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[Lily35]

Hi all - first post.  I have probably had the same journey as many of you with a couple of years of cystitis infections and pain and soreness after sex.  My female GP gave me one antibiotic to take after sex which helped for a while.  At 50 I was having some other peri symptoms and intermittent periods so started systemic HRT and had Mirena.
Fast forward a year and I mentioned to the menopause nurse that I was still struggling with infections and she read my notes and immediately started me in Imvaggis.  I used this for 9 months twice a week after the loading and then things got worse and I ended up reading all about VA on here.  Cue starting Vagifem and ovestin on the outside in September last year.  I have re-loaded twice as it hasn’t settled.  I have just completed 4 weeks of daily Vagifem and finally feel comfortable every day.
About to start maintenance again.  Does anyone have a good regime with systemic alongside - 2 x 10mg not enough.  Do people prefer every other day or is twice a week using 2 better (would be easier for me but sooo don’t want to go backwards!). Thank all 

[CLKD]

Use every night if necessary, many do.  As well as inserting an extra 'vagifem' in the afternoon to keep the condition under control.  Some use 'ovestin' on the outer labia or another moisturiser.

I do wish that GPs would not prescribe an 'as necessary' AB - the World is becoming too reliable on the drugs to the point that bugs are becoming resistant.  She should also have heard alarm bells if you were returning for the same condition 

When I feel the need2P I take 2 Nurofen to ease that nip as the urine flow stops.   Keep up with the nightly treatment.  It's a small amount of active ingredient.

 

[Lily35]

 Hi and thanks.  Yes I have made my point to the GP that I cannot understand why a woman in her late 40’s with ongoing issues like this would not even have VA considered!
They are happy to prescribe plenty of Vagifem on repeat but if obviously like to get down from 7 nights a week if possible and just wondered what regimes people are using alongside systemic

[Joaniepat]

Hi Lolagirl and welcome. I use 100 mg Estradot patch (no uterus) and 5 Vagifem a week, plus Ovestin on the labia about 3 times a week. Vagifem used to come in a 25 mcg dose, and the idea of twice a week maintenance comes from the original trials on those, so 10 mcg twice a week is underdosing for many.
If your symptoms are controlled on 7 a week, continue as you are for a while longer, then drop to 6 for a while and see how you go.
The addition of systemic helps some with VA, but by no means all.
You could also consider the Estring  which gives you about 50 mcg estradiol per week. You leave it inside the vagina and it lasts for up to 3 months.
JP x

[Ecl]

Hi, I was on vagifem x3 a week for pain, when I started with cystitis symptoms, pain, urgency, frequency, the usual list. After 2 sets of antibiotics I persuaded them to give me ovestin. They would not give me both ovestin and vagifem. I used the ovestin daily for 2 weeks but then could not drop a day without symptoms returning. They therefore allowed me to have it on repeat for daily use. I am now on my third month and am doing well right now with no intention of cutting down. I am also on Evorel 75 patches and utrogestan. If you need longer on daily then you should have it, I believe it says in the instructions to take for at least 2 weeks but maybe more for some.

[Tinkerbell]

I am on systemic HRT plus Mirena and post meno now. I need to use Vagifem every day plus Ovestin every other night to keep VA under control. One female GP I saw said that many of her ladies could not manage on 2 x a week and she was happy to prescribe 5x a week as that was equivalent to old dose.

[Cara999]

Hi and welcome. I use vagifem every other night and estriol externally nightly. I tried dropping to 2 x a week after the loading dose but it wasn't keeping symptoms at bay. If every day is working for you I'd just drop to maybe 5 and see how you feel xxx

[Jillyboo]

I've never really understood why it would matter how often we use Vagifem if we're already on a systemic HRT and are either on progesterone or have had a hysterectomy. I use it every other day but bump it up to daily from time to time if I feel the need.

[Lily35]

Thanks ladies good to get others views on how they maintain.  It has taken me such a long time to get this under control and my advice to anyone starting Vagifem is if it hasn’t settled in the two week load keep on daily until it does settle.   I am going to try 5 x this week and see how it goes.
Surely the gp’s etc must be seeing that the Vagifem dose isn’t right - wonder if this is fed back to the manufacturer as it needs sorting! x

[Ayesha]

I've just posted a thread on my experience of Vaginal Atrophy and the treatment, it's in our own hands until the medics and scientists get their act together!

[Jillyboo]

I agree. Most of my HRT journey has been informed by my own research/sharing with other women. Fortunately there are many more resources to draw on these days than when I first started a couple of decades ago.

[CLKD]

Jillyboo - different area and different form of treatment?   I have VA treatment on a regular basis but have never required other HRT.

[Lily35]

It just shouldn’t be this hard!  And if ‘most’ women are not getting the benefit from the prescribed dose it really should be investigated.  Hopefully they will get better at this over time now people seem to be having more open conversations about it. x

[Cara999]

Lolagirl let's hope so, too many women suffering xxx

[Lily35]

So my plan of moving to every other day on Vagifem isn’t working.  Within a week I was burning again so have gone back to daily. I will try after a few weeks reducing to 6 then 5 as suggested.  How on earth are people managing on 2 x weekly? x