I am post menopause and use vagifem twice a week but i have a persistant ich and dryness in my nether region and it actually keeps me up at night. what can i do about this as it is becoming debilitating.

Menopause/dry, itch: If you are not as yet over five years past menopause, taking low dose estrogen orally may improve your symptoms. The medical literature has supported taking estrogen at this point. Ask your gyn provider about this, as there are many types of remedies which are now possible.

Talk to doctor: In t he meanwhile, try avoiding using vagifem for a week to see if this reduces or resolves the itching. If the answer is yes, you are allergic to one of its ingredients. The excessive dryness also suggests that your vagifem dosing may not be sufficient. One way or another, this should give you some idea. See GYN again if not better.

Get a GYN MD exam: The itching/dryness may be a result of a vulvovaginal infection or other vulvar dystrophies. Your GYN MD can evaluate them all with an exam and testing.