How long have you been using Vagifem, are you just using 2 a week.
I would do a two week reload and then try a higher maintenance dose, i have never coped on two a week.
You could also ask for Ovestin cream to be prescribed and just use that sparingly on the outside bits along with Vagifem.
I know lots of ladies in here use moisturisers but i can't as i react, you may be the same. I do understand how sore you are, i struggled to get VA treatment and my whole day revolved around my sore bits, couldn't sleep, walk or sit it was miserable.
But i got it under control and only have odd flare now, although i did go on systemic HRT as well.