When first starting Vagifem it is quite normal to get itching, throbbing, burning, soreness, stomach cramps and even a bit of spotting. Vaginal atrophy has deprived that area of a vital nutrient - oestrogen - and it has to wake up and absorb this vital nutrient before the benefits will be felt. I agree with Stellajane - some find Vagifem quite an irritant - I think it can be the fillers in Vagifem that causes some of the problems - but I find that if I use some vaginal moisturisers like Sylk and Multi Gyn Actigel, this helps to reduce discomfort and, as the VAgifem does it's magic, things gradually improve. I use the Sylk etc everyday anyway as I like things to feel slightly lubricated down there generally.
Some women swear by the creams, some like the Estring while others prefer Vagifem. I have tried all three and on balance find Vagifem the best I but need the moisturisers alongside.
It's worth persevering with local oestrogen as in the long run it will help to maintain healthier 'lady bits' and the bladder. Dgx