Vaginal oestrogen, is the dose enough?

[Flowertrees]

I’ve started on vaginal oestrogen, for about 2 months so far. The first two weeks of using every day was great, symptoms seemed to get better quickly but now I’ve gone to twice a week, everything is rubbish again. V dry, wiping after a wee feels like I’m using sandpaper.
has anyone had their doctor approve a higher dose? I’m using the tablets if that makes any difference

@FergoMcFergFace Yes. After years of being dismissed I was prescribed Vagifem pessaries. Utterly horrendous. I had pains like I was in labour. Had to give them up. Asked for estriol cream and it’s like a bloody miracle. Do give it a go

Is there a limit on how many tubes of cream the GP will prescribe. As in only 'allowed ' 1 a month etc

Oh thank you - I really needed to hear that today. So glad you found something that worked.

I was prescribed Intrarosa pessaries by a menopause GP specialist and they’re amazing. I use one a day and apply estrogen cream externally 2 or 3 times a week. I also use Yes vaginal moisturiser. So I’ve pretty much covered all bases!
I have had breast cancer so some GPs can be a bit nervous but luckily have a clued up GP who ‘allows’ me a prescription which means I’m not in constant pain.

I’ve also use the Yes VM (oil-based) as well as of the oestrogen cream & everything is so much more comfortable!

Those pessaries are different to the estrogen pessaries or cream. They are DHEA, which the body can convert into estrogen.

I'm not sure they are widely prescribed as they are often for women who can't use other treatments.

Good that they are working for you :)

@Cheese55 That's actually more than a month's treatment.
The whole tube is 30 applications (0.5mgs each application) so on the basis of two applications a week that's 15 weeks.

That doesn't include applying it externally as well.

They really have helped me. After a few years of using estrogen I was still in quite a bit of pain, but after just a couple of weeks of Intrarosa pessaries everything was so much better. They are definitely worth a try if nothing else helps.

I get four tubes with every prescription. I use my finger and apply liberally.

No limit.

That would need to be agreed with the GP because the licence on the product is to use it internally and the tube lasts 15 weeks. There will be GPs who won't agree to using it off-licence, externally, so not all women will be able to get that amount.

How long does that last you?

I request two tubes at a time. I don’t use the applicator, I apply it inside and out with my finger. I was prescribed the two tubes I was due but owing to a mix up the chemist I was given four. Saves me bothering the GP again for a good while. Honestly, I couldn’t live without it x

I'm genuinely curious how it works with your finger. I tried that and all that happens is it spreads down my finger and none goes inside!

Ha! I make sure it’s on my urethra plus I poke a bit inside and towards the front so the hormones are absorbed by my bladder

Can't help but 🙄 at the it's not progressive but does get worse - yes this is true if it remains untreated!!
So re estriol cream, we are all different in what suits us best and sometimes we might react to the added ingredients in a product, at least at the start due to the tissue already being sore, which then often resolves.
A tip to help is if you have a moisturiser that you know you tolerate try using that first. Oil based moisturiser (eg YES OB) can be kinder than water based - also longer lasting and protective when used externally on the vulva (emollient ointment is good there). Then mix a small amount with the estriol cream before applying with your finger internally and /or externally as needed. You don't have to do the loading dose if you don't want - just go by how you feel.

I initially had an issue with estriol 1mg when using it externally (already using Vagifem pessaries internally) because the tissue was so sore and switched to Estriol 0.01% (larger tube, weaker formulation, more cream in a dose, contains peanut oil) for a while which worked better for me, though had to buy it from an online pharmacy after going through health screening. I've since switched back with no further issues.

Great you've found what suits and you have a good knowledgable GP.

Intrarosa as mentioned is DHEA that the body converts to estrogen and testosterone. It's not generally first line treatment like estriol 1mg cream and estradiol pessaries and can be a lottery in that it's not included on all GP formularies. However if available might be prescribed if other treatments haven't helped.

It's becoming more popular as a treatment, although like any treatment doesn't suit everyone with some not liking the oily discharge that they experience. Some use half a pessary daily or insert every other day.

Still doesnt work for me! I've tried it lots of times and the cream literally slides down my finger and I got a nice creamy hand! How do you get the blob to stay on the end of your finger? The applicator (horrible hard thing) does tend to get the cream a long way inside, but all that matters is what works for you.

Brilliant - thank you. I've just ordered some hydromol emollient today and I bought a fresh tube of Yes VM (didn't realise that had to be discarded after four months and I've been using it six 🤦🏼‍♀️), but I'll look for the oil based one. Then I'll try your tip for a smaller dose application once I've got this flare up under control. 🙏🏼

I only use a pea-sized amount

@jini
@JinglingSpringbells I put the amount of a large grape on my middle finger. Put it inside, obvs some slides down my finger. Then I do the same again and hook the second dose inside. Theres so much I easily get an internal large dose then tons on the outside tissue. There's no restriction on using it.

I don't like the applicator as it touches my cervix and makes me feel odd. I also don't think the amount is enough for me at all.

I suspect it’s a geographical issue. There’s a huge difference for me when I’m sat on the loo, v standing v lying down. I had a pelvic floor exam and she commented how sore I was in a particular area which surprised me as I’d not noticed. But that area is somewhere else when I’m not lying on my back! And that, I had noticed!

For me, when I’m on the loo, the area is significantly opened up. There isn’t much of an internal depth at all. I need to use the cream further back than I realised to get it on the area the nurse identified was a problem.

I’m assuming we all vary anatomically. I put one foot on the side of the bath. That works for me.

Which is the least messy type? And causes the least discharge/leaking etc? I had an estring but will need to change to something else as I got some side effects. I preferred it as I didn’t have to do anything each day and it wasn’t very messy

That's right- that's the amount that goes in the applicator.

Is it? I’ve always chucked the applicators away. My main problem was my urethra so started off putting the cream around that and a bit inside for my bladder.