Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Eviepf on October 05, 2017, 10:22:43 AM
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Good morning all
Before I continue, I know I shouldn't have to buy oestrogen cream online, but this honestly seems like the most stress-free option.
Because of VA, which in my case seems to have caused urethral soreness more than anything, I'm using Vagifem daily and am also on low dose systemic HRT (oestrogen only as no womb). Although I think this has helped a bit (after 6 months) I still have urethral soreness and burning, which is occasionally pretty dreadful. I'd like to at least try applying something directly to the urethral area but the gynae I saw privately a couple of times this year, who started me on Vagifem/HRT, told me she didn't think it would help and that the other ingredients of the cream might just cause more irritation. I know this may be the case but would still like to try it. I don't think the Gynae feels she has anything more to offer me and has suggested no further follow-up appointments. Going by previous conversations, I think that trying to get this out of my GP would be a fruitless task.
Can anyone give me their opinion on whether this is worth a go and, if so, suggest reputable sites/the best product to try?
Thanks in advance.
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I assume you have had investigations of your bladder?
I doubt you can get the proper vaginal oestrogen cream online without a prescription.
If burning and soreness of the urethra is your issue, then more oestrogen may not necessarily help.
I have had this burning on and off for many years. I had investigations and told is was interstitial cystitis - which basically means ‘they don't know what it is' - however, recent studies have shown this type of burning could be a deep seated infection so it could be worth seeing a urologist. I was simply told to keep using the Vagifem.
My other strategies that seem to help:
No caffeine or acidic drinks
Avoid spicy and acidic foods.
Drink lots of water.
When burning starts I drink some water with bicarb of soda morning and evening.
Gentle on my ‘lady bits' - special vaginal wash, cotton underwear and no tight clothing.
Vaginal moisturiser daily - I use Sylk every day and also some Multi Gyn Actigel if i‘m feeling itchy or sore. My theory is that if the flora balance if off in my vagina, then this will cause irritation of the urethra.
I use Vagifem every 3 days and sometimes more often. I did find the oestrogen cream burned like crazy.
I've stopped milk and use Soya milk instead.
Try not to sit for too long - get out for lots of brisk walks to get the air around your ‘bits' and the circulation going.
DG x
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Hi there,
I was actually looking for an old post of yours earlier this morning, in order to ask you how you were doing...I have very similar issues to yours. Urethral burning and stinging..in the past I've used the exact words I found you had used as well "It feels like pincers"...It's completely miserable.
I saw a vulvar specialist earlier this year in the US and she said and I quote : "Vagifem won't do anything for the outside bits, for those you will need a cream". She prescribed Estrace and I am trying that and Estriol as well, to see which is better. Many women here are comfortable with Ovestin I understand. I think Estriol does help and I find it doesn't burn me. If you were in the US you could get a compounded cream with no ingredients that would burn. I suppose that is not possible in the UK? If I were you I would ask on this site for the name of a sympathetic gyne who will prescribe a cream, I don't understand why yours doesn't.
What happens when you increase your systemic HRT? Is it an oral delivery or through the skin ? Maybe you have tried that already, in my case increasing my dose helps my bladder and other bits immediately.
I have found that Estrogel does a better of delivering estrogen to the urinary/vaginal/bladder tissues, much better than oral HRTs do.
Another thing you can consider is the laser procedure that others have mentioned on the site - Maryjane has shared her experiences with it, she's had 5 sessions now I think. In the UK it is called the Mona Lisa Touch; in Europe there is a less intense laser which is called Renovalase. The latter is now very widely used in Italy and Spain. The interesting thing is that the procedure is being taken up in the US by urologists and urogynecologists and not just gynecologists, clearly indicating that urologists see how it benefits the urethra and bladder and improves or gets rid of the urinary symptoms of low estrogen.
I hope this is a bit helpful. Let me know how you get on.
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I use systemic HRT, Vagifem and estriol cream (generic 0.01%) - all from my local GP on NHS. If you feel you want to try this then your doc should prescribe - there is no reason not to, and they can't argue that you would need a progestogen as you've had a hysterectomy. After all if it doesn't work you will have given it your best shot. There is also the Estring which delivers a higher dose of estradiol directly to the vaginal tissues without the need for fillers, and possible irritation from daily vagifem/insertion, as it is a physical ring containing the hormones. A few members have tried this.
Hurdity x
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I can recommend this clinic online
http://www.onlineclinicuk.ltd.uk/?gclid=Cj0KCQjwsNfOBRCWARIsAGITapZXmk1_ZUEuFXsibtJzCpmfLMkuoGF6fISKBzgP91cmTkQ0aemnPRIaAoASEALw_wcB
I used it when I wanted to try oestrogel. You have to answer questions and you can allow them to contact to your gp (I did this and oestrogel then appeared on my NHS repeats)
I needed help along with vagifem and ovestin was great. It got to be a palava with oestrogen and test gels plus vagifem and ovestin cream so I upped my vagifem to 5-7 weekly and now rarely need the ovestin
You're not being irresponsible by looking online at reputable dispensers and they don't give you an answer straight away and may contact you for further info before prescribing
I still use them sometimes when I want oestrogel as opposed to Drs oestrodose
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Thank you all so much for replying. I just composed a long post but managed to delete it when attempting to preview it, so will try again!
Dancinggirl - sorry you have been suffering in this way for so long. I've seen urologists and also been diagnosed with IC/Painful Bladder Syndrome although, after a cystoscopy, my bladder looked normal. I use the usual 'flare management' techniques and avoid trigger foods etc, but am just so sick of the (often useless) attempts to try to damp down the symptoms.
I always felt that some infection might be involved, as this all started after an acute urine infection which never really went away. I've taken long-term, high-dose antibiotics but found these to be of limited help, while also causing side effects and thrush. I decided to see the gynae to discuss the hormonal aspect to all of this, having found the MM website and been amazed at the other women suffering similar symptoms (I was amazed to learn that VA didn't just involve the vagina, for example). It was also an eye-opener when I met the gynae to hear that she had treated so many women in similar circumstances.
Kkay - I think I remember your previous posts about this, and thank you for thinking about me! Interesting to hear that your vulvar specialist told you that a cream would be needed, which is pretty much what I was thinking. It's not possible to get compounded creams in the UK, I don't think. How long have you been using the creams, and have you noticed any good results? I did try to increase my systemic HRT by moving to a higher dosage patch, but had no beneficial effect after a couple of months and was suffering such bad breast pain (not just discomfort, actual stabbing pain) that I reverted to the lower dose. I've been thinking about the Mona Lisa Touch and have read differing anecdotal reports on whether or not it could help urethral/bladder symptoms, so interesting to hear that urologists and urogynaes in the US are taking it up. I know who did Maryjane's treatment, so perhaps I need to bite the bullet and make an appointment to discuss it with her.
Hurdity - I did try the Estring but didn't get on with it - it kept falling out (not sure what this says about my insides)! You are quite right that I should see my GP. It's just that their attitude seems not to be very pro-HRT and, as I'm already on topical and systemic oestrogen.... I think I will be brave and go to see them, though.
Annie0710 - this is very helpful. I will try the GP first but reserve the right to look online if I need to.
Thanks once again. I will report back! x
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Eviepf, I was plagued with constant vaginal burning and itching when I had a Mirena coil (not relevant to your case I know) without adequate levels of oestrogen. I have since had the coil removed and now take the right dose of oestrogen and now I never get any itching or burning.
This is a long shot but have you considered using Oestrogel on your inner, upper thighs? I used to get some mild discomfort in that area but since apply one pumps of gel to that area every day, I never get any problems there now. It might be worth a try.
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Hi again,
All of this is very good advice and I agree with Mary G that using Estrogel on the thighs helps - I realise you are on a patch. Where I apply the Estrogel definitely makes a difference to my urinary symptoms.
Annie, that is so useful re that pharmacy that has Estrogel. I've long noticed that Oestrodose does not work for me as well as Estrogel and am frustrated to learn that its no longer easily available.
Eviepf, a doctor friend of mine attended a conference on vulvo-vaginal atrophy and vaginal lasers and taped the presentation of a gynecology professor at from Pisa, Italy, which I have. I found two statements particularly relevant to my (and your) situation:
1. The label "Vulvo-vaginal atrophy" is being replaced by the more accurate "Genito-Urinary Syndrome of Menopause" or GSM. I think that tells you right there that the bladder and the urethra are very affected by the menopause. Most urologists don't understand how hormones work, don't ask me why, its a mystery.
2. A statement this professor makes early in his talk where he says that the urethra and bladder are lined with estrogen receptors and therefore when the practitioner sees as signs of atrophy in the vagina, they should expect these changes in the urethra and bladder as well.
I can try to send it to you as a private message if you are interested.
Estriol does not burn me and I am finding it quite helpful. It started helping right away. I was told to use it every other night on the outside and inside the lower third of the vagina but at the moment I am using it every day just outside and waiting to see what that does.
I also ordered Saginil gel from Italy that helps with nerve pain in that are. That seems to be working too.
I agree with Hurdity that you should definitely try the cream. Print out the guidelines that are pinned here and take them with you to your reluctant and ill-informed GP !
Good luck and let us know how you get on.
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Thank you MaryG and Kkay
I've made an appointment to see a GP on Tuesday and am cautiously hopeful. The GP I'm seeing is not the one I normally see (good!) but have seen this one a couple of times in the past about different issues. She is very much in demand, but only works part-time and I'd pretty much given up hope of ever managing to see her again. I've never spoken to her about hormonal stuff, but she seems open-minded about other things, so I'm going to ask her about the cream and, now, also about Estrogel instead of patches. It's really interesting that you both feel that where the oestrogen is applied could make a difference - I would never in a million years have thought of that.
Saginil gel - have had a quick look and it seems that it's available via Amazon. I will investigate further!
Kkay - I'm glad to know that estriol cream seems to be helping you. I would be very interested to have that info via PM, if possible.
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Good morning all
I'm reporting back after my visit to the GP yesterday. GP was great (wish I could see her every time I go...). Very happy to prescribe estriol cream and also to think about the possibility of applying systemic HRT to the inner thigh (I asked about changing to a gel, rather than patches). She was uncertain about the dosage if I wanted to go down that route, having only ever prescribed patches and said she'd have to do some research. I then had what I hope is a brilliant idea (!) and asked her if I could just try applying my existing patches to that area instead of on my lower abdomen, as I've done before. She said she thinks that's worth a try, so I'll do that and see how things go.
My mind went blank when she asked me if I wanted 0.1% or 0.01% estrogen cream, so she suggested I try Ovestin, the stronger option. I was worried about this when I got home and cheked on here and read that Ovestin has caused discomfort in so many people, but thought I'd give it a try. I applied a small smear last night and thankfully had no burning at all, so will continue to do this daily and see what happens.
Thank you again to everyone who replied to my original post (and to Kkay for sending me more info by PM). I'm glad I followed your suggestions to visit the GP again. I don't know whether the Ovestin will help at all, but I'm glad to be giving it a try. x
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Thanks for the update Eviepf and so pleased you had a positive consultation with your GP. Good for the NHS eh?! Are you able to choose this doctor again when you make another appointment - I can choose who I see at my local surgery?
I do hope it all works out for you and be sure to let us know :)
Hurdity x
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Hi All
Hurdity - Good for the NHS, indeed! I CAN choose which GP I want to see, but the problem is that the one I saw yesterday is so much in demand that it's virtually impossible to make an appointment with her. The same applies to my 'second favourite' GP - obviously all the surgery's other patients feel the same as me.
It turns out that my idea of applying patches to my inner thigh was not such a good one. I clearly underestimated the flabbiness of my thighs and found that the patch had fallen off (friction of walking, I think). I tried a Heath Robinson solution involving plasters, but that didn't work either and I had to admit defeat. I now have so much black sticky gunk on my leg from patch and plasters that I think I'll need a whole bottle of baby oil to remove it.... It might have worked if I'd been able to use Estradot, but they are like hen's teeth to get hold of and Elleste Solo are much larger and seem less sticky.
I think I need to contact the GP and say that I'd like to try gel after all. Can any of you knowledgeable ladies tell me about the dosage equivalent (or point me towards a good link)? As I said, my GP had no idea. I had a quick look yesterday and think that one pump of the Estrogel generic alternative seemed to be about the same as a 50 mcg patch, but am not sure I got that right.
Thankyou!
x
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Eviepf - the amount fo gel you use can be variable depending on how much you personally need. Because it is applied daily, it maintains a consistent dose as well, which for some women is a bonus. 2 pumps per day is the standard dose so if you using a 50mg patch that would probably be the right dosage. The GP can simply look at this sight to get the info she needs - MM has been set up and is run by an NHS gynaecologist and is a linked from the NHS Choices website. DG x
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I'm on 2.5 pumps a day and would consider that dose nearer to 50mcg than 75mcg (I'm not great on high doses of oestrogen x
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Thanks Dancinggirl and Annie0710 - I'm on a lower dose of patch (currently 40 mcg) so wonder if something like 1.5 pumps might be the answer. If whatever I started with was too high, I'm sure I'd notice quite quickly as the awful breast pain would probably return. I might pass this over to the GP and ask her to have a look...
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Evie start at 1 pump and work up as and when needed x
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I've been away from the forum for a few days but Eviepf, I am really glad to hear your GP appointment went so well - that's wonderful. Can you ask to see the same GP every time? I'm not too familiar with how the NHS works...
Hope the Ovestin cream is helping...keep us posted and good luck !
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Dear All
I'm sorry it's taken me a while to report back - things haven't been going well.
As I said before, my idea of applying patches to my inner thigh was a non-starter so, until I could see the GP again, I went back to applying the patch on my abdomen. I tried using the Ovestin and all seemed well - no stinging at all, so I carried on applying it for a few nights. Last weekend I developed really terrible burning to my urethral area, which is where I had been applying the Ovestin. This was accompanied by bad urinary frequency and I had several nights where I hardly slept at all. I put this down to the Ovestin (I'm pretty sure I hadn't eaten or drunk, or done, anything else which could have caused it) and stopped using it. Now, several days on, things are still pretty bad stinging/frequency/sleep-wise, if not quite as bad as they were last weekend. My symptoms have always varied, but are not usually like this.
I saw the GP again on Wednesday (thankfully, the nice one who I saw last time) and she has prescribed me Estrogel and suggested starting with 1 pump per day. I applied my first dose this morning. She also prescribed me the weaker estriol cream (0.01%) but said that it probably wouldn't have been the estriol itself that could have irritated me and that the 'filler' in the weaker cream could still be a problem. I haven't used the cream yet, and won't unless things improve.
I had previously booked an appointment to see a gynae about the Mona Lisa Touch procedure - really just to get information - and this happened on Tuesday. She was great, had a look at my nether regions and confirmed what I already knew, i.e. that my vaginal tissue looks fine (I don't think it was ever that bad, and I've been using Vagifem since March). My urethra also looked OK, but she suggested using the laser on the area around the urethra and vulva, chiefly where my inner labia had once been. She said it was worth a try, shouldn't make things worse and might improve matters - should she do it there and then?! I thought 'what the hell' and said go ahead. I have to go back and see her again in 4 weeks. I knew I wouldn't really be a candidate for the full MLT procedure, but am willing to try anything that might improve things even a little.
So, here I am... I also took a fluconazole capsule yesterday, as I know that I've had bad urethral/frequency problems before with thrush, although I don't seem to get much itchiness. I just hope that something will help as I'm feeling desperate. I keep thinking that maybe it IS 'just' bladder illness after all - maybe the menopause had nothing to do with it - although in my calmer moments I try to remind myself that this started when I was perimenopausal and worsened when (I'm guessing) my ovaries must have failed, post hysterectomy. It just feels like a huge mess and that I have no answers or solution.
Sorry for writing such an essay. x
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You sound like me...I use vagifem and patches. I keep messing about with ovestin on the outside and then it hurts me. I wonder if our bits are really sore it's too strong as it's meant to be applied high up, soak in I suppose and a little bit works it's way down. I know some ladies tolerate it rubbed in. Hopefully the weaker cream might be better. I take thrush tablets too- often wondering if it's thrush. Fingers crossed for MLT. All this is utterly miserable and so hard to live with xx
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I have had MLT 3 internally and 5 externally and it has made a huge all round difference this far , I still use the estring but the vagina is now absorbing it far better since MLT due to the collergan ( sp) etc .....
The whole area looks very healthy including my urethra , scar tissues etc.
I haven't needed to use the local oestrogen creams since having it ( I was very sensitive to them the fillers in both ) .....I still use YES oil based smothered everyday just to look after a rather expensive area 😳 as you no.
I am on oestrogel re HRT and utrogestin ( having a 3 month break from utrogestin gynae suggestion ).
Re MLT patience is the key , healing takes 6 eeeks after each procedure ....I don't understand why you don't have it internally however , as having the anterior wall layered also helps the bladder .
I admin a secret FB group for VA and a few are in the throws of having MLT at the moment .
Did a gynae with the initials T do your procedure.
Also Testosterone helps many in the vulva area , but do one thing at a time as you won't no what's friend or foe .....I have been at this for 5/6 years, and the only real help has been MLT , allowing the estring to work better along with the HRT.
Good luck , it's the pits and is a life time of management as you no MLT needs a yearly top up . 😊
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Thank you both
Zara69 - we do sound quite similar and it really is the absolute pits. Do you have the same as I did with the Ovestin. i.e. no apparent burning when you apply it, but terrible soreness and burning after a few days of regular use? I wonder whether it might be better than Vagifem for vaginal use, as presumably the cream that does work down would then help the outer area but, given the stinging/burning of last weekend, I'd be very reluctant to try that. At least Vagifem doesn't irritate me. I'm really hoping that it might be thrush-related (what a thing to be hoping for...).
Maryjane - it is indeed Miss T. I'm on your group and decided to see her as I know she was who you went to. I just wanted to ask someone who could tell me straight about possible use for mainly external/bladder problems, as Dr Google had not been very helpful. I thought she was great - she gave me the info I needed and was honest about the fact that my vagina looks fine. She did say that she 'might' think about internal MLT treatment at some point, after I'd had the external lasering, so we'll see how things go.
xx
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Goodo.....injabe no idea who you are 🙈 forget immediately once I have joined ladies....hope it helps and don't expect miracles over night. 😊💐
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Hi all - new here. What an incredible forum. Have had a difficult time getting oesteogel ( wish i had bought in Spain). Bought my first one and the uveg one, from an online company - then told doctor . So she has prescribed 1 month only on nhs. So that's a start. But she had no idea about the 1 week with uve ( progesterone sorry can't remember name). Please can anyone let me know if they take a break from Estrogel for 1 week to take the progesterone. Many thank yous. Also can anyone point me to who miss T is in uk Doc
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Hi and welcome to MM jillzrz
I am relieved to hear you have gone to your GP about this - one shouldn't buy HRT without appropriate medical advice really. Anyway, Oestrogel should be used every day(no breaks) and the progesterone is added for 10-12 days each month. I think you have Utrogestan? If it is Utrogestan then you take 200mg (at bedtime) each month. Your GP should find this under 'micronised progesterone' in his/her book of drugs. Utrogestan(micronised progesterone) is also used for fertility treatment so isn't listed under HRT - your GP may have to do a bit of hunting in this book.
Look under TREATMENTS at the top of this page and in the ‘Progesterone' section you will see Utrogestan - print off this info and show it to the GP. Taking Utrogestan for 7 days per month is not licensed on the NHS - it's supposed to be at least 10 days each month, however some women do get away with the 7 days if they are seeing a private gynaecologist and getting regular scans to make sure their womb lining isn't building up - the NHS won't give regular scans as standard as it's too expensive!!! Some women also use Utrogestan vaginally (again not licensed in the UK). The importance of progesterone is to protect the uterus (womb) lining from building up, so it's a very important part of HRT. In peri menopause, and for some time into post meno, one needs to use HRT sequentially - used sequentially there should be a withdrawal bleed each month starting a couple of days after finishing the 10-12 days of progesterone pills. Once you are well into post menopause then progesterone can be used continuously and if using it continuously (so every day alongside the oestrogen) this will usually result in no bleeding at all after the first few weeks.
Do read up all the factual info on this site about the menopause and the various treatments and get really clued up on the menopause. It's much safer to seek professional medical advice before embarking on any drug or hormone treatment. Good luck and let us know how you get on.
Sorry, don't understand you question about “who is MissT†???!!! DG x
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I can recommend this clinic online
http://www.onlineclinicuk.ltd.uk/?gclid=Cj0KCQjwsNfOBRCWARIsAGITapZXmk1_ZUEuFXsibtJzCpmfLMkuoGF6fISKBzgP91cmTkQ0aemnPRIaAoASEALw_wcB
I used it when I wanted to try oestrogel. You have to answer questions and you can allow them to contact to your gp (I did this and oestrogel then appeared on my NHS repeats)
I needed help along with vagifem and ovestin was great. It got to be a palava with oestrogen and test gels plus vagifem and ovestin cream so I upped my vagifem to 5-7 weekly and now rarely need the ovestin
You're not being irresponsible by looking online at reputable dispensers and they don't give you an answer straight away and may contact you for further info before prescribing
I still use them sometimes when I want oestrogel as opposed to Drs oestrodose
Thanks for the link, would they prescribe progesterone cream as I want a progesterone i can taper off, as I am addicted to valium and when i come off hrt, the micronised progesterone i am on, when suddenly withdrawn, as its cross tolerant with valium, will knock me off my feet and have me bedridden whereas I could taper the cream.
I cannot find it anywhere.
thanks
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I'm not sure they'd do prog cream, but I haven't looked. The cream is so weak I'd doubt they do but you can buy it online , try Amazon
X
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I'm not sure they'd do prog cream, but I haven't looked. The cream is so weak I'd doubt they do but you can buy it online , try Amazon
X
Am interested in proper prescription prog cream like the americans get, the weaker stuff wouldnt help me at all, but thanks.
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I thought you meant the stronger stuff, but I've never heard of it here in uk
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Dandelion, I think you are referring to compounded progesterone which is made up to a specific prescription in pharmacies in the US. I don't know anything about it but I suppose you could make some enquiries in the US and see if they could ship it to you?
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Progesterone creams are possibly very unstable - there must be a reason why a gel or cream progesterone isn't available. Please don't use compounded hormones - there are very clear warnings from many professional sources about these, as they aren't regulated so coddle be potentially harmful. Hopefully one day, there will be something other than Utrogestan that will be effective with fewer side effects. DG x