Vaginal HRT
Moderator: talkhealth
Vaginal HRT
I have been using Vagifem pessaries for vaginal atrophy,over a two year period,on and off. As I still have uterus,how safe is this? I didn't have dryness,but had an unpleasant smelling discharge. Swabs revealed no bacteria were present and on clinical exam Atrophy was diagnosed. I now use Vagifem once or twice weekly.
- Mr. Hugh Byrne, MRCOG
- Posts: 186
- Joined: Fri Mar 16, 2012 12:21 pm
Re: Vaginal HRT
Ideally you need progesterone to oppose the estrogen, otherwise the estrogen you are absorbing throught the vagina will stimulate the womb lining to overgrow. I would advise occasional estrogen use if you need it, estriol cream 0.01%, but only every 2-3 weeks. To reassure yourself, I would also advise and ultrasound of the womb lining and perhaps a biopsy if it is thickened. Also, beware in case the discharge is a sign of the womb lining overgrowing.
Mr Hugh Byrne
Consultant in Obstetrics and Gynaecology
St Georges Hospital
http://www.talkhealthpartnership.com/online_clinics/experts/mr_hugh_byrne.php
Consultant in Obstetrics and Gynaecology
St Georges Hospital
http://www.talkhealthpartnership.com/online_clinics/experts/mr_hugh_byrne.php
Re: Vaginal HRT
Thanks for advice. I had a scan and biopsy a few years ago,before I started the pessaries,and it indicated a slightly thickened endometrium. Consultant told me to return if I had any more vaginal bleeding,which I haven't done. My GP prescribed the pessaries for treating the atrophy. I've been using them intermittently over a two year period. I think I will stop them.
- Dr Sarah Gray
- Posts: 27
- Joined: Tue Aug 14, 2012 10:27 am
Re: Vaginal HRT
I would disagree as there is no evidence that the very low dose of estrogen in vagifem will have any stimulant effect on the lining ot the womb with twice a week use. Addititional progestogens are not necessary.
It is possible that the change in smell relates to insufficent estrogen to restore the natural acidity and organisms to the vagina.
It is possible that the change in smell relates to insufficent estrogen to restore the natural acidity and organisms to the vagina.
Dr Sarah Gray
Primary Care Lead for NHS Cornwall for Women's Health and Cancer
Primary Care Lead for NHS Cornwall for Women's Health and Cancer