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[Maryan1285]

Hi All    Just joined this great forum and hoping for some helpful hints re VA. After suffering a couple of UTIs since last year and months of discomfort and OAB I decided to start doing something about my quality of life and not spending so much time mapping out where the nearest toilets were ! I had to wait a month to see the GP and my appointment was yesterday. Did not see my usual GP but a nice, but very young part time trainee. Explained my situation and asked for a prescription for either a pessary or tablet HRT. However when I went to collect the medication she has given  me Estriol cream 0.01% which I really did not want. Can anyone let me know if  the NHS do not prescribe Vagifem or similar if one is  over 65?
If that is the case and I have to use the estriol cream has anyone find that it is strong enough to help?
Many thanks for any advice.

[Ayesha]

You can definitely have Vagifem on the NHS if that's what you want. Some of us here use both Vagifem and Estriol, the cream used sparingly on the outside as sometimes the Vagifem doesn't reach all the way down.

This thread is very informative and should help you
https://www.menopausematters.co.uk/forum/index.php/topic,69936.msg949995.html#msg949995

[CLKD]

MayB that's what they had in the Surgery?  I have used 'ovestin' now renamed with success.  Why don't U fancy the Estriol cream?

Welcome - browse round, do read the 'bladder issues' and those threads about vaginal atrophy.   Make notes ;-). Let us know how you get on.

[Maryan1285]

Thank you all for your advice .   I must admit not knowing too much about all  the products I thought that the estriol cream 1% appeared to be weaker than then pills or pessaries but maybe I am wrong so will give it a go for a couple of weeks.  Maybe as Ayesha has suggested I could use the Vagifem with the cream and see if it helps. In the meantime I am trying  other ways to keep healthy such as cutting out  wine , caffeine and fizzy drinks . Keeping my fingers crossed that a combination will result in improvement and get rid of the constant discomfort.  Will report back as to what works for me.

[CLKD]

Hi.  It depends on how you want to deliver the atrophy treatment.  'vagifem' is a pessary, 'ovestin' is inserted via a syringe-type thingy - sorry bad night, little sleep.  Both into the vagina as deep as is comfy to allow the vaginal walls to absorb the product = plumped up, less itchy skin.

Vaginal atrophy mimics repeated urine infection-type symptoms really really well. 

[Jules]

Im over 65 and using vagifem or equivalent and  since last year I also used estriol 1% externally. I use the vagifem 2 nights on and 1 off at present but am grandually reducing and I used the estriol cream externally every night with a moisturiser. I have not had the dreaded UTIs since. I did have a flare up 2 months ago but I had reduced the treatment and since increasing, I have been fine.  If I had known, I would have used something externally years ago, it would have prevented the atrophy. I just didnt get any advice from my GP.  I was told it was normal for my age. If you start your treatment, you will learn what works and what you need to change.

[CLKD]

I've used KY Jelly internally and around the labia for many years with success.  'ovestin' helps replace lost oestrogen. 

[Maryan1285]

Update.... managed to leave a message at the surgery requesting a prescription for Vagifem but in the meantime I ordered a Box of Gina as replies from the GP usually take 7-10 days.  The order arrived really quickly so I started yesterday but now have terrible urgency to wee all the time. Not sure if it is a genuine UTI as no burning or pain. Should I take a specimen to the surgery on Monday just in case ? I am loathe to do so as it takes forever to get the results.

I have read that VA can mimic UTIs so really confused. Thanks in advance for any replies.

[Jules]

Update.... managed to leave a message at the surgery requesting a prescription for Vagifem but in the meantime I ordered a Box of Gina as replies from the GP usually take 7-10 days.  The order arrived really quickly so I started yesterday but now have terrible urgency to wee all the time. Not sure if it is a genuine UTI as no burning or pain. Should I take a specimen to the surgery on Monday just in case ? I am loathe to do so as it takes forever to get the results.

I have read that VA can mimic UTIs so really confused. Thanks in advance for any replies.

You can get feelings of  a UTI with VA. Ive a history of UTIs and in my case, the difference was distinct. My UTIs were sudden and escalated quickly to the point I desperately needed antibiotics. I was doubled over with the pain. My VA symptoms were milder discomfort, needing the loo more but not the awful pain that I got when I had the infections where I couldnt get off the loo and didn't go worse

[Ayesha]

The thing with GSM (VA) treatment it can take so long to work that its easy to think something else is going on.
For me it took four months to start to feel better, back to my normal self with Vagifem, Estriol and a moisturiser.
Patience is the key but if after three months you think the treatment is not having any effect, then seek further help with your symptoms.

[CLKD]

Vaginal Atrophy mimics repeated urine infection-type symptoms really really well.   When I do a reload I get the 'need2P' feelings so take nurofen, 2 x 3 times a day which 4 me eases the nip as the urine flow shuts off. 

U should find that after a couple of nights these symptoms disappear.  Let us know!

[Maryan1285]

I now see that sorting out the right treatment is a bit like a jigsaw .... all the pieces  have to fit and take effect.  Decided to do a urine dipstick test and unfortunately it is quite positive even though I hardly have any symptoms but I don’t think I can kick this with  loads of water and D Mannose.

 This is the 3rd UTI in 10 months! All started after catching COVID last year...maybe a coincidence but  before that I may have had one every 3  - 4 years so doing quite well considering I am 79.

Question is  - do  antibiotics  change the normal flora of the vagina and would taking a probiotic at the same time help.?

I know it is early days on HRT but getting increasingly stressed and fed up with getting old. But hey ho keep on telling myself it’s only a number !!!

Happy Monday to all .

[CLKD]

The best way to know if you have a urine infection is for a sample to be sent to a Lab for testing. That way should you require anti-biotic therapy - which will relieve symptoms with/without infection present - the correct drug will be prescribed.

As we age the skin becomes thinner - do continue with the VA treatment as it may take a while for the skin to uptake the product.  U should find that the need2P feelings ease. 

ABs alter the gut flora from mouth downwards.  Taking a probiotic at the end of a course will allow the AB to do its work.

How do U feel this morning, did U need to get up in the night?  What do you consider 'positive', many have signs of blood due to VA for example.  The thin tissues up there may well bleed until treatment begins to replace the oestrogen.

The whole body may become dry: scalp, deep in the ears, nostrils, skin ........ due to a lack of oestrogen which is our elasticity. 

[Maryan1285]

Looking at the test strip the leukocytes were high, nitrites negative,protein negative ,ph 7.5 ,blood**(80). Not sure what all that means. Don’t really have any symptoms other slightly cloudy urine and
 visiting the toilet more than usual but then I am drinking about 2 litres  of water a day.
I did get up 3 times last night but that is quite usual for me.

Just off to the surgery to drop in a specimen....hope the results come back quicker than last time.
 
 Thank you  CLKD so much for your advice it has put my mind at rest particularly about the blood in urine. I am afraid I always think the worst !!

[CLKD]

Was the cloudy urine the first P of the day?  Do the GPs ever ask these days  .  Years ago 1 had to deliver a mid-stream sample 

Let us know what happens?