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[misskh]

A week after finishing antibiotics for a 3rd UTI, lab tested samples, and I'm burning again/feel discomfort around the vulva area.

At the moment my urine looks clear, no smell, but I did notice early this morning that the vagifem pessary I inserted last night had slipped down and was sat at the opening to the vagina.

I was wondering if it's possible that this could be the cause, if the pessary had been sitting there for most of the night could it give off a burning sensation if that area is quite dry.

I've taken a dose of D-mannose first thing, an ibuprofen tablet and applied a bit of canesten cream ( thinking it'll help some way), in the hope that it'll ease the burning.

As a side note I've had a scan and now awaiting a referral to see a urogynaecologist as it was seen that my bladder doesn't fully empty but there's a 5/6 month waiting list so looking like Nov/Dec before that will happen.

Would anyone know if its possible that the pessary could be causing it and it'll ease off soon or am I on my way to yet another UTI?
Many thanks.

[Suziemc]

Can't comment on the burning but I have a friend who found pessaries weren't dissolving. Turned out her vagina was so dry there was no moisture at all to start the dissolving action of the pessaries. She found that putting some moisturiser (like Yes or replens) onto the pessary/end of applicator worked to help dissolve it once in place.

[Ayesha]

If the pessary is not inserted properly it will hurt like hell and it shouldn't fall out. The only way I can describe it is if you don't insert a tampon in the right position that will also hurt.
Using a moisturiser will help but there's also an alternative like Estriol cream might suit you better if the cause could be weak muscles making it difficult to insert the pessary.

[Ayesha]

I would say you are not using enough treatment to be effective. Two or three days a week is just not enough and both treatments need to be used together.
My regime is every day Vagifem, a smear of Estriol twice a day on the outside and I also use a moisturiser.

Are you worried about using too much GSM treatment?

[Ms_london76]

I am also new to vagifem. And yes it causes burning. It is normal.

You are stimulating that area. My female pharmacist said it is
normal as you your body gets used to using it.

Also been recommended using over the counter stuff for any burning.

I have just shy of the loading phase, and choose to do it slowly pulling away from using it.
Instead of 2 times a week maybe every 3 days.

I exoerience the burning still at the two week mark.

[misskh]

Ayesha... Thank you.

To be honest there are times when I want to apply the cream more often but do hold back due to so much different advise.

I've honestly learnt more information from forums like this one than any Dr has given me. I'm not saying they aren't knowledgeable but just believe that it's not a case of one dose fits all.

My regime at the moment is vagifem Mon, Wed, Friday.
Estriol cream Tues, and Thurs, both just before bed and YES moisturiser every morning.

I'm more than happy to up, especially the cream, although I have been suffering from UTIs for years they seem to be happening more frequently since I had a total hysterectomy.

 

[misskh]

Ms_london76...

Thank you...

I've been using it for around 8 or 9 years, could be more but it never seems to keep the burning/UTI's at bay.

I'm now in my 60's and have suffered from them since my early 30's.
There are times I think they're like cold sores that just linger waiting to pounce.

I used to use canesten hydrocortisone cream but it's a bit difficult to get hold of and the pharmacist always asks what it's for, always saying it's not recommended for vaginal use now...used to be pretty helpful.

Like a lot of people face to face appointments are now few and far between but I'd like to see if I could go on a long term low dose antibiotic, was hoping I could have a chat with the urogynaecologist about it and see what they think.

I'm of an age now where I'd prefer quality of life rather than living to a grand old age..

[Ayesha]

To put your mind at ease here are the latest guidelines on treating GSM.

"The clinical response to treatment with topical oestrogen is usually rapid and sustained.
Women should also be advised that the information packaged with vaginal hormone preparations is out of date and factually incorrect. This needs to be changed by the MHRA.
The dose of vaginal oestrogen is very low, for example, using 10mcg oestrogen pessaries regularly for one year is an equivalent dose to just one 1mg of oestradiol HRT tablet.
If symptoms do not improve with vaginal oestrogen, consider increasing the dose, changing preparation (and consider DHEA) or using an additional treatment such as systemic HRT or two local treatments.
The frequency of using these preparations can be increased in women who have persistent symptoms as the doses of these preparations are very low.
Vaginal oestrogens can often improve urinary symptoms, including urinary infections.
Some women use vaginal oestrogen preparations more frequently than the recommended dose to improve symptoms sufficiently, for example Vagifem alternate days instead of twice a week. It is safe to use the treatment in this way as the dose is very low.
Women should be reassured that it is safe for topical oestrogen to continue in the long term (medication should be on a repeat prescription). Women should continue to be reassured about the long- term safety of vaginal oestrogen preparations."

The pdf document if you want to print it for further information and until you get that appointment which will hopefully have some answers for you.

https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[misskh]

Thank you..

I've downloaded it and will make some notes for when I see the urogynaecologist.

I'm normally a bit of a wallflower when it comes to seeing specialists, and say nothing but I'm so fed up with, what feels like, constantly feeling uncomfortable.
It really can affect every day living.

[joziel]

misskh, you should feel free to liberally use as much as you like of both Vagifem and Ovestin.

When I had these symptoms, I used Vagifem every night and Ovestin every morning and evening, along with YES VM externally and I would often apply more Ovestin in the middle of the day.

It's imperative to get on top of the broken skin and stinging/burning. It's pointless suffering to stick to some arbitrary amount or only twice a week dosage...

[misskh]

Just a quick update...
Hopefully won't jinx things.

I've felt much better since applying the cream twice a day.

I still have a very mild stinging, not burning, feeling first thing after my morning wee once the cream has been applied but I put this down to there still being a bit of dryness still, so will continue with twice a day.

Also take D mannose once a day, mainly because I bought some months ago and I may as well try it.

I also got my appointment to see the gynecologist, although the referral was to see a urogynaecologist, not sure if they come under one title, come through today very unexpected as when I called to check last week I was told more nearer December so that was welcome.

Many thanks for the suggestions to up the vagifem/ cream hopefully it'll go some way to helping stop these awfully painful flare ups and ill definitely be sticking to using it more than twice a week.