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[linfit]

HI
Struggling with VA. I have been on Evorel patches for six weeks, plus vagifem twice a week for four months and still have symptoms. My question is......Is oral hrt stronger and would it help me more with VA symptoms? Does anyone know?

[Annie0710]

Not sure really as tablets have to go through body etc first whereas patches and gel are direct

I use 2 vagifem twice a week (so double dose as per gynae instructions) plus rub Sylk moisturiser outside and that really helps x

[Hurdity]

Most HRT types come in different strengths so one delivery method is not stronger per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.php

It also depends on how well you absorb the different HRT types. Some women find they do not absorb the oestrogen so well with tablets.

I presume you've had a hysterectomy as you are on oestrogen only or maybe have a Mirena for the progestogen part?

Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (wheras Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.php

Have a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.

Hurdity x

[Tinkerbell]

I am another one who uses HRT both systemic and local to control V.A, my only other symptom is palpitations.
I use 3 pumps of Estrogel, so not a low dose, plus Vagifem every night and Ovestin cream on the outside bits about four times a week.
Even with all that I do get iffy days now and again, I then double up the Vagifem for a few nights.

[linfit]

Not sure really as tablets have to go through body etc first whereas patches and gel are direct

I use 2 vagifem twice a week (so double dose as per gynae instructions) plus rub Sylk moisturiser outside and that really helps x

Thank you, did you notice or do you remember if the moisturisers stung at first and made symptoms worse. Is this normal for a time?

[linfit]

Most HRT types come in different strengths so one delivery method is not stronger per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.php

It also depends on how well you absorb the different HRT types. Some women find they do not absorb the oestrogen so well with tablets.

I presume you've had a hysterectomy as you are on oestrogen only or maybe have a Mirena for the progestogen part?



Thanks for this, it's really helpful.
I haven't had a hysterectomy; the patches are Evorel Conti 50 which I think is both estrogen and progestogen? It's good to know the doseages so I can think about increasing etc.

I have asked above in a previous post about whther stinging is usual at first when using moisurisers etc.



Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (wheras Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.php

Have a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.

Hurdity x

[linfit]

I am another one who uses HRT both systemic and local to control V.A, my only other symptom is palpitations.
I use 3 pumps of Estrogel, so not a low dose, plus Vagifem every night and Ovestin cream on the outside bits about four times a week.
Even with all that I do get iffy days now and again, I then double up the Vagifem for a few nights.

Thank you
Did you use any other hrt, like patches or orally or did you go straight onto the gel? And how long did it take you to get under control, to the point you are at now?

I have had VA since August, or at least that was when it was diagnosed, didn't have troublesome symptoms before that. Have been on vagifem since Sept, symptoms better but still difficult

[Annie0710]

Not sure really as tablets have to go through body etc first whereas patches and gel are direct

I use 2 vagifem twice a week (so double dose as per gynae instructions) plus rub Sylk moisturiser outside and that really helps x

Thank you, did you notice or do you remember if the moisturisers stung at first and made symptoms worse. Is this normal for a time?

I was sore anyway when I started the moisturiser but next day it felt better, there's a few to try but luckily Sylk worked and was prescribed by GP

I use YES vaginal wash too when I get chance at loo visits at home as I was becoming paranoid I smelt x