AIBU to wish I had known sooner about vaginal oestrogen cream?

You'd really think a nurse who does smear tests would know a little bit about vaginas wouldn't you and inform you that oestrogen cream can help?

Hi, oh yes I forgot her name - I did listen to Louise Newson's excellent podcast on this. Thanks for the reminder.
I think I will pursue this again as I am on constant antibiotics for the never-ending UTI and it's awful.
However, I was unable to get it through an online pharmacy when I tried - I ordered it. Then got a follow up email saying they would not process and I'd need to speak to my GP first. Ulgh! Must be less defeatist I guess

I’ll have to see my GP about this. I went for a smear recently (my last one hopefully) and the nurse wouldn’t do it as I started to tear when she put the speculum in, and she said I’d have to get it done at the hospital.

Because unfortunately they're behind the times in many areas, and they generally aren't very well informed or up to date about HRT etc, unless they have a special interest in women's health. That's why doctors like Louise Newson (she has an excellent YouTube channel and website) who are menopause/HRT experts have flourishing businesses! You can buy it over the counter or online if your GP won't prescribe it - type "vaginal oestrogen cream" into Google and the brand names and online pharmacies selling it come up.

I use both the pessaries and the cream and my bits are just like they used to be. I can also now do my pelvic floor exercises which I couldn't before as I had zero sensation

I an rejuvenated! I firmly believe every woman over about 40 should be offered it. Both for their benefit and in the longer term for the benefit of the NHS , so many women sent for all sorts of testing when in many cases the cream would prevent issues occurring. Luckily my doctor knows her stuff and offered it plus HRT immediately.

Possibly. Worth a go.

I am going to the loo sometimes 2-3 times a night. I’m early 50s taking bio identitical progesterone. Might this help?

Mine is in pill form. So I insert a pill through an applicator instead of a cream. Perhaps you could switch to that? No mess at all.

I am 42 and been using it for a year. I had dryness after a period and lots of utis. It’s been life changing tbh. I’m sorry you suffered for so long. It should be routinely offered alongside hrt

I hear you, @TheBoots but quite honestly if I had a quid for every woman who has had to fight to get HRT or estrogen cream I would be rich. Lots of GPs don't care, aren't interested, are poorly educated on menopause, and get huffy when you point out the guidelines.

@Latitudeohyeah there is a thing which happens to some women in menopause/perimenopause which basically dries you up down below. Your vaginal walls go from being juicy and red to being dry and whitish-pink. It's called atrophy. Symptoms are feeling itchy and sore, sex being uncomfortable, pelvic pain, UTIs. Your GP may want to examine you (mine did) but it's far less invasive than a smear and is basically them taking a quick look. Estrogen cream replaces the estrogen your body is not making itself. My symptoms haven't gone completely, but are far more manageable.

Your GP isn't following NICE guidelines then, and they should be. Go back to them with these and ask for an explanation (Section 1.5 has the bit you want) https://www.nice.org.uk/guidance/ng23/chapter/recommendations#identifying-perimenopause-and-menopause

For everyone having difficulty getting a GP to prescribe, here are the NICE recommendations that they should be following. See section 1.5 "Genitourinary symptoms associated with menopause". This covers anyone having menopause associated symptoms over the age of 40.
www.nice.org.uk/guidance/ng23/chapter/recommendations#discussing-management-options-with-people-aged-40-or-over

What is it good for and from what age?

Yes.

Just to add, my GP did do an exam before prescribing, decided my cervix looked a bit funny and sent me for a colposcopy! She confirmed vaginal atrophy and said she would be happy to prescribe once I got the all clear from the hospital. Everything was fine but best to be safe than sorry. From what I have read not all Drs will examine you but if they do I agree as if there is anything wring I would rather know and catch it early. I think it was because I mentioned itching which can be caused by other things not just VA.

The pessary/ vaginal tablet option is estradiol

available as Gina OTC

Or Vagifem / vagirux on prescription, again it’s the same thing.

Estradiol is stronger than estriol (the creams) and as I said in a pp online pharmacy won’t let me have Gina as I’m on systemic HRT without speaking to my GP.

There are also gels, rings, and intrarosa which is a different product altogether - a hormone precursor.

I have recently started on this and it has stopped me getting up so much in the night to pee which is amazing. I get itching too and that hasn’t resolved so i am trying a moisturiser alongside as I have been given the pessaries. If you get the cream or gel you can use those externally too. If the itching doesn’t go, I will ask to switch. I found out about it by listening to Davina on her podcast Begin Again talking to Dr Nighat Araf. Definitely worth a listen. I was telling my friend about it at the weekend and she hadn’t heard of it.

It is baffling how much of a "secret" this cream is. I got it from GP on prescription. I just asked for it and it wasn't an issue at all. I didn't have to have any exam (ugh) I just mentioned that I understood Ovestin was good for urinary urgency and atrophy and he had no hesitation in prescribing it.

It is a no brainer for GPs as it is not systemic HRT like the cyclical, gels, progesterone etc. and so forth (I never needed full on HRT at all). The cream is localised to the vagina/urethra etc. only, so therefore is safe for the vast majority of women, even those for whom full on HRT might not be advised.

However, ALWAYS check with your doc first, I can only speak for the general population, some may have problems with using it due to other health issues etc.

Literally! As Vaginal Atrophy is caused byow estrogen levels so its a matter of managing rather than resolving.

I don't have UTI's but find sex a bit uncomfortable, would it help with that

As someone who works in a pharmacy that has a lot of menopausal women as patients coming to collect their HRT meds, it baffles me how little the cream is dispensed when I see posts like this pointing out how life changing it can be. Do that many women just not need it, or are that many women completely unaware of its existence and what it can do for them because GPs are keeping it a big secret?

If I am grateful to Mumsnet for anything I am grateful to the person who told me about this.

I use Gina on a private prescription online, because I would have to wait an interminable time to see my GP who still might not prescribe (I've been told to 'just use lubricant' before now, but sex is not the issue). I use it twice a week in pessary form and it's made SO much difference. I'm single and couldn't care less about sex but I ride horses and bikes and run and walk a lot and I was getting sore and bleeding just from dryness and friction.

So much better now.

Someone please correct me if I’m wrong

The only vaginal oestrogen cream available in the UK is 0.1% estriol (1mg/ml) which is either branded as

Ovestin (prescription only)
or
Ovesse (OTC about £18 a tube)

They are the same thing.

Ovestin for me too.

My GP prescribed it over the phone. I said ‘apparently all menopausal women should use vaginal oestrogen’. He said, ‘ok I’ll add it to your prescription’. That was it.