Hi kay21, I really feel for you, I couldn't use vagifem due to awful side effects, when I started ovestin I thought here we go again with the same horrible side effects and I stopped, but had another go with it as can't stand the va symptoms, on the loading dose I got exactly what you described especially the upper gut pains and nausea it was horrible but I pushed on with the two weeks loading dose and once I got to the twice weekly those side effects went away, but if you really can't continue due to side effects maybe ask the gp for the estring if you haven't tryed it already, I was going to try that next, but once I got through the loading dose on ovestin it did settle, there are other options the gp can give you, so don't give up trying to find something that you can get along with, I too was shocked at how bad a small amount of cream can cause such awful side effects, I hope you find some relief to this awful situation, x