Vaginal dryness

[Hyperfish101]

I have had an easy menopause so far but this is a new thing. I don’t just mean dry during sex but feeling a bit dry all the time.

I’m not on HRT. Is there any OTC thing I could use?

I use megs menopause moisturiser its the best I've tried Superdrug and Holland and Barratt sell it. Its branded as MM.

I’m not on HRT. Is there any OTC thing I could use?

There is nothing OTC that will reverse changes due to loss of estrogen.
The OTC stuff is just a sticking plaster approach.

You need to see your GP and get either Ovestin or Vagifem- estrogen treatment placed in the vagina.

It's not classed as HRT and isn't absorbed. If you ignore the problem it can get worse and affect your bladder and pelvic support, and in the end be a much bigger issue.

The OTC stuff like the stuff Meg markets (and she's just jumped on the meno bandwagon) is like putting Vaseline on your face. It makes it slippy but it doesn't change the cells of your skin to make them plump and 'tough' again. Sadly a lot of women spend money on OTC stuff because they are too embarrassed to discuss with a dr, yet it's normal to have dry vaginas post meno.
If vaginal atrophy gets really bad, the skin splits, it can bleed and very long term the walls of the vagina can fuse closed. You also need to be aware that you will need smear tests till 65 and using lube or an OTC treatment won't work really, and smears will be difficult and hard to collect the sample.

Would you be OK with something prescribed? My GP prescribes Vagifem for this, and it makes everything feel a bit more, err, resilient.

Ok will go to the GP. Thanks for the advice.

How grim it all is. 🙁

Thanks.

Have just looked at side effects though. Are homones the only option? Really wanted to avoid them.

@JinglingHellsBells, may I ask you a question about Ovestin? My gynaecologist recommended it (along with HRT patches) and my GP started to issue the prescriptions. (I had a BSO total hysterectomy a couple of years ago.)

All seemed well. It certainly helps.

But this year my GP has twice refused prescription requests for the Ovestin cream, without saying why.

Presumably I'm being perceived as using too much?

I'm only asking for one 15g tube every two months!

Before I speak to the GP about this, I wondered how often it is safe to use? I'm currently using it every other day, as without it I experience pain and discomfort. What are my best arguments here to present to the GP?

Hyper- go to the website of Dr Louise Newson and search for VA in the search box.

The leaflet in Ovestin and Vagifem (what you have found online) is irrelevant to vaginal estrogen. Medical experts are trying to get this changed. Legally, the companies have to include that leaflet with anything containing estrogen BUT it's totally irrelevant to vaginal estrogen. It's not absorbed into the body .

@JamieLeeCurtains You need to ask why. The dose is 2 x a week. So that's 1mgs x2 = 2mgs a week, so a 15mgs tube lasts 7 weeks.

Be aware that is 1mg of cream but the actual estrogen in it is 0.01%. So using it 2 days a week for one year is the same as 1 mg of estrogen in a daily tablet of systemic HRT- minute.

However, there are women here and on other forums who need to use it daily with medical advice.

Some dr are very out of date and the old literature said it could only be given for 3 months then stopped. The NICE guidance says if it is stopped symptoms will come back and therefore it can be used indefinitely.

Sorry ignore the first line.
A single application is 0.01% estradiol. you need 100 doses to make even 1gram of estrogen which is the same as 1 dose of a tablet / pill (as full HRT.)

Cool, thanks Jingling. I'll try to get an e-consult.

Thanks Jingling.

Do not ignore VA, it will get worse and do not stop using topical HRT once it is under control.
I use systemic HRT, Vagifem and Ovestin.

As has been said, there's nothing you can get over the counter that can replace the loss of oestrogen that causes vaginal atrophy.

Vagifem makes things feel completely normal again for me. I haven't noticed any side effects whatsoever.

I haven't felt the need for HRT, I've had a very straightforward menopause, but Vagifem is a necessity for me.

I've re-read the NICE guidelines.

My GP has ignored pretty much all of them.

I'm so very bloody tired of all this. I have other major health issues going on as well, and it's just exhausting.

I gave my consent to a BSO total hysterectomy on the condition that I would be subsequently looked after with sufficient HRT and necessary medication including e.g. Ovestin (or similar). My gynae surgeon wrote letters to my GP practice and I have copies.

I feel as though my GP is unravelling my informed consent.

@JamieLeeCurtains Sorry you have had such a crap experience. In all honesty, I have never used a GP for my menopause issues. That's a bit of a coincidence in a way as I was seeing an excellent gynae (through private insurance) for one possibly-hormone related issue anyway in my early 50s and decided to continue with them when menopause started. I have to pay but it's worth it as they are one of the top meno specialists in the UK.

The info I tend to share here is based on what I've learned through my dr (but I also write on health anyway.)

My advice is if you can afford to consult a dr privately, you spend your money that way, and choose an expert. You only need 1 initial appt (and many are doing them remotely now anyway) and they can write to your GP with their suggested treatments. After that you need only 1 appt annually unless you have issues .

I’m only at the start of this and off to see my gp this morning about this exact issue.
I would really recommend as above Dr Newson and the book my menopausal vagina www.mymenopausalvagina.co.uk/ as it’s made me recognise my issue and given me the guts to see my GP.

I would really strongly recommend you try vagifem. Without it things will not get better. I suffered from dreadful soreness and recurrent cystitis & the vagifem got rid of it within the first fortnight.
My gynaecologist also recommended Hydromol (he said it’s cheaper than the meno branded treatments but just as effective). It is just a topical moisturiser though- it supplements vagifem rather than replacing it. (Plus it makes a good lip balm.)

Sylk lube was recommended to me by my GP. It is plant based and seems to have excellent reviews x

@anotherdoghere Lube and estrogen are very different in the way they work.

Older women in their 80s and 90s also use vaginal estrogen to keep themselves comfortable and prevent bladder issues. It's not just for anyone having sex, it's to keep your vagina and pelvic tissues healthy whereas lube is just to create a wetness when you have sex.

Thank you again Jingling, I appreciate the advice and support.

@JinglingHellsBells , I always appreciate your wise words on these threads. I'm brca2 positive and had a BSO 5 years ago after breast cancer. I have a huge problem with VA - but from what you've said, I might be able to use something like vagifem?

Vagifem is a tiny amount of hormone delivered locally, and really does the job. My GP - a woman about my age - recommended it when I showed up post meno with cystitis (for the first time in decades), before I'd even noticed dryness - I didn't get it then but sure enough was back asking for a prescription within a couple of years.
Vaginal atrophy is normal, but nowadays we don't need to put up with it.

[quote weebarra]@JinglingHellsBells , I always appreciate your wise words on these threads. I'm brca2 positive and had a BSO 5 years ago after breast cancer. I have a huge problem with VA - but from what you've said, I might be able to use something like vagifem?[/quote]
You need to see a specialist. If you look at the website of dr louise newson - I linked to it in a previous post on HELPFUL INFO - and go to the tab for medical resources there is a lot on what women like you can use or not use.

Ultimately I'd say it was your choice about quality of life over risk. The amount in vag estrogen is tiny- one year's worth is the same as one day of hrt.

@weebarra This is the link and scroll through the articles for info on other pages.

www.menopausedoctor.co.uk/professionals