Vaginal estrogen, any experiences or advice?

[Messelina]

So I'm on Femoston 2/10, and doing much better on it than I was off! But vaginal symptoms are persisting so I asked my dr for vaginal oestrogen, which I've read helps when oral doesn't. She was reluctant to give it to me as I'm on tablet hrt and said that should be doing the trick; finally she relented and gave me pessaries, telling me to use 2 a week and not more because of increasing the bc risk. She also said I should only use them temporarily - a few weeks - for the same reason. Isn't her thinking on this now rather outdated though?

She is completely out of date...I use systemic HRT and Vagifem every night.
Vagifem is safe to use long term.
You should also use them for 2 weeks every
night before going on the maintenance dose.

I use Vagifem pessaries twice a week, no other HRT. Been on them for almost a year and afaik will stay on them for life. I don't know whether you can use the pessaries every day long term though.

Makes me SO cross that SO many GPs are utterly behind the times and ill informed on a condition that will affect most women.

25% of women ( 1:4) uses vaginal estrogen as well as systemic HRT.
I've used both for 8 years.

The dose is daily for 2 weeks then 2 x a week forever. If you stop the symptoms will come back.

Suggest you change your GP if you are having it 'educate' her! Why doesn't she read up on all of this? It's in the NICE meno guidelines- that vaginal oestrogen can be used indefinitely.

I'm just on vagifem. Its a tiny, local dose but very effective. Reaches the parts other meds don't.

I was told by menopause specialist that even using Vagifem every day was only equal to one systemic HRT tablet a year.
She put that in bold writing to my GP practice so hopefully it may help others!

Thanks so much for all your replies! You have all confirmed what I thought - that my doctor is pretty clueless and that I am going to need the pessaries or similar forever.

I am not in the uk and I think I may have to stick with my gp (as this place isn't as advanced as the uk meno therapy wise, and there are others much, much worse here). At least she is generally sympathetic.

I am going to try to get some evidence together and print it out for her, hopefully that will do the trick! If anyone has a good source, I'd be grateful for a link. Thanks Polly for the NICE ref, I will check out that one for starters.

This is from NICE. Scroll thru the doc till you come to this section.

Urogenital atrophy

1.4.9 Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.

1.4.10 Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.

1.4.11 If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.

1.4.12 Explain to women with urogenital atrophy that:

symptoms often come back when treatment is stopped

adverse effects from vaginal oestrogen are very rare

they should report unscheduled vaginal bleeding to their GP.

1.4.13 Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.

1.4.14 Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.

I am on HRT and also have an estring
It lasts 3 months so i can forget about it inbetween changes

Thanks again ladies - the e-string sounds good but think I've no chance of getting it where I am :(

There is no reason why a GP should refuse you a product that can help your condition. If you ask for it and they refuse, ask why. If it's not a good answer, ask again!

Sorry- do you mean it's not available overseas?

Yes Polly, I mean I can't find it listed in my country of residence - of course it might be there but under a different name, haven't found it yet anyhow. I've now visited the menopause clinic here and, while they concede I might need the pessaries or whatever longterm, they still reckon twice a week should do it. Actually they told me that oestrogen is only responsible for 'everyday dryness' and that dryness during sex is down to not taking enough time or problems in the relationship!! Would any of you agree with that? Sounds distinctly odd to me. Why wouldn't dryness during sex be down to lack of sex hormones?

Hi my GP advised me to start vagifem and gave me perscription for 10mg pessaries in October but due to other health issues i didnt start them...last monday i decided to use them but i had taken them out of the box and could not find the instrution on the dosage and i thought it was 2 a day which is 20mg which i did over 6 days i found the bix and realised it was only ment to be 10mg my GP is away so cannot talk to her and i am now worried i have cause myself some damage as i have read the sites i looked on onky reccomend small doses does anyone know i need to be worried i used 120mg over 6 days i am afraid to continue

No harm at all. The dose is tiny.

It's not milligrams- it's micrograms (mcgms). So you have used 120 mcgms.

120mcgs is around a tenth of 1mg HRT estrogen pill (dose women on HRT take daily.)

Until a couple of years ago, Vagifem was only prescribed as 25mcgs.
Carry on and you will be fine.

Thanks so much was a bit concerned as i have never taken hrt or anything like it again many thanks feel a lot happier noe b4

@Messelina . Vaginal Atrophy can be a problem for some women . There are lubricants you can use .
A lot of women are on HRT ( patches , gels , tablets , and have to use creams or pessaries too ).

When I first saw a meno specialist, she prescribed two Vagifem each day for two weeks to get it under control, so you have nothing to worry about.

Thanks eveyone for advice feeling a lot happier about using this medcation and i have had no side effects so e everthing seems good will carry on using as i think it will help....the joys of menopause😂