Any vagifem experts? Need advice

[AriadnesPiglet]

Just been prescribed vagifem following an apparent uti, symptoms of which did not clear up with antibiotics. Going on for months.
Went from feeling like I needed to wee all the time and then also started to feel sore and uncomfotable in the vagina.
Tried some over the counter stuff, multi gyn actigel from boots, but that made me sting and hurt more.

So I've just started vagifem, day 2 and it's not going well so far. I feel sore and not sure if its coming from my bladder, inside where I inserted the tablet or the uretha. Maybe its all 3. It's so long since I had a period I'm not sure if its cramping I'm feeling

I feel like packing it in but is this normal to start with? Is it worth carrying on because at the moment I feel worse than I did before. I'm miserable because I thought this was the answer to my problems.

It might not be the Vagifem.

Try to stick with it. If not, it's likely to get worse. Some initial irritation is possible until the tissues start to thicken up again.

Vagifem is slightly more powerful than Ovestin which is a cream. (Some women don't like it as it's a bit messier) but you might get on with it better. You can also use it externally to if you're a bit sore.

I'd give the vagifem a bit longer but maybe swap to Ovestin (from GP) if you still don't feel better.

I've experienced similar. Was prescribed Vagifem.
I used it for 6 months. I've now stopped and swapped to HRT.

When I was using it I experienced what you describe. I found a localised application of a low dose hydrocortisone ointment helped hugely with what turned out to be urethral irritation. If I used it for a few nights the symptoms went away for a bit.

I too went through all the urine tests to rule out infection.

Now I'm on lowest dose HRT.
I still get some symptoms but so much less and with less frequency.

Thank you Queen. I thought maybe I was having a bad reaction to the tablet. I certainly feel a worse than I did before so what’s going on?

I’ve got a gp appointment next week so I shall try and hang on till then. Can’t imagine feeling much worse than this though :(

Thanks Cooking. It’s not just the urethra irritated but inside as well.
I’m an emotional wreck with it all.

I’ll see what doc says next week but tbh don’t think she has much clue.

You do understand vaginal atrophy don't you? Has your GP explained how Vagifem works?

VA affects the urethra, bladder and vagina. All rely on estrogen to keep them happy and working. Without it, they get dry and sore.
Vagifem and Ovestin put it back. The dose is daily for 2 weeks then twice a week after that- forever - or it will come back.

Are you sure that the discomfort now is due to Vagifem and isn't the symptoms you had before?

You have to let the estrogen get to work- it will be gradual and can take up to 4 weeks and 6 months to make it all go back to pre-menopause health especially if you have not had periods for a long time.

this is a really good summary of what happens and how to treat it,

www.menopausedoctor.co.uk/menopause/vaginal-dryness

Hi Queen. No my gp didn’t explain anything tbh. The appointment was a bit rushed. I knew about it by looking a stuff on the internet. I mentioned it and she said it was one of the options to try, the other being overactive bladder meds.

All I know is that the symptoms, especially the soreness inside is worse than before. It certainly wasn’t stopping me sleeping like it did last night. But maybe I just have to put up with it for now and see if things improve.

Just a thought, are you lying down to insert the pessary applicator? When I started using it I was standing up to do it, like inserting a tampon, and was told this could be the cause of irritation I had. Since I started doing it lying down I'm no longer getting any problems.

How would lying or standing make any difference? It's where the pessary ends up that's important. Some research posted on another meno website said that if you can manage to put it about half way into the vagina and towards the front wall, it help absorption in the bladder.

OP if you still feel really irritated by it in a week, go back and ask for Ovestin. It's a slightly different estrogen and the cream base it's in might be more soothing. It's quite common to feel a bit irritated for a few days with either and also to have some period type pain simply because the estrogen will have a very weak effect on all the tissues in the area until your tissues plump up again.

Thanks Queen. Advice much appreciated.

Interesting Aniseed. I’ll try anything.

When inserting the applicator standing up with the effect of gravity it could be irritating / scratching the tissue.

The applicator is tiny though isn't it- like a matchstick? Not like the large tampon like applicator for creams (or thrush pessaries.)

Yes it it quite thin Queen.

Had an OK day today but I'm feeling a bit worse now. That's weird that things things change, that I can go most of the day feeling OK then later on things get worse again. And yet yesterday I felt grotty all day then better last night.
But its not a quick fix I suppose and I'm only on day 3.

what exactly are your main symptoms?

Hi its hard to explain. I feel sore and uncomfortable/stinging/burning in the vagina but not sure if its just the outside bits or just inside the entrance. Doesnt feel like its high up inside but hard to tell.
Started off with the feeling of needing to wee all the time but this had lessened but I do get soreness/pressure in the uretha especially if I do need to wee and it can feel like I've been holding it in for an hour.

Not sure what cramping feels like any more as its been so long so random aches and pains but probably not related.

I sound like a nutter. How can I explain this to the doctor?

I've had a similar experience. I started the vagifem and had a bad time after the first one. I felt sore straight away, panicked being the anxious person that I am, then was up all night running to the loo.

I decided to try again so I've used 4 now. Too early to say but no improvement and I'm sore and irritated but I am determined to carry on and give this a chance to work.

sounds exactly like VA.

Go back and ask for some Ovestin as well to use externally, which ought to help- or try it instead of the Vagifem internally.

Whichever, give it TIME.

I don't want to scare you but it took 6 months for it to really work on my bladder, though other areas improved much more quickly- in about a month.

Oh thank you so much Queen.

I'll ask about the cream at the docs next week if she agrees. It's sad that the soreness got worse after I started to use the vagifem. Maybe it is just irritating the tissues as you mentioned or maybe its just coincidence. Hopefully the cream doesn't irritate externally as well.

As the soreness is the main problem at the moment I am happy to wait for the other. Well not happy but ykwim. I don't feel like I am going to wee myself any more, which is a bonus.

Its just good to discuss this as I know no one in RL who has experienced this, or if they have they don't talk about it.

And thanks Olives. Not a nice club to belong to.

Queen. You say the symptoms sound like VA but is it usual for them to be worse at some times ie, ok during the day and worse in the evening or vice versa? Or ok for a few hours and then worse again? I know it’s early days for me too but just curious.

I would ask my doc but don’t think she knows much about this tbh. It’s much better talking to someone who has actually experienced it.

If it's happening for you, then it's normal for you!
If it's linked to bladder urgency or pain it's worth being checked for an infection, or noting if it's linked to what you are drinking- acid fruit juice, tea, coffee and booze will all make it sting more. If you don't have bladder symptoms, then I guess the vulva and vaginal burning etc might vary over a day . I don't think there is any 'set rule' for this.

Its not so much the bladder stuff just the pain/stinging in the vag, which is the newest set of symptoms which have got worse since the vagifem. But you explained about irritation to the tissues etc.

Sorry op not trying to take over your thread.

Both Vagifem and Ovestin have ingredients that are in addition to the active hormone. Also, Vagifem and Ovestin are slightly different estriol in Ovestin is slightly weaker and may be worth a try.

I have not used Vagifem but have used Ovestin for around 12 years (eek!)

I had quite a bad day yesterday and another awful night. Pain in urethra etc. I’m at the end of my tether with all this.
Anxiety is playing a big part in my problems. I just can’t think of anything else, which is making my heart pound and I’m unable to relax. I wish I could just forget about it and get on with things.
I am going to ask for some help with the anxiety but I’m not keen on antidepressants because I can’t cope with the side effects on top of all of this.

Try a couple of paracetamol before bed? Not Ibuprofen as it's acidic and may make things worse.

Go and ask for Ovestin cream ans Vagifem is stronger and may not suit you.

I will. I took ibuprofen last night.

I didn’t think using this would do any harm, thought it might do nothing but certainly didn’t think it would make things worse. Might just stop it and see how things go but will discuss it with doc.

Thanks Queen. You must think you’re banging your head against a brick wall with me but I do appreciate your advice. I’m just very upset at the moment.

I've been reading stuff on the menopause matters forum. There's so much conflicting advice on there. Some say you might be allergic to the fillers, others say just carry on and you'll get used to it.

This is my second attempt. I tried one and had a bad reaction to it. Within 2 hours I was sore, up all night peeing and unable to sleep. I think I just panicked as surely it cannot have reacted so quick.

So now I'm trying again. Mornings this time with mixed results. Not sure if I will carry on but need to see doctor.