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[pebbles]

I am 61 and I use everol conti patches for about 8 years i think- I have reduced them to 1/2 patch twice a week about a year ago. Recently the vaginal dryness/itching has been awful. I also have experienced a lot of urine infections/ urethral irritation and pain when passing urine. GP gave me estriol 1mg cream but i still have to use it daily and I feel that it irritates me too ? It does help though.
I was thinking about going back to full patches but i reduced them as i felt really anxious, not sure if due to the patches or not tbh.... I dont have flushes any more but i am very depressed and i was recently found to have an old fracture following a minor fall so a bit worried about osteoporosis... oh the joys.
My GP tries her best but they are just so busy and they dont have the time to spend on this. i have never had any form of blood work and even take my own BP on a shop bought blood pressure monitor, so rarely see a GP. Does HRT help depression and crazy thinking ?  : )
There doesnt seem to be  anything that helps, I have been on anti depressants a lot historically and never found them to be helpful..

[AngCho]

I don’t know what to do either! I am 70, had an easy menopause and so have never been on systemic HRT. My vaginal atrophy, UI symptoms and burning seemed to come out of the blue this summer. Currently on week 9 of Vagirux and Estriol and messing about with the dosage. Went to GP yesterday with acute soreness and UI symptoms. She took swabs and did urine test with results expected Friday. I know in my heart that they will come back negative. I agree that GPs don’t really have time for this. I have seen a private urologist, who prescribed the first lot of Vagifem, but I don’t think he’s the right kind of medic for this issue. The GP yesterday suggested that I consult a private specialist yesterday as the waiting list following referral to NHS gynaecology is 18 months! So I’m looking for the right kind of specialist but thinking that I’m going to have to sort myself out.
I hope you find a solution. I have found out a lot of stuff and gained some useful tips by search and browsing this web site. Onwards and upwards…

[orrla]

Do yourself a favour ladies and, stick that whole patch on! If it wont go away, stick another!

In a meantime, stick in Estring. It will help, no mess!

Your vaginas are dried from lack of hormones.

But stuff vaginas. Urine tracks are made of same. So only systemic HRT will prevent further UTI like symptoms, leaking, burning, whole jazz.

Do you want to pee uncontrollably to the end of your life?

70% of older women do! ...because they listened to whipped up whole panic about, and were afraid of HRT!

That HRT that makes body stronger, and protects bones!

[CLKD]

If your GP hasn't time in the 10 min app allowed by the government of the day, ask for a double appt at the end of Surgery time.  Or see a Nurse Practioner who at our Surgery have longer slots than the GPs do.  Take a list of worries with you. 

U could ask for a referral to a dedicated menopause clinic - there R waiting lists so sooner rather than later, U can always cancel the appt when it does arrive if you no longer require it.

[Ayesha]

If its a case of straight forward VA (GSM) topical oestrogen is the place to start. It can take months of consistent treatment, sometimes every day until symptoms ease and its really a condition that you can take full control of yourself.

This document helped me to understand the science of it all, worth a read and worth printing a copy
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[Dr. Heather Currie]

For vaginal and bladder symptoms, vaginal estrogen should be the focus as stated. There are a range of different types and it is usually possible to find one that suits, and it can take several months, as Ayesha explains, to have the full effect. Increasing patches at this stage is unlikely to help and is more likely to cause side effects.
Great advice is to ask for a longer appointment either with a GP or Nurse Practitioner.
Hope this helps.

[AngCho]

Thanks everyone. I think I need to be patient, stay hopeful and stop feeling sorry for myself.

[CLKD]

U can feel sorry for yourself if you want to >wave<.  MayB keeping a mood/food/symptom diary would help, to jot down the better days ;-). It's easy to 4get that we do have them when in the middle of peri.

Let us know how you get on.  I missed the patience gene somewhere along the line ;-)

[pebbles]

Thanks everyone for your messages.
I have started using the ovestin every day again, as the itching was driving me mad and adds to my depression.
I do find it difficult asking for what i need and i have been at the GP via econsult  a lot recently with UTI's, arthritis in my hands and my leg/ankle following a fall. I really appreciate this site. thanks everyone 

[CLKD]

It's a small amount of active ingredient so continue every night until comfy.

Let us know how you get on both.  It's a bit Trial and Error initially so worth persevering.  When my symptoms niggle I take 2 Nurofen 3 times a day which eases the nip as the urine flow shuts off.

[AngCho]

Instead of twice a week I’ve been using the Vagirux every other night and Estriol externally every night. I have been doing this for a week and actually am starting to feel a bit better. I have made a private appointment to see a gynaecologist who specialises in menopause later this month. (I am hoping she will allow me to use the vaginal hormones more frequently than the official doses, and advise my GP accordingly). I am hopeful that I can manage this awful VA. Today has been my best day for a long time. Thank you all for your advice.

(Urine test came back from the lab negative - as I knew it would. Waiting for swab test results. Bet they are normal as well!)

[CLKD]

VA then AngCho ....... using nightly should help and there is no reason not to continue this regime.  'official doses' ........ ignore ;-)

[Ayesha]

I am hoping she will allow me to use the vaginal hormones more frequently than the official doses, and advise my GP accordingly)

If it helps to reassure you, when the 'official' dose of two a week Vagifem was having no effect on my condition I phoned my GP who is a gynaecologist and she told me to increase my dose to every day, I sounded shocked at this and she explained that the dose is so low that it doesn't even reach the blood stream, she also told me its what she does and had no hesitation in increasing my prescription. She later included Estriol cream as the Vagifem wasn't reaching down below. Four years on I don't have any symptoms and am leading a normal life, like being able to sit down in comfort for instance.

If you are simply visiting a private gynae for GSM (VA) symptoms alone I honestly can't see the need to pay when your own GP should be writing you a prescription for the amount of oestrogen you need to control your symptoms, if its ok for me and my previous GP (I have recently moved) it should be ok for you too.

[pebbles]

Thanks everyone for your messages, very helpful.
I am still continuing with half evorel conti patch twice a week and using the ovestin on the urethral area twice a day. This has significantly helped with the dryness and an added bonus is that my pubic hair seems to be growing back....  However although the dryness is better i still have this awful itch. I am not sure if it is the ovestin that is causing the irritation or what . I had read online - dr google lol that it is ok to use over the counter hydrocortisone cream for this on a daily basis ?
Has anyone else tried this ?

[CLKD]

Steroids should be for short term use as they can thin the skin.

R U able to explain where the itch might be, I get it in various places around the vagina/labia/vulva so use KY Jelly, lots of - then lay on a towel in bed reading to allow it to soak in.  As well as 'ovestin'.  Sometimes treatments can cause irritation usually due to the fillers or container rather than the active ingredient.

How about using the 'ovestin' at night in the 'open air'?  Could it be that clothing is drying out the morning application: 4give me if I've misread that : so that it isn't proving useful?