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[Menomale]

Hi Jackanory,

I think Kkay has given you good advice and other ladies here will also pop in with a lot of info on vaginal dryness. Browse the site, there are a number of threads on this subject.

I have taken DHEA (oral) for 6 months and it helped me with vaginal lubrication but I don't have vaginal atrophy. I'm not familiar with DHEA vaginal suppositories... but I read an article recently that they are under trial. Be aware that there are many different products available and many are not reliable.

Good luck from me too!

[Jackanory]

Thanks for your replies ladies, I have tried to get Vagifem on numerous occasions from various GPs but to no avail. I have had my lady bits looked at and been told that they are fine. I have been prescribed Replens which is nasty nasty stuff, doesn't help with the dryness and generates masses of horrible gritty white/pink/grey/brown gunk which I had to scoop out of myself. I use natural lubricants and moisturisers including Yes and Vit E capsules. I am still waiting for the DHEA capsules, they are quite hard to get hold of and I ordered them from a website called Biovea, which I have never heard of before, I hope it's not something dodgy. Anyway, hopefully they will arrive any day and I can try the home made DHEA pessaries.

[Dancinggirl]

Jackanory - Here is the section from the NICE guidelines regarding treatment of urogenital atrophy - so burning, dryness, UTI type symptoms etc.

Altered sexual function
1.4.8
Consider testosterone[1] supplementation for menopausal women with low sexual desire if HRT alone is not effective.
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.


Print this off to show the GP and ask why they won't give you the Vagifem when it is now the standard treatment for your problems? I assume they have sent you to a urologist for investigations as well? To not give appropriate treatment is frankly negligent - you should not be having to buy expensive alternative treatments that may or may not work, when there is treatment that is tried tested and safe. 
Do be careful with DHEA - look at the side effects it can give - just because you can buy it easily and is a supposedly ‘natural' product, doesn't mean it's entirely safe. Many of our most powerful drugs are derived from botanical and natural sources.
It makes me so cross that GPs won't give appropriate treatment where needed.  Dg x

BTW , have you tried SYLK - I find this great for moisturisation.

[Jackanory]

Thank you very much for the NICE guidelines Dancinggirl. I have not had any investigations or referrals, only had 2 different lady GPs and one male GP look at my bits and advise me that I am not suffering from atrophy and that because I have regular periods I have enough oestrogen. I guess my symptoms are not severe enough, and having read what some other poor ladies have had to suffer through I can see that I am not suffering that badly. It is only really sexual activity that gives me bother. I have tried just about every lubricant ever invented, and have tried Sylk, which is good, but I prefer YES, to me it feels natural and soothing and it doesn't irritate in anyway. I use the water based one, I think the oil based may have given me an infection.

I should have mentioned that I am in Scotland, I don't know whether the policy in Scotland is any different to that in England as regards hormonal treatment. I have not long since been to the GP and been knocked back again, I can't really face going back again so soon, even with the NICE guidelines, I have had the indignity of explaining my problems and having to take my pants off and have my "bits" looked at just to be told that they "are fine". I may need to wait until my periods stop completely which surely will happen soon and for the atrophy to get worse, which it most certainly will.

[Menomale]

Hi Jackanory,

Biovea is a trusted site but has all sorts of supplements and vitamins from different brands, some of them may not be trusted...

Home made DHEA pessaries? Will you buy the capsules and then use the powder? Would you care to explain that?

[Jackanory]

Hi Menomale!

I came across some posts on Mumsnet from ladies who had made their own DHEA vaginal suppositories. Apparently DHEA vaginal suppositories have been used in clinical trials in Canada with great success, working in a way similar to Vagifem, though they don't contain oestrogen, the DHEA is converted into oestrogen and this only happens locally, the oestrogen does not travel around the body, so is considered to be completely safe.

Ladies have used between 2 mg to 10 mg of DHEA, daily for a fortnight then twice a week. I have bought 10mg DHEA capsules. I intend to use 5mg per day. I will open the capsule, tip out half the powder. I will then cover a Carlsons Vit-E pessary in the powder and insert.

[Menomale]

Thank you Jackanory!

I see from the links that you have posted elsewhere that these home made pessaries is a sort of experiment tried by one user of that forum. I wouldn't be comfortable trying this approach based on only one personal experience. I am aware of the Canada trial and would wait for the final outcome. You said that you stll have periods, so maybe your problem is not low oestrogen, that would explain why Vagifem has not worked for you. Have you considered other vaginal issues, like lichen sclerosus? There are some threads on this subject here.

XXX

[ancient runner]

I had periods AND VA, and I think I am not alone in that.
I also didn't look too bad from the outside as far as I know. But using oestrogen supplements were the only thing that helped.
Jackanory, you're in Scotland aren't you? Dr Currie who runs this site and is chair of the British Menopause Society is also in Scotland and answers email queries. You could drop her a line and explain your predicament, and with luck you'll get an answer you can take to your GP. They might pay attention to her, as she's a big cheese/local/an expert.

[Menomale]

Hi ancientrunner,

I hope you didn't take my post as a statement that if you have periods you can't have vaginal atrophy...  I am just suggesting another possible route of investigation, since many ladies here with VA have controlled it with local oestrogen. I only had 2 periods in the last 2 years, my 4 blood tests in this period show very low levels of oestrogen and still I don't have any signs of VA so this is clearly not a simple correlation issue. I'm sorry if I have upset you in any way.

XXX

[Maryjane]

Menomale is right regards other things could be a miss so I would want to see a vulva dermatologist.

Internet DIY stuff is when we are desperate and nothing else has worked .

I have VA with full periods , BUT i also have vulvodynia/ vestibuldynia the oestrogen is doing so much , but I have added nerve damage also.

Also you don't need to look atrophied to actually have it from what Dr Annie Evans told me now retired.

We can get excema down there all sorts , the two Lichens .

However dermos a generally not great at VA.

[Tinkerbell]

I developed VA five years ago but my last period was nearly two years ago so you can definitely get it whilst still having periods. Also VA apart from some palpitations was my only problem! Like you I found the Replens rubbish at doing anything.
I hade to persevere getting prescribed topical HRT as I kept getting told I had thrush as doctors would not acknowledge VA in perimenopause stage.
I eventually got treatment prescribed
by insisting that I be allowed to try it and see if it helped, which of course it did.

[Suzi Q]

Thank you very much for the NICE guidelines Dancinggirl. I have not had any investigations or referrals, only had 2 different lady GPs and one male GP look at my bits and advise me that I am not suffering from atrophy and that because I have regular periods I have enough oestrogen. I guess my symptoms are not severe enough, and having read what some other poor ladies have had to suffer through I can see that I am not suffering that badly. It is only really sexual activity that gives me bother. I have tried just about every lubricant ever invented, and have tried Sylk, which is good, but I prefer YES, to me it feels natural and soothing and it doesn't irritate in anyway. I use the water based one, I think the oil based may have given me an infection.
Do what DG said print out.
Do you think any man would suffer if his penis was burning throbbing and having sex was impossibly painfull thats if no matter how h... he is he still couldn't do it. Not on your life
I should have mentioned that I am in Scotland, I don't know whether the policy in Scotland is any different to that in England as regards hormonal treatment. I have not long since been to the GP and been knocked back again, I can't really face going back again so soon, even with the NICE guidelines, I have had the indignity of explaining my problems and having to take my pants off and have my "bits" looked at just to be told that they "are fine". I may need to wait until my periods stop completely which surely will happen soon and for the atrophy to get worse, which it most certainly will.

[Bluebell1]

Hello All. I tried to use replense but found after insertion. I experienced sharp uncomfotable stomach pains. It also did not seem to lubricate me. I have tried other lubricants are better esp before attempted sex. But it is a small pain applying the lubricant just before sex & a bit of a passion killer. My vaginal lips otherwise feel often thst dry that they stick to my pants & this is really uncomfortable. On one occassion I was that dry when attempting sex that it caused damage to my partners tip of his penis & he is awaitng surgery for this. So if anybody hasany suggestions I would be eternally grateful as my GP is not the most sympathetic with menopause symptoms. I have asked her about Oestrogen creme but she said the sideffects are a worry with cancer. Plus I would have to be referred to a menopause specialist..??  I am 48 & was still having regular periods but horrendous PMS type symptoms/ night sweats. So now 3/12 in with Femostan 1/10 & it appears to of stopped working ... arrrgh 😪

[Maryjane]

I am truly speechless by this , regards your GP ........I am sure dancing girl and other fellow sufferers will be the same .

You can have local oestrogen for life/ for ever .....the NICE 2015 menopause guidelines say so.

I am really busy today so can't put a lot into the post.

But you may also need full HRT I do.

If you GP is being awkward DEMAND to be referred to a menopause centre , hopefully dancing girl will add onto this. Do not give up it is your right to get local oestrogen tou have VA , vaginal atrophy .

[Dancinggirl]

Hi bluebell 1
Do look at the post I did earlier in this thread where I give the full quote from the NICE guidelines on the treatment of urogenital atrophy. Unfortunately I'm posting on my phone these days ( can't get MM on my MacBook as it's too old) so it's difficult to copy and paste stuff.
Your GP is totally wrong so go back with the NICE guidelines printed off plus info from this site and demand a referral to a gynaecologist or meno clinic. Most of us offer using a local oestrogen called Vagifem as it's easier to use and causes less irritation.
Do try using a vaginal moisturiser SYLK - I find this much better. Lots of lubrucation is essential for sex - I actually find the Durex extra glide really good.
You may need to go to the higher dose of Femoston as well. DG.