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[Julieg]

Hi
Hoping someone may be able to help.  I went through the menopause about 10 years ago and am now symptom free apart from vaginal atrophy.  I was fine all the time I was on oral hrt, but since being taken off that by gp because of risk factors I am now really suffering.  Sex is really painful, not just a little sore, but agonising, as if I have open cuts inside.  In fact it's impossible.  My gp prescribed vagifem 10 micro gram vaginal tablets, which I have been using as prescribed for several months and I have been buying vagisil prohydrate external gel and internal pessaries, none of which has made any difference at all.  Does anyone know of any other treatment available?  I'm only 62 and really want to get back to making love again.
I'm sure the problem is physical, not caused by anxiety.

Thanks so much for reading this post

Julie

[CLKD]

Your GP is remiss.  How old were you when your GP took you off HRT?  If treatment was working, what did he think that taking you off it would do?

Get to the surgery pronto and ask the receptionist for an appt with the Nurse Practitioner:  discuss vaginal atrophy treatment- do read our threads here.  There are two treatments: Vagifem which is a very low dose and Ovestin : which ladies find useful, I am prescribed the latter.  Other moisturisers such a 'sylc' and 'yes' products can help too.  Some ladies find that they need 'vagifem' nightly and occasionally two doses at once.  It is about managing the symptoms.

As oestrogen levels drop the body may become dry: inside and out, vagina included 

It may be that you do have cuts inside.  Do you use anything else, I find KY Jelly [ducks behind the sofa] helpful to .......... which is why 'sylc' and 'yes' might be useful, apparently you can get free samples by contacting the web-sites ;-). 

[Julieg]

Thanks so much for your reply.  Will have a look at websites for sylc and yes and contact surgery.  Didn't realise you could use vagifem nightly after the first fortnight of daily dose.  Thanks for your advice, really helpful.

[Joaniepat]

Hi Julieg, welcome to the forum!

So sorry to hear you have been taken off HRT and that you are now experiencing VA. If you are using Vagifem "as prescribed" I suspect that is only twice a week, which is probably not enough. Many of us use more than that and the latest BMS recommendation is up to x5 per week. Some folk use it daily. Vagifem used to have a 25 mcg dose, so you can see why 10 mcg twice a week is not enough, only 20 mcg as opposed to 50. My advice is to do a two week reload and then use every other night. You could also ask for a prescription for an oestrogen cream to use externally on the vulva, either Ovestin or the weaker Estriol Cream.

As to Vagisil, a kinder moisturiser with less chemical stuff would be better. The Yes products are best, have a Google for them. Another good one is Olive & Bee - just olive oil and beeswax.

If you have Facebook, there is a private Vaginal Atrophy Facebook group run by Jane Lewis (Maryjane on here), it is well worth joining. Jane has also written an excellent book called "Me and My Menopausal Vagina", essential reading for all sufferers! I think Amazon sell it.

Were you not offered transdermal HRT, which has far fewer risks than oral?

Best wishes,
JP x

[Julieg]

Dear Joaniepat

Thanks for all the advice.  HRT patches were never suggested, my gp just said I'd been on hrt for too long and was risking getting cancer, so had to stop. Will definitely ?reload? and try using every other night.  Thanks so much.

[CLKD]

Oh dear another mid-informed GP?  Where those his/her words?

I would go back and ask him/her for up-2-date Peer reviewed Research explaining the risks etc..  Then ask for an appt to a Menopause Clinic.  Is there a Nurse Practitioner you could speak with?  This may of course by Surgery Policy especially if they are trying to cut costs, end of Financial Year and all that.

Obviously the information from the various Menopause societies/organisations, including the NHS, aren't getting through.  Again.