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[Otter15]

Hi everyone

Probably been discussed before but can't see it but do people have times where their VA suddenly gets worse for no apparent reason? Have been going along quite nicely for a few months on Vagifem and Yes. Thought I'd cracked it but it appears not! The last week has been bad and it feels that what I have been doing isn't working again! Burning at night and discomfort are back (not that they ever went completely but it wasn't enough to be a problem). I can't think of anything that I have done to cause this so just wondered if others experience the same at times?

[Daisydot]

Yes otter it's an ongoing battle, I find the biggest culprit is the ph balance in our urine,you have to keep that as neutral as possible by avoiding anything acidic and drinking water throughout the day,I find after I pee now I bottle wash with just plain water,I carry one round in my bag if I'm going to be out a while ,then I smear some lub on and that helps but the tissue is so thin even constipation and straining is enough to set it off again.just keep doing all the things your doing and be aware of what triggers it so you can avoid.xx

[Joaniepat]

Otter15, as well as Daisydot's good advice, you could also try doing a 14 day reload of the Vagifem. Sometimes it's necessary. How about asking your GP for some Ovestin cream as well, to use on the external bits if vulval soreness is a problem?
JP x

[Otter15]

Hi ladies. Thanks for the advice. Will start on more Vagifem and drink more water. Just had a thought though. I have been experimenting with phytoestrogens having flaxseed in porridge for a few months. I stopped when the weather got hot - the timing fits. Maybe they do help after all! Will start eating again and see what happens.

[Dancinggirl]

Others have given great advice but I must add that the hot weather can be a trigger. I find that if the lady bits to get too hot it can be a problem- wear loose clothing, don't sit down for too long and never sit on anything plastic!! 
Do avoid caffeine as well as fruit juices. Clean really well after opening the bowels and perhaps use a bit of Mulit Gyn Actigel if the burning starts, as you may have some bacterial vaginitis that will often trigger the burning. In my experience, It's heat and bacteria from the bowels that can trigger this burning.  Half a teaspoon of bicarbonate of soda in a glass of water twice a day will neutralise the urine really well and can alleviate the burning quickly.
DG x

[Otter15]

Hi Dancinggirl. Thanks for the advice. What is multi gyn cream? Can I get it otc (and ovestin)?

[Joaniepat]

You need a prescription for Ovestin (an estriol cream). It helps keep the vulva oestrogenised. Multgyn Actigel is a gel which balances the pH of the vagina and vulva, as these areas become less acidic at menopause and this upsets the vaginal flora, causing soreness and bacterial vaginosis. It is available otc or online. It can sting a bit on application but is soothing thereafter. I use it once or twice a week to help keep things ticking over nicely.
JP x

[Otter15]

Thanks for that. Will get some today and try it.

[Dancinggirl]

I buy Multi Gyn Actigel online - it can be cheaper that way. Not all chemists have it and I have tried various other products that claim to do the same thing but always go back to this one.  I tend to put a little on the end of my finger and push some up inside and around the outside.  IF things are bad, then use the nozzle to get stuff right up inside. 
DG

[Dierdre]

If I don't drink enough and get dehydrated I will suffer for a few days and need to up my dosage.  Also I've noticed if I'm stressed or worried about something I will have a blip. Definitely do a reload and perhaps use more Vagifem a week, I use daily now plus Ovestin every night and still struggle some days and sitting all day at work doesn't help.  When I'm on holiday I can manage on much less. I think over the years as the oestrogen levels drop even more we need extra and sometimes need full HRT as well as local.
Interesting about the flaxseed, I did try this a while ago and also soy products but things got worse. I then read that they attached to the receptors and just mimic oestrogen, blocking the real thing, so let us know if you have improvement again with this.
I would ask for Ovestin this certainly improves the outside and you can use inside also.  I usually put a small amount of Bepanthen on the outside after applying Ovestin as this sometimes stings if you are sore.

[Otter15]

I have started on the 14 day Vagifem. Really burning now and very sore. It is so similar to a water infection but I have been here before. I find I get stomach pains if I use the Vagifem too often so have to balance that too. Do you ever have a break from it? My doctor said I should use it then have a break for a while but the last time I did I went back to square one. I was going to this month but don't think I will now. I have ordered the multigenerational gel so will try that. Will let you know about the flaxseed. I read a really good book which explained about the flaxseed. I had not thought much about it but will see whether I settle down again now I have started. Thanks for the advice. Just talking to people who know what I am talking really helps.

[Dierdre]

Your doctor is wrong you don't need to have a break and if you did the atrophy will return as it is for life because of oestrogen deficiency.  I used to get the cramps, try putting the tablet lower about half way in not up near your cervix. This seem to help the outside more too.

[Joaniepat]

You definitely should not have a break from the Vagifem, your GP is wrong there. The NICE guidelines state that patients should be warned that if they stop treatment for VA, symptoms will probably return. I think it's unlikely that Vagifem would cause stomach pains, but you could try inserting it half way up. Several ladies on here recommend that. Where is the burning, is it urethral or vulval or both? Could you have another urine infection perhaps?
JP x

[Otter15]

Thanks again for all the advice. Yesterday I drank loads, used tons of coconut oil, upped the Vagifem and this morning it is not as bad. I think I needed more oestrogen. The burning when I get it is inside and outside and this is how it affects me. i will definitely try the vagifem lower down and should get the multigyn gel today (don't know where multigenerational came from!). It is sad to think that this is for life but that makes it more important to learn how to manage it effectively. Will keep eating flaxseed too. I agree about my doctor too. There seems to be little understanding about VA out there. It may not be life threatening but it is certainly debilitating and miserable.

[dahliagirl]

I think some of the older prescription guidelines, that appeared post millennium studies debacle, do say to cease using it for a while to see if symptoms come back - this was in line with 'the lowest amount for the shortest time' guidelines.  These were a knee-jerk reaction to the initial results from these studies and further research over the last 18 years have found that these fears were not founded.  They are still kicking around the internet in places.

Since then, NICE guidelines have come out.