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[Maryjane]

Hi 😊 about 12-18 months ago someone posted about using vagifem lower was beneficial to some ladies ( definitely helps some ladies in my group ).

I have searched & I can see discussions on it, but can't find the paper, obviously not using key words.

Does anyone know where this paper is ?

Quick update VA campaign is going well, a GP on Instagram today posted about my book, what she has learnt from it, she now realises at 45 she is suffering also & apologised to patients who she didn't realise it was the problem.

She is not the first to say this, however she is the first to say it publicly. That's pretty darn good.

Posters are in the process & I have an army of women & professionals who will distribute them.

They will be downloadable. CKLD will contact you when done . You have been a champion from the start.

Another fab Utube video I'm doing tomorrow with someone. 

[Hurdity]

Hi there Maryjane - just had a quick Google using these words:

insert vagifem lower third of vagina

and got this:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252029/

This is the relevant extract:

"Vaginal Estrogen and the Endometrium

Intravaginal application of estrogen plays a unique role in hormone replacement therapy because of evidence that there is preferential delivery of hormones supplied in the vagina to the endometrium. This has been termed the “first uterine pass effect.” This phenomenon is theorized to be the result of countercurrent exchanges with vein to artery diffusion. While this phenomenon is known to occur in the upper third of the vagina; it was unclear if this occurs throughout the vagina. A recent study examined this phenomenon. Vagifem® was applied in postmenopausal women either in the lower or upper third of the vagina. Estradiol levels along with Doppler velocity measurements were made both at baseline and after 2 hours. Application to the upper third of the vagina resulted in statistically significant higher serum estradiol levels but only a small absolute difference compared to the lower third of the vagina. Also, with application of Vagifem® to the upper third of the vagina, there was a decrease in pulsatility index and resistance index which was not seen with lower third application. Thus, the first pass uterine effect appears to be exclusive to the upper third of the vagina. With application to the lower third of the vagina there was preferential delivery to the periurethral area. 47 "

The "recent study" which is summarised in the review is this one:

47. Cicinelli E, DeZiegler D, Morgese S, et al. “First uterine pass effect” is observed when estradiol is placed in the upper but not lower third of the vagina. Fertil Steril. 2004;81:1414–1416. [PubMed] [Google Scholar]

So the study was not looking at differences in efficacy that you mentioned but specifically the effect on the uterus.

There may be other studies that you are looking for?

Hope this helps

Hurdity x

[Maryjane]

Having posted & trying to delete it, I then found it.

But can't delete my post.

Many thanks for finding it. 💐😊

[Maryjane]

There is another also somewhere from New York I think, anyway it does seem to help those with bladder woes to insert lower.

[Katejo]

There is another also somewhere from New York I think, anyway it does seem to help those with bladder woes to insert lower.

I have tried applying it high and lower but haven't noticed any difference yet.

[CLKD]

  Maryjane - 

Keeping threads active for a while never does any harm.

Well done Hurdity