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[CaptJaneway]

It's looking like I might need a vaginal estrogen, have started 'dripping' in the night, though no problems holding on, no urgency, no urge to get up at all in the night, no problems if I cough or sneeze with a full bladder.  Just this drip, drip, at night (barely at all daytime, starts about 8pm).

I'd like to go armed with some knowledge to my GP, & that is likely to be that I think my urethra needs topical estrogen. So, Vagifem seems to be the popular choice but I don't know why? Easier, less messy?  I'd prefer to start on something weak but the dosage of each is meaningless to me.

Gynest - Estriol 0.01%
Ovestin - Estriol 0.1%
Vagifem 10 - Estradiol 10mcg

I know this sounds trivial compared to some of the posts I've been reading about bladder problems. Have had my fair share of horrors with the meno in general, & been on low dose HRT for 12 years to control ferocious hot flushes, cutting up the pills so for at least half that time I've only taken 1/3rd tablet each day, just enough to keep the flushes manageable (though my GP finds it amusing & says the dose is so negligible it can't be working).

But now THIS instead...………..!!!   

[CLKD]

Nowt is trivial!

Vaginal atrophy can take a hold.  As oestrogen levels drop off the body may become dry: inside and out! as well as muscles may become lax = aches and pains.  So appropriate treatments as well as over the counter pain relief can help.

I had pessaries initially which were withdrawn so my GP - who diagnosed my VA without examination 3 years ago,   purely on repeated bladder problems - so I use with success Ovestin.   Applied by applicator nightly for 2 weeks then every 3/4 and 5/6th night, it has worked well for me.  I can now go several weeks between treatments, I recognise that the heavy bladder feelings and extra wees means that I need to start treatment as well as Nurofen. 

If your regime is working for you, don't knock it  .  I think any of the treatments might be messy but once the treatment kicks in, relief is great.  4 me it was like razor blades up there 

[Perinowpost]

I use both. Vagifem on the inside, ovestin on the outside x

[suzysunday]

I use ovestin alternate nights at the moment.  I think that's OK too.

[Tinkerbell]

I use Vagifem every night and the Ovestin cream on the outside bits every night too.

[CaptJaneway]

Thanks, seems Vagifem is the most popular choice. 8 nights of the drip drip, I can't get to see the GP until 11 Jan  and blow me if this morning there wasn't pink coloured discharge on the panty liner as well.  I'm not liking this one bit.

Not enough I had a bu**er of a meno from the age of 50 (periods stopped) ferocious hot flushes 24x7, finally driving me to low dose HRT at 52/53.  I've pretty much always chopped up the tablets & for past 5 years or so I've used only 1/3rd of the tablet each day. GP always finds that amusing, dose so negligible he says it serves no purpose but lets me have my way, because each time I stop altogether I start hot flushing.

TBH, I was surprised a month ago before this drippy thing started, I had a migraine followed by 'spotting' - things that were regularly present when I was peri-meno.

The menopause - a hellish, never ending nightmare!

[Hurdity]

Hi CaptJaneway

 

I think I missed this post - Christmas and all that!

Firstly - if you've had spotting this long post-menopause - even though you are taking HRT - you really must mention this to the doctor. It is most likely to be due to uneven amounts of HRT if you are cutting up pills (which one are you taking) but theoretically it should not cause any build up of uterus lining as the dose is so low - so do mention it at your appointment. However the spotting can be caused by bleeding from the vagina if your tissues are very delicate as they are easily damaged especially eg after sex. The migraine suggests this latter is less likely though.

As for the vaginal oestrogen - the products and doses of all the different ones are meant to be equivalent ie they do the same job. Although the generic estriol cream is 10 x weaker than Ovestin, the dosage is 10 x larger. However some women use estriol cream on external areas as well - around the vaginal entrance so in this case a weaker one would be better as you can use it quite liberally as a moisturiser as well as providing additional oestrogen to the delicate skin in this area. I am on HRT, but also have Vagifem and estriol cream.

I can now go several weeks between treatments, I recognise that the heavy bladder feelings and extra wees means that I need to start treatment as well as Nurofen. 

Please note also this is not the way to use vaginal oestrogen. It is not a case of using it and stopping and then starting again if symptoms return or going several weeks between treatments. It is meant to be used continuously to keep the vaginal tissues at the right level of maturity and the right ph of the vagina. The standard treatment is nightly for two weeks and twice a week therefater for ever otherwise symptoms return. If treatment is stopped and symptoms return it can sometimes be necessary to go through the whole two week "loading" again. Some women with very severe vaginal atrophy need longer for the "loading" period and also may need a higher maintenance dose eg 3 x per week or more.

Hurdity x

[CLKD]

However, it works for me.  After 5-6 years I can recognise the symptoms.  I also don't, overall, have as many meno symptoms as others here suffer with.  I expect that my levels have evened out hence the less necessity for Ovestin.

[CaptJaneway]

Thanks for responses, quick 'update'. The drip, drip of urine was joined within a few days in the daytime as well 24x7! After about 3 weeks of it I started fully bleeding, like a mini period - not something I've experienced for about 12 years.

Though it wasn't heavy (my ordinary pre meno periods never were either), it built up then started to subside, but still hasn't stopped, today being day 14 of it. Thankfully, somewhere along the line the urine drip, drip, stopped - no idea what on earth that was all about or what is going on.

At first wasn't sure where the blood was coming from, but used a tampon & it is clearly not the urethra.  Seen the GP who has referred me for a Hysteroscopy, says if I don't hear from the hospital within a week I have to ring him, & he expects me to be seen initially within 2 weeks.

He did mention the word 'camera' given that I had no idea what a Hysteroscopy was, hopefully it won't be on borrowed from David Attenborough's film crew! I'd prefer something half the size of a flea - there's not much lubrication in my nether region (age 64).

Thanks for responses ladies - helpful advice should I need it. GP seems fairly knowledgeable about the vaginal oestrogens, but wants what he called the "red flag" of bleeding investigated first.  Even he is puzzled by the onset of drip, drip from the bladder, replaced by bleeding.

[Tc]

Re Hurdity. Post.May I ask a question.
I'm on the estriol 0.01. I'm confused about 10 times weaker but 10 times dose. Maybe I haven't been taking enough

I've been inserting one applicator full and putting some outside at night or nearly 3 weeks
Its not working.
Slight improvement in bladder but dryness seems to come back within hours especially at entrance and just inside.even though i put some extra there. and it's not working great. .
After 2 weeks i just continued scared not to so will be 3 weeks on monday

before surgical meno 5 months ago and am on systemic hrt so I'm so upset and worried its got so bad so quick.and is only gonna get even worse and I'm gonna end up like my mum having bladder repair and vaginal prolapse..
 The thought that it's never going to be any better and maybe worse even with treatment makes me just cry My eyes out.
I wish I knew what to do.
Thank you.

[Dierdre]

It does take a few weeks to start to work but maybe you would be better with Vagifem for the inside and Ovestin for outside and around the entrance, this combination seems to work for alot of us, well most of the time.

[Tc]

Thanks D. I've Ben on it nearly 3 weeks. Don't know how long I can continue every night and also off the doc will keep giving me that much cream.
I'm on estriol 0.01 but ovestin is 0.1
I'm realy confused about the 10 times weaker thing.am I right in thinking the active ingredient is weaker than ovestin so you need 10 times the amount of cream omg I sound thick. Wouldn't that mean a bigger measure applicator or putting several applicator full in at once ibdont thinknim understanding it right.. Maybe the estriol is not strong enough and I need ovestin confused TC here. 

[Joaniepat]

TC, the applicator that comes with Estriol Cream is bigger than the one that comes with Ovestin. If you are using the applicator that came with your product, then you are getting the correct dose.

I agree with Dierdre that Vagifem pessaries, plus Ovestin applied to the labia, would be a good combination, certainly less messy! If you switch over to Vagifem you will need to do the initial 2 or 3 week load-up again, and then drop to whatever dose does the job. Having said that, many of us use it every night.

JP x

[Tc]

Thanks JP. Crikey the applicator must be tiny fo ovestin if it's 10 times smaller than the one I've got.