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[badgersmall]

hello sisters
I posted a few months ago about my AV (see original post below). Had it for over 2 years now (age 58). It usually cycles between quite bad and less bad.
This week it is REALLY bad - a large red very visibly sore patch on labia (GP called it "excoriated" and a sore clitoris.
 It just hurts all the time this week - a miserable, burning pain, plus pain below the surface (probably because of all the nerve endings involved?)
I'm on combined HRT patches but had stopped the Vagifem oestrogen pessaries for a while - i've just started back on them now.
GP couldn't come up with anything much to help.
Anyone know anything to soothe the soreness & pain?
I'm applying hot flannels soaked in an infusion of thyme with a few drops of lavender oil (a.m. & eve) and also now using some coconut oil with a few drops of lavender oil mixed into it, to apply several times a day/night.
I have some vitamin E oil - has anyone had good results with that?
Also I thought of making some oat water to use on a warm compress (it's good for eczema apparently so maybe it would help - tried it once, no help yet.)
Wondering if this will ever get better or am I doomed to this for years?
It's painful to wear clothes and to sit - both of which seem to be necessary for daily living :-/


Original post: Do HRT patches help with A.V. (atrophic vaginitis)?
Does anyone have direct experience of whether combined HRT patches (e.g. Elleste Duet Conti) help for A.V. (atrophic vaginitis/vulvitis)?
I am 57, stopped periods about 8-9 years ago, & still have a womb.
The main menopause symptom I have is a very sore vulva - visibly red areas, with tiny dark red lesions that heal and re-appear. These areas feel very irritated - not itchy, but sore and burning. I have had this continuously for 18 months, and used lots of topical oestrogen - Estriol cream and Vagifem pessaries - but these have not helped.
I have never had hot flushes. I am depressed, and I have leg cramps at night - but both of those could be down to other causes. I have had disturbed sleep for over 30 years because of fibromyalgia syndrome (FMS).
So I need to make a decision whether to take the only other thing being offered to me to sort out the A.V. - the patches.
Is anyone in a similar situation to me, with A.V. as the main menopause symptom? Have you tried HRT patches, and did they either improve, or NOT improve, the A.V.?

[Joaniepat]

Hello badgersmall, so sorry to hear about your woes. I think your best resource would be to join the Vaginal Atrophy Facebook group. It is a closed group, administered by Jane Lewis who appears on here as Maryjane. You will find plenty of support and advice from the very experienced ladies there. You have to answer a couple of questions to be able to join as it is women only.

The important thing is that you have restarted the Vagifem, hopefully using it every night. I don't know if a warm compress with those oils is a good idea  - might be irritating things perhaps? If you are dry perhaps a little Yes Oil Based would be appropriate. Sorry I can't suggest anything else to sooth.

Hope you find some answers.

JP x

[jaycee]

I am sorry that you are having such pain and discomfort, i cant really advise anything as not had that problem at least not as bad, but when i did have some soreness the pharmacist suggested thrush cream, which made a big difference
I hope you can get more help, i cant believe your Dr hasnt been able to help more,have you thought of trying a different Dr,or ask to be referred to a specialist in this area
I think you need something more soothing than water based, and it could be the lavender oil and the others are making it worse,
I know hydrocortisone cream isnt good to be used a lot, but i think it might help initially,
Also the vagifem might help, when you have got used to them again, i think they can often seem to be more irritating at first,
I use them nd i thought they were not doing any good but after a few uses they settled down

[pepperminty]

Hi Badgersmall,

I would advise joining Jane Lewis Vaginal atrophy closed group on Face book.

Also ask your GP to refer you to a vulval dermatologist who specialises in the vaginal area. If there isn't one in your area the GP can refer you out of area.   If you can afford to go private Victoria Swale in london is very good.  Vaginal atrophy is due to declining estrogen. Some women need HRT to help with symptoms.

Local estrogen such as vagifem/ ovestin cream or estriol a weaker topical version.  It is advised to have a 2 week loading dose every day and can be used 5 nights a week ( guidelines ) although many women have to use daily. YES VM/OB  moisturiser or Sylk are good. Google them.

I would advise not to put any home made oils on the area .

Try to go knickerless if you can.

It is awful to feel this way. It should improve with treatment.

Peppermintyx

[Dierdre]

Hi badgersmail, sounds like you need something for the labia, I use  Ovestin on the outside area and vagifem inside this has made a vast improvement for me. Agree with peppermint ask for a referral, you may need a short course of steroid cream to help with the healing, I have to have this sometimes after a flare up. I would keep off the oils and coconut oil burns me. The YES waterbased in the little 5ml containers are the only thing I can use as all organic with no preservatives that irritate.  Dont use soap powder or conditioner for your pants, I wash mine on 60° then tumble dry, this cleans but theres no irritation. Also only use water to wash, I can use Cetraben for washing but for now keep it basic and try things one at a time so you know what helps and what irritates.

[CLKD]

Your GP should have prescribed appropriate treatment for vaginal atrophy.  There are so many nerves down there that the whole area gets 'upset'!  Do read our vaginal atrophy threads here and pop over to Jane's group too.

I use KY Jelly for the outer areas and Ovestin for inside the vagina.  The idea begin that the treatment plumps up the internal area and reduces dryness which causes problems.

Let us know how you get on. If possible don't wear knickers.  Maybe a cool bath with Epsom salts in and pat dry. 

[badgersmall]

hi and thanks for all the suggestions.
I joined the VA group on Facebook. Looked through advice there - some women are saying coconut oil is helpful.
Can't have baths (shower only) and it's hard not to wear pants but will try to get some loose knickers. Someone recommended silk ones but they're hand-wash only i think, grrr.
About getting referred to a specialist - i live in a rural area & won't be able to travel until this subsides. My GP has referred me to Gynaecology dept at the hospital 25 miles away (with a 6-month waiting list) but I was not impressed when i did go there before. I was first misdiagnosed with LS & sent for a biopsy, which i refused because it clearly was not LS, asking for 2nd consultation. When the second consultant had a look & admitted it was AV, she just said "put Sudocrem on it" & that was it. (which didn't help of course). So, I'm not really sure what i am going back there for.
GP said they can't refer me to anywhere other than that hospital.
If I did manage to see a private specialist, does anyone know what range of treatment options they have for AV?

[CLKD]

Not many.  Go to your GP and ask for vaginal atrophy treatment i.e. Vagifem or Ovestin both need using every night for at least 2 weeks then every 3rd and 5/6th nights.  For ever.  Is there a Nurse Practitioner in your Surgery?  Not a lot of good going to the Consultant as they often don't know much about menopause anyway and I think that patients have a choice of hospitals so your GP is not correct on that either. 

Let us know how you get on.  Have you read the appropriate threads here too, make notes ;-).

[badgersmall]

hi CLKD, thanks. Yes I have already restarted the Vagifem after being only on the HRT patches since Nov. Not sure when I stopped the Vagifem - a few months ago. Had been using Balance Activ twice a week instead.
It is usually a nurse practitioner that I see - she is quite sympathetic, but says they can only refer me to this one hospital. Maybe it is different here in Wales.
I will read more when I can bear to sit long enough. It is very sore. Typing standing up :-/

[CLKD]

Drink enough.
Go knickelress ;-).
Maybe put 'vagifem' up there now and again this evening, plus a pain relief tablet.  Same tomorrow.  The dose is really small so getting as much up there ASAP should begin to relief symptoms.  I can feel my belly is irritable which is a sign that I need to up my 'ovestin'. 

Health care has changed recently in Wales.  If the regime works you can cancel the appt. at the Hospital anyway ;-).

[Dancinggirl]

Hi badgersmall - please stop using all those flannels soaked in various oils - this would probably be making things worse.  There are great intimate moisturisers that would help - SYLK or the YES products are best. If the pain is burning, try frozen peas wrapped in a clean tea towel applied gently to the area to reduce any inflammation. Keep the area as cool as possible, no scented products anywhere near your intimate area at any time - especially essential oils. 

Keep using the Vagifem at least twice a week and this needs to be used for the rest of your life.  Systemic HRT doesn't always help with urogenital atrophy so Vagifem will really help alongside the HRT patches.

Sadly GPs are not up to speed on how awful this type of problem is.  DG x

 

[badgersmall]

Thanks Dancinggirl & CLKD.
I don't use scented soap or anything like that. I'd been using Epaderm (on prescription) as a cleanser for my bits in the shower but I guess I could just use water.
Can't go with the no pants option - it's too cold here this week anyway! which makes the ice idea unappealing.
I used the lavender oil (a few drops in an infusion of thyme herb, not oil) because a friend said it healed her AV completely - though hers was not as bad as mine, and she uses lavender generally for all first aid purposes.
I have a tube of Sylk but it is way out of date - do you think it's still OK?

Vagifem for ever - gosh, that is going to be a mountain of single-use plastic.

Not wanting to sound totally negative but i do feel miserable as hell with this.

Has anyone else got, along with the specific AV symptoms, a general feeling of whole-body unpleasantness? Don't know what else to call it. Like "everything hurts". I have fibromyalgia syndrome (FMS) so it often feels like everything hurts, but that is mainly muscular & fatiguey, & doesn't go on day after day like this has been doing for a couple of weeks now. Mostly pelvic/abdominal, plus a loss of appetite (very unusual for me). I have no idea if it is related to the AV/low oestrogen, or if it's the aftereffects of the nasty cold virus I had a few weeks ago... or something else. Or maybe I have a UTI, though it doesn't actually hurt to pee.
I guess I should start a new thread with that but will leave it here for now.

[CLKD]

You continue with this thread so you don't get lost! 

VA mimics urine infection-type symptoms really really well which is why GPs do dip urine tests in the surgery which prove nowt! 

STOP using lavender!!! STOP using anything other than tepid water and tap dry.  STOP worrying about single use plastic, needs must 

Epsom salts in the bath can soothe.  As can LIVE yoghurt, it is at least cooling ;-).  But appropriate VA treatment is the way to go plus a pain relief if necessary.

You will feel miserable because your body has suddenly become upset inside and out. This too will pass. 

As oestrogen levels drop off so the body may become dry, inside and out; and muscles may become lax = aches and pains.  Has your sense of taste altered which can cause a loss of appetite?  I still get period-type pains and my last bleed was in 2002, I think "OH NO, not after all THIS time" but it doesn't happen.  But the little hormones left aggravate occasionally 

[badgersmall]

I did stop using the lavender when women on here advised that.
I have been reading a very long & largely negative thread on FB re coconut oil, so gave up with that.
Not using any soap or cleanser now.
Am making oat water & making warm compress of flannel soaked in that. I can't have baths as I can't get up from sitting in it - Fibromyalgia & lower back problems. Showers only.
I'm using the Vagifem every night for nearly a week now but will go back to the GP or nurse practitioner tomorrow to tell them that - & maybe ask for Estriol cream, just to be able to use a bit of that on the sore patch until the Vagifem starts making a difference.
Do women on here think that a lubricant like YES.OB or Sylk should help soothe the sore patch in the meantime? (And is it OK to use Sylk that is out of date?)
CLKD: no problems with taste. Sense of smell is messed up but that wasn't due to menopause.
The whole-body horrible-ness hasn't happened today, thank goodness.
 

[Joaniepat]

badgersmall, I wouldn't use out of date Sylk. The use by date must be there for a reason. Yes OB might be a good idea, and would provide an oily barrier over the sore area. Yes products are pH-matched to the area, and I find them preferable to Sylk, but that's just my own experience. I can't recall anyone on Jane's FB group having a problem with Yes OB.

JP x