Ovestin and vagirux - how to get both prescribed?

[RichardMarxisinnocent]

Hi, I've been using vagirux, and before that vagifem, for the past 18 months or so. It's been working well, but in the past couple of weeks my vulva has started to feel sore and possibly a, but dry. Internally feels ok I think. I did an econsult and asked for ovestin so I can use them externally while still using vagirux internally.

The GP has replied saying they are just different forms of oestrogen, both for internal use and there is not a separate cream for the vulval area. She suggests a thrush tablet if I am itchy, not using soap, not wearing tight clothes, wearing cotton underwear, and using an eczema emollient. Other than the emollient and thrush tablet (I am sure i don't have thrush) I already do all those things. I am arranging an in person appointment and wondered if anyone can advise the best way to ask for both ovestin and vagirux? I know many women do use both, and do use ovestin externally even though it is intended for internal use, so some GPs do prescribe both, I just need go persuade mine to!
Thank you

Yes OP, I have the same problem and my GP, won't prescribe both.

It's so frustrating isn't it? Especially as I've read about some GPs actually suggesting or recommending using both. Why do our GPs think differently?

Could you not just ask for Ovestin cream? Insert it internally and also apply it externally?

This is what I'm doing. I'm buying it from an online chemist, as my GP's no help.

If you were determined to use two products, you could get the other online. You don't pay for the consult (it's just a form) and you even have the option not to inform your GP!

I could do, but as the vagirux seems to be working for internal issues, I am wary of switching from it in case the cream doesn't work. Cream inside and outside also seems potentially quite messy?

I did look at getting the cream online but decided to try my GP as a prescription would be cheaper. I'll probably get it online if I have no luck with the GP

Ovestin is a cream too.

@RichardMarxisinnocent the cream definitely works and I don't find it especially messy. I insert at night before bed and don't get any discharge or excess on my pants the next day. TMI I know! I'm a prescriber too (pharmacist, not a GP) and I can see why they would be reluctant to prescribe two separate vaginal oestrogen products. It's not particularly dangerous as the doses of each are very low but just seems incorrect!

My GP wouldn't prescribe both and patients are only allowed 2 boxes of vagirux per year because she won't prescribe for more than 2 doses a week. I got one box total. I have ended up having to buy ovestin and gina. The gina comes with individual applicators which is very wasteful but I can't get vagirux over the counter. I am going on a walking trip and approximately a quarter of my backpack will be taken up by packaging and I will be carrying the used ones with me for weeks. I am having to pay for private prescriptions for normal HRT as well.

I see your point about it seeming wrong. Actually I wonder if you know the answer to this please? As all the oestrogen tablets and creams are for internal use, are they also supposed to help the vulva? Or do they only have an effect in the vagina? And if they don't help the vulva when used internally, what treatments/medications are we supposed to use to sort out a dry and sore vulva?

My GP wouldn't prescribe both and patients are only allowed 2 boxes of vagirux per year because she won't prescribe for more than 2 doses a week. I got one box total.
That's awful. Why are women not able to get the treatments they need?

They don't know where you are putting them. If oestrogen will help the problem they will work, iyswim.

@RichardMarxisinnocent Ovestin cream (Estriol) is only licensed for intravaginal use so I'm presuming that the clinical trials only included women who used this internally. However I think it's pretty common to use this externally too. Dr Louise Newson's fact sheet lists this as an option.

www.balance-menopause.com/menopause-library/vaginal-estrogens-what-is-ovestin-and-how-do-i-use-it/

It's a bit ridiculous. The cream is better/ useful for external use (as well as internal use.)

Makes me so cross that some GPs put up these barriers that you wouldn't find with a consultant who knows a lot more!

Plenty of women use both.

If you hit a brick wall it's probably worth paying to see either a private GP or a private menopause specialist. (In the long run probably cheaper than paying almost £30 for Ovestin online.)

@pharmachameleon There are zillions of women who use Ovestin externally. Sensible doctors say use it where you need it. That might be inside, outside or both. It's so weak it's not an issue.

@JinglingSpringbells I agree that it's common to use it externally.

You CAN be given both.

Vagifem doesn't reach the vulva.

It's a tiny tablet that sticks to the vaginal walls.

This nonsense is only from some GPs who are poorly educated on menopause.

A private consultant wouldn't bat an eyelid if you asked for both.

I use ovestin and squirt it inside but use my finger to spread some of the dose on the outside. It seems to be working well . Lots of women use ovestin externally .

I'm a GP and part of the problem is prescribing budgets and funding.
You absolutely can use the cream internally and externally but I might be reluctant to issue 2 different vaginal oestrogens when our prescribing is so heavily monitored and questioned and the targets for each year are to reduce by 5% for example from the previous year.

It's all well and good a private GP or hospital clinic saying issue 2 different but it's not their prescribing budget that will utilised if you are getting the script from your GP.
Of course you have the option to pay for a private prescription.

Just giving you another view point.
Not saying it's right by the way, I'm 40 this year so not a million miles off all this myself!

My consultant (hysterectomy) gave me Ovestin for use internally and externally which seems to be working well. On the days when I'm not using Ovestin (as it's twice a week) I use Yes moisturiser.

It's all well and good a private GP or hospital clinic saying issue 2 different but it's not their prescribing budget that will utilised if you are getting the script from your GP.
Of course you have the option to pay for a private prescription.

@smilesonlyforyou I wasn't suggesting women bother their GPs with a consultant's request- more that they get a private prescription. It's not worth the bother TBH of seeing a private consultant and then faffing about trying to get a GP issuing the cream.

Ovestin is not too expensive on a private prescription- depends where you go for it- but it's around £9 and that should last for 6-7 weeks.

Thank you, I did think the tablet likely wouldn't help the vulva.

I'll see what the GP says when I see her, but if I can't get a prescription for it, I think I will find another way of getting ovestin.

Thank you to those who have suggested a private prescription. Is that something I can ask my normal NHS GP for? Or do I have to find a private GP? Or is it something I'd get from an online pharmacy?

I have this issue as well I use vagifem for internal but was also suffering a bit externally

my mum has sjorgens (sp) and uses sea buckthorn oil tablets for all her dry eyes and mouth and it really helps with that so I had a lightbulb moment and lo and behold it helps with all dryness!! I take two 500mg tabs a day and let's just say after about a month I am smooth and silky in all areas 😂 😂

I still use vagifem as well though