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[Cedrus]

Afternoon ladies
You are all a wealth of information so am hoping you can help me I am 60 had an hysterectomy in my 40s but luckily didn’t need hrt but this year I have been having loads of problems the first was redness by Vulva and friction burns when walking, then urine infection , redness round anus and very sore and dry inside which I was using yes for. the first doctor just kept giving me creams for the soreness which didn’t really help that doctor was a women then I got a urine infection and at last spoke to a male doctor who said it was VA so told me to look at menopause sites and then we will discuss what to do and he said I could see him next time we’ll that didn’t happen another phone call and a random doctor put me on estriol which I used for a month and just made it worse then another doctor said blissel which again made it worse so at the moment after doing my own research am using victory oil for out side and hyalofemme for in side which that helps but my problem now is that I now have an anus fissure which again I think is connected and my skin around my anus is red raw so my question is could this soreness by my bottom be connected to the menopause and has it happened to any one else ? This is really getting me down as I just don’t seem to be getting any where with the doctors and I am now having problems sitting sorry for the long post

[CLKD]

OUCH!   This condition needs to be seen, diagnosed and treated appropriately. 

How is your diet overall?  Also your urine; as acidity can cause the bottom skin to be sore and split.  My GP recommended 'anusol' over the counter applied liberally. It might sting ! 

This will make sitting painful, one idea is to buy a ring support from a medical aids-type shop to sit on, which relieves any pressure on the sorer areas.  Is there a Nurse Practitioner with whom you could make an appt.? 

Nappy rash is treated with, I think, sudacrem which may be another route to try. 

You mention a urine infection, was a sample sent to a Lab to be 'grown' to C if there was a bug?  Also there is treatment for a condition, Vaginal atrophy.  Do read 'the bladder issues' and VA threads on the Forum, make notes. 

[Cedrus]

OUCH!   This condition needs to be seen, diagnosed and treated appropriately. 

How is your diet overall?  Also your urine; as acidity can cause the bottom skin to be sore and split.  My GP recommended 'anusol' over the counter applied liberally. It might sting ! 

This will make sitting painful, one idea is to buy a ring support from a medical aids-type shop to sit on, which relieves any pressure on the sorer areas.  Is there a Nurse Practitioner with whom you could make an appt.? 

Nappy rash is treated with, I think, sudacrem which may be another route to try. 

You mention a urine infection, was a sample sent to a Lab to be 'grown' to C if there was a bug?  Also there is treatment for a condition, Vaginal atrophy.  Do read 'the bladder issues' and VA threads on the Forum, make notes. 

I feel like all the symptoms are connected but you know what doctors are like at the moment they don’t seem to want to know it’s as if I start to get the front of me sorted and then the back starts playing up I was only at the doctors two weeks ago seeing the nurse and when I told her I wanted to ask about something else that was connected to my issue she told me she couldn’t talk about anything else and that I would have to make another appointment , I first started going to the doctors in February this year and we are now august  and I don’t feel like I am getting any where even when I tried the estriol and blissel there was know I want to see you in a months time to see how your doing.

[CLKD]

It's seems 2 B part-time care these days  .  As if discussing something that may/not B connected take too much time!?!?!  What happened to 'care'.

At least at our surgery I take a list so that my GP can go through it with me and he always asks 'anything else'. 

Do U have a Plan as such?  Personally I would buy 1 of those cushions with a hole in to lift the buttocks as well as Sudacrem or similar and apply.  Gently. On the outer area initially at least every 20 mins., without knickers when possible.  As the skin becomes less tender include any area that requires treating. Laying on a thick bath towel face down if possible will also help. 


 We would probably get better treatment visiting a Vet Surgery  . 

[Of course Granny would say sit in a warm bath with lots of salt  or Dettol ....... and there was Zinc and Castor oil which I think was green  ]

It's supposed to be Pharmacist First but I wouldn't be keen with something so personal though discussion there may be an idea. 

[CLKD]

I haven't actually answered whether this might be due to low oestrogen: as levels drop the body may become dry: inside and out.  Skin, deep in the ears, eyes, nostrils as well as vagina and anus.  Vaginal atrophy can become problematic too.

[CLKD]

Morning.  Did U sleep ?

[joziel]

I'm sorry you've been treated like this. If you had an ovario-hysterectomy in your 40s, you should (no question) have been put on HRT until the age of average menopause for women (52). The reason for this, is that early menopause (which you would have been plunged into) definitely increases the risk of osteoporosis, dementia, cardiovascular issues etc etc.

Whether you then decided to continue HRT past typical menopause age, would have been the decision to make - but not whether to go on it until then. Until then it is replacing the hormones you lost.

And yes, the symptoms you are experiencing sound very similar to mine before starting HRT. I not only had VA but also itchy soreness around the anus as well.

You can at the very very least demand some Ovestin cream to apply there (local estrogen). You need this for the VA at least and you can also apply it further back to that area. But really you need systemic HRT for optimal health....

[bombsh3ll]

Certainly it can be related to low estrogen, but has a doctor actually examined you since this started?

I would not keep throwing creams at it without an examination as you could have a condition that requires specific treatment.

Make an appointment for this one issue.

Don't try to tack it on to an appointment for something else - they have 8 minutes.

Ask for your vulva and perianal region to be examined by a GP and swabs taken if appropriate.

If this doesn't get to the bottom of things (pardon the pun) 😉 ask for a referral to a specialist - either dermatology or some gynaecology services have a dedicated skin clinic.

[Wren]

Cedrus,  I have suffered with burning and soreness to the whole pelvic area.  The anal area being the worst to deal with as it prevents walking, sitting, sleeping.  Stood up all day sometimes - and bathed in the middle of the night!   (no UTI's or any redness - nothing visible).   It's been over 4 years for me - the knowledge and information just isn't available.  Consider the ignorance of VA symptoms and I've found it even worse for how oestrogen affects the anal area.


I have found a little info on menopause websites so will have a look through my notes.  In the meantime this might help -


https://www.balance-menopause.com/menopause-library/pelvic-floor-health-during-the-menopause/

If you've been diagnosed with a fissure, the NHS website has info on treatment/prevention. 
For me, the area would bleed when walking - but not a fissure.

It's early days but in the last 3 weeks things have improved and I can walk in comfort.  Three weeks doesn't sound long but it's a definite change for me. The turning point was a GP persisting and providing timed, follow up appointments (and willing to prescribe daily local oestrogen).  What is working for me -

Ispaghula Husk (Fybogel) - I didn't realise I needed this! 
Drinking more.
Keeping moving even if can't go for a walk.  Pelvic floor stretches improve circulation.
Getting the right dose of local oestrogen that works for me.

I've tried various doses of Estradiol pessaries (Vagifem, Vagirux, etc) - steadily increasing till I've got what works.  For me it's a pessary nightly and daily use of Ovestin externally.  (In the early days I started on Ovestin internally - this didn't work for me).  I apply a tiny bit to the rear but that was a slow process - stings at first.  Until the skin calms down/overcomes dryness I find anything burns.  Once the Ovestin has absorbed, 15 mins or so, I apply emolient.  I can't imagine walking with no emolient.  I wash with emolient too.  No perfumes, scented washing products, shampoos allowed near me!  I also find I need to use Yes VM daily  to keep moisturised - a couple of hours before the pessary.  I also find bathing in a small bit of bathwater soothing once a day - in and out though and applying emolient to that area first, otherwise it's drying.

(It's taken over 4 months of daily pessary to make a difference for me.  Once oestrogenized the skin has become comfier).

I also looked at pelvic floor dysfunction and, whilst waiting for a Womens Health Physio appointment, I've found a book helpful - 'Heal Pelvic Pain' Amy Stern.  It has good info including stretching exercises and massages to help the pelvic floor.

As Bombsh3ll says though, you need to be examined by your GP - including the anal area.  It's important to rule things out - including for your peace of mind.

[Wren]

Don't know how I didn't see joziel's post till after I posted.  Reassuring for me to find someone else who had the same problem.

Cedrus, I'm the same age as you and had early 40's meno - not offered HRT - so likely similar low/no oestrogen situation.

I'm on the 3rd attempt at systemic HRT over the last 3 years - HRT caused bleeding.  First try, 9 months at a 50 patch, 2nd try, 6 months at 50 patch, both with 100 Utrogestan.  I've now had a Mirena + a 25 patch for 3 months (increasing to 50 now).  I'm persisting with systemic to hopefully help bone density - and overhall health - I didn't know back then   

I didn't find the 50 patches helped me with the VA symptoms but maybe need longer/higher dose and so it's unlikely this low 25 patch has turned the corner for me re the rear area - unless the Mirena Coil has benefitted in some way.

[joziel]

Wren, if it helps, I needed local estrogen (Vagifem and Ovestin and Yes VM and some kind of bee wax one I forget the name of now) twice a day, it was a whole ROUTINE for a long time - I needed that until I got my estrogen to about 4-6 pumps of gel.

Then I found I suddenly had enough systemic estrogen that I could just drop all this stuff I apply locally and still be fine. I now use nothing at all locally, just systemic HRT - and am totally fine. My estrogen is around 326pmol even on 12 pumps of gel now (same as it was on 6 pumps - I'm not absorbing all the extra).

We are trying to get me even higher due to severe night time symptoms, but the VA has completely gone.

[Cedrus]

Thanks ladies firstly when I had my hysterectomy in my 40s I kept my overies so wasn’t given hrt and not sure when I started going through the menopause it’s only really been the last couple of years that things have started getting worse for me. I have never been examined to see if I have VA just told over the phone that that is what I probably have but all my issues seem to be coming at the same time so first it was feeling as if I had a urine infection then actually getting one and it took two lots of antibiotics to clear it then soreness between my legs the perineal area which I did get examined for and my female doctor couldn’t under stand was was going on and now I think it’s that some times my urine burns my bottom area and that’s why it’s red raw and sore and then I got an anal fissure which I have been examined for. I think they are all connected but you try telling the doctor that,I am also having problems with my gut as I get quite gassy and stomach hurts so now I am taking Yakut to try and help that I feel like I have so many issues but still believe they are all connected  but when you try and explain  I feel like they are not listening to me .

[CLKD]

Remind me Cedars: were urine samples sent for testing to see if a 'bug' was growing and appropriately treated [menobrain here  ]

As we age our digestive system may alter - so keeping a diary of what you eat for 3-5 days to see whether you can alter/add to help.  Yakult is good: I used 'actimel' for several years which eased my slow bowel transit.  Alcohol is certainly 1 that many find becomes problematic.

It really can be Trial and Error  .  And wearying at times.  But worth persevering. 

If your urine is burning: and it has happened to me a few years ago : then mayB spread vaseline around the area several times a day which will protect the already delicate skin.  If U have VA treatment, continue with it.  Every night if necessary. 

Don't despair.  Did your GP. not refer you for appropriate anal fissure treatment?   Let us know how you get on.  Do the symptoms keep you awake?

[Elissa]

Hi Cedrus, this is my first post outside of my now lengthy 'new member' thread about vaginal atrophy! Just wanted to let you know that I am being treated for dryness (Ovestin internally twice weekly and externally a few times a week) and the bulk of my issues have been in the perineum/bottom area.
 
Symptoms have been mainly redness and burning in the perineum/bottom area.  I have also had anal fissures at the same time which I am also convinced are caused by low estrogen/dryness. At its worst I struggled to get comfortable sitting and could not wear underwear in the house (only pj bottoms).  I had very sensitive skin on the bum cheeks to sit and also when clothes rubbed.  Also a chafing feeling in my inner thighs (clothes rubbing on this area became unbearable).

Aside from all the perineum/bottom area issues I also had itchiness internally, in the labia area and also paper like cuts in the labia area.

Using Ovestin internally really helped with all areas for me with the exception of the inner thighs.  I moisturised them several times a day and they are pretty good now but it took weeks for an improvement.

I recently had a blood test and was told estrogen levels ok (I'm 41) but that was when I was feeling close to 100% better. Pretty sure if it was tested during one of my really bad periods over the course of the last year and a bit, I would have had a different result.

I really struggled to find people referring to the bottom area online so hopefully this is reassuring. Hope your situation improves.

[CLKD]

My whole bottom area has been sore and tender for a few days so have upped the ovestin and applied liberally 'vaseline' or 'savlon' several times a day, thinking of U Cedrus