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[Carbon]

I apologise in advance that this will be long.  I am just so frustrated and fed up with how I feel.

I am 53, not overweight, do not suffer with constipation.  I am on HRT – oestrogen gel and utrogestan continuously

At the start of the year after a short (but fast for me) run,  I felt a discomfort inside.  When sitting  and standing it felt uncomfortable and heavy – a bit of a bulge feeling.  The GP diagnosed a prolapse. I self referred for NHS womens health physiotherapy – still waiting. In the meantime, I paid to see a private physio – she diagnosed a prolapse plus slight rectocele and some anterior laxity too.  She gave me kegel exercises to do.  She also suggested I start vaginal oestrogen as the tissues looked as if they needed this.

I started vagrilux and still  found that wearing pants was uncomfortable and I felt as if I was being chafed all the time. I then added in Ovestin cream (internally and externally).  I  felt as if everything had plumped up too much – I was very aware of being able to feel my urethra.  I also feel as if I have a swelling at the entrance to my vagina, at the rear edge.   In physical examinations the PT has not picked up on this despite me trying to point it out.  Perhaps it feels bigger to me than it is and I wonder if it’s just tissues replumping after maybe years of atrophy.

At the moment I am finding sitting down very uncomfortable.  My perineum gets incredibly sore if I sit for more than about 20 mins.  This is making life very hard. 

I also have piles and although they rarely cause pain they are there all the time.  They feel as if they are pushing down my perineum, in fact my perineum feels much lower than it did before.  I have never felt quite right since having my first child 15 years ago.

The GP wants to fit a ring pessary and I am waiting for that appointment.  I am hoping that it pulls everything up – it feels as if my vagina has sagged and is now slightly too long!

I work from home and try to mix sitting and standing. I also try to move around a lot where possible. If I could walk all day and not sit down I would feel pretty much ‘normal’.  It is sitting that is causing all the problems.  When I have to attend a work meeting I am in a lot of pain after sitting for two hours and although I do use a cushion I also find myself sitting awkwardly on it to try and keep my perineum off the surface.

So I guess I am asking for any advice or experience or just not to feel so alone in this . I have felt incredibly  down about this for the past 4 months and I feel as if it has been taking over my mind.

[Minusminnie]

Just wondered how often are you using each of the the Vagirux and the Estriol (ovestin) cream ? 

The physio seems to have noted that you have some anterior laxity but are you being examined lying down and physio cannot feel the ‘swelling’ that you feel ? This may be some anterior prolapse happening.

Putmans do a cushion with a cut out of varying sorts. It is a discreet covered cushion with a handle that might suit you for meetings.  I bought one but couldn’t get on with it but that is not to say you wouldn’t. I eventually had a custom made U cushion for kitchen chair & the car for comfort but it is not discreet !

One member on here called Winterose   has found the Inflatoball that you can buy on Stress no More website helpful. I think she tried different sizes before choosing one and replaces it every 6 months.

Have you been referred on to a gynaecologist or uro gynaecologist by your Gp for another opinion ?

Also you do need to take care lifting heavy things especially up from the floor, lifting down is not so bad.  Try not to let it all get you down. 

Ps Putnams not Putmans for the cushion.

[CLKD]

Sounds like your body is moving Southwards  - how often do you have to do the kegels?

Do use vaginal atrophy treatment every night, 'ovestin' internally and a dab externally where required. 

Let us know how you get on.  MayB look at mobility web-sites regarding suitable comfort cushions. 

[Carbon]

Thank you both for your replies.

I was using vagirux twice a week after the two weeks loading and ovestin a few nights a week.  I am really not sure whether the effects I felt with the ovestin were normal and due to everything starting to feel more hydrated or whether something else is going on.

I do the kegals every day.  I am also trying very hard to think about my posture as I realise that I have a tendency to slump, so I am trying to stand and sit up straighter.

I have not been referred onwards. I am still waiting to see the GP to have the pessary ring fitted.  I have just had a phone call from the NHS physio and have an appointment in a month, so that will be useful.

I am finding it so hard to stay positive. I hurt now as I have had to sit down to drive and during a visit to elderly relatives. 

[SaraUK]

You sound very much like me, same age, I can’t sit, burning like sunburn but also horrible UTI bladder irritation too. I too have tried vagifem daily for months, ovestin etc. no prolapse but I too am waiting for a private appointment with urogynocologist in June. I know exactly how you feel. And I’ve been on hrt for 2.5 years.

[Carbon]

That is really interesting SaraUK and I feel your frustration too.  Not being able to sit is so limiting! Do you have to sit for work?  I haven't had any bladder/UTI issues - just the weird perineum pain.  I hope your appointment helps to shed some light on your issue for you.

[Minusminnie]

As you are writing ‘was’ it sounds like you are no longer using the Vagirux & estriol (ovestin). 
You could ask to increase the Vagirux to more nights a week & keep the estriol (ovestin) for just externally so there is not a variation going on internally. Afraid it is very much trial and error until you find what works for you. There is also Vagifem if you think the Vagirux is unsuitable & also a weaker estriol cream 0.01%.

Good that you will get a second opinion with the NHS physio soon. 

A referral to a gynaecologist may give you other options & grade your prolapse too.  Might be worth getting on a waiting list.

You may find book by Michelle Kenway called Prolapse exercises Inside Out useful also on Utube.

[Taz2]

Hi Carbon. There is an often not talked about condition which can happen alongside the normal pelvic organ prolapses and this is called Perineal Descent. It sounds from what you describe that this may be what is happening to you. It's difficult to find out information on this but I think it is due to the extra pressure caused by the prolapsed bits. I have found an American site which mentions it but I can't post the actual link here as it has a fee paying section. If you google Austin Urogynaecology Perineal Descent it should bring it up for you. Hopefully the ring pessary will make things more comfortable.

I hope the advice so far is helping you.

Taz x 

[Carbon]

Minusminnie - I have been using both the vaginal pessary and using the cream but am really not sure whether the cream suits me so have dropped back to using the pessary only.  I have also got some Yes VM which I am trying to use when I get sore.

Taz2 - thanks for that info. I had come across perineal descent and that is exactly what is feels like.  Looking back - it started 15 years ago after my first child was born.  I always felt everything was 'lower' but not to the point where it hurt.  Now it feels as if I sit on my perineum rather than my bum bones - so when I sit  more pressure is going through it, and making it sore. I also feel as if the anterior prolapse may be pushing down when I sit too.

I will see what the NHS physio says.

I do think a pessary may help - I feel as if everything needs hoicking up a little!

Just being able to talk about it on here with people who understand is really helping.  My poor husband must be fed up of me talking about my bits!