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[lesley998]

Hi,

Have been on low dose vagifem for about two months now, since coming off prempak c tablets. 

I have noticed I have been getting really bad headaches which don't respond to pain killers.  Mainly frontal, pain behind eyes and sort of sinusy.  I thought I had a cold coming at first, or it was something to do with my diet (WW for the last month or so)  but now notice I get them for two days after using vagifem.

Has anyone else had this?

Thanks

[Rowan]

It is the vagifem sweetpea, I get exactly the same type of headache, that's why I have lowered my patch to half the dose of 25 estrogen patch, I

also find if I have a week off I don't wake with the forehead headache you describe.

[lesley998]

Thanks silver lady....oh dear,   

I suspected it was...but was SO hoping it was not the vagifem as I am having such fantastic results with it otherwise.   I genuinely dread having to stop using it, but these headaches can be awful, last all day and absolutely nothing gets rid of them....they just don't respond to painkillers.   Sitting here just now massaging my temples thinking I can't put up with this.

Oh well...back to the drawing board.  Can anyone recommend a good lubricant??

[lesley998]

...it's strange too, because I was on the higher dose HRT  Prempak C for six months...estrogen/progesterone and didn't have any problems at all with headaches (had to come off on GP advice as blood pressure was off the scale and had visual auras, also had terrible anxiety)

Maybe it is something in the Vagifem rather than the estrogen...as it is such a low dose.. ? 

[Rowan]

sweatpea I am sure it is the estrogen, you say you had to come off the Prempak C because of anxiety, high blood pressure and visual auras, I am sure that the visual auras can be cause by silent migraines that are headaches.

You may do better on estriol which is a far far weaker estrogen for VA problems that's if your GP will allow you to try it. It comes under the name of Ovestin and Ortho Gynest.

Some other ladies will probably suggest other ways to deal with VA that are not hormone based.

[Hurdity]

Hi sweet pea

It would be annoying indeed if Vagifem was aggravating your migraines.

Once you have plumped up your tissues with the priming dose ( ie daily for 14 days), for the majority of women, there is very little, if any systemic absorption of estradiol, especially on the low dose of 10 mcg - if it is used regularly without fail twice a week thereafter. Could this have anything to do with it? Maybe you need longer to plump up or more frequent/higher dose initially?

However if this doesn't appeal or is not the explanation I would agree with silverlady that Estriol does the trick perfectly - and I would recommend the Orthogynest pessaries which are what I use (although I do have some ovestin to rub on external parts sometimes). I can't think of any reason why any doc would not prescribe it!

Having said that I do use systemic HRT too (patches) but as I am post-meno will have much less natural oestrogen than you, as I think you are still peri?

Hope this helps

Hurdity x

[lesley998]

Hi both, thanks for the advice.

Hurdity, the day after I stopped Prempak C, I started Vagifem - but only used it for a week initially before then going on to twice a week.  (I noticed I had a LOT of slippery discharge, and felt very 'swollen' and full down there...I panicked a bit as I had just come off high dose Prempak and though maybe I was getting too much estrogen ??    )  GP is a bit clueless and did not give me any instructions, just sent me away with the pack.  I should have realised I needed to follow the pack instructions to the letter.   I have used it as you say, without fail, every Wednesday and Sunday since.   I then notice a headache for at least one, sometimes two days starting usually the following evening?  Not in the morning.

Oh dear...have I screwed things up?   Do you think I should take another priming dose?

I am still in peri (I think, no period since coming off HRT, and longest between periods before HRT was nine months.)

I would like to stay on a vagifem 'style' only regime for as long as I can.  I was unhappy on tablet form HRT  - although I have taken your advice and noted the names of the Bio Identicals that women seem to have a better time with. 

Your advice is appreciated...would you prime dose again, or or try the Orthogynest? 

[Hurdity]

Hi again sweet pea

I think I mentioned that some of us who are on systemic HRT need the vaginal oestrogen as well to plump things up but as you say you were on a high dose of Prempak, and still have some of your own so not sure about that....

What you do next will be personal choice really, I think I would maybe try priming again but with either Vagifem or eg trying Orthgynest. I'm not sure you would need a full fortnight of Vagifem though at this point if you have been using twice a week. I would do two full weeks with the Orthgynest as I understand these work slightly differently (from what I read recently) although have the same effect ultimately.

If you think Vagifem is causing the headaches and you can't face a week of headaches then go for the Orthgynest. It depends how much you really want to be on Vagifem to give it another go....

Sorry that isn't much help really!

Good luck with whatever you decide though - and do let us know the outcome.

Hurdity x

[Suzi Q]

Are you on HRT and Vagifem?
Maybe too higher dose of HRT with Vagifem
I sometimes get headaches hour or 2 after Vagifem but Im not on HRT
Check with GP best to be safe OK xxxxxx

[Night_Owl]

Hi sweet pea

Wondering if the headaches could be related to Prempak withdrawal - and lowered estrogen levels since coming off two months ago, adjustment is still taking place.

Maybe a tiny amount of Vagifem absorbed systemically is creating a peak when you take it, then a trough a couple of days later as it drops again.

Another option may be to take the Vagifem 10mcg on *alternate* days (not twice a week).

This is what I have been recommended (although I'm on low dose patch too, as for me Vagifem alone is not enough to keep vag/bladder atrophy at bay) by the Panay Menopause Clinic - it is still a very low dose, even when taken on alternate days.  Alternate days may offer more consistency.  Could be worth a try.  Understand that you may think that taking more may make the headache worse, but it could ease it.  The fact that it comes two days after may indicate withdrawal headache.  If it was too much for your system to cope with then you would get the headache a couple of hours after taking it?

Or maybe at some stage consider a very low dose patch - and bioidentical progesterone - to keep estrogen levels more consistent - there's some much experimenting involved with this HRT game.  I've found my headaches/migraine related to low estrogen levels and fluctuations - and conversely to too much estrogen.

Hope you find some relief - and that I haven't confused you!

Night_Owl
x

[lesley998]

Thank you all.

Suzi, no I stopped the HRT.  Am only using Vagifem.

Not sure what to do now....after usual Vagifem last night have the usual headache just starting up now.  Never the next morning, always afternoon to late evening.   its really horrible, quite painful and just will not shift no matter how much water I drink, or pain killers.

I really don't know what to do     I really don't want to stop Vagifem as I love the results - it works well for me 'down there' but can't cope with these heads.   Especially after the weird visual problems I had on Prempak..

Back to the GP I think to discuss it, definitely going to ask to be referred to a Menopause Clinic.

Thanks for all the advice - it's appreciated
x

[Hurdity]

Hi again sweet pea

There is nothing worse than those heads that won't shift.

Having read your latest post I would definitely go back to the GP and really I would try the Orthgynest pessaries - they are so very mild - estriol is 7-8 times weaker than estradiol.

Then yes ask to be referred to menopause clinic.

I agree with Night_Owl too that a consistent dose of estradiol might also be preferable eg with a patch, because your bidy will get used to it a bit more perhaps - maybe worth a try?

Hope your headache gets better soon....

Hurdity  x