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[Meeka]

Hi , I’m 58 and have taken 4 pumps of oestrogel and 7 day cycle of utrogestan for 8 years .  For the last 12-18 months I experience UTI problems during the last days of the bleed .   So tired of short courses of antibiotics which only give short term relief at best so recently consulted with urogynecologist who thinks the micro-trauma of the bleed is causing the UTI flare up.  She doesn’t think the utrogestan is causing the flare up and thinks at my age I should switch to continual utrogestan and reduce to 2 pumps , I informed her my serum oestradiol is only around 140 now on 4 pumps .   
She has also orders pelvic scans etc .
I am now taking 100 mg utrogestan orally and although I’m currently on nitrofurantoin for UTI I seem to tolerate utrogestan ok continually .
Has any one else experienced anything like this .   I have searched old posts and I see some ladies have reported flare ups of old bladder irritation symptoms on utrogestan ?
I have also read that utrogestan can cause relaxation of the pelvic area and contribute to UTI problems which are more common in pregnant women who have higher progesterone .
I am considering consulting prof mallone lee who specialises in UTI .

So fed up I’ve considered giving up on HRT but my bones are low density and I also feel well on it apart from this UTI situation ..

[Elizabethlovejoy]

Have you considered local oestrogen in addition to your existing HRT? I am 66,on 4 pumps oestrogen plus 100mg utrogestan vaginally every other day. The only way to keep my bladder comfortable is to use vagifem alternate days plus a dab of Ovestin externally around the urethra area daily [I do mix this with some yes moisturiser to dilute the “sting”] This was all advised by the Newson clinic -it has taken me over ten years to achieve a comfortable bladder!

[CLKD]

If you haven't improved with the 1st course of ABs, your GP should be prescribing appropriate vaginal atrophy treatment.  A short course: 3 days : if it's a UTI confirmed in a Lab isn't enough anyway.

Have a read of the 'bladder issues' and 'vaginal atrophy' threads on the Forum. Make notes ;-).  If you get the need2P feelings then take pain relief, I find 2 capsules of 'nurofen', 3 times a day really helps.

It may be that the Utrogestan is aggravating the bladder, there should be other forms of HRT - mayB think which symptom/s you would like to ease? 

[Meeka]

I forgot to add I also use ovestin internally . If I use the utrogestan vaginally my bladder is irritated more than orally .
In have no signs of VA , Gyne examined me , but it could be there I guess .   I never had UTI until around 5 years ago and then they became more common . Been with same partner for 36 years so no real connection there .
I feel the bacteria is embedded in my bladder wall and just waiting for the right conditions to flare again .
I agree 3 days is not long enough of antibiotics . I have just had 7 days of trimothroprim which didn’t work for me ,infection was worse . Practice made me wait for another urine sample result from lab which took five days before prescribing me 3 day course of nitrofurantoin which seems to be working on day two.  However 3 days wil not be enough to prevent another one flaring soon .   I rang practice and couldn’t speak to GP about it , receptionist insisted it’s enough as it’s stronger . She couldn’t inform me which bacteria it was this time so I have to wait till Wednesday for a telephone consult .
I think I require a much longer course of antibiotics to eliminate the bacteria .   This is the principle of prof mallone lees treatment . I tried to consult catriona Anderson who is closer to me but she’s so busy she’s not accepting new patients .   

[CLKD]

There is certainly the possibility of an embedded infection if the ABs haven't sorted it by now.

Get those feet up, under a blanket and rest.   

[Meeka]

Thanks CLKD ,  just want to get effective treatment so I can get on with my life .    It’s a chronic problem for many women and the specialist UTI clinics are mega busy with women who have been suffering for decades without having any affective treatment .   I have also ordered some hiprex which is recommended on the ITI forums and by the urogynecologist , it’s interesting treatment , I’ll post a link

[Meeka]

This is hiprex
https://www.drugs.com/mtm/hiprex.html

This explains how it works
https://www.netdoctor.co.uk/medicines/infection/a6848/hiprex-methenamine/