Diagnosed with vaginal atrophy

[newnamenellie]

I posted a couple of weeks ago about having a sore vulva and some of you suggested it could be VA.

I managed to get a GP appointment last week and was told it was VA.

Well, in fact initially the GP said lichen sclerosus! She had a quick look and said it was LS which surprised me as I’d read about that and didn’t feel that it fitted my symptoms (I have no itching at all, only soreness with stinging/prickling and no white patches of skin as far as I can see). Anyway, I started asking her about LS and she began telling me then suddenly said that she didn’t think it was LS but rather VA. This is more in line with what I was expecting so I was sort of half relieved, half 😳. She prescribed Vagifem. She asked me if I’d had sex recently and I said I hadn’t as things were too sore. She said to be very careful when trying as my vagina had narrowed quite significantly. That was it.

I’ve been using the Vagifem for three nights now, as yet no improvement though I realise it’s early days. I will give it a few weeks and go back if necessary.

I’m nearly 47, still getting regular periods and no other real peri symptoms although my hormones are definitely doing something different in recent months.

Im trying to educate myself as this has all come a bit out of the blue, so any advice e we would be great.

I’m wondering if vagifem will work for me given that my soreness is external and only a little around the entrance to my vagina (just feels dry/uncomfortable there).

Op, my soreness was/is just on the outside. Vagifem did work for me but took many months. The standard dose regime of 2 weeks everyday then twice a week thereafter didn't work for me, I use one every other night, regardless of what Gp says. I also use Ovestin a small amount every day on the outside bits. It's cooling and one tube does a while. Ask your Gp for it. I'm on patches as well, and it did take quite a bit of arguing to get these all. I'm 45 and am through menopause early.

It can take a while for VA to settle, you might be lucky and get relief quickly. I have Ls as well and have given up on sex completely as its just too painful.

Just remember to keep up treatment as if you stop all symptoms come back. Good luck.

Vagifem works IN the vagina.

If your labia/ vulva are sore, it's better to use Ovestin which is a cream (estrogen) and apply where you need it.

Vagifem is designed to stick to the vaginal walls. It won't slip down to help your vulva.

@Tootsey11 thanks for replying and sorry to hear that you’re suffering too.

Interesting to know that Vagifem worked for you eventually- it seems from what I’ve read that the standard dose is pretty much useless for many people. I’ll see how it goes. I definitely think I need the cream too, so I’ll have to go back and ask my Gp for that. Don’t know why she didn’t give me that to start with 🤔.

@JinglingHellsBells thanks for replying, you’ve been very helpful on my various posts recently!

The soreness has got worse since I started using the vagifem but I gather that can happen, so I’ll stick with it.

Still can’t quite believe how bad it’s hot in the space of a couple of months. I’m wondering if I do have LS as well based on the GP’s initial diagnosis. Not sure why she changed her mind mid consultation! She did say something about maybe needing a steroid cream but I was half way out of the door at that point and didn’t really query it. That would point to LS though, right?

I’ve just pierced a starflower oil capsule (which I take orally for breast tenderness) and rubbed that on my vulva, so let’s see if that provides any relief from the soreness 🤞🏻

64 years old, 10 years since I said farewell to last period.... Now I get GSM! Genitourinary syndrome of menopause (thank god its not called vaginal atrophy any more)
Struggling with getting a useful treatment. Trying blissell gel, but the minute I go on the maintenance dose it all comes back😒
Anyone else got any wisdom to help me talk to GP??

@Menogran Is blissell gel a new type of vaginal estrogen or something you have bought? Not heard of it but I know there are a couple of new products out. I can google, but am in a hurry right now.

Basically, you need to keep using vaginal estrogen at a dose that works. The 2 x a week for Vagifem and Ovestin has been blown out of the water by consultants, who say it's fine to increase this to more days to get relief. There is no concern over the womb lining building up as it's such a tiny amount.

What do you want to talk to your GP about? That you want to use more? Or a different product?

Hi JinglingHellsBells..... I think need to use more, or try something stronger. It's been going on since early March when I was prescribed Blissell gel (it's a new hrt gel, and very low dose I think) so you use it 3 weeks every day, then supposed to reduce it to twice a week which was a disaster, all symptoms came back. After 3 weeks it was totally under control so it was so depressing when it came back just as bad. Then was told use it every 3rd day - Same thing back to square one. Same when I tried alternate days, and every time I then gave to use it for at least 7 days in a row to reduce the symptoms. I'm so fed up of it.
So tomorrows consultation (this will be the 4th since early March) I have to get something stronger or just use it every day. GP seems very reluctant and last time told me it was 'dangerous' to increase the dose.
I've done a bit of research now though and will insist on more help.

GP is ignorant. Using Ovestin or Vagifem for a whole year, on the basis of 2 x a week is the same as 1mg of estrogen used in 1 day with HRT.

So if you doubled your use to 4 days a week that would be the same as 2 days of hrt .

If you find you're not getting anywhere after a few months of ovestin and vagifem, I'd say ask your doctor to prescribe Estring. It's just a silicone ring which sits in the vagina and steadily releases estrogen, higher dose than vagifem I think.

I had the reddest, rawest, agonising vagina, vulva, urethra, and bladder. I wanted to commit suicide and as it went on for five years.
I saw 18 different urologists, urogynaecologist, and gynaecologists. All useless.

In the end, an end urologist convinced me to start on systemic HRT followed by insertion of estring. I'm 80% better and no longer terrified.

I flared up very badly with vagifem and ovestin. Possibly the additives in there. So that could be worth a try in the long run.

Good luck.

• endo-urologist

Thank you everyone for your comments and advice. Still battling on trying to find a regime that controls the dreadful itching/soreness /crawly feeling. Currently trying daily Blissell (hrt gel) and ovestin externally, but I think I'm reacting to something in the Ovestin as it doesn't seem to be helping much. Have bought Olive & Bee moisturiser (£18 off Amazon) which doesn't irritate. Might try mixing a bit of Ovestin with it. Has anyone got relief from vulval symptoms with systemic hrt? My GP has mentioned it and might be willing to prescribe it, just don't know if it's helpful.

@menogran you might pick up more info from Jane Lewis and her book on this. She's just an 'ordinary woman' who suffered really badly and was advised on another forum how to find help. It was a long journey for her and she ended up writing a book on it.

She is interviewed on many meno websites including Dr Louise Newson 'My Menopause Dr'

There is also a video chat about VA on the BMS website videos- I posted a thread about these a few days ago here.

Systemic HRT might help but it' s usually the other way round- women who use systemic hrt often find they also need topical estrogen.

Also, bear in mind you might need to increase the doses of whatever you use now, beyond what it says on the box. Often it's too low for women to see real improvement.

I gave up on intimacy, just far too painful. This is a miserable condition and I never even knew it existed, until I had to go into hospital for another reason. GP was useless. Ive given up on doctors and dont go unless it's something really desperate.

It's never too late @Gothichouse40. Older women in their 80s and 90s use vaginal estrogen not necessarily for sex, but some do!- but to prevent infections and soreness.

It's a shame to give up sex if you can be sorted.

Gothichouse40 please don't give up! Bloody awful as it is, it can be helped. Not for sex, but for quality of life!
I will keep going until I find a regime that keeps it controlled.