Vagifem - dark brown discharge

[MandyMayflower]

I’m 58, postmenopausal and have been on Vagifem since early June due to having painful vaginal spasms and burning. Currently on twice a week and my symptoms have generally improved but I’ve had a few days where I’ve woken up with a small amount of dark brown discharge (looks like old blood) when I’ve had an orgasm (with no penetration) during the previous night. The burning also returns with a vengeance during the morning but disappears by the next day.

I know that penetrative sex can cause bleeding because of the thinning of the vaginal walls but can orgasmic contractions have a similar effect?

Has anyone else had anything similar?

Spotting and some light bleeding is listed as a possible side effect. It won't be down to orgasm, but using Vagifem. I'ts possibly increasing the blood flow to the vagina and cervix.

If it happens more I think you should see your GP so they can take a look for a start- you could have a polyp on the cervix for example, or depending how long since your last period it could be some old blood coming away. (unlikely at 58.)

Thanks JinglingHellsBells, will keep the possibility of a polyp in mind.

You're right - my last period was too long ago (7 years).

@MandyMayflower It's possible to have spotting/ bloody discharge with VA regardless of anything sexual going on because the thin walls of the vagina can bleed slightly just with normal day to day activity (my mum had this I think well into her 70s) . Maybe the Vagifem has just given you a bit more lubrication/ normal discharge and it's bringing the blood out with it.

@JinglingHellsBells, it was interesting to read about your mum - I didn't know that non-sexual activity could cause vaginal bleeding.

I'm really hoping that Vagifem will work for me eventually because I'm not able to take systemic HRT.

Thanks for your help.

@MandyMayflower Yes, you can get spotting with bad VA- think of thighs rubbing together and chaffing- it's the same thing- thin walls rubbing. In some older women who never get treatment, the vaginal walls can actually fuse together and any penetration (for using treatment etc) is impossible.

You need to give it a bit longer. Vagifem used to be a dose of 25mcgs and a few years back they reduced it to 10mcg- this means some women need more than twice a week or need to carry on for several months to reverse the changes.

@JinglingHellsBells, I assumed I might have to be on Vagifem indefinitely.

My current prescription states discontinue every 2-3 months for 4 weeks to assess need for treatment - I've printed off the NICE guidelines ready to do battle with my GP!