Vaginal cream or pessaries - which is best?

[AlleyRose]

I've been suffering a lot with bladder problems.

I've been prescribed pessaries which are great when I'm using them every day but I've been prescribed every other day - and the day I don't use one, I feel uncomfortable again.

Can you use the cream every day? Or maybe use it with the pessaries? My GP is great, but I'm not sure what to ask for? Can I use the pessaries every day for longer than two weeks?

Thank you, I'm just so fed up of feeling like I have a UTI - I don't. I've had my urine tested many times.

You need to use the cream every day, cause if you don’t, you feel like how you describe!!

I have been suffering for some time and my GP prescribed me pessaries every day for two weeks then twice a week. She also prescribed oestrogen cream/gel every day the used liberally and bioidentical combined HRT tablets. I tried patches and gel but wasn't absorbing the hormones properly.

It took a couple of months but my atrophy has vastly improved. See if you can get the oestrogen cream/gel for every day use.

How is your pelvic floor? Tight pelvic floor can cause bladder/uti symptoms and it can sometimes go under the radar

I use the cream and most days. I get four tubes a month on repeat.

@AlleyRose How long have you used it? The first step is every day for 14 days, either cream or pessaries. After that you should be able to manage ok with 3-4 times a week.

It's easy to underestimate how long it takes for the benefits to kick in. I had terrible bladder issues and it took several months to notice a good improvement.

It's not a 'quick fix' as the estrogen has to rebuild your bladder lining.

The choice of cream or a pessary is a personal choice. Some women find cream messy but it can also be used externally if you're sore . Pessaries are a slightly different type of estrogen and slightly stronger. They won't help any irritation externally.

Thanks everyone, I knew I'd find answers on here!

I've been taking a pessary every day for two weeks and now doing every other day (as prescribed). The nights and following days where i haven't taken one are still uncomfortable.

During the loading period i had no issues at all.

I think, I might ask for some cream to use externally alongside the pessary and see if that helps.

Menopause is bloody brutal.

This is what I was wondering - whether I could use pessaries and cream together. So thank you, I'll ask the GP about that.

I'm not sure what @FlowerUser means.
I think she's saying that she's now on full, systemic HRT (tablets) as well as vaginal treatment.

She also prescribed oestrogen cream/gel every day the used liberally and bioidentical combined HRT tablets.

There is a vaginal gel called Blissel - it is that @FlowerUser ? It's one of the weaker types.

And you're using it with vaginal cream as well- or instead of?

https://www.balance-menopause.com/menopause-library/vaginal-estrogen-what-is-blissel-and-how-do-i-use-it/
Blissel is a newer product which contains a lower dose of estriol than most other creams or pessaries.

Using vaginal estrogen isn't like a 'painkiller' or something that works straight away. It's really weak and is absorbed through the vaginal walls into the bladder. It can take weeks and weeks to rebuild the bladder lining (and stop symptoms.)

I'd suggest you try keeping on every day for another couple of weeks.
You can use cream externally on your vulva, but there's no need to insert it as well as Vagifem.

curious about how people are getting 4 tubes at once? I get one which seems expensive for each prescription and doesn’t last that long? Do I just ask for more at the GP?

@Newgirls my gynae said I needed to use it daily and so my GP prescribed it.

I have a general pre payment prescription (not the HRT one) so it is paid for by that.

I use Vagirux pessaries twice a week, plus a slosh of a non-oestrogen moisturiser called Yes every day for comfort. Worth a try?

Thanks Lowry

For comparison, a tube contains 15mgs- 15 applications, so twice a week would last 7 weeks. Every day you'd need 2 tubes a month.

Just for info- not all GPs will be so helpful!
There have been posts here where GPs simply refuse to increase the number of tubes a month.

@JinglingSpringbells yes I do have some tubes in hand, but I also use a lot more than the applicator provides. I squeeze out until there is a blob the size of an old 50p about a cm thick. This gets inserted and rubbed around.

I have prolapses, plus a failed prolapse surgery, plus a lot of scar tissue. Gynaes seem very keen that I use it daily, liberally.

I usually go for every other day as touching the scar tissue makes me feel sick, I have to grit my teeth, hold my breath and shut my eyes to do it. 😂

That sounds horrible for you @Ilovelowry . Thanks for explaining.

@JinglingSpringbells it is! Thank you very much for saying it. 🌻I feel that I should be stoic about it and not complain, but some days it's very upsetting.

🙁

I'm not sure what FlowerUser means.
I think she's saying that she's now on full, systemic HRT (tablets) as well as vaginal treatment.
She also prescribed oestrogen cream/gel every day the used liberally and bioidentical combined HRT tablets.
There is a vaginal gel called Blissel - it is that ^ ? It's one of the weaker types.^
And you're using it with vaginal cream as well- or instead of?

I have had considerable problems with vaginal atrophy causing pain and soreness so I was taking HRT patches. I wasn't absorbing oestrogen so moved to HRT gel to be rubbed into my arms. I still wasn't absorbing so moved to tablets.

At the same time I was taking vaginal pessaries twice a week after using them every day.

My gynaecologist suggested liberally applying oestrogen cream on my vulva and just inside my vagina, and I was prescribed Blissel. But as you've said it's weaker, I will ask for the cream.

My vagina is much more oestrogenised sinc taking the tablets but I'm still sore, hence the cream suggestion.

My gynaecologist suggested liberally applying oestrogen cream on my vulva and just inside my vagina, and I was prescribed Blissel. But as you've said it's weaker, I will ask for the cream.

Blissel is a gel, not a cream which is why I was confused, especially as there's also Oestrogel.

Blissel is really only for internal use.

The only cream is Ovestin although that name has lost its patent so it's now a generic type called Estriol 0.1%.

I have been using blissel externally its absolutely fine its a weaker blend as per gynae. I can't tolerate ovestin

@AlleyRose how are you now? Any improvements?