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[Bo]

Hi All, I have been on HRT (100 mcg Estradot patch and Utrogestan PV every other day) for a few years. Before I went onto HRT, I used Ovestin for VA - lubricants were not enough. HRT helped with the VA so I stopped the cream. HRT has never got sex to be pain-free (it was bearable though), nor have the nighttime flushes completely gone (although are very improved as are my energy levels). However, since I had flu last December, sex has become unbearably painful. I started using Ovestin again daily a few weeks ago (I've just finished about 3 weeks of daily) and I am just about to reduce the dose. The pain has eased a bit but I am not back to where I was pre-flu. Also, the cream has caused my boobs to be quite sore.
I am not sure what to do now when it doesn't appear to be working and I have an undesirable side-effect. Anyone else had similar, or got any advice? 

[CLKD]

Why reduce the dose?  When I have a flare up, I often put two doses up, 1 in the afternoon the other in the evening.  It is unlikely that 'ovestin' will affect the breasts.  Also, take pain relief as necessary. 

[Bo]

I have started to reduce the dose as per the leaflet instructions - not meant to be used daily for more than 4 weeks max apparently, and then gradually reduced down to twice a week. But do people generally not follow the guidelines? And are such flare ups of VA common? I've not experienced one before.

'Swollen / tender / painful breasts' is listed under possible side-effects 

[CLKD]

We use VA treatment as necessary.  Dr Louise Newson is trying to get the leaflet details in the VA treatment boxes altered as it's pretty similar to that for other types of HRT  .  Some ladies require it nightly for many years: as well as internally, it can be smeared on the outer labial areas to keep them soft and less itchy.

Initially it can be Trial and Error.  1 cannot over dose on VA treatments as once the vagina is more comfy, we can reduce is necessary.  It's about managing the condition until 1 finds what works for our own vaginas. 

Flare ups are common unless 'managed'.  I know when mine is going to become problematic as I get a strange heavy feeling under the belly button area and an urge 2 P! So up I shove an 'ovestin' mid-afternoon and again in the evening, then using for 3-4 nights. 

When I first began using I would have breaks which was silly of me, because the symptoms flared up.  Now I can judge what keeps my vagina 'happy'  .  Let us know how you get on. 

[sfreesto]

Maybe try switching from Ovestin to Intrarosa, it is licensed specifically for painful sex, though I found it worked wonders for my VA related bladder issues.

[Jules]

I've had one sided breast pain. I had increased my vagifem and introduced nightly ovestin externally.  I also had a bleed. I was told to stop vagifem for 4 weeks to see if the symptoms waned. I could continue using ovestin but only externally.  Gp thinks it was a side effect of the estrogen but I'm having a scan Monday. So increasing estrogen via any product can possibly cause a reaction.  We all tolerate things in different ways, I don't think one rule fits all and I think you've to approach it as you would any medication.