Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[SaraUK]

Here's the relevant bits of the reply to my email:
- If you have vaginal dryness you should be offered vaginal oestrogen, which is put directly into the vagina as a pessary, cream or a vaginal ring. You can use vaginal oestrogen for as long as you need to, even if you are already using HRT. Moisturisers and lubricants can also help. If vaginal oestrogen doesn't help to start with you may be offered a higher dose.

Previously we often used Vagifem 25 twice weekly, which provided 50mcg of estradiol per week. There were no concerns about the safety of this, it was taken off the market because of economics. Vagifem 10 or Vagirux 10 used twice weekly provides only 20mcg of estradiol per week. The option of up to 5 times weekly is therefore just replacing the same amount as we used previously. Perhaps 3 to 4 times weekly will be enough. Please feel free to share this information with your GP, including the NICE reference.

Thanks, but I used vagirux daily, 7 days per week for 4 months and 4 times weekly prior to that for 7 months when I only had the bladder issue. Also ovestin external too for 4 months. The burning started when I went on vagirux daily after 2 weeks, which I only went on because of bladder issue, which has never been solved.

To date I’m on none and bladder burning the same. It’s such a tedious situation that just won’t go away no matter what I do.

I wonder if the vagirux has damaged my tissues and nerves permanently.

[SaraUK]

Hi
I don't know if this would help you as a suggestion .... I had similiar problems for months and as a last resort my doctor prescribe me trimovate cream ( which babies get apparently) - solved all my external irritation. Maybe worth a go?
J

Thanks. I was prescribed Betamethasone which is a strong steroid and used it for the maximum 7 days. It very slightly reduced burning but not much.

How long did you use it for?

[MrsMitch]

Sara have you actually been to a Menopause consultant/specialist at your hospital? Sorry I may have missed if you said so. If you haven't, it sounds to me as if it's all guesswork. Again, forgive me if I've missed that you say you have.
If not, you really do need to see one. Prior to me getting on the right treatment my GP and gynaecologist diagnosed a variety of different conditions ( none of which I actually had) and you do tend to start reading online, as you have, and find there are a myriad of conditions with similar symptoms. You mentioned using a steroid cream and I used a number of different ones, obviously all prescribed by different specialists,  for a number of years. I think they caused a lot of tissue damage and made everything very sensitive when I started using VA treatments.
But again all this is guesswork. You really need a dedicated specialist, not a gynaecologist,  to get to the bottom of what you actually have. You can end up doing more harm than good, as I did, in the end.

[CLKD]

VA needs management.  Some products give better results than others might do.  I use 'ovestin' internally and when necessary on the labial area.  Or KY Jelly there.  Others find that a regime of 'vagifem' internally with 'ovestin' smeared outside helps. 

Some find that they might be sensitive to the fillers/packaing of the VA treatment.  When I get bad symptoms I insert 'ovestin' mid afternoon, swallow 2 Nurofen and repeat at night.  Do read 'the bladder issues' and the VA threads as there will be experiences shared there too.  A referral to a dedicated menopause clinic - not a gynae - will give you access to advice.

[SaraUK]

Sara have you actually been to a Menopause consultant/specialist at your hospital? Sorry I may have missed if you said so. If you haven't, it sounds to me as if it's all guesswork. Again, forgive me if I've missed that you say you have.
If not, you really do need to see one. Prior to me getting on the right treatment my GP and gynaecologist diagnosed a variety of different conditions ( none of which I actually had) and you do tend to start reading online, as you have, and find there are a myriad of conditions with similar symptoms. You mentioned using a steroid cream and I used a number of different ones, obviously all prescribed by different specialists,  for a number of years. I think they caused a lot of tissue damage and made everything very sensitive when I started using VA treatments.
But again all this is guesswork. You really need a dedicated specialist, not a gynaecologist,  to get to the bottom of what you actually have. You can end up doing more harm than good, as I did, in the end.

Hi, thanks, no, I have not yet got to seeing a meno specialist. I am still waiting for the results from hospital last week. Should be this Thursday.  If no fungal infection, then it must  obviously be VA, although I don't have dryness.  I am considering Newson Health, but I will soon ask NHS to refer me to a meno specialist before doing that.

[SaraUK]

VA needs management.  Some products give better results than others might do.  I use 'ovestin' internally and when necessary on the labial area.  Or KY Jelly there.  Others find that a regime of 'vagifem' internally with 'ovestin' smeared outside helps. 

Some find that they might be sensitive to the fillers/packaing of the VA treatment.  When I get bad symptoms I insert 'ovestin' mid afternoon, swallow 2 Nurofen and repeat at night.  Do read 'the bladder issues' and the VA threads as there will be experiences shared there too.  A referral to a dedicated menopause clinic - not a gynae - will give you access to advice.

Thanks CLKD, I have tried all those methods for months.  I even tried ovestin externally a bit last night, as it's been weeks that I haven't used anything. Today, burning just as much. Nothing works, or it makes it worse. I am at a loss as to what to try next. So far, tried vagirux daily for months, vagifem too, ovestin daily externally, steroid cream for 7 days, tried increasing estrogen from 2 to 3 pumps which I went even worse (anxiety, shaking, sweating, increased burning, same old bladder full, UTI sensations).  Nurse suspected progesterone intolerance.  Tried long cycle (which no is no longer approved!), stopped all use of topicals and the burning reduced, bladder always the same (although it always follows a bad burning episode, as if nurve pain up the urethra triggers bladder).  Even the meno nurse is baffled because I looked well oestrogenised, used daily vagirux/ovestin more than standard for months.  I am now wondering if this has even caused the burning issues, like damage to nerves? But the bladder issue only started first a year ago, before vagirux and before I ever had burning issues.  The burning only started after 7 months of frequent vagirux use, even before using ovestin.

[Minusminnie]

Before deciding on Newson Health it may help you to read this thread. 
https://www.menopausematters.co.uk/forum/index.php/topic,64837.15.html

A member Primrose3 was advised initially to use 2 Vagifem daily for two months.  They may all sing from the same hymn sheet there. ?
(Afraid i questioned it and not my intention but Primrose3 left the forum.)

Just mentioning it as you have already used daily levels of Vagirux for several months and are now wondering if this caused  burning.  Some find use of Vagirux different to use of Vagifem though.

[CLKD]

Good advice Minusminnie - when tissues are thin they may react with stinging when anything is applied.  Sticking with one product for 3 months plus moisturiser should ease symptoms, if U are continuing with burning and urine samples are clear of bugs: so no embedded infection: then upping the VA treatment might help.

A urologist with knowledge of menopause could be another option, mayB ring round your local hospitals to see if there are any Consultants with an interest in womens' health.  No one should have to suffer with this condition!  It can become all consuming.

[Minusminnie]

Sara UK I was just trying to forewarn you (going by Primrose3’s posts ) that you may find that Newson Health advise initial high doses much as you have already experienced with the vagirux but with vagifem and  may or may not want to do again.

[joziel]

Newson will help you find the dose that works for you and if that happens to be higher than the licensed dose, that's fine. They will also listen to your preferences.

It doesn't sound like all the local estrogen in the world is helping much so increasing systemic would be the way forwards especially if serum estradiol is 150ish.

The dose itself is completely irrelevant, it's the serum estradiol which counts.

[SaraUK]

Before deciding on Newson Health it may help you to read this thread. 
https://www.menopausematters.co.uk/forum/index.php/topic,64837.15.html

A member Primrose3 was advised initially to use 2 Vagifem daily for two months.  They may all sing from the same hymn sheet there. ?
(Afraid i questioned it and not my intention but Primrose3 left the forum.)

Just mentioning it as you have already used daily levels of Vagirux for several months and are now wondering if this caused  burning.  Some find use of Vagirux different to use of Vagifem though.

Yes my concern too. I’ve tried both vagirux then vagifem but same results, horrible burning in the vestibule so bad I’m scared of touching whilst showering. It’s like burning nerve pain.

[SaraUK]

Good advice Minusminnie - when tissues are thin they may react with stinging when anything is applied.  Sticking with one product for 3 months plus moisturiser should ease symptoms, if U are continuing with burning and urine samples are clear of bugs: so no embedded infection: then upping the VA treatment might help.

A urologist with knowledge of menopause could be another option, mayB ring round your local hospitals to see if there are any Consultants with an interest in womens' health.  No one should have to suffer with this condition!  It can become all consuming.

I have a private appointment with a gynocologist with an interest in urogyno. It mentioned menopause too on her specialties. I’ve got to wait until June for that.

Honestly it really is consuming me. I’m not working and losing thousands of pounds in income. My husband is worn down too because it’s all I talk about. I can’t think of anything else with a constant urge to pee and a crotch that feels like radiation burns 

[SaraUK]

Newson will help you find the dose that works for you and if that happens to be higher than the licensed dose, that's fine. They will also listen to your preferences.

It doesn't sound like all the local estrogen in the world is helping much so increasing systemic would be the way forwards especially if serum estradiol is 150ish.

The dose itself is completely irrelevant, it's the serum estradiol which counts.

Yes thanks, increasing my systemic would be the next option but as I’m progesterone intolerant and have two fibroids (5cm and 1cm) it’s complicated.

I don’t want a Mirena (synthetic, permanent and right next to bladder). Vaginal utrogestan the same. Taking continuous utrogestan was horrendous at week 6 whilst even upping to 3pumps (that was when my bloods showed 159 Estrogen after 2 weeks on this).

Gp won’t approve anything over 3 pumps unless progesterone is doubled up. Seems crazy and not an option for me. I expressed this, so that’s why she suggested new bloods. Maybe this silly rule could be overturned if I’m not absorbing.

I wonder if I can go back to cyclic even post meno (last period oct 23), but it was a withdrawal bleed anyway. Seems coincidental that bladder symptoms came back in November and burning started December.

[CLKD]

 

[Wren]

SaraUK,
Have you considered a Women's Health Physio? They can help with a pelvic floor that is too tight - causes burning, urgency, etc.

Apologies if you've already mentioned it.