Print

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

[Nas]

Just had a blazing argument with Boots pharmacist re: oestrogen cream and vagifem. He said I can’t have both as I will be “ overdosing” on oestrogen! What the actual hell??

“ Have you had a FULL hysterectomy AND are having to take hormone blockers” I asked him.

“ No” he said.

“ Well when you have, let me know!”

Furious!

 Not that vagifem does anything. My surgery are ringing next week, to hopefully change my useless imvaggis pessaries to a stronger oestrogen cream.

Why is it all so hard? 

[suzysunday]

Why is the pharmacist interfering if you have a prescription?  Like gnatty said, maybe the 0.1 ovestin will be better, it's the one I've always used.  Now you have to wait till next week and the days just go by.  I don't know why it all has to be so hard!  X

[Nas]

I don’t know why suzysunday..it’s just a joke! Meanwhile you can buy men’s viagra or whatever, no questions asked! Women’s health just isn’t taken seriously enough.

Will drop you a message this weekend (sorry for the delay, what with this and work… urggh)  xx

[Dierdre]

Serious bladder pain and frequent weeing. I’m using vagifem and estriol cream twice daily. What else can I do? 

Buscopan recommended by the doctor helped my bladder spasms when I was suffering with recurring thrush, the constant infection caused inflamation of the bladder and also a long term VA flare up last year. It's not just for IBS.
Also Lidocaine is the cream that numbs everything but I think it's on prescription. My gynae prescribe once for me years ago when I was struggling with VA and a prolapse and it was painful to sit down.

[Dierdre]

I am experiencing exactly the same which is so unusual for me being symptom free for so long. I had the Covid vaccine two weeks ago and wonder if that's the reason or the fact my tube of Estriol might have degraded because of being in a new build house that seems to constantly have high room temperatures.

I've started a new tube of Estriol and have upped the dose, I haven't increased the dose of Vagifem yet, and hopefully it will help, but other than doing the usual non soap washing I honestly can't think what else to do. Such a wretched condition that's always lurking in the background ready to pounce.

It's probably the vaccine, I'd double up on both for a few days to compensate. Temperatures over 25° will degrade estriol cream, l put mine in the fridge if hot and on holiday abroad. Also you have yours opened for a few months too so might not last as long. I use a tube in 3 weeks.

[Ana21]

Hi Nas!

To ease the pain while waiting for your new Rx, you could try phenazopyridine (pyridium).  It's an oral urinary analgesic used to relieve urinary urgency, pain caused by a urinary tract infection, surgery, catheters, etc.

It's not a long-term solution but it will bring you almost immediate pain relief.  It's available by prescription and OTC at a lower dose.

Back in the 90s, I had a UTI and my doctor prescribed pyridium with my antibiotic.  She said there was no point in suffering while waiting for the antibiotic to kick in.  It was like a miracle.  Pain and urgency stopped completely in about 20 minutes.  A word of warning:  It turns your urine orange and can stain your clothes, so don't wear your best undies.

More info about phenazopyridine (pyridium) here:
https://www.newyorkurologyspecialists.com/urinary-problems/medications/pyridium/

AZO is available OTC
https://azoproducts.com/products/azo-urinary-pain-relief-maximum-strength-tablets

I'm in Canada, so you may have a different selection of products there.

Hope you're feeling better soon.

[Nas]

Thanks Ana21
I will take a look at all those links; much appreciated. Hopefully I will find something which works.

To be honest, there needs to be much more support and advice out there for women who’ve had a hysterectomy, are living ( sorry existing in my case!) with cancer and menopause. The support just isn’t there.

Anyway, I digress.

[Ayesha]

It's probably the vaccine, I'd double up on both for a few days to compensate. Temperatures over 25° will degrade estriol cream, l put mine in the fridge if hot and on holiday abroad. Also you have yours opened for a few months too so might not last as long. I use a tube in 3 weeks.

Thanks Dierdre, a lesson learned here! Since using a new tube of Estriol cream things are calming down but not there yet. I've stopped using a moisturiser as I don't want to dilute the cream and see how things go.
It could be the vaccine or the fact the cream, which usually lasts me three months, had lost its potency in the heat of summer. I will be keeping in a cool place from now on.

Nas, apologies for sabotaging your thread but hope this helps others, a condition that can never be taken for granted.

[Nas]

No worries Ayesha.
Knowledge, advice and shared experiences, equal power.

I too will keep my cream in a cooler location ( just to see).

[Ana21]

Hi Nas

It makes me so angry that you've been provided with such little support and have to endure such debilitating symptoms.   Everything I've read says that vaginal estrogen is safe for breast cancer survivors.

If I were in your shoes, I'd keep a tube of estrogen cream in my purse and apply it after I used the loo.  I would wear a panty liner to absorb any excess cream.  I'd essentially be sitting in it.  That should ensure it's reaching the urethral area and my skin is not being further damaged by friction.  I would do that until the skin had recovered.

Thanks for keeping us posted on what's working and what isn't.  It's an education.  I hope you get some relief soon.

[Nas]

Thanks Ana21
Is just horrid how they’ve left me

The letrozole ( AI) which oncology have put me on, to inhibit the small amounts of oestrogen I do produce, won’t be helping the situation I’m sure.

They just dont want to know about the fall out from these drugs. It’s very much “ We are keeping you alive, be grateful”

Anyway, the surgery are calling Tuesday and hopefully they will allow me to swap from imvaggis ( which doesn’t work) to a 0.1 strength cream ( which hopefully will improve things).


Again, many thanks for your input and for actually hearing me.

[CLKD]

    He said I can’t have both as I will be “ overdosing” on oestrogen! What the actual hell??
. We cannot over dose on a natural hormone! 

Ignorance reigns.  Which book hasn't he read, I would be sending him and the MD of the pharmacy a copy of "Me and My Menopausal Vagina"!  I am spitting bricks on your behalf.

Could you buy 'gina' over the counter?  As well as a note to the BMS and Dr Currie.

[Nas]

Yes I was furious CLKD.
What happened was, that I bought Gina from Boots and then 3 weeks later ( this week) bought Ovestin.

So the  pharmacist queried
a. Why I had gone through so many vagifem ( I use daily or twice daily).

and b. Why did I need the cream when I can only have one or the other.

Anyway, hopefully surgery pharmacist will let me have BOTH.

[Ana21]

Nas,

I don't know whether you've been given any specific instructions on how to use Vagifem or estrogen cream.  To minimize any systemic absorption and to ensure the estrogen goes to the periurethral area, you want to apply it to the lower-third of the vagina.  You may find Vagifem is more effective if applied in this way.  Worth a try.

 "Vagifem® was applied in postmenopausal women either in the lower or upper third of the vagina. Estradiol levels along with Doppler velocity measurements were made both at baseline and after 2 hours. Application to the upper third of the vagina resulted in statistically significant higher serum estradiol levels but only a small absolute difference compared to the lower third of the vagina. Also, with application of Vagifem® to the upper third of the vagina, there was a decrease in pulsatility index and resistance index which was not seen with lower third application. Thus, the first pass uterine effect appears to be exclusive to the upper third of the vagina. With application to the lower third of the vagina there was preferential delivery to the periurethral area."

"... when vaginal E2 tablets such as Vagifem are used for a local cure of vaginal atrophy, the least possible impregnation of the endometrium is desired to limit the risk of hyperplasia. Consequently, E2 tablets should be positioned in the lower third of the vagina, which will also optimize the desired effects on periurethral vessels. Proper positioning of the E2 tablet Vagifem is not intuitive, however, because the manufacturer provides a long dispenser and instructions for deep placement of the tablets in the vaginal fornices."

Sources:
“First uterine pass effect” is observed when estradiol is placed in the upper but not lower third of the vagina
https://www.fertstert.org/article/S0015-0282(04)00089-5/fulltext

Local Effects of Vaginally Administered Estrogen Therapy: A Review
https://pmc.ncbi.nlm.nih.gov/articles/PMC3252029/


How to apply estrogen vaginal cream:

"Spread the cream into the vaginal/urethral area. As the cream is spread,
make sure to cover the urethral opening and just inside the vagina as this
is where most estrogen receptors are located. It is not necessary to push
the cream high into the vagina."

Source: https://www.med.umich.edu/1libr/urology/EstrogenVaginalCream.pdf

[CLKD]

So BOOTS pharmacy are tracking us on what we buy then ?  There was an article in a recent Sat paper on a similar topic but I didn't read it.

There R ways of talking to people, rather than "U should not/cannot " it should be "Talk to me about why you are/not" ........