Ladies only!

[Catwifie]

After my HA in November, Dr's stopped my Vagifem pessaries. I thought they were just a localised treatment and not systemic...anyone else had this advised? Can they restart at any point? Noticing their absence!!😤🥺😢

[Lowerfield_no_more]

The likely reason your cardiologist stopped your HRT is because there is a slightly increased risk of heart attacks and strokes for women who take it, and you are already at risk due to your history. And the HRT method you were using is generally for localised treatment. My wife takes an oral form of HRT, and she was told that if you stop taking it then restart the risks are increased and the body struggles to cope, and since she only has grudging agreement from her GP to prescribe it in the first place, she thinks it unlikely the GP would prescribe again if she ever stopped it. However whether the latter applies to local HRT treatment is an unknown. I suggest you discuss with your GP.

[Catwifie in reply to Lowerfield_no_more]

Thanks for your reply. I know the reasoning behind the decision and the risks associated with oestrogen . I think I'll ask my cardiac rehab nurse..she may know if it can be restarted...fingers crossed!

[Happyrosie]

I’m a bit surprised. Find out if there acceptable alternatives.

[Shabana1974]

I take Elleste duet 1mg it's lowest dose and that's working for me. My doctor said if needed they can increase but honestly I feel better on the lowest dose so at the moment leaving it there.

[VelvetSky]

I have taken Indivina HRT for over 30 years, I appreciate the risk but after a heart attack in 2017, told go home dear it’s only indigestion and then another in 2019, had a stent fitted. I decided to continue to take it after having discussed it with a gynaecologist. I have other co morbidities, it’s probably a question of what will get me first. I would have thought that Vagifem was a very small dose, localised HRT. I would question it, he is being over cautious. Also he is a man and they sometimes do not appreciate how things affect a woman. Only you can decide, perhaps get a second opinion from a gynaecologist. Good Luck!

[APC65]

I was taken off my oestrogel and progesterone after CABG for three months - was told by cardiologist I could start them again after the three months mark... Which I have and no problems.

[AuntyEdna]

Hi My experience- I took Vagifem for years Nurse took me off it claimed I didn’t need it anymore. Then Micro Vascular Angina ramped up, bladder and bowel prolapsed and hot flushes returned! So I’d say if you think you need it you need it keep plugging away to get some sense. So I’m back on it soon - after prolapse surgery. Good luck take care 😊

[scentedgardener]

Vagifem is a very low dose, I had it for a time and reported some unwanted side effects to my GP who told me it wasn't possible to get side effects from such a low dose.Can you check with your cardiologist, ask his/her opinion on the advisability of usibg it.

[Catwifie in reply to scentedgardener]

Yes..I'll ask through my rehab nurse..I think she's in frequent contact with the cardiologist. The fact that it's effectively like a topical cream surely can't be a huge risk!

[scentedgardener]

That's what I think too, but it's a difficult one.I recently had a steroid injection in the sacroiliac joint, and pain everywhere is much relieved, much to my amazement. As I was very doubtful that it would work at all I haven't talked myself into seeing an improvement that isn't there.

[Poppy451]

I took localised estrogen for awhile (estradiol- ovestin) but found my chest pain increased significantly. I kept going for a couple of months but had to stop because of the chest pain. Very strange as it was only 1mg pessary but it still effected me alot. I was really annoyed.

[Catwifie in reply to Poppy451]

Crikey! You wouldn't think a wee pessary would have that effect! Hormones are tricky!! I think I'll ask my pharmacist as well as the Cardiac team

[fishonabike]

this is a tricky area and at the moment too many decisions about HRT are being made on insufficient evidence by people who are not necessarily weighing up all the risks and benefits - they are not the people who live with the effects of their decisions

i feel it is important to consult someone who is a specialist in HRT - they can help you to understand the whole picture for you to make this decision yourself

[Milkfairy Heart Star]

My Cardiologist referred me to a Menopause specialist. He wanted me to start taking HRT as it's beneficial to improving the function of the inner lining of blood vessels.

As others have said it is sometimes a balancing act of risks and benefits of a treatment to improve the quantity of your life. Sometimes a small extra risk is acceptable to some people if their quality of life is improved.

I just wish there was more research available so that women can make a more informed choice.

This consensus document published in the BMJ suggests this:

"HRT initiated before the age of 60 or within 10 years of the menopause is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of estradiol administration. Evidence from the Cochrane data-analysis as well as that from the long-term follow-up data of the WHI showed no increase in cardiovascular events, cardiovascular mortality or all-cause mortality in women who initiated HRT more than 10 years after the menopause."

thebms.org.uk/publications/....

[Catwifie in reply to Milkfairy]

I've didnt take HRT for menopausal symptoms as I had hypertension. just the Vagifem for " genitourinary atrophy "!! I said to the Gynaecologist..I'm too young to be atrophying!! 62 then 🤣 I'll see who I can ask ..Gynaecologist was very good..might start with her and my cardiac rehab nurse... watch this space!

[Milkfairy Heart Star in reply to Catwifie]

Good luck!

[Qualipop]

I've had a heart attack and stents in 2018 . I was given the same vagifem about 2 months ago, hopefully to bulk up the tissues and help support a mild prolapse. No mention of my heart. I would ask your GP. They are a localised treatment so I can't see a problem.

[Catwifie in reply to Qualipop]

That's what I think..I'm in a rural area of West Scotland and we have no GP at the moment..locums instead. Some are loathe to make decisions or dont know! Will put on my matron voice🤣 ..retired District Nurse 🤣🤣

[Qualipop in reply to Catwifie]

I had asked to go back on a very low dose of HRT because I had an early menopause but the pessaries were all they would give me. GO get em LOL.

[Warm-heart]

Hi, I use Regelle which is good, daily, on prescription. But also have tried Estriol cream .01% which is good but I reacted to the added ingredients. Also there are some good natural products from the US from rootganic.com a site run by a pelvic physio Isa Herrera, I use her Total Fem Rejuvenator Serum (all natural) and Down There Oil which is lovely. Both have rejuvenated my tissues to the surprize of my gynaecologist. Another thought is to ask for the Vagifem Cream so you can place a lower dose inside instead of a whole pessary tablet?

[Foxly]

Hi - my doctor stopped my HRT pessaries as well - to be honest I havent missed taking it, symptoms not as bad ( not sure why as I took it for good reason at the time ) and so didnt question it....

[Hidden]

I took HRT for over 30 years (now 79) happily then got a very early breast cancer in 21, so stopped cold turkey!😭and experienced all the associated side effects! I had a lumpectomy but no lymph node involvement, so was put on aromatise inhibitor-Letrozole-terrible side effects, I was so stiff and achy joints,I felt and acted as though I were 95! I said no, I am now on Aromasin-just-as I have decided it's quality rather than quantity at my age! I take it twice a week. No oestrogen means all sorts of issues, dry wrinkly skin, heart problems, high cholesterol, my thyroid is all over the place, osteoporosis-shall I go on? Oestrogen helps prevent all the things! It's a balancing act and we have to follow our heart, whatever is right for you. The Oncologists want you to be obedient and do as the say, the cardiologist only looks at your heart, the Endo only at you thyroid-it's a juggling act and we are piggy in the middle! Read all you can about your issues and follow your gut thinking.

[Newstart3]

You have certainly raised an interesting question Catwifie. 🤔 please let us know how you get on ... I'm really interested to know what they advise you. There seems to be quite limited research in this area as Milkfairy has said. Even among medical professionals there seems to be different opinions. Like you, my first thought was that it wouldn't have much of an impact and would therefore be safe to use but I don't know.

[Catwifie in reply to Newstart3]

Will do..Will speak to my Rehab nurse tomorrow

[Newstart3 in reply to Catwifie]

Thanks and good luck.

[Astronomyrules]

Hi Catwifie, I've just read your post. I've have been on twice weekly 10 microgram dose of Vagifem/ Vagrilux for at least 15 years despite extensive CHD and PAD. Full blown HRT is untenable, but my GP , many cardiologists and an oncologist who have cared for me have all been content for the pessaries due to the low dosage and localized action. I experienced no problems although I now also use a steroid cream in addition. This has been my experience and I hope that you do find a GP who is sympathetic regarding your symptoms. You seem to have a good strategy for seeking a number of opinions to support you in this quest. Good luck.

[Hidden]

The regional NHS medical commissioning group should have an intermediate Gynae clinic, which specialises in all things gynaecologist, from pessaries for prolapse and continence, to hrt and contraception usually run by local female doctors, separately from the GP surgery. Ask around, and you can make an appointment directly-you don't have to be referred.

[Catwifie in reply to Hidden]

Is that NHS England? I'm near Glasgow

[Hidden]

Yes, but it may have been rolled out nationwide-worth checking!

[Qualipop]

I was given vagifem last year, the only thing my GP would consider and I was told they are localised, definitely not systemic and perfectly safe. They are on my repeat prescription. I still use them- no reason not to. I had asked to go back on HRT that I had to stop 25 yrs ago but she wouldn't even consider it. I wanted progesterone not oestrogen.