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[Ljp]

Hi all,
Been on HRT since Dec 15, I've had external vaginal soreness since March this year, have estring, Mirena and I use estrogel, managed to get estriole cream prescribed for external use, it has been improving things, but need to use it twice daily?  I have had another few days discomfort this week, seems exactly 4 weeks after last lot,which makes me question if it's still cyclical despite having no periods for three years now?… but the other issue I'm having and really not sure why, is the skin around my anus is very sore and uncomfortable, no apparent reason, it was bad on Friday, then yesterday it seemed ok, I'd used a bit of estriole around it, and applied coconut oil. Did the same today thinking I'd sorted it, and it's been really sore again!

Is this possibly all part of VA? Or is that unlikely and it's something else'should I be using estriole around that area too? Or could that be what's making it sore?…just trying some sudocrem now....… no one ever told me about the nightmare of VA as part of menopause,  just though I was hot flushes and periods stopping, this, if it's all part if VA is just awful 😩

Is twice daily estriole too much alongside estring and estrogel!… will Yes VM and/or coconut oil the tissues in the same way? I only 52 and it's really getting me down

[margaret]

Hi Ljp, I use Estriol cream around my bottom too it's all connected with the VA, I was having a nightmare with water infections until I read about Vaginal Atrophy causing them or giving you the feeling that you had one, I have an Estring put in now and change it every 3 months  and also use the cream on the outside front and back, I feel much better now, try drinking lots of water too, keep hydrated x

[Wrensong]

Wondering whether it's possible you might have a touch of thrush - I've been fooled by this once or twice post-meno -  it can still cause soreness without the classic itching or discharge & a little Canesten cream used for a few days has sometimes soothed discomfort.  Tea tree cream used externally & Multigyn Actigel can also help.  However, all of these burn a bit if the area is already sore. 

I also have VA & have noticed that the anal area has in recent months started to feel different, sort of less supple & like you, wondered whether this is another manifestation of VA.  I imagine thrush could make that area sore too, so if you think there's any chance of this, you could perhaps try carefully applying a little Canesten cream there on a tissue.  I also wonder whether you might have tiny anal fissures - if so Proctosedyl should help heal these, I think this is prescription only though. 

I know the oestriol cream is supposed to help VA, but wonder whether you've perhaps become sensitive to it & need a rest from it.  I was told to apply externally just twice a week on Vagifem nights (but Vagifem frequency later increased). 

Patting gently with tissues after towel drying to ensure the external vaginal area is completely dry & applying a little E45 cream can sometimes help with dryness/soreness.   You can also apply a little on a tissue to help clean & moisturise the rear end after a BM (taking care not to leave obvious residue).  Wet wipes can be quite drying to the sensitive tissue in that area, but unscented baby wipes seem the least irritant.  Sorry - hope not tmi - I know what misery the nether regions can inflict when they play up!

[Ljp]

Thank you for the replies, Margaret, how often do you use estriole? I'm currently doing twice day, been using it for almost 4 weeks, so still early days, but the soreness around anus is a new issue

Wrensong, when I first had flare up of VAsymptoms in March I presumed it was Thrush as I used to have recurrent thrush when I was younger, so I treated it with canesten, but didn't resoond to treatment as previously, so used a second pessary, soreness subsided a bit but not much. Saw my doctor a couple of weeks later, had a swab taken and no thrush although I still had soreness.
The internal vaginal area is fine, the estring is doing its job, this is all external, outer skin of vagina (although seems oki she the past few days again, last flare up was after sex).…and now external skin around anus, sore and stinging, irritated at times too.

[CLKD]

Thrush smells.  Is a coloured discharge when really bad.  Normal vaginal secretions have no odour. 

LJP - exactly which products are you using?

[Wrensong]

Hi ljp - GP told me she often got negative lab results back for ladies she was convinced had thrush.  This happened last time she did a test for me but a Canesten gel cap got rid of symptoms, so both of us were fairly convinced it was thrush.  This can affect the outer area - doesn't have to be internal as well, but as you're familiar with symptoms you will know better than me whether thrush seems likely at present.  Perhaps sensitivity to the oestriol cream instead?  I'm sorry you're suffering this way, as you say it is a really horrible aspect of menopause.   I'm sure other ladies will be along with some good advice.

[Ljp]

I really dont think it's thrush, and am loath to try canesten in case it exacerbates the problem.

CLKD I'm using estriole cream twice daily at present, I use Yes VM, or coconut oil in between applications
Re sore, stinging skin around anus, I have used coconut oil, also tried anusol, lanacane, and today, just applied some sudocrem.

I have stopped using anything other than aqueous cream and water for washing, it's just confusing as to what's the cause

[CLKD]

It really can be confusing.  For me thrush was high up, intense continual itching.  I had stopped The Pill 4 weeks prior.

Ljp - maybe add lots of salt to your evening bath.  Stick to one product or you won't know which is really working.  Some people are sensitive to the fillers of products or even the coatings. It's difficult to find out which is actually aggravating the area/s affected 

How is your urine?  If mine is dilute there is no stinging.  If I haven't drunk 'enough' it stings ...... so maybe check the colour next time you pee?  Straw coloured is fine, pale you are drinking too much, dark is not enough.

[robotwars]

I have VA, currently using Vagifem, silk and yes ..... slowly keeping on top of it but it does seem to vary how bad it is during different times of the month...... good luck hope you feel better soon

[Ljp]

Thanks CLKD, urine is fine, not stinging when I pee.
I rarely bath, I'm a shower girl, but if you think salt will help I'll run a shallow bath to sit in, but won't it dry out the vaginal area more?

I did buy one of those canesten tests and ph was fine and discharge was clear so indicated no thrush.
The irritation when I do have it, feels different to thrush, it's more prickly, soreness, and a burning/stinging sensation. The estriole is definitely helping, but it does seem necessary to use it morning and night at present, I would like to be able to reduce it to once daily then every other day if possible and maybe keep things healthy with coconut oil and/or Yes VM but I'm wondering if this is going to be possible

[CLKD]

If it hasn't improved so far I think you may well require it twice daily for a long while.  What's your rush?  If it is working twice daily .......

[Ljp]

No rush, just the usual health anxiety concerns, overuse etc

Do you think I should try a canesten pessary to see if it helps? Or just bide my time with what I'm using?
Had sex last week and the following morning, despite using estriole afterwards, I had a sore crack in the skin near clitoris, which took a couple of days to settle, and now this around back passage, but seems strange how Friday it was sore, Saturday it was fairly good, and then today it's been really sore, I'm wearing skirts and cotton underwear and trying to stop wearing liners, despite my urgency which isn't as bad as it was, but can catch me out sometimes, was using Tena lights, but now using breathable liners.

[Ljp]

Hi Sparkle,
I used to use hydrocortisone if I got sore, but I'm aware it has a thinning effect on the skin, so not sure it's a good idea?

[Ljp]

Anusol hc? Didn't know they did that

[Ljp]

Just to add, I also have two very sore mouth ulcers, it's all going wrong this last week!