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[Whatsupwiththis]

Agree Tinkerbell.  My GP who specializes in women's health, has INSISTED I use Vagifem DAILY.  When you are in extreme discomfort, you'll take ANYTHING!

[Tinkerbell]

Yes, when you can't sleep, sit down or walk because of VA you will use everything, I use Vagifem and Ovestin daily.

[Sammiejane]

it's seems different menopause specialists have different views !

i would of thought the guidelines on the leaflet for topical use would be for that product not for general systemic hrt as it's completely different otherwise they would have one leaflet for all hrt products .
i found the more ovestin i took the more it irritated my bladder and had more burning ! everyone is different

[CLKD]

You need to do what suits you.  The amount is so small that it is better to be with it than without.  I had breast disease in the 1990s and my GP has never queried whether I should or for how long I ought to apply Ovestin.  Once you get into feeling comfortable you can use as necessary. 

Menopause specialists?  Sometimes ......... they don't understand vaginal atrophy, 2 them it's two words 

[Dierdre]

All you ladies using vagifem and ovestin daily, are you also on full HRT so taking progesterone also?  Its just that ive recently had my scan results and have fibroid and endometriosis tissue in my lining that wasnt there 2 years ago on my last scan and never  been diagnosed before. Im 10 years postmeno.

 I used full HRT for the first time 2 years ago for 6 months, finishing 18 months ago because of constant heavy bleeding (could this have caused fibroids etc) but since then have used vagifem daily, until a few months ago when i was reduced back to 5 a week due to the introduction of computerised repeat perscriptions  I also use ovestin daily, externally and just inside the entrace. 

Im concerned as fibriods and endometriosis are oestrogen driven and yet i was only taking this locally, but  daily,, albeit above the licensed amount and without progesterone.  I know the NICE guidelines say we dont need progesterone but are those guidelines for the licensed amounts and if we are doubling this does it still count. Could this daily amount have caused fibroid growth?

So are doctors saying this daily use is ok because you are also on HRT with progesterone and if not are they still happy to prescibe every day?  Mine said 5 is the maximum limit for vagifem and every day for ovestin but externally, which i am now following as im worried now to go above this even if i really need to.

[Sammiejane]

hi

me personally i stick to guidelines of my doctor menopause specialist because for me guidelines are there for a reason and also have clinical trials of the product been done using daily continuous use internally no they haven't and this could very well help VA but could also open a door for other side effects ! there is also a mixed review as to whether or not the vagifem and ovestin topicals are actually obsorbed to some degree into the blood stream ? it depends on the individual and symtoms our bodies are all different i mean i still quite young at 40 and maybe when i'm 50 it maybe a different story i very well might need to apply more often but i would seek advice from menopause specialist or GP !

[Tinkerbell]

Birdy...that is shocking to read what your GP said, i had severe VA from around the age of 48, a female GP, who is older than me, kept telling me i had thrush and that you couldn't possibly have VA until you were two years post meno.

We did have another female GP who was younger and more informed, she told me that most of her ladies needed to use Vagifem and Ovestin 5 times a week and she had no issue prescribing everyday use if needed, she attended menopause conferences so was up to date on guidlines.

[CLKD]

I wish GPs would listen to patients  .  That way they would learn something about vaginas and how the products are labelled to cover all HRT rather than specifics!

Once I find a product that works I rarely think of side effects or if they might aggravate my breast disease.  Quality of Life is important to me .  By trial and error I've found out how all my meds suit me, might not be as the manufacturer's leaflet suggests but I rarely read those anyway. 

VA was like razor blades   up there along with repeated aggravated bladder and I was unable to live with that.  So 'ovestin' has been a Life saver.  I think I've been using it 3 years .........

I suspect that most people in the manufacturing industry are men.  So are unlikely to have any idea when writing the leaflets for female products how important information might be so the HRT leaflets say pretty much the same.  Regardless.  Also one has to consider the litigation culture so all possibilities have to be considered.

It won't make any difference who we are, if the product is absorbed it will be.  I haven't noticed much difference over-all apart from breast soreness when I had too long a gap between treatments. 

Let us know how you get on! 

[CLKD]

Maybe he needs to ask questions Birdy?  Go in with a view to educating him ;-).  Also an annual review is required for most medications. 

[suzysunday]

I fully understand Sammie being worried but the VA needs controlling otherwise life is unbearable.  I use ovestin internally alternate nights on gp advice, and a non hormonal gel the other night.   I don't like thinking I have to use it for life, and sometimes worry about long term use effects, but I have no choice. 

[CLKD]

   Birdy. 

Also worth remembering that occasionally ladies who haven't had access to 'vagifem' or 'ovestin' require surgical intervention to separate the vagina ......

[Wilks]

I've been working in clinical research for 20 years. It's my job to write the huge numbers of scientific/medical documents that support the prescribing information and patient information leaflets for medications.
They are not thrown together by people who don't know what they're doing, they are based on strict guidelines.
Of course everyone is different and will need different doses of oestrogen cream to control their VA symptoms. If an individual's symptoms aren't controlled by using as per the prescribing information then it's up to the doctor to advise on higher doses, more frequent administration, alternative products, etc.
It's not up to strangers on the internet to tell other people that a medication is “perfectly safe” to use in higher doses than on the packaging.
I'm not talking about the contra-indications (which are indeed based on HRT), I'm talking about the recommended dose.

[Tinkerbell]

No, i am sure they are not thrown together but i have been told by meno specialist and a GP with menopause training that the leaflets need updating.

Vagifem, i know this thread is about Ovestin but they are both topical estrogens used to be 25mcg per application so women received 50mcg but it was reduced to 10 mcg an application so women were getting less than half of the old dose. That is why the GP with meno training said she was happy for 5X a week as that was equivalent to old dose.

Of course everybody should take advice from a specialist, but unfortunately some of us have come across professionals who obviously don't read up to date papers.

Anyway as i said my meno specialist is a reputable one, so will go with what she said, obviously you and Sammie are perfectly capable of reading and making your own decisions, none of us is forcing you to use more.

[CLKD]

By manufacturing products doesn't make the people know how they actually work, nor how patients may be affected by the ingredients.  So leaflets in packages might give information but that may not be appropriate for all patients.  Strict guidelines by whom? 

Sadly people have to reach out to others who have experience of using the products.  If GPs were up 2 date or ready to listen, it would be much easier.  The Forum is about sharing experiences so that people can make informed decisions.  Informed by users ;-).   

[Whatsupwiththis]

If it wasn't for the awesome and knowledgeable ladies on this site, I would be pushing up daisies!  Because of their advice, I was able to communicate with my GP about what was going on and what I would like to try.  Fortunately I have an incredible GP who is well informed and was quite wlling to offer proper treatmenr.  Her advice??? Use as much as you need to be comfortable.  As CLKD said, Quality of life vs quantity is more important to me.  Any woman who suffers so much needs advice from those who went before her.  I don't think anyone is suggesting to ignore leaflet info but like any medication, the published side effects are mandated simply to prevent future lawsuits.  Everyone should heed the warnings certainly but LISTEN TO YOUR BODY.  It will never let you down.