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[cjmca]

I'm really sorry if this comes off as a rant and a rave, but I need to say this to someone who gets it!

I posted quite a few weeks ago about bladder (at least I think it's my bladder!) pain and urinary urgency.

I started on Vagifem and within 4 days the terrible pain I had when trying to lie on my side just disappeared. But I was still getting the "I have to pee and can't wear tight clothing and can constantly feel my bladder" pain. This also subsided over the past few weeks, to the point I put my skinny jeans on, pain free! I can't express how ecstatic I was about this - cried for an hour when I put those jeans on and pranced around my apartment in them like a total wally!

But yesterday, the pain came back. I have been very regimented about taking the utrogestan 100mg daily (no break), changing the Estradot 50 patch and using Vagifem and the Ovestin cream.

This may seem like overkill, but I actually have had Premature Ovarian Failure since my 20s, so technically not menopause. It's documented that women with POF need more estrogen than menopausal ladies, and I've certainly discovered that now.

My gynae has said to use the Vagifem every day for 4 weeks rather than 2, then reduce to 2-3 times a week. I started reducing 5 days ago. Unfortunately around the same time I've had a bleed as I missed 2 utrogestan tablets. I've been bleeding for 4 days and have never bled this much. Is this normal?

When my symptoms initially started improving, I'd actually use Vagifem morning and evening, and every second day switch a Vagifem for the Ovestin cream. 

I just can't believe the level of pain I'm in today. I'm presuming this is because I've made a horlicks of my meds. I'm now got a big supply of utrogestan and I won't run out! But jaysus when will I stop bleeding... and will I just use the Vagifem forever more!

Also, my eyes are completely dry. Which is really bad as I have lens implants in my eyes and don't want any dry eye problems. Have any ladies used testosterone cream/eye drops to help with this? I think I might have set this off when I missed the 2 progestin tabs - and st the same time we upped my Estradot patch. I read that high estrogen and low testosterone leads to dry eye. I'd no idea that eyes need testosterone and that high estrogen can actually dry your eyes out...!

Why are our bodies so crazy?!

I just want to feel almost pain free like a did a few days ago. This is hideous and I hope it goes away again like it did before. It took consultants 5 months to figure out what was causing my bladder discomfort, even though POF was written all over my medical file. A top urologist in Ireland put me on amitriptylene, a muscle relaxant and wanted me to get a nerve block in my spine.  Surely he should know the bladder is full of estrogen receptors?!

I'm angry, upset, scared, in pain and hormonal as hell. And absolutely sick of idiotic consultants.

Sorry for ranting. Please someone tell me I'll get over this blip 😥

[CLKD]

You will!  At least when your hormones settle. 

There are products to use for dry eyes.  As oestrogen levels drop so the body dries, inside and out: vagina, skin, eyes, deep in the ears ……. so having a good cleansing regime followed by liberal use of hand cream etc. may help.

What have you taken for the pain?

 

[Dancinggirl]

cjmca
You have mentioned that you are using an oestrogen patch and Utrogestan daily - do you take the Utrogestan orally?
How long have you been using the systemic HRT and local oestrogen - it can take some months for any HRT regime to settle.  Unfortunately many women find the Utrogestan or any progesterone taken every day can cause side effects e.g. problematic bleeding and bladder issues - this is why many women choose to stick with a sequential HRT regime and put up with a monthly bleed. Missing the Utrogestan for even a day is likely to result in bleeding so don't worry about this.

In my experience, urinary urgency and the burning urethra has to be managed with a whole range of strategies.  HRT and local oestrogen is vital but avoiding tight clothing is also essential - tight trousers will make the area hot so encourages the burning and discomfort. Vaginal moisturisers like YES or Sylk will also help keep things healthy.  Take showers not baths and never use anything scented to wash with - so don't wash you hair in the shower or the shampoo will get to the ‘lady bits'. Avoid caffein, fruit juices, alcohol and anything that will make your urine acidic.  Drink plenty of water each day and if the burning starts then drink a small glass of water with half a teaspoon of bicarbonate of soda to neutralise the urine and ease the discomfort.

I'm afraid there is still very little understanding among the medical profession of how distressing menopause symptoms are and the connection between the meno and bladder problems is rarely picked up on - it's all very depressing.

Give yourself time - you are doing the right things and hopefully you will find a balance. DG x

[cjmca]

Apparently estrogen does the opposite with the eyes - too high estrogen and not enough testosterone can lead to dry eyes. You can get testosterone eye drops in the US, but in Ireland it's a different story! I don't take anything for the pain, as nothing touches it. Just have to wait for the hormones to balance out again, hope things will return to how good they were 3 days ago 😌

You will!  At least when your hormones settle. 

There are products to use for dry eyes.  As oestrogen levels drop so the body dries, inside and out: vagina, skin, eyes, deep in the ears ……. so having a good cleansing regime followed by liberal use of hand cream etc. may help.

What have you taken for the pain?

 

[cjmca]

Yes I do take the utrogestan orally.  Is it better to take vaginally? I know a lot of it is lost in absorption into the digestive system when taken orally, but it's not recommended for vaginal use. But in all honesty I'd rather take the advice of ladies who have experienced otherwise! 

Until I missed the 2 utrogestan in a row, and started reducing the Vagifem, I was 90% better. Wasn't experiencing any bleeding. I say skinny jeans, but there's breathing room in there. Cotton undies too.  Never take baths & always use Elave products, shampoo, the works. Only use Silcocks Base for the bits!

So I seem to have messed myself up with the meds tooing-and-froing.

It's crazy that a basic biological fact that the bladder is laced with estrogen receptors in the bladder wall is so easily overlooked. €5,000 spent on consultants 😫

cjmca
You have mentioned that you are using an oestrogen patch and Utrogestan daily - do you take the Utrogestan orally?
How long have you been using the systemic HRT and local oestrogen - it can take some months for any HRT regime to settle.  Unfortunately many women find the Utrogestan or any progesterone taken every day can cause side effects e.g. problematic bleeding and bladder issues - this is why many women choose to stick with a sequential HRT regime and put up with a monthly bleed. Missing the Utrogestan for even a day is likely to result in bleeding so don't worry about this.

In my experience, urinary urgency and the burning urethra has to be managed with a whole range of strategies.  HRT and local oestrogen is vital but avoiding tight clothing is also essential - tight trousers will make the area hot so encourages the burning and discomfort. Vaginal moisturisers like YES or Sylk will also help keep things healthy.  Take showers not baths and never use anything scented to wash with - so don't wash you hair in the shower or the shampoo will get to the ‘lady bits'. Avoid caffein, fruit juices, alcohol and anything that will make your urine acidic.  Drink plenty of water each day and if the burning starts then drink a small glass of water with half a teaspoon of bicarbonate of soda to neutralise the urine and ease the discomfort.

I'm afraid there is still very little understanding among the medical profession of how distressing menopause symptoms are and the connection between the meno and bladder problems is rarely picked up on - it's all very depressing.

Give yourself time - you are doing the right things and hopefully you will find a balance. DG x

[CLKD]

However: many of us have to 'try' reducing meds to see how we feel  - I did it with ADs …… until I realised that actually, I require regular treatment.

Maybe keeping a mood/food/symptom diary would help chart your feelings and product use?

[robotwars]

I have suffered terribly with dryness since starting with peri-menopause and like you I have plastic lens etc in my eyes, I have found that liz earle eye bright is fantastic, you just put it on some cotton wool pads and lay them on your eyes, so refreshing, I also use a moisture eye spray, which I get from the chemist.
I also use vagifem and sylk.
Good Luck

[cjmca]

I suppose I can see the measure in reducing the meds, but I think I'm going to struggle with it!

I feel like a total idiot for missing those 2 tablets, and my gut told me that reducing the Vagifem wasn't a good idea. It's a steep learning curve 😞

However: many of us have to 'try' reducing meds to see how we feel  - I did it with ADs …… until I realised that actually, I require regular treatment.

Maybe keeping a mood/food/symptom diary would help chart your feelings and product use?

[Dawncam]

Don't beat yourself up hon, we've all done it! I can't believe that a couple of days of missed utro would cause so much drying up. I'm no expert on it but the E is more important than the U in terms of staying lubed up. You were probably due a bleed if it happened so easily and utro bleeds can be alarming - it's not your natural 'period' but a 'bleed' which you've induced, and probably need. My eyes get dry when my E gets low. Never when it's high. You say that you've increased your patch - what strength are you now? Replacing E is the name of the game at this stage and the progesterone is a necessary evil if we're taking E.

Please don't worry, we've all had moments of fluctuations and it's worse when it's over a weekend as we feel we're coping alone. I bet by Monday it'll all be sorted again. Try the remedies as suggested by others and it might be worth your while doing a phone consult with a different specialist - there's loads of them on here.  Keep going with your protocol and I bet even by tomorrow you'll feel better.

Dxx

[Annie0710]

Hi

I started with nocturnal dry eye post meno, a few months before that I developed double vision too so assumed they were linked

Anyhow eye clinic told me what eye gel to use before bed (or a nap) as basically anytime I'm asleep the eyes dry but it didn't work.   Each morning they'd take about 20 mins to stop hurting and relubricate

I started Testim gel last month and nap times I wake up with NO dry eye and each morning it's only about 5 mins of discomfort


I've never heard of testosterone eye gel ?

X

[Hurdity]

Hi cjmca

Sorry to hear about your woes and bleeding.

The reason you are bleeding heavily is not just because you stopped the utrogestan for two nights, it is because you stopped the utrogestan and your womb lining had built up sufficiently to come away. This means that the 100 mg oral dose is not sufficient to keep your lining thin as Dancinggirl has already said. In your case therefore the three days off (ie utrogestan days 1-25) would be better as it would enable any lining to come away each month.

Re vaginal use - it's not that it's not recommended - it's just that there is no licence in UK for it to be used like this. In France for example where it was developed, vaginal use at the same dose is recommended where there are side effects from oral use. Limited research also shows that more progesterone gets into the system and to the uterus when used vaginally. However I can see that at your young age you would not want to do this all the time for obvious reasons! 

Also I see from your posts that you are very young and with POF so I would want to be taking a higher oestrogen dose - but this would mean a higher progesterone dose too. Have you actually had premature menopause or is it that your cycle is very weak? I have read that some women with POF can experience spontaneous resumption of ovarian activity.

Have you considered the possibility of higher dose oestrogen with your gynae?

Also I have never heard of high oestrogen causing dry eye - more likely the reverse. Also - testosterone eye drops  . I wouldn't trust anything like that from US - there are all sorts of weird products available out there because of their different healthcare system and all sorts of specialists propounding all sorts of wild and wacky theories!  If you think testosterone would be of benefit, the first thing I would do would be to increase your oestrogen dose, go back onto cyclical HRT (so you have a monthly bleed) and then ask him/her about the possibility of testosterone gel. You will tell if you need it because the main indication is lack of libido and after this women can later experience depression, fatigue, muscle aches and pains.

Sorry tohear about the pain - could it be partly due to the withdrawal bleed ie period pain?

Hope this helps and you feel better soon

Hurdity x

[CLKD]

Did U take any pain relief   

[cjmca]

Thanks so much for the long reply Hurdity, really appreciate it.

The short-term plan with my gynae (who is amazing - calls me regularly to check in), is to not take a monthly break from the Utrogestan, to monitor this with regards to lining thickness and with a view to reviewing in 3 months time. This is to allow my pain to settle. Which it was doing before I missed the 2 utrogestan and gave myself a bleed. More importantly, and I feel this is what really helped the (bladder? Uterus?) pain and urinary urgency/frequency was the topical oestrogen. Given my POF status, the plan was to use Vagifem daily for a month (not 2 weeks) and then reduce. My month was up this week and I had 3 days of no Vagifem. Big big mistake!

The plan was to slowly introduce the hormones rather than stick me directly on the 75 Estradot patch. I can't remember what I mentioned before on here (I don't remember what I did 5 mins ago!) - I'm now 34, only ever had 3 periods (all while on holiday!) and at 20 my hormonal profile was post-menopausal. In my 20s I was pushed (bullied!!) into taking the pill. My gynae now says what on earth where they thinking! The pill flooded my body of empty hormones with a load of synthetic hormone that was far too high a dose, and made me depressed, and on occasion, suicidal. So it's slow and steady approach this time, that has been working wonderfully. I actually feel really good on HRT. Anyway, I had just increased the Estradot to 75, missed 2 utrogestan and reduced the Vagifem. Recipe for disaster 

Ha at this stage I don't care what has to go up there to keep me comfortable! I really want to use a progestin patch, but the only form you can get in Ireland is a tablet. No cream, gel or patch 

There's no chance of me having any spontaneous period - my ovaries have shrivelled up and disappeared. The little bastards!

This is the same pain I had before I started on the Vagifem. When I was in good shape before reducing, I was using Vagifem twice a day, and every other day using Ovestin instead of a Vagifem dose. Also using Ovestin externally.  This may sound like overkill, but POF is a different ballgame and it's clear that for now, it's what my body needs. No oestrogen for 15 years = unhappy bits, and my bladder was what set off all this pain.

RE: testosterone eye drops, I got dry eyes within days of upping the Estradot to 75. Now reduced back to 50 for a while. I have lenses implanted in my eyes i.e. Stitched in there and not removable. Any form of dry eye condition is a major problem for me. I went to see my lens implant surgeon last week because of the dry eye and bloodshot appearance, he asked me if I was on any meds and I said no, not thinking of HRT. So I googled HRT and dry eyes, and this is what came up:

https://www.womentowomen.com/menopause-perimenopause/dry-eyes-and-hormone-imbalance/

"Before menopause it is known that the greater your testosterone, the fewer tears you produce and the greater your estrogen, the greater your tears. During menopause, this reverses, the greater your testosterone, the greater your tears and the greater your estrogen, the fewer your tears. We have much more to learn about how hormones play a role in the lubrication of your eyes, but we are understanding that dry eyes can result from a deficiency in estrogen, progesterone, or testosterone."

Some interesting research done on testosterone application for dry eye, particularly by a Dr. David Sullivan. He notes that we have androgen receptors in the lacrimal glands in the eye, which become the dominant hormone receptor in the eye at and after menopause. Prior to menopause, estrogen receptors take the lead. Ladies on estrogen-only HRT had a higher prevalence of dry-eye than ladies on a combo. (Oooo I want a combo meal from Pizza Hut now. Bloody hormones!!!)

http://jeffreydachmd.com/2014/07/testosterone-dry-eye-syndrome/

http://www.schepens.harvard.edu/research-storydevid/david-sullivan-phd/research-story.html

I just find this really interesting. I'm going to get my hands on some unlicensed testosterone gel and whack it on the eyelids (quite a few ladies do this!) I'll see how it goes and hopefully won't grow a willy on my eyelids, but I'll let you know 😂

[Hurdity]

Hi cjcma

Sounds interesting and I will have a read of it when I have more time -  but in the meantime  I really would not put testosterone gel on your eyelids! If you need testosterone then it should be applied transdermally to your skin below the waist and only a very tiny amount. This needs to be prescribed by a gynae! All the best.

Random search found this:

"Be careful not to get testosterone topical in your eyes. If you do get testosterone topical in your eyes, wash them right away with warm, clean water. Call a doctor if your eyes become irritated."

Hurdity x

[cjmca]

I shall be guided by your wisdom in times of desperation! I feel like I've sandpaper in my eyes     Now onto the task of trying to get my hands on the patch/cream/gel...!