Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Starproms on March 03, 2017, 04:49:49 PM
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Could someone please explain to me what vaginal, vulva and womb atrophy is? I recently underwent a scan at the local hospital and those expressions were on my report. Thank you.
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:welcomemm: ...... we have lots of threads on vaginal atrophy so do have a browse - I'll bump the current one for you ;-)
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Sorry, I'm new. What do you mean bump?
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That's OK - if you look at 'show unread posts' you should see the 2 threads with previous conversations ....... one called 'My Bladder etc.'. If you click they will open.
As oestrogen levels drop so the body may become dry: nostrils, deep in the ears, vagina, skin ....... this can cause thinning of skin in the vaginal area which may present with urine infection-type feelings, i.e. the need to pee much more often. These symptoms can be eased by using Ovestin1mg or Vagifem - either is delivered into the vagina every night for 2 weeks then every few nights after to control symptoms. This is different to other types of HRT though some ladies find that they require other types in order to boost the effect of localised treatments.
It can be Trial and Error >:( ::) ..... tell us more about your age, why you were sent for the scan etc..
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Ok here's the story. Thank you for asking. I am 65 years old and have been on h.r.t. for five years. I took Climesse and found it wonderful. It cleared up all my symptoms and I felt well on it. Then! I went to get a prescription filled and I was told it was discontinued. The doctor found me another one, similar she said! but it wasn't. She gave me Elleste 2 mg dose. I took it for one month and then on the third day of the next month, I had a period, which was painful and heavy. I freaked out, went to the doctor (another one - I never see the same one twice). I thought and so did he, that it was the tablets that caused the bleed, but because of my age and the fact that I've been on h.r.t. for five years, but to make sure he sent me to the hospital for a scan, two in fact, one external and one internal. Then I saw the consultant, had yet another internal examination. The scans were clear but he wants to see me again in April just to make sure. I decided then and there to come off the h.r.t. and the consultant agreed with me. I have been off it now for one week. Already I am weepy. I am very worried about the symptoms that I may now experience, having come off the drug. I have, in the past, experienced most of the female problems like cystitis etc. and I don't want to go through all that again.
When I was with the consultant, he was very kind and understanding. After discussing matters with me for a while, he suggested I try yoga, swimming or acupuncture to help myself. Fair comment I suppose, but I have a bad back so don't fancy yoga. If I am to get a dry vagina with associated problems, I don't want to go swimming because then I am exposing myself to all sorts of germs which I will have no protection against. The acupuncture, I have tried before for migraine headaches but after three sessions of that, I then had the worst migraine headache I've ever experienced so I stopped doing it.
I was not prepared for giving up the h.r.t. and it has come as a shock. I now need to find alternatives, which brought me to your site. I am pessimistic. I don't think any of the alternatives will do any good and I am loathe to give myself a new range of problems. I am not anxious or depressed at the moment, but if I start getting the symptoms I had before, I shall soon get anxious and depressed so I need to sort myself out as quickly as possible.
When I was with the consultant, he suggested another tablet - Clonidine I think it was, but when I looked that up I saw that it was for anxiety and depression, migraines and high blood pressure. I already take Beta blockers, I don't have anxiety as I said before and my migraines were under control. I don't want them to come back because I am lacking in hormone balancing!
Unlike some of the posts I've read on here, I love taking the estrogen. It makes me feel great. My breasts fill out, my libido is very high and I feel good. Progestogen makes me feel like just before a period and also causes bleeding. Climesse was a combined pill, estrogen and progestogen in each tablet and it suited me so well.
I want to know why Climesse was withdrawn? It must have been something bad that happened to someone or many someones, but nobody will say. I asked the consultant at the hospital, but he wouldn't say either. I feel cheated. It would have been nice if someone had told the customers that the pill was being withdrawn instead of just finding out at the last minute.
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Hi I'm not an expert - just some thoughts - I think that many manufacturers discontinue things because they are just not selling as many so it is probably just a commercial decision and not that there is a 'problem'. It has happened recently with some other preparations. No one seems to know until they suddenly can't get their prescription. It also happened to me with the progestogen only pill, Femulen, that I was trying for contraception and the doctor had no idea.
Climesse is 2mg oestrogen and 0.7 mg norithisterone. Elleste conti is 2mg oestrogen and 1 mg norithisterone. So it may have been the change in the amount of norithisterone that upset things providing there is nothing else the matter.
They are both at the high end of dose, according to the information on the tabs above. So it is probably a lot to deal with when you are coming off it all at once. I would be tempted to ask to try a lower dose one for a while, then a very low one before coming off completely.
There is topical vaginal oestrogen as well which may help you through the vaginal/bladder symptoms and you can keep taking this.
Hopefully Hurdity and a few others who are more knowledgeable and know a bit about hrt over 60 will have some ideas soon.
;)
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Thank you for your reply dahliagirl. I presume by topical you mean a cream to apply? This is something I could discuss with the doctor, but I wouldn't want one that made me bleed. I think I'm too old for a monthly bleed! ;D but I'm not too old to want to enjoy my physical life as much as possible.
I did ask my doctor if I could reduce the dose of Elleste to 1 mg but he said I would still probably have a bleed and in any case, since I've been on h.r.t for five years, he thinks I am right to come off it. If I had been taking Climesse, I would have weened myself off, but I'm not keen to ween myself off Elleste because it is a split pill. The first half of the month is one thing and the second half is the other.
The real problem for me is that I didn't want to stop the h.r.t. I'm fighting it in my mind. Perhaps that will ease if I stick with it. At the moment I feel like someone is taking my favourite toy away from me and not replacing it with anything else.
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You say the elleste is two different pills ? This indicates that you have been given the sequential version,ie one where where you will get a monthly bleed ! There is a version elleste conti where you don't,or you could try femoston continue but they only have 1mg estrogen,which maybe might suit you better and also give you a more gradual drop down.
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Hi starproms and welcome to MM
I'm 61 and decided to stop HRT after using it on and of for 26 years.
I think it is important to be mentally prepared when stopping HRT but it is a good idea to take a break at your age to see how you cope - you may be surprised and find meno symptoms subside more quickly now.
Give things 3 months before trying a different HRT - patches are preferable when older and there are more natural alernatives to try that bring fewer risks e.g. Estrodot oestrogen patches with Utrogestan capsules (micronised progesterone). See Treatment section at the top of this page.
What you must get is some local oestrogen that is used regularly to Prevent urogenital atrophy. Most of us prefer using Vagifem pessaries as they are less messy and irritating - the fillers in the oestrogen creams can burn.
I will use Vagifem for the rest of my life. It's quite safe as it's very low dose, no systemic absorption and therefore no progesterone needed.
Pop to the GP and ask for this - simply explain that you are very dry and sore and you know this is what you need. DG.
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Dazned is right.
You should have been on: ELLESTE DUET CONTI* 2 mgs estradiol & 1 mg norethisterone daily
It sounds like you are taking: ELLESTE DUET 2mg* Estradiol 2mg Norethisterone 1mg for 12 days/28. Which is for perimenopause and designed to give you a monthly bleed. This usually happens on the third day after you have finished the pills containing progestogen, which is what happened to you.
Please check your packet and instructions and see the pharmacist, then go and see another GP and get the right one.
It is also possible that the pharmacy have given you the wrong one. Do you have the other half of your prescription to check it against?
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Also - if I understand you correctly, you've been on HRT for years but do have atrophy. Bit puzzled by that but you definitely need a local HRT like vagifem.
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Thank you again people, for your kind and helpful answers. I can't do patches DancingGirl. I am allergic to them. In any case, I am off the h.r.t for good now, whether I like it or not >:(
Ancient Runner - I don't think I have vaginal atrophy, yet, but I expect that is coming now I'm off the h.r.t. In my original post I asked what it was? Because on my report the consultant put that I had an atropic womb, vagina and vulva and I want to know what that means.
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Atrophy is the shrinkage or wasting away of part of the body.
This happens to reproductive organs to a greater or lesser extent post menopause, as oestrogen levels drop and ovaries etc no longer function. Most people experience vulvo vaginal atrophy as dryness, thinning of skin, pain on intercourse, irritation and irritation on sitting, walking etc, bladder problems and urethra irritation, and ultimately shrinkage. Oestrogen, especially the topical stuff, helps manage it, slows worsening, and makes it more comfortable, but it does not go away.
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So I think your scan report is saying you already have atrophy of the vagina, womb and vulva. So definite need for topical HRT. It won't make you bleed.
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For me it was like razor blades up there >:( - my GP prescribed treatment which is inserted into the vagina and I've had no problems since.
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Thank you dahliagirl and ancient runner. I will ask my doctor for the pessaries you recommend and I will try and find some herbal tablets to ease me through the withdrawal of h.r.t.
I was not aware that I was 'wasting away' down there! It's not a very pleasant thing o come to terms with.
I wish you both a very happy Sunday. God bless :)
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It is what happens to any bit of the body that is no longer used, like muscles if you have bed rest - can't do much about reproduction being over though :-\
Vagifem shouldn't give you a bleed, although you may find you need more that the 2 twice a week.
I can't believe that someone appears daft enough to give you a sequential hrt, then send you for investigations because you bled ::)
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You probably won't need anything whilst stopping HRT :-\ ......... herbals can contra-indicate conventional medication, have a read through the 'alternative' threads? :-\ ?
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Dahliagirl, I think the doctor sent me to the hospital because of my age, 65 - just to make sure that the bleed wasn't caused by something else. Different doctors!! If the doctor had given me the conti version of Elleste, I wouldn't have bled, freaked out etc.
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If the prescribing practitioner had told you what to expect you wouldn't have freaked out >sigh< >:(
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Yes, that's right. All the doctor said was that she was prescribing a tablet as much like Climesse as possible. I skipped through the booklet that came with it. I tend not to take much notice about the booklets that come with drugs because they always put the fear of God into you if you start to worry about all the side effects! I am surprised that the doctor expected a woman of my age (65) to have a period again so no wonder I freaked out. To be honest I thought I was haemorrhaging! I was expecting to be sent to the hospital that very day for a hysterectomy!
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Hi Starproms
Belated :welcomemm: from me - have been busy for a few days!
I can't really add much to what's been said - just amazed as the others have said - that you were given a cyclical HRT when you were in mid 60's and post-menopausal - yet another example of the ignorance of some doctors - such a very basic error!
Having said that I am in my 60's and still having a bleed (every 6-8 weeks though) - through choice because I don't want to be on continuous progesterone.
A pity you had to give up though - ideally you could carry on if you suffer from symptoms but I agree that 2 mg (high dose) tablet HRT is not ideal in 60's and especially as you started at 60 I think - was this long after menopause? If coming off HRT does not work for you there is always patch HRT to consider which is better in over 60's or late starters to HRT, but yes get the local oestrogen definitely.
I presume for docs to say you had atrophy of the womb too you must have had an ultra-sound scan and maybe a transvaginal one too which measured the thickness of the womb lining? It is normal for it to atrophy later in post-menopause and sometimes also on HRT if the progestogen is quite high dose compared to the oestrogen - and in your case this would be why you were fine on the tablets. However surprising to bleed after the first cycle on the new tablets - but I expect your uterus didn't know what had hit it - all that pure oestrogen making it grow!
I hope you manage to sort out with the doc what you need to be comfortable and without horrible symptoms.
Hurdity x
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This Ancient Runner. I have now been off the h.r.t for six weeks and as expected, symptoms have developed. After two weeks I developed cystitis and had to take anti biotics. As well as the cystitis I experienced leakage. Even if I didn't particularly need to go to the toilet, once I got in there I could hardly get my knickers off quickly enough!
My bra keeps coming undone, which puzzled me at first and then I realised that my breasts had shrunk and now droop.
My vagina has dried up. I have tried using local creams but that only provides temporary relief.
All in all I have been struggling! I went to the doctor and asked for some Vagifem, which he has given me.
Tomorrow I go to a follow up appointment at the hospital with the consultant. I am really missing the h.r.t right now. I won't take the Vagifem til I've discussed it with him, but right now I am not wanting any more internal examinations.
I didn't realise when I first got the menopause that the symptoms would be for life!!!
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One doesn't "TAKE" Vagifem by the way :-X.
It should ease your vaginal dryness.