I saw my doctor last week and she said she had just been to a menopause seminar where the continual use of vagifem was discussed to treat VA.
She said that there have not been any long term effects and that patients could use it twice a week for an indefinite time .
She also said that if a patient stopped taking it the recurrence of VA could be severe and much harder to treat going forward.
I asked about the Mona Lisa laser treatment but she had not heard of this.
My Ob/Gyb had not heard of this either. It makes you wonder how they much they are keeping updated! Major institutions are starting to use this. I can understand why some clinics are still waiting for more data, but never having heard of it I think is not a good sign.
Sorry to be so cynical, but do you know if it was vagifem or a company with a financial interest in products like vagifem who ran the seminar? Again, I apologise for being cynical, but I can't understand why vagifem would put warnings all over their site saying about the risk of using it and saying it should be used for the minimum possible time if there was no risk. It baffles me why a GP would say thre's no risk for an indefinite time, but then if someone does use it and then stops they are likely to have severe problems, possibly worse than they would have done without using it? Implying that someone needs to start on this and use it forever, which is totally against the directions on the vagifem site? Am I understanding this correctly though? I'm wondering if I've got the wrong end of the stick?
I totally agree with you Chris. Sounds like there may be some self interest going on at the seminar from a pharmaceutical company. I have come off Vagifem expecting some kind of repurcussions. There have not been any. As long as an alternative remedy is sought, there is no need to agree with the doctors.. Linda once you have VA you have it for life so I am not sure what you mean my re-occurrence, but I can certainly assure you that I have had no repercussions and I would advise you to read up on the side effects of long term use. Where is that doctor getting her statistics from?
I've been told the same about Ovestin by a specialist, if I want to continue. Every medication has risks attached and it's good to be informed but each individual should assess them for themselves as each case is different.
Linda, are you in the UK or US? Wonder if that makes a difference in what doctors are aware of. Secondly I would want to know exactly what was meant by "long term". As scientists they should be using exact language; the doctors attending the seminar should been given and required facts. And thirdly how she could not have heard of the Mona Lisa treatment if gynecology is her specialty when we all know about it? Doctors are pressed for time and a good deal of their off time is spent reading the latest findings in their fields. If any gynecologist in the developed world has not heard of the Mona Lisa treatment I would question their competence. Did you mention that it was a laser treatment? Could it be that the name is the issue?
Of course, is there is no pharmaceutical salesperson in their ear pushing it the way they do drugs. But I should think someone would be pushing the equipment. To be completely ignorant of it is scary to me. We put our bodies in the hands of these "experts".
Chris, you are not being cynical, you are being responsible and smart. More than can be said for a lot of doctors. My last GP (who unfortunately left the group) would google right in front of me. I loved him for that. No pretense. We got along great and actually laughed quite a bit. It's the thin skinned ones you have to be leary of.
We should start a mini campaign here and have everyone who posts ask their gyn's about the Mona Lisa and let us know their responses. I'll not be seeing mine for at least 6 months so I can't contribuite anything pertinent. But when I last saw her she said that using Premarin cream (which she prescribed, but I chose not to use) was very safe. I believe she even said it was given to women with history of breast cancer.
I absolutely agree Tracy - you read up on it, you read manufacturers instructions for use as well, and then make up your own mind. An informed decision is the best we can do for ourselves. I was SO stupid - I accepted my GP's word that it couldn't hurt me! That was something I (thankfully!) lived to regret.
Yes, this thing about VA being harder to treat puzzles me too. I was on it for 16 months a triple the recommended dose, but never felt it was doing anything to help, and when I came off it and started using the balance active menopause plus pessaries they did more for me than the vagifem ever had. I've a feeling I was either allergic to something in the vagifem or the applicator was causing problems because I used to get a bad discharge with it but all my GP did was put me on a higher dose, which gave me even worse discharge but I don't get discharge now, even though I've got a prolapse pessary, as I had then. I don't know if it's because the prolapse pessary is made of a different product or if it's because I'm not using vagifem!
Hi linda. Well I don't believe there won't be long term
Effects. That's what docs said in the 90,s about hormone therapy then recanted.
Also her not knowing about Mona Lisa gives me pause
I do like the sound of a doctor who is prepared to look something up rather than arrogantly tell you they know it all. Something very weird still puzzles me - when my GP knew I was having the hysterectomy because of endometrial cancer after I'd had triple the recommended dose of vagifem for 16 months, she wrote to the consultant at the hospital that I was under and asked if I could go back to vagifem straight after surgery! I wouldn't have touched it with a bargepole, so I'm still trying to puzzle out what she was thinking of achieving by asking the question. The consultant told me clearly what the answer was - NO! I can only wonder if she was thinking if they said yes, it would relieve her of any guilt about prescribing it.
Hi Chris: I so agree with you ... we have to monitor ourselves and doctors are to be questioned.... they are not aways or even sometimes right. I want off this premarin.... checking out mona lisa after christmas.... at my wits end with Uti and yeast infects (Yeast I believe from the premarin)..
I am also cynical BUT having used Ovestin for about a year I had to come off it I February due t having unrelated surgery. Because the UTIs had stopped I didn't restart it until I had a bad flare up in September. I'm back on Ovestin twice a week and my GP wrote to the Royal Marsden (cancer hospital) where I attend a breast cancer family history clinic annually. The reply from a breat consultant was that she " would have no concern about my continued use, whilst there is some systemic absorption there is no strong evidence that oestrogen only HRT is associated with an increased risk of breast cancer. If anything women n oestrogen only have a slightly lower risk of breast cancer". I'm not totally comfortable with using it but........ I had a hysterectomy ten years ago so at least am not at risk of endometrial cancer.
This Mona Lisa treatment really sounds so interesting. It wouldn't be any good for me because I think prolapses rule it out, otherwise I'd be tempted to go to the States for it! Having said that, the coconut oil sorts my mild issues out, so it's not that desperate for me.
Yes, I think the biggest risk with estrogen is certainly endometrial cancer, but my gynie did ask me if I'd had a mammogram to check that aspect out. If I understood it rightly, it's the progesterone that is linked more to breast cancer? But the progesterone stops the estrogen causing the endometrial cancer. But because you don't have a uterus you're safer to use estrogen.
On the note of yeast infections when I mentioned this to the specialist he said sometimes you it can be resistant and needs a longterm treatment. If I get another within 3 months he recommended 6 weeks of continuous treatment which I believe he meant using the tablet weekly.
Why is it most doctors have never heard of the mona toich treatment?I find it amazeing how they dont research new trestments,they do have computers dont they?Also I guess once a person starts any form of hormone treatment according to what the doctor said they should be prepared to stay on it for life or even get worse.This despite the fact that most feel it should be used for the shortest time possible.Very confuseing.
By the way i have been to two gynos at a world renowned hospital in the US and neither of them heard about it.They know about it now..because I told them.They both were going to look it up.Pass the word!!
I get the feeling that doctors restrict themselves to courses they are sent on and it takes years for new treatments to filter through to the NHS. I thought that hormone treatment was supposed to IMPROVE the skin of the vagina, so if someone stopped it they would presumably be better off than if they'd not used it (the studies on hyalaronic acid give the impression that the skin is in better condition at the end of the study as it has IMPROVED) so I just don't get it. Vagifem talk about using it for the shortest possible time, so they must be expecting it to deal with a problem so someone can then stop taking it, and then start again if the problem recurrs?
I had read many women go on it and come off it then back on according to need.
That was how I used it in the early days when the VA was mild an 8 month course and my symptoms dissappeared for quite awhile. But it usually does return eventually once your oestrogen levels decline again. As your usually menopausal I doubt it will improve only stabilise for a period of time.