Vaginal atrophy - Lets mention the unmentionable

[roseenglish1969]

So, it happens to 50% to 60% of women at or around menopause time yet very few women approach their doctors about it suffering in silence with painful sex and all of the other horrible symptoms.

The sad thing is once the damage is done you can’t reverse that damage and your bits do shrink.

The clitoral hood often shrinks back exposing the clitorus which can lead to extreme pain and sensitive as you walk about or move. So tight jeans are a no no.
The inner labia shrinks sometimes to nothing and the inner labia has glands which provides moisture to the outside of the vagina. So no labia no moisture equals dry itchy broken skin. Pain in and outside the vagina, burning to the skin around the vulva and bottom,.
VA also affects the bladder causing leaks, urgency, increased frequency and nighttime trips, so Tenna pads ARE avoidable, we don’t have to accept incontinance as part of getting old.

The difficult part is getting your doctors to
a) understand what your symptoms are
b) give a damn
c) prescribe it as they think vagifem is HRT. It isn’t

Most GPs know next to nothing about VA or menopause so it’s up to you to take some printed information off and ask for vagifem.

A years worth of vagifem amounts to just two full HRT tablets. That’s how little oestrogen is in it. And most of that is absorbed by your reproductive organs as it’s a pessary not a tablet and designed that way for that very reason.

What are your symptoms?

I do wonder if some women are confusing increased libido (sex surge) with VA, I know I did, I thought the sudden sensations to my vag was some new meno symptom which it was but it was because my skin below was thinner and the nerves more exposed and sensitive. I felt arousal below out of the blue, no thoughts of sex at all and it was a very confusing time for me. It’s not a common symptom and I fell into a rabbit hole of health anxiety which I’m still not over... I thought I had some rare nerve disorder that effects the vagina. I literally wanted to die rather than live with the condition. Thanks Google.
Videos of women having 100 involuntary orgasms a day haunted me and I was sure that’s where I was heading.
As I say, still very raw to me as I’m trying to accept I don’t have the condition and have VA.

So I wanted to reach women who perhaps had symptoms and were too afraid or shy to ask,
Pm me if you wish .,,

I notice VA featured on GPs Behind Closed Doors last week. The dr recommended the pessaries.

After asking many times I was given Vagifem but only enough for 2 weeks and then about 6 weeks after.
My GP insists that it cant be taken for longer. I will have to look for the NICE guidelines.

I was then given Ovestin which has been given for the same restricted time.
Problem is that I finish up with a burning sensation when I use the cream and I'm not sure which is worse.
I have also started getting infected lumps which burst like a boil after a few days - this is after scratching myself raw

I'm not menopausal yet but it could be any time (46) I just wanted to say thank you for posting this. I've been worried about this aspect of the menopause. You have really helped.

elephantoverthehill that's pretty much what my symptoms were too.

I had my last period 2 years ago.
Six months ago I became sexually active again and noticed finding it harder to reach orgasm. A month ago I began taking an anti depressant which has a side effect of dehydration and immediately my vagina became dry and I noticed my clitoris smaller and much more difficult to reach orgasm. I’ve read up on VA and am going to ask the GP next week for vagifem. Do you think the AD is making it worse or has my vagina dried up coincidentally at the same time? Also, am I in time to reverse/save it?

NottonightJosepheen

OTC will ease with symptoms but they won’t prevent atrophy. Only local oestrogen can get to the route of the problem as lack of oestrogen is the cause.
I don’t mean to scare you but if you do notice symptoms you really should be looking at treatment.
I’ve read about women who can’t walk without having involuntary orgasms due to their most sensitive parts rubbing, and women sitting on cushions with holes in the middle on trains, at work etc bc sitting on a chair is excruciating.
Women who can no longer reach orgasm bc their clitorus has shrunk and vanished or the nerves supplying it have atrophied.
It’s something we don’t hear about for obvious reasons but it’s a huge issue and one that shouldn’t be taken lightly.
It can happen at peri or after meno it’s brought on by lack of oestrogen.
The vagina and bladder and anus are all effected.

Thanks DramaAlpaca. I've been trying to convince myself into going to the GPs and then had that stupid 'Oh what if it's very bad news' loop going through my head. Cowardice, I know. I would rather see the female GP in our surgery, rather than my slightly awkward but very good in a medical emergency male GP, or I could make an appointment first with the female practice nurse who has been able to diagnose me and prescribe for UTIs. What do you think?

myidentitymycrisis

Yes. I was put on ADs when peri hit me aged 40. The first thing I noticed was lack of sensation to my clitorus. It took me a lot longer to reach orgasm.
It’s a very common side effect

Add to that possible atrophy and it’s a double whammy.
Get on vagifem and you should be ok the AD will always have that side effect as long as your taking it. X

NICE GUIDELINES (JUST GOOGLE THESE WORDS)

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.
[NOTE; CONTINUE TREATMENT FOR AS LONG AS NEEDED- ie YEARS/ FOREVER/ OLD LADIES IN THEIR 90S USE IT]

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.

@ceecee32 Your GP is being ridiculous. vaginal estrogen for a year = 1mgs HRT pill ( a daily dose.)

Following this thread with interest.
I had a surgical menopause 5 years ago and almost immediately sex became very painful. It wasn't until I was having a routine smear test and I was crying with pain that I saw my GP.
I can't have HRT and she didn't want to prescribe Vagifem so I tried replens for 3 months but no improvement.
So I got the Vagifem, but it hasn't improved things. Throw in a vaginal varicose vein (I've had a pelvic scan) and foĺlowing my mastectomy and reconstruction using my belly fat (so effectively a tummy tuck) where everything has been pulled forward and up (rocking that camel toe lol) I have some major discomfort going on!
As it's my only symptom I don't know what else would be available to me.

Does anyone know whether Vagifem is better than Ovestin or are they about the same - I must admit I prefer the Vagifem inserter thingy

ceecee I think it is a personal thing. I have tried both, and like you, got a burning from the Ovestin, which I suspect was thrush, brought on by whatever is in the cream. I stopped for a while then the gp suggested trying the Vagifem. I use two a week. I much prefer these, but I do feel a bit guilty about all the plastic involved, as each tablet has its own applicator. I was told there is no limit to how long either can be used.

@ceecee32

They are different forms of estrogen.

Ovestin is estriol and Vagifem is estradiol.

Estriol is weaker and is a metabolite of estradiol (in other words it's a by-product of estradiol once it's processed.)

This makes no difference really but some women find the burning they get with Vagifem may be less with Ovestin.

Ovestin is a cream so in that sense it's potentially more soothing, but at the same time some women find some ingredients in the cream irritating.

There was some research which showed that with Vagifem if women were able to position the pellet onto the front wall of the vagina close to the bladder, it helped bladder symptoms more than if it was placed higher in the vagina.

At the end of the day it's personal preference . I've only ever used Ovestin ( for 11 years) and have been happy enough with it.

great thread thank you

menopause and common issues seems to still be taboo really doesn't it > i had not heard of this before but glad that i have so i know what to look out for etc

@Queen - thank you

Destiny

Systemic HRT can help with VA yes, and
Some ladies find the local Oestrogen is not enough and have to use both.
I would try both and then reduce and stop the local Oestrogen after 3 month on both and see how you feel.

Ceecee
It’s a matter of preference I think
Some find the fillers in Vagifem cause irritation and others say the same about the creams, it’s a “suck it and see” type thing I think.
I’m using Vagifem but I’m also using the cream version to apply to the outside bits.
Some ladies say Vagifem is great but their exterior parts tend to get left out of the process so they prefer the cream as they can apply that externally as well as internally

@roseenglish1969 thanks for this post. I was not aware of VA so at least I now know of it when I reach the menopause, I think I'm verging on peri menopause now judging but the way my body is going at the moment.

I think it's great this thread is here but I'm also really surprised that so many posters say they've not heard of it. Jenny Eclair is on a telly ad at the moment for some vaginal treatment (it's not hormonal- just a lubricant/ moisture thing.)

It's all over the media if you read women's mags, websites for women, health websites, and anything on menopause.

Decades ago, a friend who is 30 yrs older than me used to say with a 'look' that when you get older everything dries up (I think we were talking facial skin at the time.) My mum also used to say how she knew women whose smears were agony as they got older....and mum herself uses creams, well into her 80s, now and then.

They reckon at least 50% of women suffer and tbh it's probably a whole lot more who simply don't talk about it or want to admit it, or they have symptoms but can't give a name to it.

We've got to get over the taboo- to gynaes, it's just another bit of your body, like your ear or something! Mine is quite upfront about asking me how mine is and I'm happy to discuss!

I don't read those things though.

I read MN and the BBC news.

I had genuinely never heard of this and I'm not the only one.

If it is still only in "womens" stuff then it will miss plenty of women.

I haven;t seen Jenny Eclair ad either but I watch most stuff streaming and on normal telly turn the sound off when the ads come on these days - they make them way too loud (turning into my parents lol). It sounds like this isn;t what it's about anyway?

I think restricting this info to "womens" stuff will miss a lot of women, surely.

"We've got to get over the taboo- to gynaes, it's just another bit of your body, like your ear or something! Mine is quite upfront about asking me how mine is and I'm happy to discuss!"
Under what circs do you have general chats with a gynae?
Is this sometihg you get if you are having this issue in which case I bloody well do agree they should ask abotu it!

Can anyone offer some advice please? I use the Vagifem pessaries at bedtime, but the Replens in the morning. I can't lie about in bed until it absorbs, but I don't see how that can be very effective judging by how much ends up on my panty liners!
I'm absolutely dreading my next smear, as even the Replens applicator hurts me.

Vagifem has really helped me. Reading this thread with interest