Menopause Matters Forum

Menopause Discussion => Postmenopause => Topic started by: Brownie on December 02, 2023, 03:47:40 PM

Title: OAB/IC
Post by: Brownie on December 02, 2023, 03:47:40 PM
Hi
Wondered if anyone can help please. I was diagnosed with IC couple of years ago. Had been Elmiron for 6 months or so + things going ok. For past few months I have been having flare ups every few days, settles down then starts again. Practically spent most of this time in the house/bed and it's getting me down that I can't get out + hubby at end of his tether too !!!
Apparently I had a UTI which then led to thrush. I've had more intense UTI testing but no infection although will hand further samples in next week.
My main question was that I never really felt food/drink was a trigger for me but I'm wondering can this change over time ?
I've now been taking marshmallow leaf tea/aloe Vera capsules + GP now given me vesicare to try.
Sorry for long post, any help would be appreciated Xx
Title: Re: OAB/IC
Post by: CLKD on December 02, 2023, 05:06:16 PM
Could you explain what OAB and IC might mean  :-\

I wasn't aware that marshmallow has leaves  :-\  :-\ Aloe Vera is supposedly very good at treating some complaints, but apparently is VILE  :-X.

Vesicare ? 

U may need treatment for vaginal atrophy which can mimic urine infection-type symptoms really really well and which GPs fail to realise.  If your urine isn't growing any bugs, then your GP should be prescribing appropriate VA treatments.  Usually 'vagifem' or 'ovestin' are suggested, do read 'the bladder issues' thread and any relating to VA.  Getting a copy of 'me and my menopausal vagina' might be worth while, a very good read.

Title: Re: OAB/IC
Post by: Brownie on December 02, 2023, 05:17:11 PM
Overactive bladder + interstitial cystitis. I know some ladies on here have those conditions.

Yeah I'm on the generic estriol + use it most nights now. I'm taking aloe Vera capsules which are supposed to be good for the bladder as is marshmallow root/leaf tea.

I just wondered if something I used to be able to eat/drink before can potentially now be irritating to the bladder ???
Title: Re: OAB/IC
Post by: Wrensong on December 02, 2023, 05:39:36 PM
Hi Brownie,
Quote
My main question was that I never really felt food/drink was a trigger for me but I'm wondering can this change over time
I'm another with a long history of IC, diagnosed on cystoscopy in my 40s & still intermittently problematic in my early 60s.  You have my sympathy, as the discomfort can be miserable & at times overwhelming.  A few of us have been discussing this recently on a thread started by Kirsti called something like "is this much pain normal", which I'll find & bump for you. 

There's also a link here that may be helpful if you don't already know the IC website.  It should display a summary of articles on how diet can affect IC.  I find I have to be more strict with exclusion during flares, but can still manage to eat a wide range of foods.  Depends on your individual triggers, which can be quite hard to identify.  I think as the GU tract becomes less robust with age then it's unfortunately quite possible that foods & drinks you tolerated easily before, thought to be irritant with IC, may now be causing you problems.  Worth experimenting to see if that helps you feel better, I'd say.
https://www.ichelp.org/?s=diet

Wx
Title: Re: OAB/IC
Post by: Brownie on December 02, 2023, 05:52:03 PM
Thanks for your reply.

Yeah I've been on that site but will look for the thread you have mentioned but I will look for the thread you have mentioned. Have you been able to eat/drink things previously that now would cause you to flare at all ?
Yes it sucks grrrrrr
Title: Re: OAB/IC
Post by: Brownie on December 02, 2023, 06:03:07 PM
Wrensong,

I've found the thread thanks. Couple of things interested me. Firstly I took d mannose for the first time yesterday/today but noticed that it mentioned it could be a irritant. Also I have been taking probiotics (capsules ) for a few weeks now. Do you take any of these ?
Title: Re: OAB/IC
Post by: CLKD on December 02, 2023, 06:03:35 PM
Certainly some do develop sensitivities to foods/alcohol that hasn't bothered their digestive systems until peri-menopause.

Tnx for the clarification. 
Title: Re: OAB/IC
Post by: Wrensong on December 02, 2023, 06:10:13 PM
I've been excluding some triggers for years but can't say I've identified new ones recently, though I'm starting to suspect apples may be a new one  :-\.  Those long troublesome for me include coffee (both caffeinated & decaff), obviously alcohol, citrus & cocoa is sadly very irritant for me.  Have you tried D-Mannose?  If not & you have a tree pollen allergy, just be aware that some of it is derived from Birch.
Wx
Title: Re: OAB/IC
Post by: Brownie on December 02, 2023, 06:14:55 PM
I just started the d mannose yesterday but I've more or less been flaring for a few days every week for the past 3 months.
Have you eaten/drunken anything whilst you have had IC which was ok for you initially but causes flares now ?

I'm just fed up +wish I knew what was causing the flares😭
Title: Re: OAB/IC
Post by: Wrensong on December 02, 2023, 06:16:39 PM
Our posts crossed over, Brownie.  I didn't find D-Mannose irritant to the bladder, but not effective either.  That said, I didn't take it for many weeks because it started to cause oral allergy symptoms similar to those I get from tree pollen & when I checked the source, was dismayed to see the brand I'd bought was derived from birch.

I have taken probiotics on & off for decades, but some strains can be irritant because of the histamine generated.  Are you taking one specifically marketed for the GU tract?
Title: Re: OAB/IC
Post by: Wrensong on December 02, 2023, 06:20:54 PM
Quote
Have you eaten/drunken anything whilst you have had IC which was ok for you initially but causes flares now ?
Sorry, I can't be sure, but as I mentioned above, possibly apples.  But, the long UTI while off Vagifem for several weeks has muddied the picture
Title: Re: OAB/IC
Post by: Brownie on December 02, 2023, 06:53:09 PM
Not sure about the probiotic, just one from Holland + Barrett with high CFU.
It's just strange I started d mannose yesterday + flared today however been like this for some time now unfortunately.
I was told I had a 'slight' UTI (whatever that means ) + got 3 days Trimethroprim then that led to thrush I had for ages. I've had more intense UTI testing but nothing significant so GP wants to do more samples. I thought maybe embedded UTI ?
Anyone I read somewhere else about d mannose initially causing flare then gets better so maybe lower dose ?
Sorry could I ask another question???
Do you ever drink diluting juice + if so does that flare you ?

Thanks
Title: Re: OAB/IC
Post by: Wrensong on December 02, 2023, 07:10:58 PM
Optibac do a probiotic targeted at the GU tract, I've taken it in the past & wasn't convinced it made any difference but have very recently started it again.  Too soon to know how that will pan out.  Could you stop the probiotic for a while & see whether your symptoms improve? 

I haven't drunk fruit juice undiluted for years but generally avoid it altogether & stick to plain water.
Title: Re: OAB/IC
Post by: Brownie on December 02, 2023, 07:19:31 PM
Yeah I'm going to stop the probiotic but will stick with d mannose for a few days but maybe lower dose + take at bedtime (which I read might be better)
I was meaning juice (ie apple/lime etc) that you put a small amount in then fill up with water. Again something I could have previously but may be irritant now ???
Thanks
Title: Re: OAB/IC
Post by: Wrensong on December 02, 2023, 07:32:43 PM
Yes, sorry I wasn't clear.  What I meant by saying that I avoid juice altogether was that I don't drink it diluted either, as I find it can still be irritant mixed with water.  When I took D-Mannose I took it at bedtime.  Too  expensive to take multiple doses every day.
Title: Re: OAB/IC
Post by: CLKD on December 02, 2023, 08:42:37 PM
There's no such thing as a 'slight urine infection'.  It's either an infection or not!  Dip sticks in the surgery can give a false idea of positive/negative, so GPs still prescribe ABs.  Which is why all samples should be sent to a Lab to be grown.

Is there a worse time for symptoms to flare?

Title: Re: OAB/IC
Post by: Brownie on December 03, 2023, 07:49:28 AM
No just past few months has been happening every few days then it gets better then few days later flares up again.  I just wish I could get to root cause so I can start living some kind of normal life again Xx


Title: Re: OAB/IC
Post by: CLKD on December 03, 2023, 09:13:07 AM
there can be embedded infections

Have U thought to try VA treatment to keep the whole vulval area less dry?
Title: Re: OAB/IC
Post by: Brownie on December 03, 2023, 09:25:47 AM
Yeah I'm on the generic estriol +use it most nights now.
Title: Re: OAB/IC
Post by: CLKD on December 03, 2023, 12:37:16 PM
U probably said that already  ::).  Sometimes 1 needs two insertions a day.  With 'ovestin' I put 1 up mid afternoon and again in the evening when symptoms niggle.  Then every evening for at least 5 nights.
Title: Re: OAB/IC
Post by: CLKD on January 06, 2024, 09:52:20 AM
Can any1 give this poster advice?  Tnx.
Title: Re: OAB/IC
Post by: Brownie on January 06, 2024, 10:16:51 AM
Thanks CLKD
Will + try keep this as short as poss 🤞
Been on 0.01 estriol 3ish years now (just started everol conti to see if that will help with dryness too, I know several ladies on here use both)
I've had several antibiotics/antifungals over the past 5 months so unsure if my vaginal ph is just totally off whack + causing me probs or do I need a change of estrogen? I took some cranberry juice to see if it would help the flare which it did seem to do initially but not sure if I overdone it + that's now causing me pain/discomfort (I read somewhere that cranberry can cause pain if you are estrogen deficient)
Just don't know what to do to make the pain go away. This past 6 months or so have been hellish, stuck in my house/bed, I just want some relief to start living my life again. Any help would be so appreciated Xx
Title: Re: OAB/IC
Post by: Joaniepat on January 06, 2024, 11:12:38 AM
Brownie, sorry to hear about your recurring urinary issues. I'd advise you to look into embedded UTI and to join the Embedded/Chronic UTI Support Group on FB. There is a lot of useful information in their files.
JP x
Title: Re: OAB/IC
Post by: Brownie on January 06, 2024, 11:38:33 AM
I had a specialist urine sample taken in Nov. Said I had a small growth of bacteria that could only be treated will Ciprofloxacin. I've had 2 rounds of that now (12 days in total 500mg x 2 per day ) + I was given fluconazole to prevent thrush. I think my whole vaginal ph is totally messed up. Has anyone used multi gyn to restore vaginal ph. I don't think I could use it just now anyway as feels too sore down there + don't want to add anything else into the mix.

 I seen GP thru the week + she said see if things settle. Another urine sample was taken (but my pee was really clear) will see if I can get swabs done too. Im just glugging down water today to see if that helps.
Xx
.
Title: Re: OAB/IC
Post by: Wrensong on January 14, 2024, 12:51:00 PM
Quote
Has anyone used multi gyn to restore vaginal ph
Yes, I have used it on occasion in the past but currently use Boots BV gel intermittently to increase acidity.  Part of a multipronged approach though - I also use Vagifem, with Estriol 0.01% externally, plus systemic HRT.  I'm also careful to follow a low irritant diet for bladder comfort, having been diagnosed with IC on cystoscopy many years ago.  Probably said some (or all!) of this before but no time to reread thread today.
Wx
Title: Re: OAB/IC
Post by: Brownie on January 14, 2024, 01:08:38 PM
Thanks for reply. Do you use the gel a lot ? I'm having a bladder flare today + think its from drinking cranberry juice (although I never really thought food was my issue) I have weak/tight pelvic floor + think my IC is due to lack of estrogen. Do you take any meds for the IC? I was on Elmiron/amitriptyline but stopped both as think Elmiron stopped working after a while + think using amitriptyline more to help get a sleep. Was going to try a antihistamine to see if that has any effect.
I'm on the same estriol as you + just started on everol conti to see if it will help regards the VA but anxiety issues also. I never really liked vagifem but not sure if I should try ovestin ???
Title: Re: OAB/IC
Post by: Wrensong on January 14, 2024, 05:19:51 PM
Brownie, no I don't use a lot of the BV gel, just when I'm not sure whether something is brewing & I want to nip it in the bud.   I've found that with the decline in natural lubrication postmenopause, sex seems to upset vaginal pH so I tend to use a vial for a day or so afterwards as a preventive measure.


Yes, cranberry juice is very acidic so you'll feel that on an inflamed bladder unfortunately.  I don't take meds for the IC, no, but have an open referral for instillations should I find it becomes unmanageable.  I'm very keen to avoid that, so do all I can to try to maintain bladder health.  Did you find the Amitriptyline worsened dryness?  I can't take it for that reason.  May be worth trying an antihistamine yes & this was suggested to me by my very good gynae who's knowledgeable on IC & GSM.  He also recommends D-Mannose.

Have you seen a women's physio for pelvic floor assessment & guidance?

Can I ask how often you use the 0.01% Estriol & do you use it both internally (with the full applicator dose) & externally?  What was it about Vagifem that you found unsuitable?


There is some thought in the medical literature that the deterioration in GU & pelvic floor health may be partly due to the decline in testosterone & not just oestrogen.  The progestogen in Evorel Conti is testosterone derived & considered to be the most androgenic used in HRT & as such may help your GU symptoms, though we all respond differently so you can only try it & see.  I hope you find EC helps your anxiety & that you feel better on it in general.  If not, there are various other types of systemic HRT you can try if you haven't already, so please don't lose hope.
Wx
Title: Re: OAB/IC
Post by: Brownie on January 14, 2024, 05:28:35 PM
I tried d mannose but felt it flared me. I took amitriptyline originally for pain but by the end was taking it mainly for sleep +I wanted to get off it +I have managed to do so but think that's because the patch seemed to be helping me sleep better. Do you think a generic/over the counter antihistamine would be ok ? I'm using the estriol cream nightly at the moment. I felt vagifem was quite drying. If I can get out of this flare I can certainly try it again. Yeah I've seen a pelvic physio, I've got a tight/weak pelvic floor + also a mild bladder prolapse (along with the va +IC)!!!!
Thanks for that post very informative and helpful Xx
Title: Re: OAB/IC
Post by: Wrensong on January 14, 2024, 06:23:03 PM
Good that you are using the Estriol cream nightly at present. 

The Interstitial Cystitis Association website has a page on Antihistamines you may like to look at.  I can't paste in a link as there is commercial content on the page, but this is an extract:-

"Though the most widely used antihistamine to treat IC/BPS is hydroxyzine, some people with IC/BPS find relieve from Claritin, Benadryl, and Singulair."

My Gynae didn't specify antihistamine type.  I tried Fexofenadine last year for other reasons (sleep) but it was post-gynae surgery when my GU tract was completely messed up following numerous courses of heavy duty antibiotics & consequently antifungals + 8 weeks without any vaginal HRT  - a nightmare scenario for GSM!  I don't recall any improvement in the GSM while taking Fexofenadine, though was not on it for long at all.
Quote
I've got a tight/weak pelvic floor + also a mild bladder prolapse (along with the va +IC)!!!
Ouch, that's a shedload of GU/PF issues for you to manage, but sadly not uncommon at this stage of our lives.  The HRT, vaginal & systemic, should help over time, taken at the right doses but if anything like me, you may also need to be vigilant with diet to keep your bladder comfy.  I don't need to follow a strict IC diet most of the time, but I do avoid those triggers I know from long experience spell trouble for me & then tighten up some more if a flare strikes.

Joaniepat is very knowledgeable on bladder health & though I don't do Facebook personally, I think her suggestion is well worth following as you're suffering so much.
Wx
Title: Re: OAB/IC
Post by: Brownie on January 14, 2024, 07:01:02 PM
Yeah I've also had 3 lots of antibiotics last year (2 courses were high dosage Ciprofloxacin) + A LOT of fluconazole/canesten pessary so think at the moment everything in that area is pretty much messed up. I have just started in the past week Optibac (as recommended by a lot of ladies on here ) I got the one for vaginal health to see how that helps.
🙏🤞
Title: Re: OAB/IC
Post by: Wrensong on January 14, 2024, 07:32:52 PM
I also have that Optibac probiotic plus one of theirs for general health.  I hope it helps you.
Title: Re: OAB/IC
Post by: Brownie on January 14, 2024, 08:10:58 PM
Yeah early days yet 🙏🤞
Can I ask what is the other probiotic of theirs you take ?
Xx
Title: Re: OAB/IC
Post by: Wrensong on January 14, 2024, 08:25:35 PM
It's the lower strength "Every Day" one. I've also recently tried one Boots do called Good Gut + women's health support.  It's manufactured for them by a very reputable probiotics company.  I can't yet vouch for the efficacy of any of these as my GU tract was so badly affected by the surgery & related antibiotics it's taken a long time to get the GSM back under control via multiple measures, so not sure what's helped most, but the vaginal HRT is an absolute must for me.
Wx