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[Scottish lass]

Hi all is it safe to use Vagifem more than the recommended 2x a week? I find my va symptoms are fine for 2-3 weeks on 2x a week then I start getting discomfort again. I don't find just going back to a loading dose a great way to manage longer term. I also find stress/anxiety including the thought of intimacy makes my symptoms 1000x worse, is this normal?

[Jules]

I'm using it alternate nights. I also use Ovestin externally

[CLKD]

Yep absolutely.  Some ladies use every night 4 ever.  If my symptoms niggle I put 'ovestin' up in the afternoon then every night for at least a week as well as swallowing 2 Nurofen x 3 times a day to ease the feeling of the nip as urine flow stops.

When I up my dose I often find that the following morning symptoms are more noticeable.

Some find using a moistoirisor or 'ovestin' on the outer labia helps too.  Anxiety may well cause symptoms as we may P more.

[Dierdre]

My prescription is 5 per week and yes it's safe to use more than twice a week. The NICE guidelines recommend your health provider can up the dosage if needed, 2 per week is just a starting dosage and is fine for some but many need more.
The estring is 50mcg per week and the old dosage of vagifem was 2 x 25mcg per week.
Stress and anxiety are a common cause of atrophy flareups and I know how hard it is to control stress.

[Ayesha]

Hi all is it safe to use Vagifem more than the recommended 2x a week? I find my va symptoms are fine for 2-3 weeks on 2x a week then I start getting discomfort again. I don't find just going back to a loading dose a great way to manage longer term. I also find stress/anxiety including the thought of intimacy makes my symptoms 1000x worse, is this normal?

Its perfectly safe to use every day if you want to and to be honest I think the instructions for the loading dose is a complete nonsense, it certainly never related to how I eventually treated my VA, with my GP's instructions of using daily I have been in complete control of my VA and never relapse.

[fiftyplus]

@Ayesha & @CLKD do yous still use daily?

[VioletAquarius]

I understand its fine to use everyday, from the ladies and threads on here.

I currently use it every night.

[Ayesha]

@Ayesha & @CLKD do yous still use daily?

Yes, with the addition of a pea sized amount of ovestin used topically.
I do try to miss a day of vagifem but that's a rare thing.

[Jules]

@Ayesha & @CLKD do yous still use daily?

Yes, with the addition of a pea sized amount of ovestin used topically.
I do try to miss a day of vagifem but that's a rare thing.

I think I'm using more than a pea size. I can't spread it enough to cover the area.

[lillith112]

I'm using it every other night, I also ordered ovestin online as GP wouldn't prescribe both 😞, seems to be working so far, I'm over 2 months off HRT and no atrophy or bladder symptoms so far. Lack of sleep though, well that's another matter l🫣

[CLKD]

50+ - I use when necessary: 3 times a week with a gap of a few days. 

lillith112 - speak to the Practice Manager about this issue, explaining that it is not possible to 'overdose' on oestrogen replacement.  That GP is ignorant beyond words!   

[Dierdre]

Hi all is it safe to use Vagifem more than the recommended 2x a week? I find my va symptoms are fine for 2-3 weeks on 2x a week then I start getting discomfort again. I don't find just going back to a loading dose a great way to manage longer term. I also find stress/anxiety including the thought of intimacy makes my symptoms 1000x worse, is this normal?

Its perfectly safe to use every day if you want to and to be honest I think the instructions for the loading dose is a complete nonsense, it certainly never related to how I eventually treated my VA, with my GP's instructions of using daily I have been in complete control of my VA and never relapse.

Your very lucky not having a relapse. Even though I use the same medication Vagifem and Ovestin, same dosage and near enough the same time each day I still suffer fluctuations. It shouldn't happen really as I'm not taking it orally, it's not having to go through my digestive system which can sometimes have problems absorbing etc.
I can have some bad news or something that makes me anxious and within a couple of days I'm feeling dry and sore again. If something happens really worrying I can feel the irritation and dryness almost straight away. I used to wonder if it was psychosomatic.
Also when I'm in the sun on holiday, never a problem. I'm taking regular vit D now as I think that might help.
I know stress causes IBS and other digestive problems but maybe it also effects the genital area. Afterall nervousness makes you need to pee alot.
Stress causes erectile dysfunction in men, does it also dry up women?

[fiftyplus]

@CLKD did you have to use nightly at first for a year or so before you were able to cut back to around 3 times a week? or how long did it take roughly for you to be able to cut back to 3 times a week? 

[Ayesha]

Your very lucky not having a relapse. Even though I use the same medication Vagifem and Ovestin, same dosage and near enough the same time each day I still suffer fluctuations. It shouldn't happen really as I'm not taking it orally, it's not having to go through my digestive system which can sometimes have problems absorbing etc.
I can have some bad news or something that makes me anxious and within a couple of days I'm feeling dry and sore again. If something happens really worrying I can feel the irritation and dryness almost straight away. I used to wonder if it was psychosomatic.
Also when I'm in the sun on holiday, never a problem. I'm taking regular vit D now as I think that might help.
I know stress causes IBS and other digestive problems but maybe it also effects the genital area. Afterall nervousness makes you need to pee alot.
Stress causes erectile dysfunction in men, does it also dry up women?

When I think back to how chronic my VA was before I was finally diagnosed, I do feel very fortunate two years on that with any flare ups the symptoms are now minimal and easily treated, the constant use of Vagifem and Ovestin is working well for me.

I am over 70, could younger women have more trouble controlling the symptoms, or is it a simple fact we are all different when it comes to treating this awful condition. So much is unknown about it, I was the talk of the surgery at the time with one nurse telling my husband what a bad time I was going through when the answer was so simple, treatment for a mystery condition called Vaginal Atrophy!

[Joaniepat]

Dierdre, stress can cause hypertension in the pelvic floor, which can result in feelings of vulval soreness and all sorts of other wierd sensations. Could this be at the root of the problem? A women's health physio might be worth seeing for an assessment.   (Life's stresses generally go straight to my PF!)
JP x