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[robotwars]

Hi! Can I just ask a question, I went to my GP because I'm now using estroil cream 3 times a week and its not working that well for VA symptoms, I asked if there was anything else I could try and he said no they are all the same, is Vagiflem the same as estroil, instead he has referred me to the gynaecology dept at the hospital,
I thought they were slightly different.

[Tinkerbell]

I changed to Vagifem when I felt that Ovestin cream was not working as well as it had been and things improved.
Vagifem is Estradiol, you could up your dose of the estriol cream to 5 times a week or insist on the Vagifem. Why is he sending you to the gynaecologist?

[robotwars]

He keeps prescribing full HRT but I suffer with IBS and it keeps upsetting my stomach, so he said that he didn't know what to give me anymore and has referred me to gynaecologist, in April I stopped the HRT to see what I was like without it and my biggest problem has been VA, if I could get that under control I could cope with everything else... but he said there was nothing else he could give me, apart from the estroil cream that is not working......today the VA feels awful, so sore..... kept me awake most of the night, wanted to try Vagiflem but he said it was the same thing.

[Maryjane]

Estriol is weaker than vagifem .

I use vagifem 5 xs a week and ovestin on the outer bits of needed.

Re HRT making your IBS worse ? Is that the pill form ? If so I would try either the gel or patch .

[Tinkerbell]

When did you last do a reload? Might be an idea to do a two week one and then use it more times a week...I have never managed on 3 times a week.
I would insist on giving the Vagifem a try, I have found for myself it works better. Can you see another doctor and ask for it?
Sorry you are so sore, it's awful to not even be able to sleep with it....been there!
What systemic HRT are you on? I get IBS but my transdermal method doesn't upset me.

[robotwars]

I have tried many different HRT's, 3 different pill forms and 2 patches,
so far this week I have done the estroil on mon, wed, thurs, fri night and still no better, its itching and so sore that last night I tried a cannestan treatment in desperation!
fingers crossed the hospital might give me vagifem, I can hope!!!!!

[Tinkerbell]

Have you got enough cream to use every night for two weeks? My doctor is happy for me to do that when things get bad. Do you have any idea how long a wait your hospital appointment might be?
VA is a miserable condition

[CLKD]

Your GP is that: a General Practitioner.  Go the Gynae with a list of symptoms as well as asking for either Vagifem or Ovestin1gm as these really ease vaginal atrophy symptoms.  As oestrogen levels drop off the whole body begins to dry: skin, inside the nose, deep in the ears, vagina …….. the latter can present as repeated urine 'infections' but are often due to dryness inside aggravating the bladder.

Some ladies find that 'sylk' helps too.  Let us know how you get on but don't be fobbed off if the Gynae isn't au fait with HRT!

[robotwars]

Thanks CLKD, have an appointment Friday so will let you know what happens....

[Hurdity]

Vagifem and Estriol cream are designed to do the same job at the standard dose - they work mainly on different receptors in the vagina but are overall equally effective on average. However some individual women will fare better on one than another and your GP should prescribe the other - in your case - vagifem - if estriol is not working - and/or as the others say you could do another "loading" of nightly use for a fortnight.

The NICE Guidelines give provision for specialist referrals and advice if normal treatments do not work but most enlightened GPs will prescribe and increased dose without referring to a specialist - especially those who know about the Estring and the old 25 mcg Vagifem dose - which are much higher than the vagifem dose used now - 10 mcg.

"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

Some women need systemic HRT as well as local oestrogen to fully relieve VA - so maybe need to try a different preparation as well as the local oestrogen?

Good to be referred though because at least you should be in expert hands

Do let us know the outcome.

Hurdity x