Soooo.....
I had the phone appointment with the GP and it went better than expected in some respects, and less well in others.
I explained that I wanted to change from Femoston because I wanted transdermal oestrogen, preferably start with Lenzetto, and that I wanted Utrogestan and not the Mirena. I also mentioned the early VA and associated symptoms and the desire to go for testosterone to address libido, sexual response, brain fog etc, gave her lots of detail from the research I've done and then held my breath....
She hadn't heard of Lenzetto but said it is prescribable so had no issues with that (I described it and how it is delivered differently to gel - get me, the informed patient!) and she also said she has several women on Utro so no problems there - amazing since this is Scotland....
She really wasn't sure that I'm describing VA because it 'normally affects only the inner vagina and has no external symptoms'......!!!! I almost offered her a loan of my copy of Jane Lewis' Meno Vagina book! She said she would want to rule out lichen sclerosus first.
She has no experience of prescribing testosterone to women, which I expected, so suggested a referral to the meno clinic, and for me to stay on Femoston for now so that I just make one change. That makes reasonable sense depending on the waiting time to get to see someone at the clinic. She didn't know the wait time but said someone would check and come back to me and if it was going to be months then we could talk about changing to Lenzetto and utro in the interim.
I am generally ok with that if I don't have to wait too long to get to the clinic, because although I've got plenty of ongoing symptoms that I want to address, I have a glimmer of informed hope that I can get to a point of treating them in a more appropriate way. The Femoston manages some of the worst things well enough for now, especially with that light showing at the end of the brain foggy tunnel.
Re the VA, we didn't return to that subject and I'm ok with that at the moment too, because I wanted to check out the Lichen Sclerosus first. Well having looked at some pretty graphic images online I am certain that's not what I've got! My symptoms are not too bad at the moment (and yes, I realise it might not stay that way) but I am managing them with appropriate moisturisers and a careful washing routine and will discuss that at the meno clinic, again subject to not having to wait months. I'm also possibly better off because I had surgery some years ago to deal with recurring vulvar cysts, and they ended up taking away quite a bit of the outer labia tissue and pulling in more external skin to repair that. It actually looks a lot neater as a result (result!!
![banana :banana:](https://www.menopausematters.co.uk/forum/Smileys/extended/banana.gif)
) but it also has skin that's more used to being dry and thus maybe not as thin as it might get.
That's probably sufficient detail for a Wednesday morning, so I'll wait hopefully for a referral appointment in the near future, and in the meantime will keep an eye on these forums as they are so useful.
![Smiley :)](https://www.menopausematters.co.uk/forum/Smileys/extended/smiley.gif)
Thanks all