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[Tc]

Hiya ladies.
After several months use I'm finding estriol cream has had no affect on my VA.
Whatsoever.

This morning I was reading up on local vaginal therapy for VA and a few interesting things came up which id be interested to know other ladies  views or knowledge about?

Firstly I was surprised to realise that all the other forms of local treatment contain estradiol not estriol.

Secondly, Whilst Estradiol is the strongest,  Estriol is the weakest of the 3 eastrogens. It's almost undetectable in adult women unless you are pregnant

I did some googling about estriol and I read that it reacts differently in receptive cells than estradiol does.

So heres my thoughts

I know all local treatments for VA are relatively low amounts of hormone but it would seem estriol is a low dose of a weaker hormone than the others.

Even factoring in dose differences in treatments this inherent weakness would therefore seem to  make estriol the least effective option.

 I've never been pregnant so it would appear my body lived quite happily with undetectable levels of estriol and no VA for decades so why put back something that's not missing in the first place especially at the expense of local estradiol which  is what my body IS missing. ( systemic form isn't high enough to control my other symptoms yet and certainly isnt reaching my vagina.)

As i said, For me the  cream has been completely inneffective and my VA symptoms are slowly getting worse. So I'm going to ask for vagifem at gynae appt Monday.

Any thoughts on the estriol stuff I've said above? If anything I've said is incorrect please tell me. It's just my own thoughts on what I've read. Just getting ready to go into gynae with as much info as I can.

Take carexx

[Hurdity]

Hi Tc

INteresting of you to raise this...

Sorry I'm too tired to write about it now in detail but didn't want you to think you were being ignored...

In a nutshell it's all about oestrogen receptors -we have two (maybe more?) and estriol is weaker in respect of one of them (either alpha or beta) whereas it has greater affinity for the other one ( either alpha or beta - I can never remember which way round.

It is some years since I read about all of this so the refs aren't to hand but the doses are worked out for both etriol and estradiol products to be equivalent and to do approx the same job (maturation of vaginal tissues and alteration of ph etc) - trials have shown this and the research has been published. Will look them up if you would like me to find them?

If the dose you are on is not working for you then it maybe needs increasing or changing to the other product - as we all react slightly differently the dose and preparation may need tweaking.

In fact there is only one are two estradiol products - Vagifem, and the Estring , and two estriol products - generic 0.01% cream and Gynest 0.1% cream and they all have different fillers too. They are all listed here: https://www.menopausematters.co.uk/local.php

The pregnancy issue is a red herring in the sense that we have the receptors and the hormones acts on them to do the job and it's a natural hormone. In fact some "alternative" sites wax lyrical about estriol as the answer to HRT, mainly because of the receptor affinity difference.

Checkout Maryjane's posts about VA and Dancinggirl's "Burning Club" thread in Private Lives for lots of tips and info on VA.

Hope this doesn't sound too vague as I'm v tired! Will look up more if you would like me to!

Hurdity x

Edited to correct a mistake!

[Tc]

Thank you hurdity.
I also read about estriol being pushed as systemic hrt because of the receptor issue   

I think the vaginal ring for VA contains estradiol

I don't know how I can increase my dose of estriol as I used it every night for over 3 weeks and  then every other night since without fail.

 Thank you for your reply and the info you give I will check out the threads you mention. Ta for that.
.
It is interesting though isn't it, the estriol question?
All the best Tcx

[Hurdity]

Hi Tc - sorry yes you're right I forgot about the Estring - I told you I was tired!!! And - yes it contains estradiol. So there are two estriol products and two estradiol ones. Also I posted on your other thread about DHEA for VVA quoting other threads and info about this - not sure if you saw it? That will (presumably) be another possibility.

Are you using Ovestin or generic estriol 0.01%? If the latter you could try the former and use slightly larger amounts - in consultation with your doc - but as you say you can always try Vagifem or the Estring to see if these prdoucts suit you better.

Take care.

Hurdity x

[Dierdre]

My VA is now much improved since using both Vagifem an Ovestin, I think both receptors are now being targetted.  I've tried both separately but didn't work 100% until I started using both together everyday about a year ago. My main problem was the soreness outside and the cream deals with this whilst Vagifem works inside and both help with bladder issues.  I tried the YES VM moisturiser this week and had to stop because of burning! I've been using the YES WB lubricant for years successfully so was surprised, obviously something different in the VM that doesn't suit me.

[Tc]

I use the 0.01 generic cream..   I can see how the dose could be upped with ovestin hurdity. As it's more concentrated.
Lots of ladies on here seem to favour vagifem inside and cream outside and I think that's what I'm going to ask for. I've given the cream a fair go now and the thought of VA getting worse and worse scares me.

Deirdre isn't the yes VM like replens?  You use the vagifem everyday, is that right.?. Maybe the products don't mix well. I must admit I found replens an awful product.  The gynae gave me some sachets of yes wb to try and I think it's a lovely product to use.

[Dierdre]

The VM moisturiser is also a YES product but a newer one I think and it's more of a longer lasting moisturiser rather than the water based lubricant which is more for using for sex, but it can be used for VA too. Yes I agree the YES WB is good and I've never had a problem using this with Vagifem. I also hated Replens and I dont think its recommended anymore. I use vagifem everyday when I'm working as I'm sat at a desk 8 hours a day and can manage to reduce it to 5 a week when not working, I'm also prescibed Ovestin daily. The twice a week dose did absolutely nothing for me. I dont think the original dosage of 25mcg per tablet should have been reduced to 10mcg as it's obviously not enough for a lot of us.

[pepperminty]

Hi ladies,

I am slightly confused.

What are the different estrogens in

Vagifem
Ovestin !%
Estriol 0.01%
Estring

I assumed it was the fillers that caused problems for some.

Could it actually be the type of estrogen then in some cases that causes issues?

Is Estriol better/kinder?

Thanks PeppermintyX

[sjpercy3]

Hi ladies,

Ovestin cream works okay for me, but I need something stronger as I'm quite young. I have been given the Estring but it is too big for me. Could I ask my GP for Ovestin cream and Vagifem together? Is Vagifem a stronger than Ovestin?
Sorry if I'm asking something really obvious.

[Joaniepat]

Hi ladies,

Ovestin cream works okay for me, but I need something stronger as I'm quite young. I have been given the Estring but it is too big for me. Could I ask my GP for Ovestin cream and Vagifem together? Is Vagifem a stronger than Ovestin?
Sorry if I'm asking something really obvious.

Yes, you can use Vagifem internally and Ovestin on the vulva. They contain different oestrogens. Vagifem and the Estring contain estradiol. Ovestin contains estriol. So it's not that one is stronger than the other as such. Some folk prefer one, some the other, and some use both. The dosage in Vagifem is quite low these days, only 10 mcg estradiol compared to the 25 mcg it used to be. After the initial 2 or 3 week loading dose you can use it anything from twice a week to daily, according to need.

JP x

[Hurdity]

Hi ladies,

Ovestin cream works okay for me, but I need something stronger as I'm quite young. I have been given the Estring but it is too big for me. Could I ask my GP for Ovestin cream and Vagifem together? Is Vagifem a stronger than Ovestin?
Sorry if I'm asking something really obvious.

As Joaniepat says re different oestrogens. I briefly explained what the difference is in my earlier post (20th Feb straight after Tc's original post).

I use the generic estriol (rather than Ovestin) on the outer areas (in addition to Vagfiem internally) - because it is weaker it is easier to spread more liberally like an ointment without giving yourself a large dose of the hormone - but it depends where your particular problem is.

Hurdity x

[Tc]

 I haven't used ovestin but I know it's a more concentrated preparation than estriol 0.01 I.so it makes sense it might be thicker and not spread as easily as hurdity says.

I find the estriol 0.01 uncomfortable to use internally. It's too much cream I find it extremely messy  and I  can't wait wash when i wake up and even after that it's still leaking out most of the mornig making me feel sticky and not clean
.
It also has made it impossible for me to use utrogestan vaginally. It's so much cream the pill just slides out with it.

Add to that the fact that im not seeing results from it and I am desperate to change over to vagifem.

I believe, correct me if I'm wrong ladies, that the vagifem has disposable applicators and I think this is a bonus. The reusable ones with 0.01  aren't easy to wash out and it's a bind.

I will stick with the cream for the outside.
But  at the moment I'm using it internally every other night and i think with a more user friendly option I could use every night which might make it more effective  for me.

I read a survey in which the results found far better "compliance" with the vagifem versus the cream. I.e women were far more likely to keep using it on a regular basis so  I guess I'm not the only one who doesn't like being a sticky mess!!

Pepperminty. I don't know if estriol is kinder the question we were pondering was whether it was weaker and therefore less effective than estradiol which is contained in vagifem and estring. It's an interesting discussion but not sure we've got a diffinitive answer yet.

The difference between ovestin and estriol 0.01 is simply that ovestin is more concentrated. I.e one application of each contains the same dose  but with ovestin it is suspended in less cream.

[suzysunday]

Really interesting thread. I have been using Ovestin for 4 months for VA uti symptoms.  I still don't feel good and have lots of days when I keep weeing although there is no stinging.  I don't want systemic hrt after pmb.  I keep thinking maybe vagifem would be better.

[Katejo]

Really interesting thread. I have been using Ovestin for 4 months for VA uti symptoms.  I still don't feel good and have lots of days when I keep weeing although there is no stinging.  I don't want systemic hrt after pmb.  I keep thinking maybe vagifem would be better.

Vagifem is working fairly well for me so far. Occasional soreness for short periods but no more UTI /frequent peeing since November.

[Tc]

Katejo has it helped bladder?