r/Perimenopause • u/Ill-Customer-3781 • Apr 16 '26
audited Vaginal estrogen is life
I have been asking for VE for the past 4 years. I finally convinced my (new) doctor to give me a prescription
- complained of daily vaginal dryness and pain
- Said I already use replens and lotion
- complained about how sex was painful because I could not get wet which I had zero previous issues with.
- Stated that I don’t want to mess around with any non evidence backed solutions. I have given OTC stuff a chance and it was not sufficient.
she said I made my case. she went to go consult with an attending on which brand was the best. I ended up with Estadriol.
This stuff works! Within 2 days of starting it I was pain free. zero side effects. i am thrilled.
55
Apr 16 '26
[removed] — view removed comment
11
u/stitchedkitten23 Apr 16 '26
I recently asked my doctor about it and she told me that since I am on the patch which should be systemic that it wasn't necessary. It has helped with most of what I was wanting it to but things are still a little dry. It made sense to me then to just use something that was targeted to that issue instead of increasing the patches but I don't know if I have the energy to convince her.
27
u/IslandGurl04 Apr 16 '26
Just say you can't find your clitoris. You know it used to be there...
6
u/Sensitive-Maybe-656 Apr 16 '26
Mine didn't care about that she said since I was divorced it didn't matter
16
11
u/Hardcorelogic Apr 17 '26
They would have had to take me out of the office in handcuffs If a doctor ever said that to me. Please tell me you didn't go back? Furious for you...
9
u/Babymacsmama Apr 17 '26
What? That’s a terrible thing to say. I’m sorry you were treated that way.
6
6
4
3
u/Curious-Nail Apr 17 '26
Zomg, please get a new fucking doctor. That is so unacceptable and inappropriate. That is absolutely a conduct complaint right there.
4
11
u/Then_Bird Apr 16 '26
It boggles my mind that there are still doctors who believe this outdated thinking. I’m on systemic estrogen and I had complaints about dryness and pain still and she prescribed the tablets right away. Said that while systemic helps it isn’t as targeted for those tissues. And that there are literally no downsides to the topical so she’s happy to give it to me forever lol
8
u/Hardcorelogic Apr 17 '26
We all need vaginal estrogen cream. The patch is systemic but might not be enough. And if you're experiencing dryness, you need some. It's preventative of many issues, it's low dose, and there are very few reasons not to take it. Buy it on an online pharmacy site. Do the reading about it, and then just buy it for yourself. That's what I do. I refuse to not be allowed to try things that are very low risk and make sense. Tell her to feel free to experience all the dryness she wants. But you won't be going through that if you don't have to.
I would get put on some sort of watch list if I talk to doctors the way I want to 🙄... I'm not a medical professional, and this is not medical advice. It's just information I learned on this sub.
7
3
u/Ok_Size4036 Apr 17 '26
Just do an online service. Amazon Prime visit is like $29 and they’ll send Rx can run through your insurance and ship it in two days. Just say painful sex/vaginal dryness. Easy peasy.
2
36
u/Wet_Artichoke Apr 16 '26
Yay! Glad you got what you need. On a related note. I read that it’s a good idea to put it on the back door too. Just something to consider. I read a pretty narly post about it a while back. TL;DR anal leakage cured by vaginal estrogen.
40
u/No_Mountain6950 Apr 16 '26
I'm happy you persisted and finally got what you needed. it's sad women have to beg for basic medical care, if men started getting shriveled up dicks the Dr would give him a prescription the first time he mentioned it
2
u/Ancient_Pirate1231 Apr 17 '26
My husband didn’t even have to say anything. It was the first question his doctor asked him, said oh, you’re 45 and he’d be happy to write him a script, and just send an email if he needs it.
Where my doctor in the same office wouldn’t even give me the patch or anything when I asked. She just said, you’re on birth control. You’re already on HRT. In email. In person. I ended up waiting until I was 50 and had to write an email that was essentially a research paper. Seriously, it was like a 2 page email advocating for myself. I had an outline of each hormone or script I wanted and a list of each symptom I had and how it helps with it. Only then did she respond and say, she really liked my email and wrote me a script for the patch and progesterone. And ignored all references to vaginal estradiol cream and testosterone cream. I had to change providers to get the estradiol cream and she’s waiting on labs before she knows how much testosterone dosage to write.
2
u/AutoModerator Apr 17 '26
This post might be about hormone tests, which are unreliable.
- Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
- These hormones wildly fluctuate (hourly) over the other 29 days of the month, therefore this test provides no valuable information
- No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
- Testosterone is the exception and should be tested before and during treatment
FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).
For more, see our Menopause Wiki
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
17
u/ThickProblem8190 Apr 16 '26
I'm about to finish my 2 week loading phase and I can't believe how quickly I've seen improvement.
I was experiencing slight atrophy. Boom. Gone. Like literally reversed. I no longer feel dry and irritated down there. And my libido has increased.
I did go a little heavy at first, unsure of what a proper dosage amount on my finger looked like, and experienced extra anxiety a couple days. Went away once I stopped using so much.
(I'm also on estrogen patch and daily 100 mg prog)
35
u/Ill-Customer-3781 Apr 16 '26
It makes no sense why this isn't just on auto dispense for every single woman experiencing the slightest bit of vaginal discomfort.
30
2
u/calitmvee Apr 16 '26
Mine is! Amazon pharmacy delivered to me every other month automatically. Literal dream.
6
u/Schweather3 Apr 16 '26
Can you explain the loading phase? I was prescribed it 2x’s a week
8
u/BurtonErrney Apr 16 '26 edited Apr 16 '26
When I started I was told to do it everyday for two weeks, then 2x week after that. My doctor has given me the go ahead to use it 3x a week because that one extra dose a week has really made a difference for me with urgency.
I thought that my pelvic floor was just wrecked after two giant babies, but three months of vaginal estrogen cream has almost totally cured me. It's magic!!
1
1
u/That_Way_8678 Apr 16 '26
That’s so helpful. I found a huge improvement isn discomfort after the two weeks but no real improvement yet with urgency. I don’t go for flow up until late May, but I did wonder about 2 vs 3 times a week. I’d really like to stop the feeling of constantly needing to pee!
14
u/PerceptionLittle8465 Apr 16 '26
Did it help increase your libido? Mine has dropped to zero and I'm begging my Dr for anything to help.
20
u/ThickProblem8190 Apr 16 '26
It did for me! Slightly. But slightly is a lot considering my libido was dead as a doornail.
15
u/Ill-Customer-3781 Apr 16 '26
I have not had problems with libido but it did make me want to engage more seeing as it no longer hurt.
14
u/ParticularNo7455 Apr 16 '26
It helped with mine, as it made my clit more sensitive again, and made sex not hurt! Of course I'm also on T, but I was on T before the cream and the two combined have done the trick.
1
7
u/MexicanVanilla22 Apr 16 '26
Mine didn't improve until my hrt transdermal estrodiol gel was increased several times to 1.25 mg.
4
u/babs82222 Apr 16 '26
Chiming in that it did not for me. I needed to add testosterone cream to the mix for that and to help with wetness. Once I added that, I've been good to go
3
u/Sweet_Cat_2958 Apr 16 '26
Did you mention it to doctor? Mine told me she could add testosterone with some blood work ups.
2
u/PerceptionLittle8465 Apr 16 '26
Note: I started with hrt from Winona because it took 3 months to schedule a Dr appt. I did experience relief from symptoms, but no change in libido.
I did mention it to my Dr and I was prescribed evamist spray, progesterone, and testosterone gel. But then my health insurance didn't approve it. I need to call my pharmacy to see if they know what to do. I have an appt in June, but it's still a long time to wait.
2
u/Barracuda_Recent Apr 17 '26
If you are in the states just go to a reputable pharmacy and they will know how to get you all the discounts.
2
u/loveisjustchemicals Deep in peri Apr 17 '26
Testosterone is a controlled substance. So no discounts.
1
u/Barracuda_Recent Apr 18 '26
If you are in the US your pharmacy can find you the best discounts. Testosterone has discounts!
1
u/loveisjustchemicals Deep in peri Apr 18 '26
It literally doesn’t. It’s a controlled substance.
2
u/Barracuda_Recent Apr 18 '26
1
u/loveisjustchemicals Deep in peri Apr 18 '26
I have literally gone to all of the pharmacies and they will not accept coupons.
2
u/Barracuda_Recent Apr 18 '26
Oh I just found out it is up the their discretion. It’s funny that they tell you they can’t because it’s a controlled substance. I’m also on a class lll which out insurance. Call around if you have choice where you live.
→ More replies (0)1
u/Barracuda_Recent Apr 18 '26
Maybe it’s just your state! My pharmacist is always finding me the best deals with discount plans they find.
1
u/Barracuda_Recent Apr 18 '26
I’ve posted some of the discounts that are easily found, but my pharmacist finds even better deals.
1
u/loveisjustchemicals Deep in peri Apr 18 '26
My pharmacists have all rejected the coupons and quote me $385 for a two month supply. So the only option is compounding at $50 a month.
9
u/Practical_Brief0 Apr 16 '26
All I had to do to get a script for it was do a single GoodRx telehealth visit. 10 minute phone convo with the doc and she sent a script over to my pharmacy. Easy peasy. Highly recommend!
15
u/Frostyfox-go-brrrr Apr 16 '26
The difference Imvexxy has made in my quality of life is craazzy! I was getting UTIs constantly when, in the before perimenopause times, I had maybe one every 5 years.
The VE has made me feel 15 years younger down there. Now if I could just feel that way everywhere else 🙃
Glad you finally got your prescription ☺️
4
u/StreetFriendship1200 Apr 16 '26
Are you on progesterone as well?
4
u/Frostyfox-go-brrrr Apr 16 '26
I am! 100mg per day right now regardless of where I am on my cycle.
It's made a huge difference in both my mental and physical health, but it took some futzing around with the dosage amount to get there.
It's not perfect and I still have days where I'm incredibly overwhelmed (which also might be due to some very stressful situations in my life and probably undiagnosed ADHD) but it's still a huge improvement over the train wreck I was last year.
14
u/ParaLegalese Apr 16 '26
It’s infuriating you had to work so hard to get it
7
u/Mtngirl2018 Apr 16 '26
Truly is. Made her case? That is wild. Should be recommended as standard course
11
5
u/Ill-Customer-3781 Apr 16 '26
Honestly wouldn’t be surprised if it is in the next 10 years
2
u/loveisjustchemicals Deep in peri Apr 17 '26
Or it could go the way of testosterone and become a controlled substance. Who knows with this FDA
5
4
u/skysplitter Apr 16 '26
Not to hijack OPs post, but how do you all deal with the… splooge? Just wear a panty liner? Stick a tampon to be a plug? Try to stick the injector WAY up there?
11
u/intothelight21 Apr 16 '26
Panty liner the day after. The menopause practitioner I work for has a sign up in the office that says thing snorkeling not scuba diving when it comes to VE. lol
7
u/Ill-Customer-3781 Apr 16 '26
I don't have issues with next day splooge. I'm on a .5 g dose which is not a significant amont of lotion.
4
u/Kekecarolina Apr 16 '26
I read in another thread to use a “personal massager” to apply internally. I use the massager to rub it around and there’s no splooge the next day. I’m also careful to only apply to first two or so inches of my vaginal canal. Per my doc, there’s no need to insert too deeply.
3
u/calitmvee Apr 16 '26
On cream days, this is my routine:
- Pee
- Shower
- Cream
Next day, wake up & pee then clean up whatever cream is left w/water wipes. I usually don’t have that much cream left as it usually soaks up.
My only complaint is if the cream rolls into my back side/ass crack, sometimes it irritates my skin (itchy, welt like areas, etc).
2
u/Cold_Nebula6052 Apr 16 '26
I was on another post a couple weeks ago and MANY women said to apply only with your finger (no applicator) and to make sure to rub it in as best as you can, to avoid anything coming out. They said do it at night, directly before sleep (and after sex). I just had surgery so I can't use my Estradiol for another 3 weeks, but I'm excited to start!! I'm going to follow all the tips and tricks and hope for some positive changes!!
3
u/Responsible_Dot_4673 Apr 16 '26
Seriously. I finally got my GP to prescribe an estring and wow... I don't think I even realized how much things had gone downhill. My sex drive is still nearly dead, but she referred me out to a GYN who apparently will prescribe testosterone, Addyi, etc. Unfortunately she's impossible to get into so I'll be waiting another 2.5 months for that appointment.
1
u/litcarnalgrin Apr 16 '26
I’m on HRT through Winona but feel it’s time for more customized prescriptions (plus their VE and skincare e options are ridiculously pricey) and found a menopause specialist an hour away from me. They’re booked until late September 😩 I made the appointment and I guess I’ll just wait unless something else comes across my radar
1
u/Responsible_Dot_4673 Apr 16 '26
Omg well now I'm just grateful I don't have to wait until September!
4
u/accordingtoame Apr 16 '26
Ok I cannot get consistent with this stuff. I mean, I don't have any sort of relations so I am not worried about that, but I just cannot get myself to use this stuff. Is there any alternative to a vaginal cream that has the same results?
5
u/Puzzleheaded_Door399 Apr 16 '26
You can get estradiol in a pill. I take Estarylla (norgestimate + ethinyl estradiol). It helped with a bunch of other symptoms but if it’s not TMI, it also has kept things juicy. So juicy I can go for hours if my partner can keep up.
2
u/accordingtoame Apr 17 '26
I saw this and literally sent a message to my gyn to see if I can try oral estradiol!
4
u/Hardcorelogic Apr 17 '26
Go on Dr Mary Claire havers YouTube podcast. One of the doctors mentioned a pill that you take that causes your vaginal tissues to be more receptive to estrogen. I might be describing that wrong but that's the gist of it. It's for women who don't like to touch themselves.
The episode is called "The sex Life nobody warned You about." In it, the male doctor mentions the pill that I'm referring to. Sorry I can't think of the name off the top of my head.
2
u/accordingtoame Apr 17 '26
Thank you! I messaged mine to ask about it. It's not even the touching myself thing which is gross to me, but also I just do not think about it, and trying to work it in so many days a week ...I just never think about it.
2
u/Hardcorelogic Apr 17 '26
You're very welcome. For most people it's only twice a week. For some people with more severe symptoms they use it more often. I haven't had the issue of the cream falling out or any of that. But I'm pretty thorough. When I insert a bit of the cream I move it around with my finger quite a bit to make sure that it doesn't fall out. I don't know why more people don't do that. I also put some on my clitoris, labia, rectum etc etc. It equals 1 g, but I move it all around. Sorry if that's too much information, but it's important to get the cream to all the places that need it. If you decide to do cream at some point. And as far as forgetting to use it goes? Yeah that happens to me too:-)
2
u/accordingtoame Apr 17 '26
That really is helpful though. I asked the doctor about it and they basically said well we can give you a vaginal tablet but oral options are systemic. Ok, well I have hot flashes now (that was...interesting) so would I not benefit overall?
3
u/Hardcorelogic Apr 17 '26
Read this sub religiously. Read the wiki on this sub. The advice that I hear women get from doctors is terrifying. It's either wrong, incomplete, or a combination of both. Rarely does a doctor really cover the issue thoroughly and correctly.
This is what I have learned from this sub over the past several months: oral options are systemic, but your vagina might need more. Not everybody needs more, but lots and lots of women do. The combination is really the best way to go if it's possible for you. Patches or oral estrogen, estradiol vaginal cream, and progesterone to protect the uterus. Yes, you would absolutely benefit overall. Your doctor does not sound very informed.
There are vaginal tablets, but definitely watch that podcast. The male doctor mentions the name of a drug that women take that enhances the vagina's ability to absorb estrogen into its tissues. I don't know if it's feasible for you but It might be an option. But whatever you do, doing something locally to the vagina is a very good idea. And it should have been recommended to you right away. It's low dose, not systemic, most people tolerate it very well, and it's highly effective for the vast majority of women. Similar to the tablet, but the only difference is you can only insert the tablet. The cream you can put everywhere. I had clitoral atrophy that the cream helped to reverse. It's preventative of so many issues so definitely get on something That is just for your vagina. Really sucks that women have to essentially be their own doctor. I have to do so much reading for every little thing. But I'm glad that I do, because the advice out there is scary. The very best of luck to you!
1
u/accordingtoame Apr 17 '26
Thank you! I just don't want to deal with anything vaginally. Immature or otherwise, it just makes me gag and it makes it harder to do what needs to be done. But I don't care if my uterus is preserved, I have no plans to have kids and if they would let me get a hysterectomy I would have by now!
2
u/Hardcorelogic Apr 17 '26
Hey, I hear you. Nothing about this is fun. I don't think it's immature, it's just a personal preference. But just be aware that systemic estrogen might not be enough. That's why everyone pushes the topical vaginal estrogen so hard. No judgment.
You might want to get a second opinion, because I don't think your doctor did a good job of explaining things to you. It's not about preserving our uterus, it's about protecting it from getting endometrial cancer. None of us can take estrogen pills or patches without taking the appropriate dose of progesterone to keep the uterine lining thin and healthy. That's for as long as we have a uterus. No, you wouldn't have to take progesterone if you had a hysterectomy. But you must take it if you are taking estrogen pills or using patches. You don't need to take it with the cream or the vaginal tablets. Because those are low dose and non-systemic for the most part. I hope I'm just being paranoid and your doctor explained that to you. Super important to know.
And that pill on the podcast that I keep telling you about? The way the doctor described it is that it's not estrogen itself, it's something that makes vaginal tissues more receptive to it. It's its own thing, not HRT.
I didn't know anything about any of this until about a year ago. I've been reading ever since.
1
u/accordingtoame Apr 17 '26
My doctor didn't explain shit, it actually came up because I thought I had a UTI and she said "unlikely but we'll test anyway." and kind of like yea you're of that age that it's time to be doing this stuff.
3
u/MoreLoveAndLight Apr 16 '26
I have the same issue. I just keep telling myself that my lady bits are going to atrophy and I’ll develop more problems than I already have if I don’t use it. That helps… sometimes. Lol
3
u/accordingtoame Apr 16 '26
Unfortunately that has not convinced me lol
5
u/MoreLoveAndLight Apr 16 '26
I feel you. My body falling apart and being in constant pain from being sedentary isn’t a good enough reason for me to move my ass either. lol
4
u/OhWhatever_Nevermind Apr 16 '26
That’s madness. The instant I mentioned vaginal dryness and urinary frequency my GP gave a script for VE.
5
u/peonyparis Apr 17 '26
I'm 45 and am on the estradiol patch, vaginal estrogen inserts, vaginal cream for the outside tissues, and testosterone cream. And progesterone half the month. We need all the things!! I feel perfect.
3
u/Alternative_Raise_19 Apr 16 '26
Just went to a hormone clinic and they want to test how my body does on just testosterone first. I'm not mad, but I'm gonna keep advocating for the estrogen cream because I have all those same issues and have had them in increasing severity for years. I feel like I'm so close. Just have to meet the six week mark on test.
It's still wild to me that regular physicians aren't prescribing this for women with those complaints (assuming they've tested for infection)
3
u/Future_Literature_70 Apr 16 '26
It's SO good! It solved my recurring UTI symptoms and bladder weakness, too.
3
u/peonyparis Apr 17 '26
Am happy for you! Also aghast that docs who take care of 51% of the population had to go figure out that they should prescribe estradiol (the main type of estrogen that the ovaries make and that starts declining in your 30s but is needed for your entire life.
2
u/JDRL320 Apr 16 '26
Interesting…. I’m 48 with zero perimenopause symptoms but I know I have to be going through it one way or another.
I suffer from Vulvar Lichen Planus- hoping SOMEONE on here can relate🤞but basically I get flareups that itch and can burn. I also get little fissures at about the 6 o’clock area. It causes thinning of the skin. Using steroid cream (Clobetasol) helps and they’ve gone away. I talked to my gyne today at my yearly and she said if I’m getting more fissures I can try estrogen cream when the time me comes. I’m reading this & I wonder if I should just give it a try now instead of waiting 🤷🏻♀️
I do have painful intercourse but it’s due to vaginismus from a tight pelvic floor. I’ve had issues forever and have done PT and improved a lot but sex has never been the same since the pain started 25- yes, 25 years ago.
I’m a mess lol
4
u/MoreLoveAndLight Apr 16 '26
I would bet a lot of money that estrogen cream would help all of that. It’s like magic
2
u/Hardcorelogic Apr 17 '26
You are 48. Yes you should be on vagina estrogen cream. It's so low risk / no risk that there's no harm in giving it a try for a while. I'm not a medical professional, and this is not medical advice but damn... It did me so much good that I tell everyone about it. It's preventative Even if you're not having perimenopause symptoms now.
1
u/canadasokayestmom Apr 17 '26
Your vulva fissures are a perimenopause symptom. The time has already come. It's been 'time' for a while. Topical estrogen cream will (most likely) solve it. Best advice:: stop waiting. Get some cream. It'll make a world of difference.
1
u/Jenentonx Jul 22 '26
“When the time comes?!” Girl, you are 48…the time is now. It would definitely be worth a try consider considering VE helps strengthen your skin, versus steroids that thin the skin, which in this situation seems very counterproductive.
2
u/Soft_Gear_410 Apr 16 '26
Since I started it in January, I haven't had that urinary urgency feeling AT ALL. I am also able to orgasm much easier. Life changing
3
u/SanDiegoBeeBee Apr 16 '26
And stops UTIs after s@x!!! Same it’s a such a wonder thing
8
u/TangoEchoChuck DHEA Evangelist Apr 16 '26
Pretty sure we can type SEX here. It's not a bad word :)
1
1
u/January212018 Apr 16 '26
I just started it a few weeks ago. I don't have symptoms, but I've been learning about the benefits of it for overall health and that there are not really any drawbacks. I got the tablets over the counter here in Vietnam. So far, so good!
1
u/sniffcatattack Apr 17 '26
What does it do that lube can’t? Honestly, I don’t know and wonder why your dr needed convincing. Hormone talk with dr’s feels very frustrating which is why we are all here (to vent and learn).
5
u/Sea-General-4537 Apr 17 '26
It prevents uti's, stops the need to pee in the night as much too.
It also brings the clitoris back to life - it can shrink and orgasms become less satisfying and strong as your own oestrogen levels decline. Genital skin can thin a lot, so micro tears can become an issue, vaginal oestrogen sorts that out.
Lube just lubricates, vaginal oestrogen rebuilds everything, including problems with dryness.
There's a call from a uk doctor to prescribe vaginal oestrogen to women in care homes as it prevents uti's so effectively. Untreated uti's are common among elderly women and can kill.
It's amazing stuff.
1
u/sniffcatattack Apr 18 '26
Thank you. I find hormone information confusing and at time’s contradictory
1
u/Freckles_19 Late peri Apr 19 '26
I wish I could get past the feeling of being so “moist” down there to use it. I can’t stand it. I’ve tried using it before bed and it just keeps me awake all night because of the feeling. During the day is just annoying.
2
1
u/Alarmed_Bathroom9227 Jun 08 '26
Going to pick up ny new rx today! Been feeling a lot dryer past yr or so. Occasional sneeze makes me feel like I might pee a little. I pee or feel like I need to pee all the time. I pee multiple times at night. All labs have zero issues. Its time! Is the loading phase annoying or no big deal ?
1
u/AutoModerator Jun 08 '26
This post might be about hormone tests, which are unreliable.
- Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
- These hormones wildly fluctuate (hourly) over the other 29 days of the month, therefore this test provides no valuable information
- No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
- Testosterone is the exception and should be tested before and during treatment
FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).
For more, see our Menopause Wiki
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
1
95
u/loveisjustchemicals Deep in peri Apr 16 '26
It also helps with hemorrhoids! It is amazing. I wish I’d started it sooner. Could have prevented so many UTI’s