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[Maltesers]

I’ve been using Vagifem twice a week for several years, due to vaginal dryness. Two months ago I developed vulval pain and a constant need to pee and I was prescribed steroid cream to use for a week, together with estriol for external use. I was also advised to wash and moisturise with hydromol. Things improved over a few weeks. However, it all flared up again and despite reloading my Vagifem and using estriol night and morning, nothing is helping. The vulval pain, the feeling of pressure and the need to pee are awful. I can’t sleep and can focus on nothing but my discomfort. Can anyone suggest anything that might help? I feel like I’ve been doing everything to sort this and nothing is helping.

[Dierdre]

Have you been checked for UTI and thrush?  Did the doctor examine you for prolapse?  Did things improve with daily use but got worse when you reduced the dosage again, you may need to use Vagifem and estriol daily.

[Maltesers]

Thanks, Deirdre. The doctor said there was no sign of thrush or prolapse. I’ve been continuing with daily Vagifem and estriol. I can’t imagine what my GP will think of that as she was very much of the “use it twice a week” school of thought, but I’ve realised from reading this forum that it’s sometimes needed. It just doesn’t seem to be helping this time.

[Taz2]

This sounds so uncomfortable for you. Does your vulva/vagina look inflamed and red or, despite the pain, is it normal to look at? If so could it be vulvodynia? https://www.nhs.uk/conditions/vulvodynia/

Taz x

[CLKD]

Morning.   Twice a week is rarely enough application.

MayB try some pain relief - I use 'nurofen' 2 x 3 times a day. 

[Jules]

Nurofen has ibuprofen in which isn't good for the stomach and especially anybody who has gastric problems shouldn't use it regularly if at all.

[CLKD]

Whilst some may be unable to tolerate Nurofen, I've never had problems Jules.  Paracetamol doesn't touch the sides 4 me  .  We had 'anadin' in child and adult doses when I was growing up as well as ?? 'Panadol ?? 

[Dierdre]

Thanks, Deirdre. The doctor said there was no sign of thrush or prolapse. I’ve been continuing with daily Vagifem and estriol. I can’t imagine what my GP will think of that as she was very much of the “use it twice a week” school of thought, but I’ve realised from reading this forum that it’s sometimes needed. It just doesn’t seem to be helping this time.

We had a thread by Ayesha recently regarding new guidelines for dosage and treatments for VA. Search GSM in the search box by Ayesha or Google
Position Statement for Management of Genitourinary Syndrome of the Menopause (GSM).  Print this and take to your doctor, she needs updating.

[Maltesers]

Thank you all. I really appreciate your replies. When I saw the doctor a couple of months ago she said my vulva looked normal and I think it still does. I’ve been taking paracetamol which barely touches the edge of the pain. I have a small Hiatus hernia so I’m reluctant to try nurofen, though I could take an omeprazole to offset it. I will try to get another GP appointment. Sitting and lying down are the worst so I’m exhausted walking about all the time!

[Dierdre]

Ask about vulvodynia too as Taz suggested. VA is not usually relieved by walking around, I'd be worse with the chafing.

[CLKD]

Initially when I began with VA symptoms I would sit on the loo with a cup of tea and glass of water and relax.  Anywhere else the need2P was intense.  Plus 'nurofen' - GP eventually diagnosed VA after discussion on the 'phone, having read my notes.  He was not pleased that a urine sample hadn't been sent for testing! 

Did the steroid cream help at all?  I've not had problems with chaffing fortunately - mayB put a dose of treatment up there this morning as well as this evening, I find an extra insert of 'ovestin' can help a lot.

[orrla]

How old are you? Are you on HRT at all?

It looks to me that VA is a natural process of ageing resulting from decreased production of hormones..

There is that thing called HRT that helps greatly but for some reason more messy, insufficient products are more frequently recommended...

After eliminating any possible infections, etc. try!  Estring works for me. It may for you too!

Best🤗

[Jules]

I know some can tolerate ibuprofen.  But nit everyone knows it's in nurofen. I was taking ibuprofen when I had flu with omeprazole on advice of a doctor even though she knew i have a hernia and IBS.  I ended up with terrible stomach problems and permanent damage from the acid reflux it caused.

[Maltesers]

I will be really cautious with the nurofen, Jules. I did take 2 tablets earlier (with an omeprazole) but I will try to stick with paracetamol. I’m 63 and not on HRT. I wish now that I was. I’ve made an appointment with a post menopause (& HRT) consultant but that’s not until august, which feels like a long way off. From my reading over the past two months, HRT may still be a possibility. The steroid cream does seem to ease it a bit, CLKD. I used it for the prescribed week (twice a day) when this first happened, 2 months ago,  and I started it again with this flare up. I am definitely at my most comfortable when I’m walking or standing.

[Ayesha]

Maltesers, the link to the thread Dierdre referred to hopefully it will help you somehow.

https://www.menopausematters.co.uk/forum/index.php/topic,69936.msg949995.html#msg949995