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[joziel]

Thanks Flossie. If estrogen every night doesn't get rid of it again, I'll for sure ask for a referral. Because I think it would mean wet mounted slides or whatever they're called and someone who can count white blood cells and bacteria under a microscope, which is clearly beyond what my GP can do. I worry there will be a very long waiting list if I need that referral though.

I don't like knowing I am teetering this close to it though. I mean, if just a week of reduced estrogen causes all this to resurface again, my vagina wasn't in tiptop shape on my previous regime of 2x weekly - or it wouldn't have come back this bad, this fast. Which is why I wondered about the e-string. I just like knowing that all its estrogen needs are being taken care of continuously and not just a blob once a day, hoping that that gets around everywhere in there...

I also don't understand why vaginal atrophy so often needs local treatment even when blood estrogen levels are high or good. I mean, earlier in our lives we don't need local treatment when our blood levels are that high. Again, I feel like there is a missing piece of the puzzle here... probably another 50 years before research figures that one out...

[Tora]

Interesting point Joziel, my specialist and pharmacist said they didn’t think I could have VA due to high estrogen levels. Yet the VA symptoms started 6 days after reducing E dose.

[Flossieteacake]

I feel like when somebody has the symptoms under control it can suddenly flare again. I have been using VA treatment since November and never have a day I feel symptom free. It seems even the menopause specialists may not fully understand it.

I am interested in the estring too. I would like to hear of other peoples experience on it.

[Nas]

Oh sorry to hear that joziel, sounds like a right carry on.
Definitely request vagifem daily now. This x 2 weekly is a load of old tosh. I think few women can get away with it that infrequently. I asked my specialist to ask the doc to prescribe daily vagifem and he did thankfully. I won’t bother with the blissel then and stick to ovestin and vagifem.

I know what you mean about reducing the systemic dose and bang the vagina and bladder go awol  . I’m the same. If it wasn’t for the damm VA, I would probably just use a 50 patch. But no, that isn’t good enough and I’m weeing for England again. 1mg sandrena no good either and gives me period pain and spotting ( or is the the coil still, who knows!)

What I’m struggling with is, if the bladder and vagina require a decent systemic dose of HRT; what happens if the rest of the body doesn’t agree and you get period pain and cramps etc..

Such a bloody minefield 

[joziel]

I think we have to meet the bladder and vagina needs with local estrogen of some description. And work on the other symptoms separately.

I don't understand why this is, if our blood estrogen levels are okay. That's why I think there is some other process at work. I could understand it if someone had had symptoms for years and things had gone too far to be recovered again just by boosting estrogen, but when we act quickly as soon as we see it happening, why can the blood estrogen levels not sustain things again (like they have done earlier in life)... 

How long as the coil been in Nas? I think you can assume any spotting is due to the coil until you are at 6 months. After 6 months, I'd be inclined to think it's the estrogen dose...

[Tora]

Really feel for you Nas, I know the weeing for England routine well! Every time I reduce estrogen I’m up 3 times a night, it takes about 2 weeks of being back on original dose to get undisturbed sleep. Can’t answer your Q about body not being happy as thankfully I’m good on full whack. . . So far!
How’s the coil trial going?

[Nas]

I don’t get the whole VA if Oestrogen levels are decent, to be honest.
I mean it was my first symptom, even before anxiety and my Oestrogen levels were 780. Then, when they dropped right off a cliff, a year after my last period, to 88, I had no atrophy at all. In fact, VA only became problematic this year really. As you say joziel, treat that symptoms as they occur I guess.

The coil is going okay, other than the spotting. It’s a nuisance more than anything. Not quite 3 months yet, but I’m impatient 

[CLKD]

As oestrogen levels drop as we age, the body may become dry: inside and out; skin, vagina, anus, scalp, inbetweet the toes - deep in the ears, eyes, nostrils ........ appropriate treatment should ease VA symptoms i.e. ovestin via an applicator or 'vagifem' pessary.  Some find that extra moisturiser is necessary.  Although VA treatment is for a loading period of 2-3 weeks, some ladies require using it every night for many years. To keep the vaginal walls moist and supple so that they don't become itchy = aggravating the bladder. 

It took a while, now I can recognise when symptoms are niggling in that my belly feels 'full', below the button area.  I immediately put 'ovestin' up in the morning or afternoon, take 2 'nurofen' tablets to stop the nip when the urine flow shuts off; as well as another 'ovestin' at night for at least 5/6 nights. 

using VA treatment nightly for 5-6 months might give better relief  

Some require replacement therapy to help.  My Gynae would never do hormonal blood tests but treated on symptoms, as does my GP.  I think that many get hung up on 'levels' - I've never required hormonal blood tests so don't know how my oestrogen levels might be.  4 me over the last 6 years it's treating my vagina as symptoms niggle which keeps the area comfortable. 

[Ayesha]

So ultra sensitive down there that VA needs to be treated separately from other HRT treatments, in my unqualified opinion.
I am an every day user and every time I think I can reduce my dose I get a little twinge down below as if its saying to me, don't you dare.

One day perhaps I can reduce the dose but definitely not yet, and that's after nearly a year of treatment. 

[Flossieteacake]

So ultra sensitive down there that VA needs to be treated separately from other HRT treatments, in my unqualified opinion.
I am an every day user and every time I think I can reduce my dose I get a little twinge down below as if its saying to me, don't you dare.

One day perhaps I can reduce the dose but definitely not yet, and that's after nearly a year of treatment.

I agree with you. It does seem it needs to be treated separately. For me, VA is the worst menopause symptom I have.

[Minusminnie]

I am interested in the estring too. I would like to hear of other peoples experience on it.

https://www.menopausematters.co.uk/forum/index.php/topic,24411.msg373949.html#msg373949

[Flossieteacake]

I am interested in the estring too. I would like to hear of other peoples experience on it.

https://www.menopausematters.co.uk/forum/index.php/topic,24411.msg373949.html#msg373949

Thank you Minusminnie 

[joziel]

Gawd, I now think the entrance to my vagina looks white. I thought it was white discharge when I saw it - but I blobbed some toilet paper there to try to take it away and realised it was the vagina itself and not discharge sitting on it. I don't know if it's thrush, if that makes the actual vagina look coated white..?? arrrrgggggg... maybe I have both thrush and VA. I am worried about lichen planus and LS.

I'm going to have to go get another exam and have someone look at it again. The thing is, I thought it looked like this last time too, before my exam, but the GP said all was okay when she took a look. And I tested negative for thrush twice earlier this year, with the same symptoms I have now. I'm going to try to see a different, more experienced GP. I don't want to just keep treating for thrush if it's not thrush.

I am so fed up of life being about my vagina 

[Joaniepat]

joziel, the pallor is probably just the VA. Mine presented like that. Have you got any Ovestin  to massage in? I can't remember what you are using. Vagifem is fine for the inside, but doesn't always do much for the labia. (This according to my vulva dermatologist.) As you probably know, many folk need decent levels of both systemic and local E to keep on top of VA. My regime now is 5 Vagifem a week, and Ovestin externally every other night. It used to be everything every night, plus moisturiser, although I no longer need the latter.
JP x

[joziel]

Oh that's a bit reassuring, that VA can look like that too....

I do have Ovestin and I'm using it morning and night at the moment. I'd use it even more but I'm afraid of burning through it too fast and not being able to get more.

I'm using Vagifem every night. I might go through that too fast, but I can get my Newson GP to send me more if I pay for it. (I know they will be happy for me to have it every day, even if other GPs aren't.)

I've only been on this regime for about 24-48hrs though, that's when this all flared up. Before that I was doing 2x weekly Vagifem and Ovestin and using YES OB every morning. I first tried using YES VM internally morning and evening instead of increasing Vagifem (to try to save the Vagifem) but that definitely doesn't seem to be helping, there is just more stuff coming out of me 

I'm getting more of the glue like sticky discharge than before now and it does look a bit thrush-like, although also has this glue like quality to it. I have fluconazole in the cupboard but I'm a bit reluctant to take it considering I did 2 rounds of Caneston last year and have been negative for thrush on 2 swabs earlier this year. I don't want to upset things even more. I hope that's the right decision...

I'm not going to go back to the GP I saw last time who said all this stuff I know is wrong about HRT. She didn't even want me to have both Ovestin and Vagifem at the same time and had a lot of misinformation about HRT and I just didn't like her attitude. But it's a big practice and there are 3 other female GPs there with the DRCOG qualification who take an interest in gynae, so I'll just pick one of those and make a double appointment....