Can anyone talk to me about starting vaginal estrogen?

[3amamama]

At quite a young age. Just that really. Bit thrown today - had thrush I’ve been unable to budge after antibiotics (horrible UTI needing four courses) it’s been a genuine misery and I’m in agony. Went to gp for swab and to see what they recommend and as well as making a plan for thrush (swab, fluconazole for 6 months, GUM clinic referral for more detailed swabs if no improvement after three tablets) she has given me vaginal estrogen on basis of how raw and damaged I look. She was lovely, she totally got how much pain I’m in and she took it seriously and I do know how hard it can be for some women to get HRT so I know maybe I’m lucky. In that respect. But, I’m only 39. Has anyone else had to start relatively young? Do you have to keep going forever? What about the cancer risk? What should I expect, I’m scared to put anything down there at the moment to be honest as just so sore. I’ve sobbed today, partly pain and tiredness but partly just upset to feel like I’m prematurely ageing. Any advice or info appreciated.

You poor thing, that sounds awful. I'm on vaginal oestrogen but I'm in my 50's so not exactly who you're looking for on this thread but please don't worry about cancer risks. Vaginal oestrogen is not the same thing as systemic HRT (patches, tablets etc) it contains a much smaller dose of oestrogen and is perfectly safe.

Older than you but vaginal oestrogen has been a lifesaver for me. I had itchy thrush like symptoms alongside multiple utis for years. Cured in a matter of days. I’m not sure what the cancer risk is that you are concerned about? The dose is tiny and very localised.

The vaginal estrogen has very low cancer risk and can be taken by those who are not suitable for systemic hrt.

You might be low on oestrogen at any age - breastfeeding does this and causes vaginal soreness. At your age you might only need a short course.

I'm heading towards mid 50s and ovestin cream is great. I think a year's treatment is equivalent to one oestrogen tablet or something so don't worry about the cancer risk.

Just to say I know how miserable it is - I had thrush recently, then I get vulval dermatitis and slight vulvodynia as the nerves get jangled. Takes weeks to return to normal and then I had to start up the oestrogen cream again.

Thank you both for sharing. As to cancer risk, the leaflet in the box is one big warning about cancer…I know the risks were massively overplayed in media years ago but this sort of shook me!! I guess the GP would have said something if it was a real concern. My aunt had breast cancer so it sort of is a slightly bigger worry to me maybe.

Also just worried it’ll make the thrush worse!!

And feeling like I hurtled right from pregnancy and breast feeding years into peri with no breather 😭. Sorry for myself in other words.

Oh more replies since thank you so much all.

@ClioMuse yes I feel like possibly I have contact dermatitis from canesten and lactic acid…I’m scared to put anything on! I just feel burnt.

Should just trust and do what GP said I suppose. Presumably the fluconazole tablet will cover off the yeast side of things.

Hi OP. I was prescribed at 36 due to breastfeeding, apparently hormone levels dipped way below normal. The discomfort was unimaginable so I'm sorry you're going through this. Fortunately the prescription worked a dream and after the initial back to back loading dose, I only had to maintain with occasional use. Like PP says, I was told cancer risk was low and the example given was that one oral dose of hrt contained more than a year's prescription of vaginal hrt (or something along those lines). I was also given a moisturiser for immediate relief but that can also be bought over the counter. Hopefully you'll get it resolved soon.

Please don't read the leaflet! It's out of date. There was a big discussion over this on another thread 2 days ago. That leaflet is in all the packaging for systemic HRT , and doesn't apply to the sort you have been given. The risks for vaginal creams etc are not the same and there is no risk. This is an ongoing issue where UK consultants are working with manufacturers to try to get that leaflet changed.

As a PP said, using it for a whole year is the same amount of estrogen as 1 day of 'full HRT'. It's meant to be used for life and old ladies in their 90s use it as can most women who've had breast cancer. Don't even worry about it.

Update, taken the plunge. Do think looking back over past 6 months there have been some other signs. Mood, mostly. Dry skin. Breast pain. Waking early. God. Before 40. I just thought I was really stressed 😑

Need to ask my mum when she went through it. Don’t think she’ll be keen to discuss though!

That’s shocking re the leaflet! It really is quite jarring. To be honest though if this is (just the beginning of 😱) the alternative to HRT I’d take quality of life I think.

I am going to be 39 this year and I’m on vagifem for vaginal atrophy. It causes bladder symptoms and constant urgency to pee so I’m hoping the vagifem will help plump up the tissue. It’s only been a few days since I started.
don’t worry about the leaflet. It’s all based on a very small study years ago and there’s no danger in vaginal HRT

Yes I'm allergic to Canestan and so fluconazole is what I use. The allergy is a ruddy nuisance. That said the thrush didn't come back after it was treated and when I started the loading dose of Ovestin again.

I use Yes Vaginal/vulval moisturiser in between Ovestin if I need it.

Hope you're better soon

My DM uses it and has had endometrial cancer and skin cancer as consultant said there is very little risk. I'm post menopause for 13 years and need it from Time to time. I have one prescription year on average. Stop worrying and use the cream. It really helps honestly!

Also, vaginal estrogen is not classed as HRT - yes, it's replacing estrogen but only locally, in a miniscule amount, that stays in the vagina, so it's not the same as systemic HRT.
The outdated leaflet is a licensing issue - anything with estrogen contains that leaflet. It's unclear why the manufacturers have not changed it because UK gynaecologists have been pressurising them for years to change it.

When you said young I thought you were going to say early 30s or lower. At 39, I'm not surprised.
I hope it makes a massive difference, my issues caused by vaginally atrophy were largely sorted by systems hrt but I needed topical oestrogen to be able to have a me Mirena fitted. I'd been on the continence pathway at 40 and spent excuricating weeks doing the things they expect and peri was never discussed. I was breastfeeding at the time and it was implied I had bought the issues on myself. Like you, straight from baby making and feeding to peri, I started systemic hrt at 42.

I’ve been on it since 37 - I have autoimmune issues and completely stopped producing oestrogen at 37, I’m now 44. I have long term bladder issues and all sorts and it’s made a huge difference to me. You do have to use it long term and consistently though. It doesn’t work straight away. I think it’s amazing stuff.

Thanks everyone. I did apply it last night. Still in agony. Worse probably. Cannot believe the impact this is having on my life, sat here trying to contemplate how I can possibly get through work.

Be patient. It can take up to a month or longer but on the other hand you may feel better in a week. Sometimes there is a bit more irritation at first but you have to power through.
The cream helps to thicken the tissues and changes the cells back to a normal state, rather than being thin and sore.
I assume you were advised to use it externally as well as using the applicator for internal use?
You might like to use a bottle of cool water to pour over yourself after weeing- wee is acidic and can burn so this helps calm it down. I you're in a lot of pain take some paracetamol.

Yep. Trying to do mindful breathing etc. Paracetamol not touching sides. But will try to keep faith!

Just found this thread and could cry that I don't feel so alone. I'm just 39, 40 in June and for the last year had around 10 utis. I still don't know whats triggering them, I originally thought after sex but ive been with my partner 23 years and nothings changed although I know being female hormones can play havoc without us being asked! I then had a shower last night. I wash with 0% fem fresh and after my shower I feel the burn starting!! Gp has mentioned an antiseptic tablet to take daily but then slipped in hrt or oestrogen creams and it made me shudder. Is 39 not too young to start this? Will i be on it for life if I do? Ive never had thrush but feel like I might have as my last uti I was given 4 days trimithorpin then labs came back saying the strain of uti was resilient to trimithorpin so had 3 days of nitrofuratoin. Then another days. Had a 2 day break and had another 3 days!!! Labs for the 2 urine sample came back okay but I feel wiped downstairs! Apologies for the lengthy post but I feel so lost.

I hear you @JG1586 ! Very similar, I’ve had so many UTIs over the years, and about seven last year alone. They are horrific. No-one can understand how awful they are until they’ve had one. Lots of love and solidarity to you. ♥️

I’ve eventually been referred to urology and I’m going through the standard tests to rule out abnormalities etc. Me and my GP honestly don’t expect them to find anything except the culminative consequences of chronic UTIs and peri, so we’ve already started discussing vaginal oestrogen. That’s how I found this thread. I’m so sick of taking antibiotics and I’m actually excited to try the oestrogen ring in the hope it can make a real difference. It certainly feels promising. Good luck!

@JG1586 i was the same earlier this year except my vaginal symptoms started before the UTI.

I started Vaginal oestrogen inserted internally, d mannose, a daily antihistamine and a probiotic and something has worked. Also saw a pelvic floor physio and believe some of mine has been related to tightness too.

I had the same 4.5 years ago.

I am now 43.

The antiseptic your GP will be referring to is most likely hiprex.

The 3 day courses of antibiotics won’t be helping - they are enough to clear the infection and can cause longer term issues rather than improvement.

I'm 38 and I've been on Blissel, low dose estrogen gel, for 6 months and it's vastly improved my quality of life!

I started having symptoms like atrophy and itchy vulva about 18 months ago and wish I went to my GP straight away instead of trying to treat my symptoms with OTC creams and supplements (presumed it was thrush).

It really is something I'd encourage women going through any sort of vaginal or urinary discomfort to talk to their GP about and ask for treatment. I was really embarrassed going into to talk to my GP but I was in and out in 10 mins with my prescription and a week or so later the relief from the gel was incredible.

There is some very good information and guides about what to ask for from your GP on Reddit also.