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[primrose3]

Hello Dierdre,

I hope the two work for you, can't see why not, Newson had no qualms about me using two a day for two months,
and they are as up to date as anyone right now it seems, I might not need to for that long but it is reassuring.
Let us know how it goes and when improvement begins! x

[Katejo]

Totally agree Ayesha. Your story sadly is very common and it was like reading my own experience of discovering VA. I had no idea and was in a right mess when I finally went to the doctors 7 years ago, I was 59 and 5 years postmeno. She did tests to rule out STD's even though I'd told her I'd not been sexually active for years. On examination I was red raw right up to my cervix, paper cuts on my vulva and a prolapse. I'd tried OTC baby creams and thrush treatments for weeks not knowing what it could be and thinking the worst.
She prescibed Vagifem and when I asked what that was and what was wrong with me, she asked if I'd ever heard the saying "dried up old woman"!  Lacking in bed side manner.....
Eventually over the years my dosage has gone up and I use every day if needed, have Ovestin also for the vulva every day and Dermovate for flare ups. Use Cetraben to wash and never use soap powder for my pants, just hot wash and tumble dry, also use unsented panti liners.
I had physio for my prolapse and at the moment all is well.
I did try full HRT for six months, Femiston and then Femseven patches but the side effects were not good and didn't improve the VA anyway. I had no other meno symptoms.
I wasted a full year suffering with just 2 Vagifem per week thinking this was it. Finally got a referral to a gynae who upped to 5 a week and Ovestin every day. It still took another couple of years and gradually sorting the prolapse before I could stop using a medical donut to sit on at work and have some days when I actually forgot I had atrophy. That was rare!
I sometimes forget to insert a Vagifem and just use the Ovestin but it soon reminds me the next day and I know I could never reduce my dosage.
For years women were on twice a week but each tablet was 25mcg thats equivalent to 5 a week now and looking back on this forum and other websites, they were managing a lot better than today.
The study to reduce the dosage to 10mcg was definately flawed but someone is now making a nice profit as we have to use double the dosage to obtain the same result has before!
There were no safety issues with the 25mcg dose.

What an awful thing to say!

  My reaction too 😥

[Clovie]

How strange you were told by a meno clinic that you would not need localised oestrogen. Although taking HRT can help with VA, it is not usually enough and women need localised oestrogen.

You are not a freak and I am so sorry you have been made to feel this way. You can have periods at 58 and there is a thread on here somewhere with members who have period after the usual age.

If you wish to buy something over the counter then you can buy a pessary called Gina. Otherwise you could ask your GP for Vagifem which is a pessary or Ovestin which is a cream.
[/quote]







Thank you Flossie

I get a different story eveyone I ask.
I'm fed up with it all to be honest.

I'll go look at Gina on the t'interweb, thanks again 

[primrose3]

Ayesha,
Thank you for your encouragement!!
Am starting new regime tonight, and throwing any accompanying literature in the bin. x

[Ayesha]

My pleasure, primrose. Hope it all goes well for you on starting your treatment. 

[Minusminnie]

[quote author=primrose3 link=topic=64837.msg909752#msg909752 date=1686044723
Suffering vaginal vulval atrophy pretty badly at the moment. Had a consultation yesterday with Newson Health,
they advised using two vagifem daily for 2 months, one inserted higher and one lower to reach the tissue around the opening.
Just wanted to share as there seems to be a lot of confusion about the dosage of vagifem, the leaflet seems way off frankly.
They also suggested Imvaggis which is 30mcg oestrogen, vagifem is 10mcg so it seems the dosage can be much higher than we are led to believe.
[/quote]

By my calculation 2x 10mcg of vagifem daily for 7 days is 140mcg of vagifem a week.

In its day the 25mcg vagifem was loaded for 2 weeks followed by a maintenance dose of 2 X 25mcg of vagifem a week = 50mcg a week.  This was okay for many but i can remember one particular member who couldn't manage on that and having to go to 75mcg a week.

Just me but i would be questioning a dose of 140mcg weekly over a period of 2 months especially as i still have a uterus.

I agree with trying one vagifem lower down as i found that using vagifem high up as suggested never helped the vulva area.

Newson had no qualms about me using two a day for two months,
and they are as up to date as anyone right now it seems, I might not need to for that long but it is reassuring.

Are they ? or just experimenting ? sorry i can be a terrible cynic at times. 

I'm sure others will comment.

[Dierdre]

It sounds alot but remember these are micrograms. If you were on an oral tablet full HRT you'd be taking 1 milligram per day, there are 1000 micrograms in a milligram. You'd have to take 100 vagifem a day. This is why taking Vagifem every day is equivalent to only 3 oral tablets a year and such a minuscule dose and not all of that goes systemic.
I know there are different dosages because of different methods of taking HRT but the difference is still a lot with local estrogens.
I recently did a reload of 2 per day as I'm already taking one a day and it wouldn't have made a difference, but I only did it for a couple of weeks.  I'll definately pop an extra one in if needed and not worry from now on.

[Minusminnie]

I understand what you are saying Dierde.

I’m still not sure about a high dose of 140mcg a week level, albeit micrograms, over a two month
period. Where is their evidence or are they trying to gather it ?

Every now & again maybe as you suggest when necessary but consistently over a length of time ?

[Ayesha]

No need for cynicism here. When you are at the chronic stage of VA you need to start with a good regime that speeds up the reversal of vaginal degeneration. The regime of two Vagifem a day for two months only is a good start which can easily be reduced as soon as the benefits are noticed and without any long term side effects, if that’s even possible with such a low dose pessary.  I cannot see any problems with what has been prescribed here.

[Minusminnie]

No need for cynicism here. When you are at the chronic stage of VA you need to start with a good regime that speeds up the reversal of vaginal degeneration. The regime of two Vagifem a day for two months only is a good start which can easily be reduced as soon as the benefits are noticed and without any long term side effects, if that’s even possible with such a low dose pessary.  I cannot see any problems with what has been prescribed here.

Is this based on your own experience Ayesha ie using a high initial dose such as 140mcg a week for two months etc ?

[Ayesha]

No, but I am coming from the conclusion of my own experience of controlling Vaginal Atrophy.  It took one Vagifem, topical use of Ovestin and moisturiser daily for nearly a year for me to feel normal again. I would have no hesitation in throwing everything at this wretched condition to bring on a faster healing and get back to a normal life quicker than I did previously, the reason why I would have been happy if offered a higher dose to start with, as in the two months mentioned.

When I first sought help for my VA (I didn't know it was that at the time) I was prescribed antibiotics because it was assumed I had a bladder infection, first time ever for me. Why is this still happening, why is Vaginal Atrophy not ruled out first in a mature woman. Women are suffering unnecessarily from the neglect of this condition and I would have thought that given three courses of antibiotics did more damage than a two month course of two a day Vagifem.

[Minusminnie]

Thanks for reply Ayesha.

[primrose3]

Good evening all!

We are pioneers with this treatment, and at the cusp of change, pharmaceutical companies are now seemingly ready to research,
as yet it strikes me that no one really knows what is best for all of us,
in the end we have to listen to our bodies and adjust accordingly, i will certainly be doing that, maybe 2 per day maybe just one and maybe 2 or 3 a week eventually, right now as Ayesha says it needs to be gotten under control and that is what I intend to do.
All power to us all in our sensitive decision making.xx

[Kathleen]

Hello ladies.

For reasons unknown I don't have a big problem with VA and I don't use anything topical in that area. However at a recent appointment with an NHS Consultant I was advised to double my use of Progesterone (Cyclogest) as my alternate nights regime may not be enough to protect my womb. This regime was prescribed to me by Newson Health and I was assured that it was safe for even higher doses of Oestrogen gel.

I am also a bit of a cynic and I wonder if NH have the necessary data. I am concerned that their approach of optimal Oestrogen and minimum progesterone may not be safe.
I don't particularly want to use Cyclogest every night incase it messes with my moods which are a bit swingy at the best of times! Despite this I will experiment with more Cyclogest when I have a new prescription next month.

Although I don't suffer with horrendous VA I did sample some of the symptoms when I came off all HRT a few years ago. I had never experienced anything like it and all you ladies have my absolute sympathy.

Wishing you all well and take care.

K.

[Ayesha]

We are pioneers with this treatment, and at the cusp of change, pharmaceutical companies are now seemingly ready to research,
as yet it strikes me that no one really knows what is best for all of us

And this is the whole crux of the matter! The little research I have read suggests that women are not coming forward giving various reasons in the UK, USA and other countries to make a difference but perhaps that is now changing. One headline in research papers written on Vaginal Atrophy read ‘The New Epidemic’, this does look promising for the future, hopefully!