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[MrsMitch]

Hello ladies 👋👋
I really hoped by now I'd be pain & symptom free from VA or whatever it's now called which I forget! Having had it for over 12 years undiagnosed or treated & finally getting estriol pessaries & cream x7 weekly. But nope, things are getting worse. I had a brief spell of around maybe 4 plus months when all was pretty good but then things have got much worse.
I managed to have a smear test only by using extra pessaries for a week before ie 2 per night. That was really good. But I didn't particularly want the extra expense every month. Should have carried on though.
I've just finished my 3rd course of antibiotics for what I & GP assumed was a UTI. I've had 2 urine samples tested, both showed nothing. Yet I'm still peeing every 20 mins & always have the urge to go.
I'm hoping the lovely GP at my practice will let me have a face to face appointment with her when she rings me tomorrow so she can then refer me back to the menopause specialist I've previously seen.
So lovely ladies: are any of you on a higher dose of vaginally oestrogen than both cream & pessaries nightly? I'm also using testosterone but my latest blood test is 0.3 & see hormone 62.8 & the surgery wants me to split each tiny sachet into 20 doses!!!
Is there anything that will get rid of the pain plus urinary symptoms or is there no hope. I'm really fed up. Sorry for the essay but after all these years I just want to be normal. (I do also use oestrogen & progesterone).
Thank you.

[CLKD]

Your GP was remiss in repeatedly prescribing ABs for an infection that didn't show, however there is a condition where an infection may become embedded in the bladder.  Your GP should now refer U 2 the appropriate Clinic as this may well be out of his/her skill base.

Blood tests are reliably un-reliable.  U should by now have had relief with appropriate VA treatments.  When my symptoms niggle I add an extra insertion of 'ovestin/estriol' mid-afternoon, take 2 Nurofen then do a 3-5 night reload.  Works for me.

U need to be referred to a dedicated Menopause Clinic.  Is that hormone level the same every day for example, very unlikely?  So splitting the sachet ........ I expect some1 will be along with more knowledge about the use of Testosterone.  Who prescribed this initially?

The Change - does what it says on the tin.  Which HRT have U been prescribed?

[sheila99]

Have you tried using cream internally instead of pessaries? You might absorb better that way particularly if the atrophy is bad. Is there any scope for increasing systemic oestrogen as that can help too?

[Ayesha]

You've been going through this for a long time, I would have thought you should be referred to urology perhaps, I think you should be seen by a specialist and not necessarily a menopause specialist.

[Shirazette]

If you're on estriol pessaries (Imvaggis?) they are weaker than vagifem estradiol pessaries so it might be worth switching to to them as also they will target different receptors to the estriol cream. However if you're already on the estradiol pessaries it might be worth trying the Imvaggis estriol pessaries as the hard estradiol pessaries might not be melting enough (which happened to me) whereas the waxy Imvaggis pessaries melt more easily.

[MrsMitch]

Thank you ladies. I have used the cream internally before when the pharmacy would only get that & not the pessaries. I wasn't using it long enough like that to know if it was better so I will try. I do know that the little hard pessaries are slow to dissolves because I had an internal ages ago & the GP said see could see the remnants of one!
I'm getting stabbing pains in my urethra from vaginal end up towards my bladder - I'd had those for a while before I ever had VA symptoms so I do wonder if my UTI symptoms are simply lack of oestrogen.
Can anyone remember what Louise Newsom uses - I vaguely remember her mentioning she uses testosterone vaginally combined with oestrogen which targets the area. One of the reasons I was prescribed testosterone was for bladder issues.
I have seen a dedicated menopause specialist at the hospital- took 18 months to get to see her. I'm going to ask to be referred back to her.
I do seem to do pretty well on higher oestrogen,  vaginally,  I have been on 7 pumps in the past of gel which didn't help VA.
Thank you for listening & suggesting things. You're a massive comfort 🤗

[MrsMitch]

GSM & Intrarosa!! That's the two things I was looking for,  found the answers on another thread!
Going to ask my GP when she calls me today if the Intrarosa might be better as I believe it delivers testosterone right where it's needed.

[Old Frumpy]

Hi
I really feel for you - I'm in my late 60's now but when I first started on Vagifem  the soreness was of the scale, I would sit in the cool bath in the middle of the night as so sore.

I went to the Out Hours GP and he mentioned irresistible cystitis or IC and inflammation of bladder lining even my own GP hadn't heard of it. He was so kind and wrote down who he felt might help. Eventually referred to Gynie who dealt with urinary problems as well and she prescribed Vagifem and also medication to reduce acid in urine.

Seems can be a something that shadows us.
,

[Northerngirl]

Hello ladies 👋👋
I really hoped by now I'd be pain & symptom free from VA or whatever it's now called which I forget! Having had it for over 12 years undiagnosed or treated & finally getting estriol pessaries & cream x7 weekly. But nope, things are getting worse. I had a brief spell of around maybe 4 plus months when all was pretty good but then things have got much worse.
I managed to have a smear test only by using extra pessaries for a week before ie 2 per night. That was really good. But I didn't particularly want the extra expense every month. Should have carried on though.
I've just finished my 3rd course of antibiotics for what I & GP assumed was a UTI. I've had 2 urine samples tested, both showed nothing. Yet I'm still peeing every 20 mins & always have the urge to go.
I'm hoping the lovely GP at my practice will let me have a face to face appointment with her when she rings me tomorrow so she can then refer me back to the menopause specialist I've previously seen.
So lovely ladies: are any of you on a higher dose of vaginally oestrogen than both cream & pessaries nightly? I'm also using testosterone but my latest blood test is 0.3 & see hormone 62.8 & the surgery wants me to split each tiny sachet into 20 doses!!!
Is there anything that will get rid of the pain plus urinary symptoms or is there no hope. I'm really fed up. Sorry for the essay but after all these years I just want to be normal. (I do also use oestrogen & progesterone).
Thank you.

Hi MrsMitch , nice to hear from you again but sorry to hear that you're still struggling with all this....it doesn't get any easier does it !!!!
I don't really know what to advise but certainly empathise with your symptoms. We seem to go through the same things at around the same time you and I.
As you know I stopped all HRT 20 months ago (ish) and started vagifem this March.I also seem to go through episodes of uti like symptoms and going to the loo every 20 mins etc...it seems to pass eventually and I'm just left with this bladder pressure.
Unlike you I was seen by a urologist and had a cytoscopy Nov 23, so I know my bladder is ok...he did say my "peepipe" (his description not mine 😂) was very narrow and he stretched it best he could, it gave relief for a day or 2 and advised vaginal oestrogen and that was it.
Maybe seeing a urogynaecologist maybe helpful....hopefully your GP will offer some good advice today.
Let us know how it goes xx

[MrsMitch]

Hi NorthernGirl 👋 good to hear from you, too, just wish we both has great news about our health. We do seem to coincide with issues, don't we?
My GP called & I'm seeing her at 1.30 today & taking in another urine sample. I'll report back.
I looked up the condition you mentioned Old Frumpy & it seems to be called Interstitial Cystitis. I will mention that to her.
I've also got a very odd dull throbbing very high up in my vagina. It is exactly the same as the discomfort I had years ago when I had a cone biopsy on my cervix. But apparently my GP wants to try an internal exam if it's possible. Gritting my teeth in advance for that as I can't see it happening!

[CLKD]

Hopefully you told the GP a firm 'no'?  It's your body, her suggestion 

[MrsMitch]

Well I'm back from the GP. I'm very fortunate to have her in that she listens & says she knows we need to get on top of my issues. She was the GP who actually managed to do a smear test when I thought it'd be impossible & she managed an internal this time with very little discomfort. She said everything is as red as a baboons bum! My urethra is very inflamed too. However it seems I have raging thrush which could have been the cause of initial irritation of my urethra or be as a result of 3 rounds of antibiotics. So now I have more!
She wants me to use the estriol pessaries & ovestin internally, too, nightly & see where we are in a month. She's sent a swab off re thrush but I've got the antibiotics to start anyway.
She did say she would keep seeing me until I'm out of pain & hopes it won't be necessary to refer me back to the menopause specialist at this stage.
My last testosterone blood test results mean I've got to make 1 sachet of testogel last 20 days! She said there is little evidence testosterone helps bladder issues but from what I've read here, I'm not sure I agree. That said, it doesn't seem to have helped mine. It did initially as well as for libido but I'm not sure it's doing anything anymore.
So overall, ladies, pretty good appointment. At least she's willing to try to get me sorted out.

[CLKD]

Why have U been given more antibiotics?    These are known to kill the bacteria throughout the digestive system and unless a swab has been sent for testing, the GP cannot know which AB to prescribe. How many days B4 this latest result is back?.  Do U feel that you require yet more ABs when none of the others have actually helped symptoms?

I would wait for the swab report and begin the appropriate VA treatment - 1 now and another this evening then every night until symptoms ease. Which mayB a long time as you've had so many problems getting this under control. Which estriol pessaries have been prescribed?  I am fortunate in that ovestin worked almost immediately, initially pessaries which were withdrawn. Now I have the tube with an applicator [estriol] plus I smear a little around the urethra and labia [or KY jelly] - anything to stop the area becoming dry = itchy. 

When symptoms niggle I have found that swallowing nurofen x 2 in the afternoon plus a 'extra' insertion of estriol really helps, then going into 3-5 nights of esrtriol.  I've been 5+ years with this and so far it's worked in that the initial urine infection-type symptoms went with regular treatment.  PHEW!



I would also ring the Surgery and ask for the appt to a menopause specialist now as there are in some areas, 12-18 months waiting lists even in the private sector. When the appt does arrive U can cancel if it's no longer required.

Hopefully some1 will be along re testosterone.  VA is usually due to lack of oestrogen which may make the whole body dry: inside and out; scalp, deep in the ears, nostrils [me] skin, vagina, anus ..........

When I had thrush after stopping The Pill and 20 years later when I had emergency surgery, it was an itch that I was unable to reach! high up.  Fortunately I didn't have the thick creamy discharge which can accompany the itch!!!  Nor was my vagina smelly.

Let us know how you get on. 

[Northerngirl]

So glad for you MrsMitch that you seem to have a GP that actually cares and wants to solve your issues.....hopefully these antibiotics will help before your swab result comes back. Did you think you had thrush?
Keep us updated and good luck xx

[CLKD]

How to get rid of Candida in NHS?

You'll usually need antifungal medicine to get rid of thrush. This can be a tablet you take, a tablet you insert into your vagina (pessary) or a cream to relieve the irritation.

What is your GP actually treating