
I also find that some of the hormone creams do sting and irritate. Am using the estring but wondering if it is now powerful enough for the problem.
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Ancient runner I'm sure hormones play a part. I suffered almost constant UTI's when taking the contraceptive pill in my late teens. But this latest manifestation of discomfort is not an infection and seems to fit in more with the symptoms of Interstitial Cystitis. I also have IBS and have read that the two often go hand in hand. Vagifem hasn't helped sadly :(
If the Estring isn't helping, it makes you wonder where else is there to go?
If only I could pinpoint the cause - it's the stabbing in the dark that's so frustrating isn't it?
I suspect bladder trauma caused by past infections has left it susceptible to inflammation and now the menopause is contributing to the problem. I'm already on a medium dose HRT and don't want to try a higher dose really. Apart from the IBS all my other symptoms are under control.
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Am sure the estring is helping... just not as much as it was. It's possible, as Dancing Girl has found, that it ran out of steam before its official three months was up so it then takes a while of using the new one for things to return to (what passes for) normal.
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Hi ladies well I have just been prescribed the vagifem 10mcg today after much persuading of a very reluctant GP! She point blank refuses to give me HRT and told me again that if I ever do get it then i will only be allowed it for two years maximum and then that will be it and i will have to go it alone! I felt like saying to her that I hope she bloody well suffers with the menopause and will realise how much she makes the rest of the female population suffer! I would never have known about the Vagifem if I had not come across this site but I just hope it helps with the frequent urination/leakage because im only 48 and don't really want to smell of wee when i warm up!
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Hi stanely2012
Gald to hear you have some Vagifem but your doctor is completely out of order here.
Iif there is no medical reason why you personally should not be on HRT and you would like it for menopausal symptoms then it is your right to have it. I seem to remember you are very early in menopause and your periods are still mostly regular? Is that right? As they become more erratic and you suffer from night sweats and flushes then be sure to go back to (a different) doc and if no-one in the practice can help then insist on a referral to a menopause clinic if there is one near you. If you are suffering now then no reason why you shouldn't be referred sooner rather than later.
With the Vagifem - make sure you do the 14 day loading ie each night for a fortnight then twice a week thereafter.
Hurdity x
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You can report to the GMC annonousmly via the Internet, these docs attitudes make my blood boil.
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Shocking >:( What did your GP suggest would help with regard to your frequency/leakage problem?
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Yes I am probably classed as early stages and have only missed the last period but I have a lot of symptoms such as poor sleep, aching joints, occasional hot flushes, skin like a teenage boy, foggy head, mood changes but the only thing she would acknowledge was the urinary issues. She seemed to be implying that it could be depression but believe me that is not the case at all as I have experienced depression in the past and know the signs. I have been advised to use the Vagifem one pessary twice weekly and have only been given 24. I feel really disheartened to be honest and wonder how we get through this minefield in one piece!
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Morwenna she just printed off the information about pelvic floor exercises and told me they were really hard to do but have a go! I am such a good fighter but cant understand why I feel unable to deal with these people!
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You must use one Vagifem pessary each night for the first two weeks. This will leave ten which will last another four to five weeks and you should be able to order a repeat prescription before they run out. I use one every third night to keep it a regular dose. (Mark it on the calendar is a good tip). After initially thinking it wasn't helping my bladder issues it seems to be working now. So it took about six weeks I reckon, including the two week 'load up. I also invested in a battery operated pelvic toner - takes the hard work out of pelvic floor exercises! Good luck :great:
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You must use the Vagifem nightly for 14 days to plump up the vaginal tissues as I said, and then twice a week. It should say that in the instructions? 24 will therefore only last 7 weeks. Make sure you get another appointment in time to renew the prescrption and please go to someone else - if you can find out which doctor in the practice understands menopause and is at least open to HRT! It could be that a very low dose HRT would be sufficient initially to alleviate your symptoms. As you get further into peri-menopause of course your dose may have to be increased. You deserve better than this!
I do hope the Vagifem at least starts to help with your bladder issues.
Yes and good luck with the pelvic floor exercises. Fancy saying they are hard :(.
Hurdity x :)
Edit - oops Morwenna we posted the same thing at same time!!
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Great minds think alike ;D
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Ok Ladies I will do the every night for a fortnight but why would she put on the instructions only twice a week? I wont be getting an overdose and my foof will fall off will it! Heavens its all so complicated! I told my husband it fluffs up your foof and he was rather excited at the prospect ha ha x
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That made me laugh stanley!!
If you have a look at this patient info leaflet (which should be included in the pack) and scroll down to how to use it you will see that it says to use one a night for fourteen nights https://www.medicines.org.uk/emc/medicine/23818/XPIL/Vagifem+10+micrograms+vaginal+tablets/
Not every GP knows how it works and so miss out on the loading up phase before settling down to the twice a week instructions!
Taz x
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Thanks Taz! I read the instructions and it does indeed say once a night for 14 days so I will do that. To be honest if I had told her I wanted a brain transplant she would have agreed so that she could get shot of me! I went to a woman because I felt she would understand but noooo!
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I take vagifem. It definitely needs a 2 week loading. In some places, I have read that it needs a further 2 weeks alternate days, before you go on twice a week.
I have never got to twice a week. I seem to need 3. My prescriptions say 'one or two twice weekly' and they do keep supplying the repeats, so no problem there.
I have GP troubles too. I decided to try full hrt because of aching joints. I went to the female GP who I had been recommended previously for womens issues but had not been able to see (the one who sorted this out in the end had left). She gave me Elleste duet and did not ask about periods or anything, gave me a speech about it being restricted to 5 years or I would be at risk of breast cancer, and I was out the door. I am not sure I even got the full 10 minutes ::) I have since seen someone else who may not be an 'expert' but is prepared to look it up and think it through and tell me why. I changed to femeston because I do not like the progestogen in elleste - I have had it previously in a contraceptive pill. So far so good, and it does help with the bladder issues too which the vagifem does not fully address.
My surgery has a lot of gps, but they only seem to be available every 3 weeks. They also seem to stick to protocols like glue, probably to give more continuity between doctors. I am hoping the new NICE guidelines will be less prescriptive when they come out next year and my gps will take note.
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Hi stanley, nice to see you.
Yep, I did the 2 weeks loading and my foof is still there ;) in fact I do a 2 week reload about once a year and it still stays where it is, you'll be fine :)