Recently Started Ovestin. A couple of questions.

[FrothyChocolate]

Hi, everyone. I've just registered here in order to be able to ask a couple of questions. I've been reading some of the posts, and there seems to be a very good amount of knowledge and understanding of the issue of menopause amongst some of the posters!

So, I'm 50 and have been going through the menopause for about a year (I don't know when I started, really, although I think I've been pre-menopausal for a couple of years prior to that). Just in the last month or so, being intimate with my husband has caused some very painful experiences! I went to a specialist, and he prescribed Ovestin (Oestriol 0.1% [1 mg per g]). I've been reading a little about it, and estriol seems to be a very well-thought-of hormone. I was told not to use the applicator that came with the cream, but to apply, with my finger, a little cream around the entrance of the vagina and a little inside where there was a slight abrasion—then to apply it twice a week. After the every-day application, all the discomfort went away. Then when I was reducing the amount, it started hurting again.

I'm wondering what you all think? And what do you think about not using the applicator? Also, I do have hypertension (though stage 1).

Don't know if it's relevant, but in the last two years I've lost 55 kilos through a major change to my lifestyle. So many things cleared up! It's been an amazing change for me (and my husband...lol). Can't believe that my blood pressure is now elevated though :(

Anyway, I appreciate any responses. It's wonderful to be able to come to a place like this and talk menopause!

Hope this may help. I have used Ovestin for 12 years , prescribed by a Harley St consultant gynae who knows his stuff.

You need to use Ovestin right up inside the vagina. It changes the tissues from dried out to pre-menopausal. It's not a lubricant or moisturiser- it actually changes the cells which are dependent on estrogen to function.

The idea of only using it round the entrance sounds ludicrous TBH if you are having issues with sex.

You need to follow the regime of every day for 2 weeks then twice a week or even every other day to keep things right. If you stop, the pain will come back.

Your blood pressure irrelevant. High BP is not a contraindication for systemic HRT but the medical advice is it should be treated anyway, regardless of HRT or not HRT. ( Ovestin in not classed as HRT anyway.)
Would more exercise help your BP? Have you tried this?
Amazing weight loss!!!

I find the applicator with Ovestin quite sharp on the end. I have my own method which is to use a cardboard applicator tampon, pull the tampon down to create a gap at the top, and put the Ovestin in that. (You can measure it in the plastic Ovestin tube first.) Weird I know but it works for me. I was also advised that if sex is painful, it helps to use an extra dose of Ovestin afterwards to help heal any tiny micro-tears in the tissues. Not exactly romantic but what the heck!

QueenoftheNights, thanks so much for your reply. It's great to get info from someone who's been on Ovestin for so long. About the BP, I exercise five times a week for an hour a session: fast walking, and hill walking (about 6.5 kms), so I don't think I can add much to that. My dad has hypertension (I've only seen him three times in my 50 years, believe it or not, but was able to ask him about his medical history just recently). Thanks, Dad!.....lol.

I wonder if the advice from my specialist is because they are not updated with current studies. I mean, even on the packaging of Ovestin, the leaflet talks about cancer risks, etc, but from what I've read about the product, it can actually be protective, so I don't know. I think perhaps that it is a litigious world we live in, and the drug companies are just covering themselves legally. However, his advice on application did actually work until I started reducing the applications after the initial 'loading'.

Thanks again for your advice, and if you have anything further to add, please do. Right, off to run my dog (7 days exercise this week as my husband is covering someone and is working shift :( ). Blessings.

Are you and your specialist in the UK (Just noticed the timing of your post and you said you were off running :)) Why did you see a specialist and not a GP?

I've noticed a few discrepancies on forums between different countries' attitudes to HRT and meno treatments.

the leaflet talks about cancer risks, etc, but from what I've read about the product, it can actually be protective,

Anything with any hormones in it like this has to have the 'full HRT leaflet' in it to protect the manufacturers even though it's irrelevant and Ovestin is not classed as HRT per se.

Not sure what you mean about 'protective'? Ovestin isn't absorbed ( or only in the tiniest amount in the first couple of weeks) so any benefits you'd get from 'real' HRT don't apply. Ovestin WILL help prevent urine infections and vaginal atrophy.

I honestly don't know why you were told not to insert the cream. There used to be an idea that it could stimulate the womb lining (not a good thing) but this is not believed any more and drs have been told not to bother giving a course of progestogens now and then to women using it long term (which would make the lining shed.) Maybe if your dr is a bit out of touch he is worried you'd get too much 'absorption'' by inserting it?

Being blunt, using it around the entrance will help there and with initial penetration, but you risk still having pain or even minor tears if you don't use it vaginally.

Women who find they have bladder issues during meno ( irritable or overactive bladder ) HAVE to insert it properly because it needs to get high enough to be absorbed by the bladder through the vaginal walls.

Hope this answers any Qs! I think you should carry on using it as much as you need to, and maybe 3 x a week if twice isn't enough.

QOTN,

I'm in NZ, actually (right at the bottom of the world ). I did go to my GP, but GPs typically refer to specialists because, as the name suggests, they are only general practitioners and don't have the depth of knowledge needed in these circumstances.

About it being protective, I was reading here: www.lifeextension.com/magazine/2008/8/Estriol-Its-Weakness-is-its-Strength/Page-01

"Experimental studies suggest that both estriol and tamoxifen (a synthetic anti-estrogen) have protective effects against radiation-induced cancer of the breast."

This possible protection only relates to the specific risk factor mentioned (radiation induced), but protective in some way, nonetheless.

As a side note, I do have androgenic alopecia and was diagnosed in my 20s. No one has ever been able to find a 'fix' for that. Hormones are complicated beasties!

In the UK, something like VA would be dealt with by a GP. Referrals to specialists are for complex meno issues that the GP can't sort. It is typical in the UK to wait several months for an appt with a consultant for something non-urgent.

I've had a quick read of the link but I don't think it's really relevant to estriol use as we know it.
As it says , estriol in Ovestin is not absorbed anyway so you won't be getting any protective effects from it for anything other than vaginal atrophy. So if you have male pattern baldness, has no one tinkered with your hormones before to try to improve things?

QOTN,

Yes, I went and saw an endocrinologist about 20 years ago. It was a waste of time and money. There is simply no advancements in female hair loss (I look every so often). I have resigned myself to that now, and it really is OK. I have a huge hat collection, and a wig that I'll wear if I feel like it (which is not often....I prefer hats). At first it was really difficult to accept, but now I just thank the Lord that it's not because I have cancer! There's always a silver lining, if one looks hard enough. . Even with the VA, imagine if we lived in a third-world country.......we'd just have to live with it. We really have so much to be thankful for.

What part of the UK do you live in, btw? My husband, daughter and I lived in Spalding, Lincs, back in 2002/03. We really loved it.