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[MrsKPD]

Had a very easy menopause really, but amnow suffering from VA (56). Saw GP and she presribed me vagifem 10- one vaginal tablet daily for 3 months and then 3 weeks off. Then repeat this cycle. I had to go back this week because she wanted to do my smear herself. Low and behold I have anterior and posterior vaginal bulges which require surgery so she referred me. She asked how long I had symptoms- occassional urinary and faecal incontinence and I said years. Anyway, she told me that had I had my smear done by a GP over the past few years, I may possibly not be suffering as much now. I asked her again about tge vagifem regime saying that according to the manufacturers info it was one tablet for 14 nights then twice a week- she confirmed that she had said 3 months on , 3 weeks off.
Should I follow her advice or the manufacturers? I don't want to see a Gynae Consultant in next couple of months to be told that I've been taking it too much .

[Dancinggirl]

Hi and welcome to MM MrsKPD
It sounds to me as though your GP is quite clued up - The dose on the leaflet is standard but clearly your doctor thinks you need to have a good big oestrogen boost to help things, so I'd definitely follow her advice until you see the specialist - it should keep things more comfortable for you, especially if you are going to have to have more examinations. Vagifem used to 25 mg and many women have to double the 10mg dose they use to keep things comfortable. Do keep us posted about your progress.  DG x

[babyjane]

I would think your GP is correct in her assessment of you. I use Vagifem 10mcg 4 times a week and occasionally do the 14 night every night reload if symptoms are niggling.  My GP says that the 10mcg pessary can be used every night if necessary so please don't worry that you have done yourself any harm.

[Hurdity]

Yes quite - it does make one wonder why on earth the 25 mcg was withdrawn since docs are being sensible and using their discretion to double up - and the NICE Guidelines recognise this!

Hurdity x

[MrsKPD]

Thank you ladies for your kind replies. I will follow the GP's advice and prescription. I must admit I feel more comfortable than I have been recently and this is only day 10. Today though I feel a bit 'out of sorts', a funny feeling below waist level and lower back pain, I suppose it could be likened to period pains.

Hopefully it'll continue to improve before I get seen at Outpatients whenever that is. The Scottish Government state from referral to treatment (surgery), should be within 18 weeks but we'll see.

Kirsty

[CLKD]

   that waiting list of over 3 months 

Your GP seems to be on the ball …….  Vagifem can mimic period pain feelings so it may well be 'within normal limits'

[scriv]

Hurdity - interesting that you say that NICE recognises doubling up Vagifem. Have they actually mentioned the 25mcg debacle?

[Hurdity]

Hi scriv - sorry I didn't mean to imply that specifically - just that it mentions the dose can be varied - this is what it says:

"If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause."

https://www.nice.org.uk/guidance/ng23/chapter/Recommendations#managing-short-term-menopausal-symptoms

Not sure whether this is covered in the full guideline which gives the evidence base for the recommendations -  as I haven't looked at this.

Hurdity x

[scriv]

Excellent. Thanks Hurdity.  x