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[Kkay]

Hello ladies,

I've been struggling with horrible VA for over two years now.

Background: I am on continuous HRT - 3 pumps of Estrogel - and progesterone tablets (Duphaston) every third month.
I can't seem to find a cream for VA that doesn't cause irritation. I've tried Ovestin and also Estrace (estradiol from the US). I'm about to try compounded estradiol (mixed by the pharmacist so it doesn't contain the fillers which might be irritating). I also tried vagifem for two straight months last year, with no clear improvement. One remaining option is to use 2 Vagifem tablets since the 10 mcg dose might be too little and it used to be 25.

But here is my question: (TMI alert) While it has its ups and downs, sometimes the burning is really intense. Inside and outside at the vaginal opening, all the time.  It burns on the outside when I pee as well. The burning seems to reach all the way to the rear (ie the perineum). Has anyone else experienced this in this way? It's just awful.

Another suggestion has been to consult a physiotherapist for pelvic floor relaxation exercises -

I am just desperate and very depressed and would appreciate hearing from others who have had similar experiences and have improved....

[Tc]

Hello kay. Sorry you are suffering like this.
 Have you had a diagnosis of VA?
By that I mean a physical examination. Also if you have VA have other conditions which may co exist .alongside been ruled out?
If  you have then I notice you didnt mention estriol cream 0.01. It is weaker than ovestin so for inside it is given in larger amount of cream. I used it inside and didnt find irritation but it didnt work for my bladder issues so I switched to vagifem but still use the estriol outside and find no irritation  from it. The vagifem doesnt help me with dryness/soreness around the opening and down the perenium but  the estriol does. I also realised that rubbing it In helped with that area more than just smearing it on.
You mention womens physio and I started a thread about womens health physio if you would like to take a look.
Also maryjane has just posted about her latest podcast about VA with a link.
Xxxxxx

[Peripurple]

Hi Kkay,

Yes I have experienced exactly the same.  I cannot tolerate any creams, Vagifem helps but still have some irritation most days.  What I found when my burning became extreme the GP tried metronidazole in case I had a bacterial infection as well (you become more susceptible to infections due to the change in ph). I found this helped the severe burning so concluded as well as VA I also had an infection.  One thing I have learnt from this site is that there is a huge amount of trial and error to work out not only what helps but what may be exacerbating symptoms. Vagifem took a long time to start working for me, and as I said still have irritation most days, but the burning where it goes back all the way to your bottom has really improved.

[Kkay]

Thank you Tc and Peripurple -

Tc, yes, I've had physical exams and there isn't anything else going on down there except "inflammation" and "dryness".....thank you, I will take a look at the thread on women's health physio. Will look for Maryjane too....thanks

Peripurple, isn't it just the pits. I am very depressed.

[CLKD]

How much do you drink in a 24 hour period?  I find if I haven't drunk enough then my urine burns ........... enough to make me go 'ouch'. 

Do you apply 'yes' or 'sylc' products, or other moisturisers around the perineum areas?  Keeping those areas supple is important too.  KY Jelly or Savlon helps my dry areas.

[Kkay]

Hi there CLKD,

I drink about 5-7 glasses a day - I should drink more but then going to the bathroom is something I dread....good advice though thank you.

No I hadn't used  moisturizers as they are not available where I live (India) - but I traveled recently and brought some back with me. Almost everything irritates my skin in general so I've ben terrified to try but I know that I should.

[Maryjane]

We have SO many nerves in the vulva area, predominantly the pudendal nerve which is everywhere including the back passage, perineum, vulva, clitoris, urethra etc.

Lots of what ifs & maybes. A women's health physio maybe able to help ?

Lots of ladies in my VA group also have the same symptoms as you ( myself including some days better than others & its 🤬🤬🤬).

[Kkay]

Thanks for this Birdy; no I'm in India. But I have seen a dermatologist (and two different vulvo-vaginal specialists) and all concurred nothing else is going on down there. Who knows.

[CLKD]

R U dry inside?  Did U look yet ;-).

You know your body.  Ask for appropriate treatment?  Do you get to the UK at all in order to get to see a GP and treatment?  In the meantime, so you have access to LIVE yoghurt: eaten and applied might help ;-)

[Kkay]

Thanks CLKD - no, I havent been able to get to the UK.

I was very dry inside until I started Vagifem one tablet every night three weeks ago.

The internal moisture is now better but the bladder and the urethra are still very uncomfortable; sometimes it feels like a UTI (it isn't - I check every time)

Depressed

[CLKD]

Symptoms can drag us down.  Do you take a pain relief regularly?  I find that when symptoms niggle I up the dose even using 2 on one day: mid-afternoon and again at night, along with a pain relief which eases any spasms.  What colour is your urine?  You may be drinking too much which will cause the bladder to become irritated.

It was the bottled water companies that pushed for 2 litres per day  which may be far too much liquid on top of what we absorb from food stuffs.  The 1st pee of the day will be dark and may be smelly, the rest should be straw coloured; any lighter and too much liquid is being taken in.  Also, if 1 limits liquid intake in the evening to avoid getting out of bed in the night, the kidneys will go into over-drive which causes more urine to be made in smaller amounts.

Some ladies find that they need Vagifem nightly as it is 10 rather than the original 25.

[Kkay]

Thank you CLKD. What have you found helps with the pain ? My bladder is extremely sore today, it feels like a massive UTI. I will leave a sample just to check, but what can I do about the pain if it isnt an infection (while I work on getting the estrogen level up)

[CLKD]

2 Nurofen - then an hour later another tablet. Then every 4 hours for 2 days.

As well as using the appropriate VA treatment.  Sometimes initial use does sting because the inside and out are dry, a few ladies use 'sylc' and 'yes' products too.  I find KY Jelly as well as VA 'ovestin' keeps the area moist enough to counteract dryness.

How large are the glasses that you drink from?  Don't restrict water intake at night or the kidneys will work extra hard = in and out of bed all night.