Menopause Discussion > Alternative Therapies
Prometrium
Dancinggirl:
Duffy
That wretched WHI report that came out in 2001/2 did a lot of damage and it has been largely discredited now.
You do not need progesterone if you only use local vaginal oestrogen - the dose is so small, the womb lining does not build up.
Only systemic oestrigen needs progesterone.
I abandoned full HRT because I got erratic bleeding and this really mucked up my vaginal area as well. The benefits of systemic HRT have be a favour benefits versus side effects.
My strategies for maintaining healthy lady bits:
Keep lady bits aired as much as possible - so no tight trousers.
Wash lady bits with unscented products - there are special feminine washes available but it is trial and error finding the one that suits you. Simply washing with lots of water or saline solution can be the best option.
Avoid scented panty liners or anything that might irritate.
Thrush and bacterial vaginitis are caused by an imbalance in the protective flora in the vaginal fluid - so maintaining this is vital.
Local oestrogen and using the right vaginal moisturisers can really help keep this flora balance right. There was a study done by a highly respected gynaecologist here in the uk on the various vaginal moisturisers available, SYLK and the YES products came high up as the best to use. You should be able to get these online.
I also use something called Multi Gyn Actigel whenever I'm aware thecflora balance isn't right - so itchy or sore or things simply don't smell right.
I too find thrush treatments irritate horribly so just use this Multi Gyn Actigel, which restores a slightly acidic environment to help kill bacteria and fungal infections. It does sting a bit at first and one shouldn't use it all the time as it will make things too acidic but it is certainly better than other options. Using 1-2 times a week can have a preventative effect I find.
I use Vagifem local oestrogen 2-3 times per week and SYLK twice daily but not just before using the vagifem as it may stop absorbtion of the oestrogen.
Diet can also help - I avoid highly acidic foods and drinks - no caffeine or sweet drinks but lots of water.
Don't sit down for too long - lots of walking is best - just keep moving.
To make sure bacteria from the gut doesn't get to the ‘lady bits', make sure you are really clean after opening your bowels - unscented wet wipes specifically for intimate use can help with this.
Perhaps simplify and reduce what you use for full HRT and concentrate on getting your lady bits healthier. The local oestrigen may well not cause problems with thrush etc if you follow my strategies.
Hope this all helps. DG x
Joaniepat:
Hi Duffy,
DG has given excellent advice as always. I cannot comment on the progesterone component of your HRT, as I had a total hysterectomy years ago so don't need it.
I am just writing to encourage you to start treatment for your vaginal atrophy as soon as possible, as it is an ongoing condition and needs lifelong treatment. I am about the same age as you (68) and developed VA a year ago. I too was affected by the WHI study, and my HRT was stopped in 2003.
I started using Ovestin in June this year, and although it worked to some extent I switched to Vagifem in September. This is much easier to use, the applicator is slimmer, and the product seems to be less inclined to provoke bacterial or yeast infections. Other folk on here seem to get on fine with Ovestin, but we are all different. My regime is similar to DG's, except that I use Vagifem daily at the moment as 2-3 a week did not keep on top of the urinary symptoms. I also use 2 pumps of Oestrogel daily, mainly for my bones but also in the hope that it will help with the VA. I still have Ovestin to use externally, and also some weaker generic estriol cream. The idea is to rub it into the vulva every other night, but I am not sure about this part of the treatment and can get sore when using it. That aside, I use Multi-Gyn Actigel when necessary, Sylk as a moisturiser, and wash the area with just warm water.
Things are not perfect, but there has been considerable improvement. Most days I can sit down comfortably, and can also wear trousers for a while as long as they are loose, but always change into a skirt when I get home.
I hope you can start treatment soon, and find some relief from your symptoms.
JP x
Cassie:
Yes I use it for 12 days per mth 100mg
Duffy:
Thanks for your responses Joni and dancing girl. I began my journey into Vulvar disorders in 2002. After many volvar biopsies , steroid creams , attempts at internal estrogen , mega yeast infections , severe allergic reactions to components to any topical meds , nine doctors and so much pain I couldn't believe it , we finally found the solution to stop the peeling skin which was ..075 patch of estrogen with norinthindrone 12 days a month, and No internal anything . Externally no direct applications of any sort, no soap ...nothing. Only then did I begin to heal. I got tested for allergies and found out that I am allergic to many industrial chemicals used in medicines and personal care products. So for me in addition to the atrophy of the Vulvar vaginal area I also have allergies that were part of the overall attack on the already fragile unhealthy skin. Finally I found coconut oil was very soothing And pure, and I used topically . In the 2005 I was brave enough to attempt sexual activity again but it is always iffy and often get tears. I medicate and lubricat with coconut oil only. Tried vagifem again in 2011 and just got all irritated again ...no doubt due to chemicals used in the tab. I relapsed a couple of times but with perseverance and plenty of coconut Oil I was able to resume relative pain-free activity. Around age 65 doc had me begin weaning down from .075 patch to .050 and problems began again but stabilized in about 6 months. But we switched from norinthindrone for bleeds , to Prometrium because she doesn't like for her older patients to use anything but Prometrium. In the beginning I did all right with the Prometrium but it really affects my estrogen balance and eventually I started having problems with breakthrough bleeds and rashes in my nether regions. This is why the doctor switched me to the 90 day protocol so that I wouldn't have to cope with the rashes etc. from the Prometrium every month. I am also hypothyroid and I suspect that that contributes to my need for the patch for the over all estrogen in my body. I am medicated with armor thyroid . I do appreciate a list like this..as women rarely speak of these probs face to face and docs canbe condescending and dismissive.
Joaniepat:
Hi Duffy, so sorry to hear that you have been unable to tolerate the usual medications for VA. Just a thought, but do you think that the Mona Lisa Touch (laser treatment) might help? One of the members on here, Maryjane, has had considerable success with this and wrote an article about it for the MM magazine.
JP x
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