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[Mrs Bennet]

Hi ladies just looking for advice.....i am now on week 4 of my maintenance dose of Vagifem and i am having quite bad headache some 6 hours or so after insertion this continues for the following day then tails off until next dose......i have very bad UTI type symptoms which come and go have taken 7 day course of nitrofurentin which worked initially ......i am taking another sample in today to send for culture as dip test are always negative.....doctor has said to carry on with Vagifem if urinary symptoms are worse than headache .....very helpful 😳 and go back in a month for review......be grateful for sny input from you guys xx

[JaneinPen]

Hello Mrs Bennet. I use Vagifem and do not have this problem. Maybe it is that the infection actually needs clearing up and then the Vagifem will do what it is supposed to do.  I have been on Vagifem for around eighteen months because of repeated UTI's and after getting the infection under control with a very strong antibiotic they are working well. I am sure one of our lovely ladies will be along soon with helpful advice

[Dancinggirl]

Hi Mrs Bennet

UTI type symptoms without infection are very common when menopause hits - I've had this for many years.  Vagifem and vaginal moisturisers are crucial - many women become very anxious about using any hormone treatment and this will cause tension and inevitably headaches are therefore more likely to happen.   Do add in either the YES Vaginal moisturiser or SYLK to your daily regime as this can help get the vaginal flora back to normal and alongside the Vagifem this can help to prevent the UTI symptoms - that burning sensation is so horrid.  I suspect the headaches is more to do with dehydration and recovering from the antibiotics - I doubt it has anything to do with Vagifem. Your gut will be out of balance due the antibiotics so eating lots of vegetables, whole grains etc will help this get back to normal - when the gut bacteria are not working well then this can sometimes cause headaches, especially if you are not drinking enough water.   
Avoiding caffein, alcohol and fruit juices is a good idea as these are bladder irritants and can cause urethral burning and can make you more dehydrated. Drink lots of water and add in a little bicarbonate of soda once or twice a day for 2-3 days to neutralise the urine.   You may have had a headache which coincided with using Vagifem so now, each time you use it, you physiologically trigger a headache by tensing the neck and shoulders.  Do you drink a glass of water with half a teaspoon of bicarbonate of soda mid evening?   If you have been using Vagifem daily then there might a small reaction e.g. cramps. I suffer badly with headaches but have never found that Vagifem makes them worse. There is so little oestrogen in Vagifem and virtually none is absorbed systemically so there are very few if any side effects.  If you were using progesterone then headaches could be a side effect.

Try upping your water intake, if you can get to a Pilates class to help with relaxation and strengthening of the tummy and pelvic floor this might also help. When in pain with our ‘lady bits' and bladder it is natural to tense the neck, shoulders and back and this will cause headaches.

Sadly when menopause hits, things like headaches often increase.  You may in fact need full HRT, if you are not already using it.

It takes time for Vagifem or any hormone treatment to work it's magic. Keep going.  DG x

[Jenna]

Headaches are listed as a common side effect in the Vagifem Patient Information Leaflet:

https://www.medicines.org.uk/emc/product/5719/pil

(Section 4)

[Dancinggirl]

Hi Jenna - I know the leaflet says all kinds of things.  If you read the leaflet that comes with Paracetomol you'd be very scared to take it. The leaflet that comes with the Vagifem is the same as the leaflet that comes with full systemic HRT - so is not really that relevant. The drug company is simply covering itself.  To give a headaches, I'm sure Vagifem would need to be absorbed systemically.  If Vagifem was significantly absorbed systemically then it would have to be accompanied with progesterone at least on a sequential basis a couple of times a year.  I believe using Vagifem twice a week for a whole year equates to roughly one, possibly two doses of full systemic HRT - this is a tiny, tiny amount.  Mrs Bennet has already been on Vagifem for some weeks so any mild side effects should have settled by now. I believe she should try things to reduce the headaches before condemning the Vagifem.  Many women are very anxious about using any form of hormone due to all the scares that have been put in the press over the years.   The benefits from Vagifem can take many weeks or even months to take effect as it is such low dose.  Vagifem used to be 25mg but is now 10mg and some women need to use it far more often to really get the benefits.

If you are in pain, this is stressful, often causes sleep deprivation and this is likely to cause headaches. Dehydration is another common cause of headaches. DG x

[Mrs Bennet]

Thankyou so much for your replys 😘😘........I don't so much have pain or much burning with this uti thingy 😳......more a pressure feeling low down......really very agrivateing....i am drinking lots of water and have cut out all caffeine with exception of my morning cup of tea....thought headache was due to caffeine withdrawal at the start but obviously not the case this far on....would VA cause this feeling of needing to wee all the time?  just to say I don't go constantly or have to get up during the night ......however i am very constipated 🙄 ......thanks again for your advice  🤗  xx

[Dancinggirl]

Ahhh! Constipation causes headaches!!  The pressure could also be partly down to the constipation.
The feeling of needing to wee all the time can well be atrophy related.  The bladder has oestrogen receptors and when oestrogen levels drop during and after menopause then the bladder weakens.  You're lucky you can still go through the night without needing to pee at least once - I'm lucky if I get away without at least 2 trips to the bathroom to pee during the night.

I'd start your day with a glass of water before your cup of tea. Try to increase your fibre intake - a bowl of muesli or porridge in the morning can work wonders and being constipated is also a sign of dehydration. Do you have at least 6 glasses of water(around 250ml per glass) per day? Menopause will mean we are sweating more and loosing more fluids (due to flushes etc.)  so increasing fluid intake is vital.

I'm afraid my headaches have increased since menopause but they were better when on full HRT. I'm nearly 63, been off full HRT for nearly 3 years now and just use Vagifem. I get many headaches and there are many things that trigger them - I do know that they are largely down to sleep deprivation - I sleep really badly these days - but dry hot rooms, tense shoulders, stress, certain perfumes. changes in air pressure etc. are all triggers.
My headaches last 24-48 hours and sometimes longer and make me feel really rotten. DG x

[Mrs Bennet]

Drinking the water as i write this dancinggirl 🤣......will endeavour to up water intake but guess i must get at least 8 glasses in a day with my mugs of peppermint tea.....I'm awaiting result of urine culture which i took in yesterday just to see if infection has returned......using yes moisturiser on days I don't do the vagifem.....just wish this niggly feeling would go .....bit of back ground I'm 59 and 5 years post meno.....had overies and tubes removed 2 years ago xx

[Dancinggirl]

You are doing all the right things. I'm sure the niggle will improve with time.  I think you would feel better if you could get your digestive system working more efficiently. Good luck. DG x

[Mrs Bennet]

Think you could be right dancinggirl......my bowls have always been my nemesis 😳 xx

[suzysunday]

Yes that niggly feeling is SO annoying and somehow you can't ignore it.

[Dierdre]

Try placing the Vagifem actually on the bladder wall and not too high up, I find this benefits the bladder more and helps if  you have a slight prolapse. Try and not feel anxious about using Vagifem, it's been around for years and many ladies use it every day, myself included.

[Mrs Bennet]

Thanks dierdre for that tip.....yes got a very slight anterior prolapse apparently 😳 and as i have quite bad health anxiety i go into panic mode 🙄 😊 xx

[Mrs Bennet]

Hi sparkle.....yes really can't give up my morning cuppa and as i used to drink 6 or so cups a day i feel quite pleased with myself that I've wittled it down to this 🤣......although i have read so many threads on mpm regarding VA and done the whole  dr Google thing i find it so hard to believe that atrophy can be giving me such severe urine type symptoms  .....no pain just a constant urge to go 😳 xx

[suzysunday]

I have had this for months now after coming off hrt for 3 months after pmb.  I got cystitis then this urge to wee won't go.  I am just on ovestin  now and struggling.  I think I'm ok then it comes back. Like you say, no pain just this pressure. Don't know if it's connected but I feel so tired all the time.  I've given up alcohol, hot baths, daren't have sex and still feel crap. I'm only 60 and feel like I've lost all quality of life. Sick of it.