Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Woodsview on October 20, 2023, 05:49:06 PM
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Hi everyone
This is my first posting, I recently joined after finding this website by constant googling, it’s so good to know, there is somewhere where information is shared. I’m at a loss as to what to do atm so I’m posting in the hope someone might have a idea/view. Apologies in advance at the size of this post ….
I’m 57 been on moderate level HRT Indivina 1/5 for around 10 years, late last year started to feel a bit off, we were selling and buying a house so didn’t connect it all together but by the time we moved end of April and less stress lol, all the symptoms very dry skin, moods, brain fog, hair loss and quite dry down below, the penny dropped . I thought I need to review my HRT. GP agreed to up my dosage to the Indivina 2/5 in May. I also asked for a referral to the Menopause Clinic.
All was well for about a month and a lot of the symptoms have diminished except the dryness in my vagina and the burning of my vulva skin has come on leaps and bounds, I started to get really dry and had this pale green discharge, I did over the counter B.V. and Thrush treatment separately and nothing sorted it, so went to the GP,
I had a swab, the GP advised nothing showing, he suspected B.V., gave me metronizole pessaries, this did nothing so I then had metronizole orally again nothing and still the discharge. I went back again and was given clindamycin pessaries for a week , this seemed to work then the day after the discharge was back. By this time I was really sore and struggling to walk small distances and had tiny water blisters appearing, I went back to the GP had another set of swabs and boy did that hurt as by now everything was on fire.
The GP said the results again were negative, but he thought it was vaginal atrophy, he did not seem to bothered by the discharge which is not a lot in quantity as I’m. Dry dry and gave me estradiol vaginal tablets 10mg for two weeks then advised to follow the twice a week maintenance dose, he said if this doesn’t work he will refer me to gynaecology. His words were, this isn’t the end of the road, but it’s probably a couple of months wait if I have to refer you.
Each time I finished the antibiotics I was more and more sore inside and even now I’m a week in with the vaginal tablets, the discharge is very slightly less and it’s a little less red inside but the outside labia is red, almost chaffing. After reading feedback on this website I ordered some Yes VM, I tried that on the lower labia outside and slightly inside for the last two days and it burns a lot rather than soothes.
Has anyone else had any joy with the tablets, am I being too impatient, should I still be having a green discharge?
I appreciate the discharge is my vagina saying whoa I’m not happy but it’s really starting to worry me that there isn’t any improvement, I’m starting to panic about not walking now.
The good news is that my Menopause Clinic appointment is in a couple of weeks but I’m not too sure if they will help given the appointment was me asking for a review of HRT medication as the plan was to look at patches and the GP said gynaecology would be my next step.
Sorry for the waffle and length of this post but if anyone has any ideas or personal experiences I would welcome them, thank you for reading.
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U waffle, you'll be in good company ;D. :welcomemm:
Get that vaginal atrophy up there every night for the next 2-3 weeks. As well as a smear of KY jelly in the vulval area to keep the outer labia moist and less dry.
If the urine sample has been sent to a Lab for testing, what's it shown as a 'bug'. Too many ABs are given when VA treatment would help a lot more.
U don't need to go to a gynaecologist but do keep the appt at the menopause clinic - take a list of symptoms. Some find that keeping a mood/food/symptom diary to chart progress.
Ask away. Nowt is OTT on there.
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You do need to give the vaginal estradiol more time to work.
After the two week loading you may find that you need more than two a week but that is a start and you can go from there. Just give each dose some time to work.
If the vulva area is sore you could ask to be prescribed an estriol cream to try. That will replace loss of oestrogen whereas the Yes VM is a moisturiser. If the VM is burning another vaginal moisturiser may suit you. I’m afraid it is very much trial & error.
As you have a meno clinic appointment I would take every opportunity to ask there and gain information as well as any from any future gynaecologist appointment.
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thank you Minusminnie and CLKD, just trying to work out how to post a reply. I use technology at work but not online forums lol. I think I need to calm down a bit, my hubby is very supportive and came with me to the GP on the last occasion as he wanted to make sure I didn’t get antibiotics again, I need to follow the process.
Fingers crossed the next week sees some improvement :)
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Hi Woodsview
I think Vulval soreness is one of the most underestimated things out there and something that is impossible to understand unless you've suffered! But I'm sure a lot of us here know exactly how sore you are :-\ In addition to the great advice you've already had, I'd suggest you have a read up on Lichen Sclerosus to see if the symptoms sound similar to yours. A lot of us have it and it can be misdiagnosed as thrush as symptoms are similar and many GPS aren't clued up about it. It does need prescription treatment so, if you think it is possible that you have it, you need to go back to GP/gynae.
I'd add to the advice already given with - avoid soap for washing the vulval area, use an emollient instead. Dermol works well for me, I use it as a moisturiser too (in addition to the vagifem for atrophy) A lot of people use Cetraben in the same way.
Good luck with your appt at meno clinic, I'd also ask the GP for that gynae referral, better to have something being arranged in the background and potentially not need it than to have to start the wait a couple more months down the line.
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Thank you Suziemc - any suggestions gratefully received, there is so much knowledge on this forum, I’m happy for all advice as knowledge is power as they say :)
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I do sympathise, had a year long battle to get VA treatment. You may need Vagifem more frequently than the two a week dose. I need it every day even though I use systemic HRT too. I would just wash in tepid water and put nothing on until the vulval skin has calmed down a bit, then ask for Ovestin cream to use on vulva as well as continuing with the Vagifem.
I don't use moisturisers as the ones I have tried, Yes being one them seem to iritate me.
That is how I managed to get it under control although do get a blip every now and again but nothing like it was before.
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Woodsview
Tena light do sensitive zero fragrance panty liners for any discharge. Avoids any irritants. Also better if your pants are cotton so more breatheable and wash in water or very little soap and rinse really well. You can also buy crotchless tights.
If you look under private lives there is a long running thread called the burning club. Also if you put vaginal atrophy into the search box various threads will come up to read.
I think I need to calm down a bit, my hubby is very supportive and came with me to the GP on the last occasion as he wanted to make sure I didn’t get antibiotics again, I need to follow the process.
The unsolved soreness causes stress but the more you can stay calm the better as any stress just adds to it.
Glad that your hubby is supportive and on your side with this.
Have you been given Vagirux or Vagifem ? Some have found that Vagirux not as good as Vagifem and specifically asked for the latter to be prescribed.
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Woodsview
:welcomemm:
If you ask for a vaginal oestrogen cream I would preferably ask for the generic estriol cream rather than ovestin because it is 10 x weaker - that is, if you are also going to continue to use Vagifem tablets internally. That might sound strange but it is designed to be used in larger quantities (the generic estriol) and therefore could have more of a moisturising effect as well as providing oestrogen to the outer vaginal area.
All the best at your menopause clinic appointment.
Hurdity x
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Thank you Tinkerbell, Minusminnie and Hurdity.
I do wear cotton pants but have noticed a slight scent to the panty liners I am using and they may not be helping the situation. I moved from the soap I used forever from a teenager about a month ago to Cetaphil emollient as it said it could be used on this area.
the vaginal tablets I have been given are not branded they say Estradiol tablets 10mcg and the white and green box says Mercury Pharma. It contains 24 tablets and two applicators. the 14 day loading ends on Thursday night and my Menopause Clinic appointment is the following Tuesday so I will see go to that and will ask questions about increasing the twice a week dosage and asking if additional external cream to use can be prescribed so that I get the right information to present to the GP as they follow std guidance I think. Thanks so much.
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U shouldn't need to ask about increasing the dose to every night if necessary. The info in the leaflet in the VA treatment boxes is way out of date. Dr Newson is trying to get that altered . Explain that by discussing on this Forum many ladies need Vagifem nightly and ovestin on the vulva area. There is no chance of overdosing which seems to worry many prescribers.
I use 'ovestin' internally and externally, or KY jelly externally.
Let us know how you get on.
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The posts in the link below, if you haven't seen it already, will put you in a good position when you attend your appointment if you are suffering from straight forward VA symptoms. It becomes more complicated when other conditions also affect the vagina which is why its great you have an upcoming appointment with the menopause clinic.
https://www.menopausematters.co.uk/forum/index.php/topic,64837.msg895647.html#msg895647
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Hi CLKD and Alesha
many thanks for the post link, it’s almost like GPS all need to go on an intensive training course, scary at the similarities of issues not being recognised. i am so glad I asked for the menopause clinic referral, at the time it was just to discuss changing from oral HRT so timing is everything I think.
I will use all of this information and now feel confident what I’m talking about. I will ask for an examination at the menopause clinic to ascertain that it is Vaginal Atrophy and nothing else. I suspect that I may know more at the end of the preloading too. Thanks again :)
I will post an update when I know more
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Oops sorry Ayesha typo :)
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Hi Woodsview, not sure what brand of pessaries you have been given then, never heard of Mercury Pharma? My repeat prescription says the proper Vagifem 10mg - with Novo Nordisk in brackets - they are in a white box with navy and purple stripy bits.
I have used them for over 5 years and still use one every other night. Have to take them for life now!
Hope you get on ok at your menopause clinic appointment x
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thank you Julia
I suspect with all the cost savings the vaginal tablets are an ‘alternative’ sourced and used through the NHS ;)
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Hi
This book was recommended to me on here, Me and my Menopausal vagina by Jane Lewis. I brought it from Amazon.
I use vagifem, which really helps me. My GP gave me a course of two weeks daily, but refused to give me any more than 3 dosages a week as a top up.
I have to buy the remaining dosages from a private menopause clinic.
It is wrong I have to do this, but the GP would not budge on this.
Best wishes
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Thanks Peanut, that’s really helpful.
It’s sad that everyone has to work around the ‘system’ that appears not have been updated to match Womens needs, a one size does not fit all. ;)
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Hi
I didn’t manage to wait until after the menopause clinic to sort out the ovestin cream, I was so sore last night I could not sit properly I had to lie on the bed so this morning I rang through and got a telephone doctors appointment. I spoke with a different GP, summarised what had happened so far and advised that everything was so sore that I was worried that the skin would be compromised soon and asked for Ovestin. I referenced I had been on this forum and that it seemed a good practice to take the vaginal tablets and use the cream topically albeit a small amount.
the GP said he was not comfortable giving me the cream as well as the vaginal tablets but advised me to stop the tablets after Thursday which is the 14 day loading and then switch to using the cream only but twice a week. he said the cream would deal with both areas, inside and out. My husband got the cream from the pharmacy and it’s not ovestin but a generic estriol 0.01%.
I’ve still got a pale green discharge but so incredibly swollen down below, probably from pre loading now and the very very sore and irritated vulva, right down from top to my bottom So I will use the cream topically until my menopause appointment on Tuesday despite what he says.
I advised in the call that my previous GP appointment had said about a gynaecologist appointment and I asked if this could be arranged, this GP said there was no need as I have my menopause appointment and they will examine me.
I’m fluctuating between being upset with the pain and feeling that my requests were of no value to him, so mad that I can’t control any of this. :-X
the saving grace is the menopause clinic but failing that giving me any joy then my husband said I’m off to the nearest private clinic and sod the cost. Would I need a menopause expert or a gynaecologist if going private? Any advise gratefully received.
Thanks
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Hi
I’m not suggesting you go with the same clinic as me, but I’m with Newson health.
My consultations are via zoom or you can have a telephone consultation, or visit the clinics.
It is expensive though I think my 1st consultation was £295.00 and I was on a waiting list for around 2 weeks.
However, they will listen to your concerns and treat each patient individually.
I made sure I had a list of my symptoms and made some notes, rather than rambling on.
I was given ovestin and also vagifem by the clinic for my vaginal atrophy, as by this time, and after research I know it was vaginal atrophy
However, prior to this I had a bladder scan with my GP, an internal with the nurse (said it was red) and urine samples taken, so armed with this information to give to the clinic.
Plus I had been on antibiotics, thrush cream etc with no success.
What made me book the clinic was I was going on holiday and taking a 9 hour plane journey. There was no way I was going to sit on a plane with the feeling of burning, itchy and wanting the toilet all the time down there.
No one should be suffering in pain like you have described.
I hope this helps.
Wishing you all the best. Xx
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Thanks Peanut, I really appreciate the information and support.
I got the Me and My Menopausal Vagina from Amazon, brilliant book, thanks for recommending. I am almost finished reading it.
hopefully light at the end of the tunnel soon ;)
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I’ve still got a pale green discharge but so incredibly swollen down below, probably from pre loading now and the very very sore and irritated vulva, right down from top to my bottom So I will use the cream topically until my menopause appointment on Tuesday despite what he says.
Would it be worth making an appointment with your local GUM/Sexual Health clinic to test the green discharge. They may pick up on something that your GP hasn't done. Even if it was just second opinion or to rule anything out.
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I didn’t realise you could do that, thanks for the flag. I will look into that
thank you :)
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Your GP's have not been helpful have they! You have an upcoming appointment with a menopause clinic and they are the one's that should help you finally get to the end of your horrible symptoms.
If not the GUM clinic is the next best thing for you, my friend years ago had great results from them when GP's had no idea what her condition was, her VA was made complicated by eczema which only the GUM clinic diagnosed.
Anyway, this is all done free, you should not have to pay privately for something that is readily available to most of us.
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Thanks Ayesha
Almost indifference from the last GP which is disappointing.
It’s really good to know there is more than one place to seek advice. I’m really glad I posted as without it I would not have learnt so much. :thankyou:
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I didn’t realise you could do that, thanks for the flag. I will look into that
thank you :)
In my area, the NHS trust do a postal swab test system. You get swabs and blood yourself and they test it.
I don't understand why he wouldn't let you use vagifem and ovestin. I'm using both. Vahifem ir equivalent alternate nights and ovestin every night. My GP told me if she gets VA she'll be on it straight away. There's no parity across GP services is there.
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Hi Jules
That’s a good service to have :)
Other than the GP saying he felt uncomfortable there was no explanation, if he were in my shoes with sore everything he would feel even more uncomfortable,
I’ve ignored what he said and used the estriol cream along with the vaginal tablet and everything is feeling a little better, a lot of inflammation has reduced, but still more time needed I think. Im onto the twice a week officially but as I’ve got the menopause appointment that hopefully will change as I’m nowhere near ok. If I hadn’t got this menopause appointment coming up I probably would have given more pushback but hopefully I will get a confirmed diagnosis and a better treatment plan on Tuesday, I am wondering if there’s more to it than VA.
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Hi Jules
That’s a good service to have :)
Other than the GP saying he felt uncomfortable there was no explanation, if he were in my shoes with sore everything he would feel even more uncomfortable,
I’ve ignored what he said and used the estriol cream along with the vaginal tablet and everything is feeling a little better, a lot of inflammation has reduced, but still more time needed I think. Im onto the twice a week officially but as I’ve got the menopause appointment that hopefully will change as I’m nowhere near ok. If I hadn’t got this menopause appointment coming up I probably would have given more pushback but hopefully I will get a confirmed diagnosis and a better treatment plan on Tuesday, I am wondering if there’s more to it than VA.
Reading this forum there seems to be a range of severity of symptoms. I didn't have any discomfort but had a tendency to UTIs particularly after sex but also I could see vulval atrophy too. These changes are difficult to seal with especially when you had no idea they were possible.
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Hope that you get some answers at your meno clinic appointment today Woodsview.
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Thanks Minusminnie, it mid afternoon so not long now :)
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Hi
I just thought I would post an update of my menopause clinic as promised. many thanks to everyone who has given advice and support over the recent postings. I hope that this can also give some guidance to anyone who has similar symptoms.
I met with a doctor who specialises in vulvar issues as well as being a menopause expert, she went through all of my medical history, my experiences with HRT and then moved onto the main cause of concern, she then examined me and advised that she thought it was vaginal atrophy but in addition I had what you could call dermatitis, she said something had triggered this, when I mentioned the canestan and continued 3 courses of antibiotics over recent months she said that was possible but also as we age the skin on our vulva get more sensitive and we need to care for it more.
So my new regimen is:
Wash with e45 or something similar.
Use hydromel ointment, she said that as we age this is a daily necessity to rehydrate, she said put itI everywhere and drew me a picture.
She then prescribed a steroid cream to use a small amount over 4 weeks at night for the dermatitis,
Continue with the vagifem or switch to the estriol cream, my choice and it was ok to continue with a small amount of the estriol cream, pea sized amount if using the vagifem.
I asked if it was LS as I had read up on this, she believed I did not have this or LP but the skin was irritated and needed something extra to get it sorted.
She did not seem concerned with the discharge but took a swab to be on the safe side, she said she would test but she believed that as long as it shows no infection it will diminish with vaginal tablet treatment.
She wrote out all of the above and explained how much of each thing to use and when and gave me a letter for the GP advising them to put on prescription.
Got to say I felt reassured and left happy with a plan of action.
I’m to go back in a few months to discuss to see how it has all gone.
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How frequently did she tell you to use vagifem and ovestin? I'm worried I'm using too much
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Sorry, and also what is hydromel ointment and is it prescription only?
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Sorry, and also what is hydromel ointment and is it prescription only?
Hydromol is an emollient. You can buy it over the counter in Boots.
JP x
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hi Jules
To be honest we didn’t go into the detail of the vagifem, I am on twice a week but I got the impression when she said use the cream as you need it that it was not a big issue. The amount of hormone in both the tablet and the cream are very low. I’m more concerned at the moment with the vulva but no doubt the minute that is sorted I will be onto the rest lol. I was in there 45 minutes and just forgot to ask - we covered so much.
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hi Jules
To be honest we didn’t go into the detail of the vagifem, I am on twice a week but I got the impression when she said use the cream as you need it that it was not a big issue. The amount of hormone in both the tablet and the cream are very low. I’m more concerned at the moment with the vulva but no doubt the minute that is sorted I will be onto the rest lol. I was in there 45 minutes and just forgot to ask - we covered so much.
Yes we're all different and have to find the balance.