Vagifem or Ovestin for bladder issues / vaginal atrophy

[dahliaaa]

Have been having debilitating bladder issues this year.
Started as a uti that took a long time to resolve with antibiotics but still really struggling.
Constantly feel like I need the loo etc. Very uncomfortable all the time.
Making day to day things difficult.
I've been using vagifem for 6 months but still really struggling.
Is it worth seeing if GP will let me switch to Ovestin or if one doesn't work is the other one not likely to either ?
I was so optimistic about Vagifem as had read so many positive things about it with bladder.

What dose are you on? You might need more than x2 a week. You could possibly try the Estring (equivalent to 5 doses a week) and/or ask gp about using Ovestin externally and vagifem internally. Or as you say swap to Ovestin for a bit. Some women need full HRT as well though.
There's a supportive vaginal atrophy group on FB. Good luck!

Just looked at box and they are 10 micrograms. I started with every day for 2 weeks and then twice a week.
Thank you for the info.

I agree that you might need to use it more frequently. I suggest you ask your GP to increase the dose. I can tell you that until I went on full HRT, I needed to use Vagifem every other day for vaginal atrophy with no bladder issues. Two per week wasn't enough.

Hi , sorry to jump on , is it enough to use ovestin daily for atrophy ? I ask because I can’t take full hrt because of adenomyosis.

I use Ovestin for bladder issues and atrophy and I find it’s made a huge difference. You do need to use it regularly and consistently long term to see a difference, it doesn’t work straight away and if you stop using it the issues will come back again. I prefer it over Vagifem because I have Sjogrens which causes severe dryness and I can’t dissolve pessaries etc- with Ovestin you can use it externally and internally. I use it internally 3/4 times a week and externally most days. I can’t take full HRT due to lupus (the oestrogen sets of heavy bleeding, had various dose changes and all the proper investigations etc) but Ovestin is really good. I also take amitriptyline for the bladder issues and find that really helps too.

Hi @Toomanysquishmallows Can I ask who told you this?

Adenomyosis doesn't mean someone can't use HRT unless that's your own choice.

I've used HRT for many years and have had adeno shown up on scans (that wasn't the reason for the scan.) Never ever been told it's not ok (and I see a private gynae consultant for HRT and other things.)

I have 2 areas of it in my uterus.
I have a slightly heavier withdrawal bleed but otherwise it's not a problem.

You shouldn't need to use vaginal treatments every day once you get some improvement. The dose is 14 days for 2 weeks then enough to maintain things. That can be every other day for most women.
What's your experience so far?

Until a few years ago, the dose was 25mcgs per tablet. It was changed (goodness knows why.)
Since the lower dose was manufactured many women find they need more.
I'd try it every other day and see how you go.

They have slightly different types of estrogen (one's estradiol the other is estriol- I'd need to check which!) but Vagifem is stronger.

I’ve been using Ovestin since April following repeated BV and some dryness. It’s great stuff. Even better after 3 months. I didn’t have big bladder issues but used to struggle to hold it when I got to a loo after needing a wee for a while. That has all stopped .

I agree with pp that since the vagifem dose reduction, lots of women need more. Since they have put pharmacists in charge of repeat prescriptions it is much harder to negotiate a dose adjustment.

You can buy it OTC now and it's called GINA.

It's not cheap but if you ran it alongside the NHS prescriptions it may well help.

I’m on full HRT (mirena plus 100mg Evoral patches) and need something for vaginal atrophy. Will OTC Gina do the trick or do I need to see the doc/gynae again?

@Toomanysquishmallows I have adenomyosis, diagnosed recently. It was spotted during a hysteroscopy and insertion of a Mirena coil as the progesterone part of HRT. I am on full HRT and have never been told that it's contraindicated due to having adenomyosis. The condition has never given me any trouble though, and until earlier this year I didn't know I had it.

Gina is Vagifem.
It's just a different name.
The difference is the cost. Look online and you will see the prices.
If you are over 50 you can buy Gina OTC.

If not, you need to see your GP and to be honest, it's a heck of a lot cheaper than buying it.

I can't see why HRT should be contraindicated with adenomyosis anyway, as HRT is just replicating normal cycles.

I wonder if this is another case of a dr not knowing much about it?

I had an overactive bladder..constant urge to wee which was such a nuisance. I never wanted to be far from a bathroom. No Uti' s. I got botox in my bladder and it has been life changing. Didn't even need it topped up. It just broke the cycle.

Thank you for all this info - really useful.
I'll update it to 3 times a week or every other day for a while and see if any improvement. If not will ask if can try Ovestin instead.

And just in case anyone can suggest a good urologist or Urogynaecologist who is good with bladder / menopause would love to hear. Particularly in South East. (I know I'll probably need to pay.) it's having such a big impact on day to day and quality of life.

Just one tip I read online (on a medical site) - you should try to place the pellet on the front wall of the vagina where it can dissolve and be absorbed into the bladder. So place it as high up as you can and if it's possible, angle the applicator towards the front.
It took a good 6 months for Ovestin to help me, and as the new Vagifem is half the strength of the old sort, maybe you should try using it daily for another couple of weeks . You might also need to think about full systemic HRT as well.

Thank you @JinglingSpringbells - really useful

Also, I use the cream (Ovestin)on the outside too. So all over the urethra opening and clitoris.

Yes, same here. You need to use it very liberally. I think a lot of women only use it in the applicator internally and really to get the full benefit you need to use it externally too.

@Pigeonqueen @greengreyblue do you just use Ovestin or vagifem too ?

@dahliaaa I have a lot of success using estriol cream internally and externally Liberally every day.

Under instructions from consultant as my atrophy was severe. Have been using it daily since February and things are so much better.

@dahliaaa I have pm'd you.

I just use just Ovestin . Not on any other HRT. I’m 2 .5 years since last period.

I had the exact same issue op was given vagifem to take every night and reduce to every second night then. My symptoms improved within a few days but as soon as I went to taking it every second night , they started again. My doctor said I could use it every night and also prescribed me ovestin cream to apply generously to the vulval area / urethral opening once a week. This has worked incredibly well for me and has cleared all my symptoms