Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: SEU666 on June 19, 2018, 01:20:50 PM
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Anyone used Replens for vaginal,dryness and irritation?
Just started to get uncomfortable and GP said to try Replens as he won't up my HRT dose at the moment.
Had a Mirena put in May 2017 and started estradot patch in September 2017, 25mg and was put on 50mg in January 2018. Been having hot flushes and painful, clotty and heavier periods that were becoming closer together since 41, now 47. Tried several minin pills but clinic then advised mirena to stop bleeding problems.
I have used Replens for a week and a half and still feeling uncomfortable with a lot of residue inside me. Leaflet says you get this after first use, but was wondering how it has been with everyone else?
Does it take a couple of weeks to soften up and clear old cells, therefore shall I persevere for a bit longer. I was so sore and uncomfortable when I got home yesterday that I showered and re did the Replens application.
Getting me down a bit as I ride a motorbike everyday to and from work and due to go on holiday on it with my hubby end of July. Need to try to get it feeling a bit better or it'll be terrible.
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Hi and welcome to mm
You need local oestrogen eg Vagifem. Even on systemic HRT, many women need local oestrogen alongside and it does recommend this in the NICE guidelines on treating urogenital atrophy.
I didn't like using Replens - I find SYLK much better and many women like the YES products. It's best to get these online.
Do tell your GP you need Vagifem and if he/she says you don't need it then you can quote the NICE guidelines and ask if you could try it. I will be using Vagifem for the rest of my life.
BTW - if sex is particularly difficult then do try Durex ‘Perfect Glide' - you'll need to get this online.
The Mirena with seperate oestrogen is a great hrt combo and you should be able to stick with this for many years but just remember to have the Mirena changed every 4 years.
DG x
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Hi,
I've never had a problem with replens.
xXx
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Was this not the one that gps were advised to discontinue because of problems with it,have a google and research it maybe? I'm sure it was.x
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Cottage cheese knickers is what I remember of replens ;D
Vagifem is much better and I am on systematic hrt as well.
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I should have been a bit clearer. Sylk and the YES products are vaginal
Moisturisers. Vagifem is local oestrogen treatment that helps with dryness and maintains vaginal and bladder health. It's best to use both Vagifem and vaginal moisturisers to keep the whole area healthy. DG x
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Doctor said HE didn't know much about Vaginal moisturisers (sorry but I think he should!) but only one he knew about was Replens. I will look up the Nice guidelines, thank you for that tip, and have a look at YES products too.
Not had the “Cottage cheese†knickers effect as nothing is seeping out! More like I found it inside when I checked the Mirena strings!
Sort of feels dry and irritated inside, don't seem to be having much vaginal discharge as I used to. Always had to wear panty liners all the time anyway. Always told I was lucky as well lubed!!!
Well not now, aaah!!
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Replens isn't good stuff , full of nasties and “ clogs†up some women and causes thrush .
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Hi as Dancng girl says you really sound like you need vagifem you will see such a difference after that initial two week load it really reduces that inflammation and dryness and then you'd drop down to two or three times a week for life.( see nice guidelines) you really don't want to stop ever or it returns with a vengeance.
As an outside lube you could use pure organic raw pressed coconut oil from Holland and Barrett it's antibacterial and no cheesy knickers effects lol ,like that description,or I also like vagisil pro hydrate I find that really pleasant to use and you can carry in your bag if you find you need it more because of motor bike useage,it's all trial and error as to what suits but your gp should be more clued up plonker.good luck x
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Here is the section from teh NICE guidelines:
Urogenital atrophy
1.4.9
Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.
1.4.10
Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.
1.4.11
If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.
1.4.12
Explain to women with urogenital atrophy that:
symptoms often come back when treatment is stopped
adverse effects from vaginal oestrogen are very rare
they should report unscheduled vaginal bleeding to their GP.
1.4.13
Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.
1.4.14
Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.
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Thanks Dancinggirl for the NICE info I've just copied it and will print and take with me for the doctor.
xx
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I tried Replens in the early days of VA hated it, I have to use 3 pumps of estrogel and Vagifem every day.
I would definitely give the Vagifem a go.
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Is Vagifem stronger than Ovdstin? I'm not finding that Ovestin is having as much effect as it used to, and my bladder problems have come back. Can anyone advise?
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Vagifem is generally liked by most women as it is less messy to use and you can place it up inside (it has an applicator) to target the area you need. Some use both Vagifem and Ovestin but vaginal moisturisers alongside are also essential but moisturiser needs to be used at a different time of day or it may prevent absorption of the oestrogen.
I personally think Vagifem is the most effective.
Bladder problems probably need more regular use of local oestrogen, so 3-4 times a week, and you must avoid caffein, fruit juices and alcohol but drink lots of water.
DG x
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Also the fact you're still having flushes means your hrt dose is not enough. Is there another gp you can talk to ? X
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Annie0710 the other doctor is just as dim and male too.
The Replens seems to have been better last night and today...not so much goop or soreness. Maybe a bit like the Sahara down there and the dead cells are clearing!
I was reading that ladies found it best to use in morning as it didn't clump as much. Gravity playing a role maybe? Anyone found this?
Hot flushes not as bad as before but think with weather being hot maybe that's why they've been bad last three weeks or so.
I've ordered some yes vm to try and a free sample of Sylk.
Thank you every for your advice...will try these others too and if doesn't improve I'll go to the Doctor and show him the NIcE info and insist that I'm allowed to try.
Have been recommended Royal Jelly capsules and sea buckthorn oil caps to try to by a nutritionist.
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Bridge48 - do a 're-load' for 2 weeks at night. I use Ovestin with success and if my symptoms start 2 recur, I put a dose up in the morning as well as at night. Vagifem is often required nightly as it is not the strength as it was originally, dropped to 10 I think from 25?
What goes up has to come down ;). If oestrogen needs replacing then over-the-counter products are un-likely to do that, I use KY Jelly on the outer lips regularly.
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I was really surprised to read here that many women are on systemic and topical HRT for vaginal atrophy. My GP seems to think systemic covers everything. I have been using YES vaginal moisturiser as well and all was Ok until a couple of months back. Now I have a thin watery yellow discharge which is really annoying but seems to be allied to atrophy. I thought that would be fully arrested by the HRT. Things are not sore down there and no odour. Strange.
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Hi Kathy - do look at an earlier post on this thread where I have posted the actual recommendations from the NICE guidelines. It clearly states that even women of systemic HRT should be offered local oestrogen.
You could try using some Multi Gyn Actigel as you may have a touch of bacterial vaginitis and this gel is great at treating and preventing BV and thrush.
Your GP is wrong so print out the guidelines and show them to him. They should prescribe Vagifem for you if you are still sore and dry.
DG x
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Thanks. I have ordered some of the gel as it seems to have a lot of good reviews. I can't believe I have reached yet another stage in this endless battle. How lucky we are these days to have access to all these products. I can't envisage how women coped in the past.
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A female GP at my practice was keen to stop my Vagifem as she said if on systemic HRT you didn't need both, fortunately she left!
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Tinkerbell - hopefully Her Time Will Come ;) and she will blush, loudly :-[
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CLKD....Yes, I have to say I muttered that to myself as I left, she is probably mid thirties, I now make sure I speak to the 50 year old male GP who is far more sympathetic!
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Day 3 on the Multi Gyn Actigel. It seems to be flushing out a lot. Loads of discharge similar to a thrush discharge in consistency but yellow and odourless. No itching as you'd get with thrush. Is this how the gel works?
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Multi Gyn Actigel doesn't exactly flush things out but it should restore the flora balance which will help to fight bacteria and fungal infections.
You may be using a bit too much of this gel, especially if you are using the long nozzle to get it deeper into the the vagina. What you are describing does sound as though you had some form of infection it's hipefully now clearing. I would now try using either SYLK or the YES moisturisers morning and evening and use a bit of Multi Gyn just twice a week as a preventative. I tend to put a good dollop of the moisturisers and the Multi Gyn on the end of a finger and push this up inside and smear around the outer area.
It's also important to use Vagifem 2-3 times a week as well.
It can take a few weeks or even months of using both local oestrogen and intimate moisturisers to get things comfortable and healthy again and these regimes need to be maintained for the rest of our lives.
DG x
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A friend recently said that vaginal dryness and irritation etc usually occurs towards the end of peri menopause, when your own estrogen levels have dropped low!
Anyone been told this??
I know that with the mirena it's difficult to know if your periods have stopped (had mine 13 months now), but would the HRT you're taking (I'm on 50mg Estrodot patch) balance your system enough so that your symptoms like hot flushes, tiredness, moods, anxiety even out and you can have actually gone through menopause without knowing it??
Guess do you need to stop HRT to see what your own estrogen level is?
Been trying to google info but still confused!
The Replens seems to be much better this week, and I have the Yes VM to try as well now. Condsidering how uncomfortable I was over last month, the last few days have been bliss!
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I think VA is different for everyone, my VA started when I was 47 and still having regular periods and no other symptoms. My mother on the other hand didn't complain of problems down below until she was early seventies.
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SEU666 - If you have the Mirena with oestrogen patches or gel then you won't necessarily know when you are truly post menopause as this will prevent flushes etc from emerging. However, Urogenital atrophy will often emerge whether on hrt or not. DG x
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Thank you Tinkerbell and Dancinggirl.
It all a bit mind boggling!
Guess only time will tell how it all goes.
Thank you ladies for all your advice.
I'll keep an eye on things down below and remember the NICE guidelines, and go see GP if things start to get bad again.
xx S
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Sorry it's me again!
Just tried the Yes VM on Saturday.
Does it work similarly to the Replens and does it leave residue behind too?
Think I may have had some of the Replens still left in me when I tried the Yes VM. Was just wondering if it leaves a residue behind too, or not.
Everything does feel bit softer, but want to get into using the right one that will help when I go away on the bike.
Thanks in advance ladies for your help
S xx
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When you say ‘residue', what exactly do you mean? When using any vaginal moisturiser, there should be some slight discharge, much the same as you would have had during the reproductive years.
If you are getting a white cottage cheese or lumpy discharge, then you probably have thrush. Thrush will make you feel sore and itchy. In this hot weather it is important to allow the air to your intimate area, so no tight trousers and try not to sit down for too long. Riding a bike can really aggravate our ‘lady bits' I'm afraid as it can get very hot and sweaty around that area.
Use the moisturiser daily after showering ( don't take baths) and use the Multi Gyn every 2-3 days to keep the flora balance right. DG x
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Let me explain more Dancinggirl. About two months ago I first noticed being sore ‘high up inside me'. At first thought I had thrush...too much wine over a couple of weekends...but no discharge that I've had before with thrush (usually after antibiotics). I did treat myself with diflucan as thinking this was probably it, early stages, so to speak.
Things didn't improve and beginning of June I ride home in tears because I felt so sore inside and now irritated outside too.
Went to doctor on the Friday for more patches and he said to try Replens.
First coupon of doses, I still felt sore, but after third and fourth dose it all began to feel much better. The residue/wet paper/cottage cheese effect that people have mentioned and leaflet mentioned, was bad to begin with then by Saturday just gone, only a little bit. I assumed I was very dry down in my vagina and thought I would take a few doses to clear dry cells.
I was asking more, if the Yes VM cleared cells in same way...ie goo/mush inside me...or whether it was more like normal vagunal mucus and didn't go clumpy!
I've always worn panty liners my whole adult life but this past month, I've had no normal vaginal mucus staining at all!
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Hi SEU666,
I had the same issue with replens and the shedding never stopped while I was using it.
I use the yes products and don't have the same issue with them at all.
It does sound very much like you have VA and I've found the only thing that works for me is local estrogen. Vaginal moisturisers may help alongside the estrogen but are usually not enough on their own.
That is my experience but we're all different of course.
Robin
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Sorry I didn't read the whole thread so ignore most of what I said 🙄 But to answer your question no yes products don't cause skin shedding it's like just the remains from using replens and will stop in a few days
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Hi SEU666
The moisturisers are not exactly ‘clearing the cells' they are putting back moisture that allows for some lubrication - so this will bring some discharge and if there is any build up of fungus, or other matter, this will come out with the discharge.
The problem is that even if you are on systemic HRT the urogenital area will often still become atrophied and dry - not every women is affected badly and some seem to be lucky and not get too many problems. With the menopause the vaginal area becomes more dry, the flora balance is therefore not as it was during our productive years and so less able to combat mild infections like bacterial vaginitis ( which is seldom treated as will often clear itself) or thrush. The skin also thins and becomes more prone to irritation. Scented soaps and washes, wearing tight trousers etc. encourage infections like thrush so the intimate area is no longer combating the onslaught of day to day life.
Vaginal oestrogen will plump up the skin in and around the vagina and can also improve bladder function. The local Oestrogen will also help to maintain some natural vaginal secretions which helps to keep things healthy.
Vaginal Moisturisers don't simply clear things out, they help to maintain some natural moisture and the flora balance and therefore reduce the chance of thrush and infections taking hold. I believe the vaginal moisturisers that were deemed the most beneficial in studies are the YES products, SYLK, and Replens but ideally they need to be used in conjunction with local oestrogen to get maximum benefit. Using local oestrogen and the moisturisers should give some clear or slightly yellow discharge but regular and continuous use is essential to maintain the whole area. It's also essential to avoid too much sugar, alcohol, caffeine and fruit juices as these will also encourage infections, particularly UTIs - burning and soreness is often to do with some sort of infection.
There is no quick fix and sadly it is a matter of maintenance and avoiding activities that aggregate things.
I'm afraid I speak from 20 years experience of this problem due to premature menopause and despite being in systemic HRT - the various doctors I saw did not diagnose urogenital atrophy and therefore did not give me the treatment I needed.
It wasn't until I saw a practise nurse at my new GP practise 6 years ago, who was used to dealing with so many older women, that I finally got the local oestrogen I needed.
I had discovered Multi Gyn Actigel some years before and this had been really helpful when BV and thrush emerged but is too acidic to use daily. I now use Vagifem 2-3 times a week and SYLK at least once a day after the shower, and i am now more comfortable than I have been for years but I still get flare ups of soreness and burning and I then use the Multi Gyn again.
Keep using the YES moisturiser once or twice a day, everyday and wear loose trousers or skirts. Your panty liners need to be very thin (preferably unscented) so the area can breathe and change these regularly through the day. Take showers not baths and drink plenty of water.
Coconut oil is good to moisturise the skin near the intimate area as well.
DG x
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The package insert on replens mentions the sloughing of dry skin cells initially but I used it for quite a long time and it happened continually
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Thank you Robin and Dancinggirl.
Liners I use are unscented and thin and changed regular throughout the day. Mostly before due to dampness from vaginal mucus (had few swabs done and always been clear) or uncertainty of when period would start as always been irregular, but changed more due to sweat lately. Even change my underwear during the day whilst it's been so hot.
I will continue with the Yes VM and not Replens, and re book to see GP when I get back from holiday.
I drink loads of water, about 1.5-2 litres a day, decaf coffee but admit to one or two more glasses of wine than I used to...hubby a bit of a bad influence where that's concerned! More will power needed in my part!
Will look at Multi Gyn actigel.
I've never had BV before but mucus that was there when I was very sore didn't smell bad, but guess it could have been irritating none the less.
DG...20 year's, oh my gosh, thank goodness you've found a regime to work and are finally more comfortable.
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Just saw the doctor today and after an examination he's given me 7 days on thrush tablets. Seems to think that's the problem. I never had thrush that was yellow before always white. I made him laugh when I said God even my thrush had gone off at this age ;D
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Did he do a swab?
I had a few treatments for thrush and BV before I started on vagifem. They seemed to work, but it just came back 2/3 weeks later. I had two swabs and both came back clear. No big issues on vagifem, just niggles that are sorted with the Multi-gyne actigel and Dermol on the outside.
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Symptoms of UTIs, BV and thrush but without actual infection present, are classic signs of urigemtual atrophy. Swabs and urine tests should be properly tested and if all is clear then these symptoms are atrophy related and local oestrogen with vaginal moisturisers should be prescribed. GPs really should be up to speed on this :bang: :bang: :bang: DG x
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That's very interesting. Swabs were taken so hopefully I will get an answer. If at the end of all this I still find the discharge returns then I can only conclude that I need Vagifem as well as the systemic HRT. Had a phone call with a friend yesterday who had her last period a year ago and never experienced a single menopausal symptom. Crumbs. How is that possible? 😱
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Little update..the Yes VM seems to be much better but was wondering if you ladies found that the Vaginal soreness got worse when you had a period??
I've a Mirena and normally have the brown blood but at the moment I've got cramps (last three days) and one or two very light spots (beige), but feel really quite sore inside!
Has no dark blood last ‘period' and none so far this time, which is 9 days late!
Used VM applicator last night, so good blob inside, sorry, so to speak!
I've booked a GP appointment for next Friday, but if this extra soreness is another indication that Vagifem might be needed, then I'd like to be prepared as I think I will have to push my GP for me to try it.
I don't want to leave it too long and so I'm feeling majorly uncomfortable if the right decision is to try the Estrogen vaginally.
Thanks again ladies xx
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For many women systemic HRT is not enough to help urogenital atrophy so I would definitely ask for Vagifem. The NICE guidelines clearly state that it should be offered even if a women is on systemic HRT. DG x
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I really would give the Vagifem a try, why do you think your GP won't let you try it?
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My last visit for more patches at the beginning of June, GP said he didn't want to give me higher hrt at the moment and said to try Replens...said he didn't know much about Vaginal moisturisers!
I don't particularly like this GP, other one is male too, so other than changing practices, not much choice.
On his last words, I Want to know my rights, so I can insist on trying Vagifem if he puts up objections.
I don't want higher patches as flushes controlled, I have odd ones now and then now, no night sweats, have constant tiredness and belly up and down like a balloon, anxiety settled and moods more even.
Been having peri symptoms for last 7 years, so hoping end in sight, and if I can manage on 50mg estrodot, then I want to stay in it and not go higher.
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Thanks Jeaniewigs, that's what I planned to say...I keep my guns in reserve generally unless I really need them...lol.
Mainly want to know what I'm entitled to try and know what I'm talking about too.
He didn't argue when I wanted to try the patches initially, back in September 2017, probably wanted shot of me ASAP, ha ha, as I burst into tears!
But I did my homework, read a lot on here, and knew the patches were best due to my Migraines with COC before.
No migraine problems with either of the POPs a couple of years ago (yes, other issues) and none with the levonorgestrel Noriday pill or the Mirena.
This forum is great, lots of advice from everyone and as the dreaded menopause effects everyone so differently, it's excellent to read about how others have coped
x S
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I use Estrogel, three pumps a day but use Vagifem as well.
One youngish female gp said I didn't need Vagifem and Systemic HRT for VA it was one or the other!
So I went to see a male GP who is a similar age to me who said he was happy to prescribe both if that was what I needed...any HRT review in future I am going to make sure I book it with him.
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I'm afraid we do have to ‘handle' doctors carefully - so often their egos and dogmatic approach can give problems - so we need go to an appointment prepared with a gentle yet determined approach - it's so easy to put their backs up and end up being ‘stone walled'.
I often start my questions with;
“Would it possible?'â€
“Is it worth considering?â€
“My research has revealed XY or Z what are your thoughts on this?â€
“As I'm still struggling with X or Y is it worth trying Z?â€
This is why I like to go in with things written down and factual evidence printed out.
Essentially, when we feel at our most vulnerable and fragile we have to be calm, strong and tenacious and make the doctor feel they are brilliant. DG x