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[sheila99]

Advice please.
So far escaped GSM but I think I may have it now. Uncomfortable down below, self treated for thrush then went to gp. Nothing came back from the swab and I think it's just dryness. She had a look 'up' and said it didn't look too bad. It isn't painful but is dry and gets irritated easily. However, the worst problem is that I leak. It's gone from only when I run to when I walk and sitting in a puddle all day isn't my idea of fun. So is this something local oestrogen will cure or is something else going on? The other thing that's changed is I've gone from Tostran (not available atm) to testogel which feels weaker. Pre hrt I had to do regular pelvic floor exercises to prevent leaking but haven't had to since using Tostran.
Have an appointment with a male gp on Monday for something else, he may not know much about GSM so I'd like to know what to ask for.

[fiftyplus]

What is GSM?

[Dotty]

Hi sheila99…yes vaginal oestrogen should help you. I’m the same as you, thought I’d escaped vaginal problems until a few months ago. I’m 59 and 9 years post menopause.

I use Blissel gel. Other options are Ovestin, Estradiol cream, Vagifem.

Testogel is weaker than Tostran. I think the recommended dose of Tostran is one pump every other day. Testogel sachets are a pea sized amount every day. If it’s the new size sachet then I think it’s supposed to last 8 days.

[Minusminnie]

Shelia99

Ovestin which is estriol in a cream may be a starting point to see if that improves things.  Vagifem is the stronger estradiol in a pessary.  You won't get an estradiol cream in the UK unfortunately.

Have you thought of seeing a womens' pelvic floor physio to get assessed/reassessed and for some advice ?  You may find that you have to take more care with physical work.

[Minusminnie]

Fifty plus……GSM is genitourinary symptoms of menopause.

Not being picky but it GSM is Genitourinary Syndrome of Menopause.  'Syndrome' a word often covering 'we don't really know'.

[CLKD]

Morning: I started leaking when I cough  the 10 days that I was taking antibiotics 

There's no harm in trying appropriate vaginal atrophy treatment for 3-4 months as well as suggested, seeking the advice from a physio interested in womens' health. 

Let us know how you get on ?

[Taz2]

I think that it's because you have stopped the pelvic floor exercises. We all need to do these each day really to keep the pelvic floor strong so if you were doing them but now stopped the muscles have probably weakened. How long is it since you stopped?

Taz x

[Minusminnie]

It isn't painful but is dry and gets irritated easily.

It becomes a bit chicken and egg.  Which comes first weakened muscles irritating nerves or irritated nerves affecting muscles ?

[Ayesha]

Vaginal Atrophy is a symptom of the aging process but if you think you are at the beginning of this horrendous condition, ask your GP for treatment as its the only way to reverse the condition, it should also help with leaky bladder situations but it doesn't cure it. Continuing with your pelvic floor exercises will help too.

[joziel]

If you find that local estrogen doesn't help (vagifem or ovestin) there is also Intrarosa which is DHEA - the precursor of both estrogen and testosterone. Some women find that helps more than just estrogen...

[sheila99]

Thanks all, I'll see what he'll prescribe tomorrow (if anything). It's 5 years since I had to do pelvic floor exercises. It's 2-3 months since I changed to testogel so I'm not sure if it's coincidence or not. Interesting you say it's weaker than Tostran Dotty, it isn't as effective for me. I've been pulling muscles again like I did before going on Tostran. Thanks for the info on intra rosa Joziel, I'll see if he'll prescribe it. Are they more reluctant if you're already on hrt and testosterone? I can't help thinking muscle weakness is involved though there's thinning of the skin too. About 6 months ago I started getting irritated by vaginal utrogeston and I'm wondering now if it's because this was starting.
 A pelvic floor physio sounds like good idea, I really don't want this to continue.
 And here was me thinking how lucky I was to have escaped it  .

[Dotty]

Sheila99…. How much Tostran were you using and how much Testogel are you using ?

[Taz2]

You will get good advice from a pelvic floor physio and you'll get a tailored programme for the right pelvic floor exercises for you. I know it's a while since you have had to do them but it's something that will help I'm sure. You'll also find out whether your leaking is caused by a prolapse.

Taz x

[sheila99]

Tostran was one pump every other day, testogel is one sachet in 8 days but I don't think I get a consistent amount every day. I'd rather have a beard than leak  .
I hadn't considered it might be because of a prolapse, thanks.

[Taz2]

Starting your pelvic floor exercises again will help as it will begin to strengthen the muscles which are getting saggy so I'd make a start on them in any case. It's horrible to leak I know (sadly)

Taz x