Menopause Matters Forum
General Discussion => New Members => Topic started by: Elissa on June 18, 2024, 01:36:38 AM
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Hi ladies, I have been reading through this forum and I'm hoping you can help. I'm 41 and very distressed by vulvar/perineum/anal area/inner thigh symptoms. The areas go very red (rash) and they burn. It's painful to walk around and sit down at times. There has been a slight itch internally and externally but this is not a prominent feature, it's the tender, irritated, burning feeling that's the worst. My GP reckons it's dermatitis and prescribed a topical corticosteroid called betamethasone cream 0.05%. This helps calm it down and cured it twice in the past year but this time around my issue has been going on for 3 months and the cream is not getting rid.
My GP recently offered Ovestin (following my suggestion of vaginal dryness) but I'm not convinced she thinks it'll help. I have completed the 2 week loading and now i'm on the twice weekly application (internally only). I wouldn't say it's helped so far.
My history: heavy periods that simply wouldn't stop 2 years ago. I was offered a mirena but wasn't keen on a device in there, so the gynaecologist put me on daily Provera (medroxyprogesterone acetate) 10mg daily. I have not had a period since I started on these tablets. My GP mentioned recently this was suppressing my estrogen so hence my suggestion that I might have vaginal dryness and she offered for me to try Ovestin. I've been told a couple of times during pap smears that I am dry inside.
I'm not currently sexually active so don't have pain during sex.
No history of thrush, have been tested a few times internally and externally and it's always negative.
I have no urinary symptoms like cystitis or urgency.
No visible changes down there.
My questions to you please:
- the burning associated with vaginal atrophy (a lot of you mention) - is it on the vulva/perineum area or are you referring to an internal burn in the vagina/when you pee?
- do you think my symptoms (burning, red, irritated skin and occasional itchiness) is vulvar atrophy?
I'd really appreciate your thoughts. Sorry for such a long post. Elissa :)
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Because you mention a red rash and that the cream you used got rid of it before imho I’m not sure it’s va.
Do you wear cotton/breathable underwear ?
Have you looked at soap powder you are using or changed to washing pants with water or very little soap powder and rinsing really well ?
What shower gel or bath products are you using in the area ?
Do you ride a bike which could affect the perineum area ?
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Thanks for your reply minusminnie, really appreciate it.
Yes, I have also thought about irritants. I initially (a year ago) felt that my first episode might've been caused by staying in sweaty gym clothes for too long before showering. My first episode lasted about 5 weeks. It started off as itchiness then quickly became burning. The steroid cream eventually fixed it up but it took a lot longer than the GP expected. During that time I did a lot of research online and changed underwear to 100% cotton. I tried to shower immediately after exercise and I was symptom free for several months.
My second episode was shorter (again treated by steroid cream). No itch this time just a burning red rash and small cuts on the vulva. I wasn't sure what caused it that time.
After many months of no symptoms I took a chance and didn't shower immediately after exercising in March and about a week later it started again and it has lasted 3 months this time. I have stopped washing my hair in the shower so shampoo doesn't reach those parts, I have stopped using shower gel, only water. I have changed to a sensitive laundry detergent but the symptoms persist. They come and go and move around. Sometimes it's the front area, then it's the back area. Sometimes there's no redness but the skin rubs on clothing and I struggle to walk around. I cannot exercise at all.
I am at my wits end. Yesterday I went out and bought non-bleached toilet paper in the hope that regular white toilet paper has been causing all this. I find it hard to believe one day without an immediate shower caused 3 months (and counting) of pain. Trying to figure this out. Appreciate any help you can offer. It's not really something I can bring up with the other mums at school pick up! Thank you.
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I’m so sorry it sounds like you have been trying everything.
The small cuts on the vulva you mention do indicate va.
Using estriol cream externally may help ie rubbing small amount on the vulva rather than just using internally.
I’d trial starting low & build up the frequency and amount to what you feel you need. It may take time to work as well.
Hopefully someone else will be along to comment on use of the Provera & if that is affecting things.
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I also think you need to use the estriol externally. Using it inside won't help the outside. My friend had paper cuts and uses ovestin. I've recently had an episode of soreness and I'm sure mine started because I was sat on a high stool in jeans for 3 hours causing pressure on fragile skin. The ovestin will plump up the tissues but you need patience. I'm using it nightly and a little in the mornings plus an internal pessary nightly.
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Most likely vaginal atrophy. Get some appropriate medication, contact your Nurse Practitioner for a consult so that she can have a lookC. As oestrogen levels drop so the body may become dry: inside and out - including the vaginal walls which become thin and sensitive. The need2P can be constant as VA mimics repeated urine infection-type symptoms really really well.
In the mean time gently insert a mositorisor, I use KY Jelly successfully. There are 'yes' and 'sylc' products too.
:welcomemm: and let us know how you get on. There are threads on 'bladder issues' as well as lots on VA!
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Elissa as a ps if you can bring yourself to talk to other mums at the school gate you may find a kindred soul & relieve some of the stress surrounding this.
Any other body part would probably be talked about in conversation. :)
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Betamethasone is a corticosteroid that is primarily used to reduce inflammation and suppress immune responses. It is not typically used as a primary treatment for vaginal atrophy.
While betamethasone may provide some relief from inflammation if there are associated inflammatory conditions or severe irritation, it does not address the underlying cause of vaginal atrophy, which is estrogen deficiency. Therefore, it is not considered a primary or effective treatment for this condition.
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Thank you for all the replies. I will consider ovestin on the outside. I did wonder how applying it internally would help with all my external symptoms!
Thanks Emma, I'm still using the betamethasone cream as I couldn't imagine not doing anything to help in the meantime, too painful! The GP said use it 'as needed' while I try Ovestin. Not keen though as I read reviews about how it can thin the skin etc. Maybe the ovestin might kick in and I can get rid of the cream...if I have VA that is...
Can I ask if any of you get a sore rash down there as part of VA? Have any of you ever had a diagnosis of dermatitis when it was actually VA?
Thanks again.
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I couldn't see because it was just inside but my GP said the sore area was quite red. Not a rash I don't think. The steroid cream started working fairly quickly.
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we can use VA treatment every night if required, regardless of what the info in the leaflet suggests or what GPs tell us: many are scared that women can overdose on VA treatments ::)
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Thank you for all the replies. I will consider ovestin on the outside. I did wonder how applying it internally would help with all my external symptoms!
Can I ask if any of you get a sore rash down there as part of VA? Have any of you ever had a diagnosis of dermatitis when it was actually VA?
Thanks again.
It can be both I'm afraid, what I call the double whammy, and makes your condition more complicated to treat and the time it takes to heal.
You have a great GP who has given you the meds required, use them as prescribed. The oestrogen will make the tissues stronger but again that takes time, its patience but you will get there.
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we can use VA treatment every night if required, regardless of what the info in the leaflet suggests or what GPs tell us: many are scared that women can overdose on VA treatments ::)
It's not necessarily a fear of overdose, its that different bodies react differently to it as mine has done after a few months. I have had breast pain quite bad last time and a bleed. Some GPs might be overcautious but many are not
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Agree, Jules. Also Elissa's condition is more complicated than just Vaginal Atrophy (GSM)
She must take the advice of her GP.
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Hi again, thanks for the replies. I've found the information really useful so thank you.
I agree Ayesha, the term GSM covers my symptoms more for sure. I have been doing a lot of reading online and I'm finding more and more references to irritation and pain in the vulva/perineum and 'back' area which matches my experience.
Jules, yes redness is a much better description as it's not really a rash I have. I am also red inside (from what I can see with much difficulty!).
Still feeling uncomfortable especially around my buttocks and inner thighs. It feels like chafing and hurts so much when my clothes rub on my skin - feels like friction burn. I have started moisturising these areas (E45 and vaseline) and have noticed a slight improvement. It honestly feels everywhere 'hips down' has dried out all of a sudden. Maybe not VA related, I'm not sure?!
I'll persevere with the Ovestin as prescribed and then revisit the GP in a few weeks. I've noticed i'm definitely using less of the steroid cream so maybe something's changing. Assuming the Ovestin helps, I'll be interested to see if the GP will recommend coming off Provera and maybe trying a Mirena. I've read online the VA is a side effect of Provera. Pity as it completely stopped my bleeding and I don't want to become anemic again.
I'll also ask her to examine me. She's only been looking at my outside bits for the last year (pap smear where she commented on my dryness was before these symptoms). I'm actually surprised she gave me Ovestin without a quick check.
Will definitely come back and update this thread for others who might be experiencing the same symptoms.
Thanks again :)
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Hi again, just thought I'd ask, if you don't mind, if anyone else gets or has had inner thigh skin sensitivity?
It feels like a carpet/friction burn but there's often nothing to see (sometimes the skin is a little pink but most times not).
Also my cheeks (where they meet my legs has the same sensation). It's really painful to walk around as clothes rub on the skin :(
Any ideas? Is this part of atrophy? Thanks so much :)
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I don't think it would be part of vaginal atrophy but obviously not an expert, could it be an eczema rash or simply sensitive skin?
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I agree & think your inner thigh burn is something beyond just VA.
If it helps a bathroom magnifying mirror is handy to check yourself out. I took the suction cup of a round mirror in a square frame and hold it between my thighs at times to check what is going on.
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VA doesn't spread down your legs!
That doesn't mean your genital area wouldn't benefit from some estrogen, but it's unlikely to be the whole picture, and if the GP treatment isn't working, a referral to a dermatologist may be warranted.
I would also SERIOUSLY question the long term daily use of 10mg medroxyprogesterone acetate. There are much better and kinder options for menstrual suppression. You will almost certainly be lacking in estrogen systemically, which is really important for your long term health.
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Hi thanks again for replies. The 'chafing' issue where pants/trousers seams irritate/hurt me, is my biggest issue right now. Interesting to hear a few saying definitely not VA. I'll need to see a dermatologist then.
Re Provera, my gynae did say Mirena was best option but gave me impression Provera was 'the tablet equivalent' so I didn't think too much about it. It has worked well but I'm worried about side affects now since GP mentioned suppressing estrogen and I have seen it mentioned several places online too.
I've previously tried the combined pill back to back without breaks for bleeding (on advice of a different GP) and also the minipill but they didn't reduce the bleeding enough.
Bombsh3ll- would you know of any alternatives? Does the Mirena contain progesterone and I wonder would it be enough for me? Cheers :)
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Some women when they can't find the answers book themselves an appointment at their local GUM clinic. A friend found out exactly what was happening with her by doing this, might be worth a try!
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Thank you very much Ayesha. I have just booked an appointment, they have a specialist vulva health clinic close to home!
I'm so grateful you mentioned that as an option. I totally overlooked that avenue :)
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If the combined pill continuously didn't help, a mirena would probably be your best option.
Yes it is invasive but a heck of a lot better than being in iatrogenic menopause for several years at your age.
Most women tolerate insertion well, and it is not that much more uncomfortable than a smear test.
If you have no interest in future pregnancy you could also consider endometrial ablation.
This is a bit more involved than a mirena and not reversible, however it can be a good option and certainly worth looking into rather than long term provera!
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Thanks for coming back to me bombsh3ll. I had forgotten about the option of ablation so will bear that in mind.
Bit of an update from me: visited my GP yesterday to chat about my situation. My biggest concern was the pain I have been experiencing from the inner thigh sensitivity and how much it hurts to walk around my house (let alone anywhere else)!
I have been leaning towards it all being to do with low estrogen and had all my questions prepared regarding increasing the frequency of Ovestin and getting rid of the Provera tablets. She still believes however, that it might be a skin thing and has referred me to a dermotologist specialising in women's health.
She also wonders if my existing blushing issue (diagnosed by a GP years ago as rosacea) might be linked to the whole genital area burning/itching and my inner thigh sensitivity.
I have been blushing at the drop of a hat since early high school. Not sure if anyone else has this? I blush (patchy redness, not sore just hot) all over my face, neck, chest and even arms at time. This can be in response to eating spicy food, drinking something hot, drinking alcohol, stress, social interaction e.g. bumping into someone in the street when I wasn't expecting to and even sometimes when I am! ;D
I don't think she agrees it's rosacea... Anyway, mentioning all this as it might help someone else if they're reading this in the future and I've posted some kind of conclusion regarding what on earth this is all about!
I struggle to think that something I've been experience since puberty (blushing) is related to a leg and genital area issue I'm experiencing suddenly in my 40s, but who knows!
With regards to Ovestin, she said no to me increasing frequency. I asked about applying it externally to my sore bits and she said I can try but advised she didn't think it would help and its external use hasn't been proven as beneficial. Fwiw, I believe you ladies when you say it helps you however, since my diagnosis is not confirmed I think I'll just stick with my twice weekly internal application for now...
She said no blood test is required to check my estrogen levels and she said she didn't need to examine internally... She said I should continue using the steroid cream. She isn't in any rush to move me to the Mirena...
I guess I'll have to trust in her for now. Please let me know if anyone has any thoughts on my situation, happy to hear what you think. Thanks for the support :)
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Look what I found! Posted by Brown eyed girl in new members thread:
Skin sensitivity / tight muscles.
This describes my situation including the knicker elastic chafing! Pity we don't know the outcome from this poster or certainly I can't seem to find it!
« on: December 18, 2018, 03:16:13 PM »
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Hi ladies
Another question which I hope you'll be able to help me with - I've just started on HRT, the 37.5mg estradot patches as prescribed by a menopause specialist.
I recently posted about some of my symptoms which were mainly bladder and possible VA issues - but I also have sore / sensitive skin which is made worse by clothing rubbing on it at times - this is either around my inner thigh / on the knicker line and also sometimes around my buttocks ( sorry for TMI). It's such an odd sensation and one that's difficult to talk about, but it has a massive impact on how I feel day to day.
I'm hoping this is another low estrogen symptom which will get better as the HRT kicks in - can anyone relate to this or offer any suggestions of how to relieve it eg creams etc?
Thanks for reading!
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That's concerning that she claims ovestin/estriol isn't beneficial. Did she mean for your particular problem or for atrophy?
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Hi Jules, she explained that there's no evidence that Ovestin is beneficial externally and I understood her to be referring to VA when she said that. If I do have dermatitis or something similar I can't imagine it would be useful for treating that, so yes I understood VA.
She's told me to continue Ovestin but only as prescribed (internally and twice a week).
All a little confusing. What do you reckon?
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Hi Jules, she explained that there's no evidence that Ovestin is beneficial externally and I understood her to be referring to VA when she said that. If I do have dermatitis or something similar I can't imagine it would be useful for treating that, so yes I understood VA.
She's told me to continue Ovestin but only as prescribed (internally and twice a week).
All a little confusing. What do you reckon?
It's certainly helped me. With symptoms and visibly. Not a miracle cure but seemed to halt or slow the atrophy. Why would the nhs foot the bill for something that has no proof of effectiveness? Did she have an alternative for atrophy externally? I'll be interested to hear what other members think.
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There is a chance she was just trying to discourage me from using it externally I guess...maybe until we know what is going on with me specifically.
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After three years of daily Vagifem and Estriol (Ovestin) I decided to experiment to check if I could cut down on the dose. I got down to five days Vagifem before the GSM (VA) symptoms returned, now back on 6/7 days treatment.
I then decided to check if I needed the Estriol (Ovestin) which I smear on the outside with a tube lasting me three to four months. After four days of not using the Estriol the GSM (VA) symptoms returned.
Therefore, in my experience the Estriol cream is essential in my treatment of GSM, confirmed by a nurse I spoke to recently at my review.
Go by your own instincts, because little is known by GP’s about the condition, it is so individualised and only you will know what you need. I am saying that even though you have other issues going on but these treatments are essential and its so annoying to hear your GP's response to what is such a low dose of HRT. But as you suggest, she wants you to wait to see what else is going on.
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Hi Ayesha, it certainly sounds like you need it more frequently so it is great you have the support of the nurse you mention. If I get confirmed as having GSM I might need to find a new more knowledgeable GP!
I'm actually totally confused now. Sorry this might be a bit of a rant.
Towards the end of my previous appointment with my GP, 4 weeks ago, I had suggested that maybe my vulva area burning and redness is caused by dryness. I listed a few reasons (me taking Provera daily and the fact that she had previously commented on how it suppresses estrogen, plus the fact that she commented on dryness during my pap smear a year ago). I also assume I'm in peri due to my very heavy periods 2 years ago and anaemia.
I had been in pain for so many weeks by this stage and was racking my brains trying to come up a solution. I had managed to establish online that low estrogen can cause dryness and asked if a moisturiser might help. The GP considered my suggestion and said she would try me on some estrogen 'Ovestin'. She never used the words vaginal atrophy or explained anything. She then made it clear my time was up and I was out the door!
I've then spent the last 4 weeks googling dryness, Ovestin etc and educated myself on VA/GSM and it seems to match my symptoms. Well everything except the thigh sensitivity (pain when pant/trouser seams rub on them) but that has only occurred in the last 4 weeks. The rest has been on and off for over a year.
I went in yesterday seeking clarification on my supposed condition by mentioning the fact she prescribed Ovestin last time and I therefore wanted to make sure she was treating me for Vaginal Atrophy (or GSM). I expected her to say yes, dermatitis is no longer the diagnosis. Instead she flummoxed me by saying she thought it is a 'skin thing' and said she'd refer me to a dermatologist.
It makes me wonder why she said to continue with Ovestin but maybe it's just in case it's not a skin thing or even a bit of both. I'm guessing she thinks that using Ovestin in the meantime is no big deal and I'm not worried.
Thanks for listening. I understand that getting a diagnosis with these sorts of issues can be a long road for lots of people :(
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The problem you have is the fact you might have GSM (VA) along with a dermatitis issue which makes it more complicated for you, you need a diagnoses and hopefully you won't have to wait too long forthat. At least you have the Ovestin to use which should help if its GSM.
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Hope everyone is going well? :) Just wanted to post an update on my situation and see what others think. Visited a GUM clinic today and discussed my situation with external burning across vulva area (perineum, back area), irritation and a little itchiness for weeks and weeks. I explained how the GP has been treating me for dermatitis and prescribed steroid cream. We also discussed my daily use of Provera 10mg (for heavy bleeding) plus my 5 weeks usage of Ovestin.
I explained that I have not had to use the steroid cream for the last fortnight, redness has gone, I don't feel as sore sitting etc. and my assumption is that the Ovestin has improved my general comfort.
So the good news is she cannot see any sign of dermatitis, lichen sclerosus/planus. The funny thing is she also cannot see any obvious sign of atrophy! I don't want to sound disappointed by this but I was kinda confused. Despite this, the GUM clinic GP was quite sure that the Ovestin has in fact done its job and dryness was the problem.
We've decided that I will have an ultrasound of my pelvis to check lining size etc and to ensure nothing else going on before I have the Mirena inserted asap. She also does not think I should be on 10mg of Provera daily for any longer. Because I am having night sweats and some moodiness (rage I would say...here one day gone the next!) she will check my hormone levels via a blood test (4-6 weeks after Mirena in place) and work out if additional hormones required.
The GP says it remains to be seen if I am going through a natural menopause or a medication induced menopause OR a bit of both! Definitely progress though!
Wondering if anyone else has experienced a decent improvement in atrophy symptoms after 5 weeks of using Ovestin? Bearing in mind that I had no urinary symptoms and I am only 41. I'm wondering if maybe it hasn't been quite as advanced with me as it has been for others (and that might explain the lack of visible atrophy today)? Thank you in advance for your thoughts :)
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I have atrophy and certainly had improvement after a short time with topical estrogen so it's possible. It plumps up the tissues. Dryness is an outcome of low estrogen too.
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Hi Elissa
Your symptoms are similar to mine - even down to sore where knicker elastic is at top of thighs, trying unbleached toilet paper etc., irritation/burn to vulva/perineum/'back' as you describe. I also have frequency/urgency.
I'm still trying to get answers - my main discomfort is the 'back' which prevents me walking, sitting, sleeping. Worse at times.
I had an early menopause so no oestrogen for 15 years so that's where I looked first.
I've come across a lot of ignorance when seeking help (which has caused stress) so had to self-diagnose and ask for oestrogen as I found bits out. I think I've mentioned a bit about this in my previous posts. I didn't mention the 'rear' in my posts though - as no-one else seemed to have this problem and being ignored about it at the GP's didn't give me confidence to be open about it. I still find it more embarassing to talk about that than the vulva - hence calling it the 'rear'! Fortunately, I now seem to have got a GP who listens and I'm beyond any embarrassment now and call it by the proper name there!
Am using Vagifem daily, and Ovestin daily to the vulva + trying a little on the 'rear'. Also been stop/start (due to bleeding) with systemic over the last 2 years. I've recently got the Mirena and am currently on a low patch till I increase.
I also now get the burning sensation in my thighs which is worse when sitting.
Have you looked into pelvic floor dysfunction?
Jilly Bond, pelvic floor relaxation info online might be of interest.
I found when I read 'Heal Pelvic Pain' written by a womens health physio I identified with it so I've started the exercises in that book whilst I wait for a physio appointment.
The underwear/clothes rubbing has got better though. I found preventing dryness by using an unfragranced body lotion or emolient helped. I find a thin layer and not dressing till it's soaked in better. The heat seems to aggravate it. I also suffered with it around the bra area and the underarms were a problem. A GP prescribed an antihistamine and that helped when it was bad but I now manage with a light pat of emolient every day to prevent any dryness.
Sorry if my post is a bit rambling. I haven't much time at the moment but wanted to post quickly because of your similar symptoms.
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What a positive outcome from your visit to the clinic, you should feel much more relieved now. Yes, the Estriol will certainly show signs of improvement after five weeks use.
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What a positive outcome from your visit to the clinic, you should feel much more relieved now. Yes, the Estriol will certainly show signs of improvement after five weeks use.
Thanks for commenting Ayesha. I needed some reassurance.
The thing I forgot to mention in my last post is that I noted (with torch and mirror) ;D that the skin (internal tissue) at the entrance to the vaginal was very pale before I used Ovestin. It was pale pink, almost white. After using Ovestin it's now deep pink/red, so something has definitely changed down there!
I mentioned this to the Dr and she was nodding her head.
Thanks once again for suggesting the GUM clinic. They seemed very informed on the topic, which was a relief like you say!
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I have atrophy and certainly had improvement after a short time with topical estrogen so it's possible. It plumps up the tissues. Dryness is an outcome of low estrogen too.
Thanks Jules. Yes it seems too much of a coincidence that I'm generally feeling a bit more comfortable. It must be the Ovestin, surely. As mentioned in my last post, I can see a visual change also.
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Hi Elissa
Your symptoms are similar to mine - even down to sore where knicker elastic is at top of thighs, trying unbleached toilet paper etc., irritation/burn to vulva/perineum/'back' as you describe. I also have frequency/urgency.
I'm still trying to get answers - my main discomfort is the 'back' which prevents me walking, sitting, sleeping. Worse at times.
I had an early menopause so no oestrogen for 15 years so that's where I looked first.
I've come across a lot of ignorance when seeking help (which has caused stress) so had to self-diagnose and ask for oestrogen as I found bits out. I think I've mentioned a bit about this in my previous posts. I didn't mention the 'rear' in my posts though - as no-one else seemed to have this problem and being ignored about it at the GP's didn't give me confidence to be open about it. I still find it more embarassing to talk about that than the vulva - hence calling it the 'rear'! Fortunately, I now seem to have got a GP who listens and I'm beyond any embarrassment now and call it by the proper name there!
Am using Vagifem daily, and Ovestin daily to the vulva + trying a little on the 'rear'. Also been stop/start (due to bleeding) with systemic over the last 2 years. I've recently got the Mirena and am currently on a low patch till I increase.
I also now get the burning sensation in my thighs which is worse when sitting.
Have you looked into pelvic floor dysfunction?
Jilly Bond, pelvic floor relaxation info online might be of interest.
I found when I read 'Heal Pelvic Pain' written by a womens health physio I identified with it so I've started the exercises in that book whilst I wait for a physio appointment.
The underwear/clothes rubbing has got better though. I found preventing dryness by using an unfragranced body lotion or emolient helped. I find a thin layer and not dressing till it's soaked in better. The heat seems to aggravate it. I also suffered with it around the bra area and the underarms were a problem. A GP prescribed an antihistamine and that helped when it was bad but I now manage with a light pat of emolient every day to prevent any dryness.
Sorry if my post is a bit rambling. I haven't much time at the moment but wanted to post quickly because of your similar symptoms.
Hi Wren, thanks for taking the time to post. I'm sorry to hear that you've been struggling also, it's all consuming isn't it!
My burning feeling (like sunburn or someone's taken a blowtorch to the area), redness and irritation has been 100% in the perineum, bottom area and between the buttocks ;D I have in fact had red burning skin right to the top of the butt cheeks! The skin actually split there at one point and it was so painful when water in the shower touched the broken skin. The skin was tight between the cheeks too (swollen?). Have you by chance had anal fissures as part of this too? Sorry if tmi!
The only time my 'front' area (labia area) has been involved is when it has been occasionally itchy and I've had the odd 'paper cut'.
At my worst, I have struggled to wear knickers and change to PJ bottoms in the house. I find it painful to sit down because it's the back area that we sit on. I would have previously thought you sit on your buttocks but they actually spread when you sit so you end up sitting on the perineum etc. Who knew?! ???
I haven't struggled with the pain when sleeping which must be awful. Instead I get insomnia from the hormones and end up lying awake worrying about it all >:(
My thighs might be a little different to yours as they don't hurt unless I walk and they rub together or I walk and the seams rub my thighs. I don't feel a burning all the time like I do in the perineum etc. My issue feels like chafing and it might just be that! It just seems strange to have started all of a sudden and to be so severe. I'm currently assuming it's extremely dry skin due to low estrogen and can only hope it gets resolved in the near future. I in fact did not mention my thighs at the GUM clinic as I didn't want to confuse things.
I have come up with a work around in the meantime which I hope might help you too...cycle shorts. I bought cotton cycle shorts and wear them under my pants (trousers). This is not a solution of course, but allows me to do my housework etc without being in pain. Because my pain in the perineum etc has reduced and I have my shorts, I'm hoping I can resume walking - haven't been able to for over 3 months! Wish I had thought of the shorts a little earlier but instead I was busy working on a solution without success.
Thanks for mentioning pelvic floor issues as it's on my radar too. I did in fact have an issue before having kids. 'Vaginismus' was mentioned by my GP when I described the issue hubby and I were having. I attended 2/3 appointments with a pelvic floor therapist/physio and we had discussions about the issue. She never examined me but whatever she said worked. I feel pregnant almost immediately after consulting with her! She said come back if you need to but I never did. Pretty sure I must have tightness still and have read that it can cause burning and redness too! Very interesting.
I think I might go and get an assessment as although Ovestin appears to be working I'm eager to rule out all reasons for the excruciating burning to come back!
Please let me/us know how you get on with your physio appointment when you go. I hope it helps x
Sorry for such a long post. Thanks again everyone :)
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Hi everyone, wondering if anyone can advise on when hormonal blood tests can be done please? I'll explain what I mean.
A few weeks ago I visited a GUM clinic and was told that my menopausal symptoms (VA - being treated by Ovestin; night sweats and insomnia) are either medication induced (I take 10mg Provera daily due to heavy periods) or early menopause (I am 41). They suggested I needed to come off the Provera (progesterone) before I can have my blood tested for hormonal levels e.g. FSH, LH, estrogen, testosterone etc.
I plan to move to a Mirena and they said my hormone levels could be tested 4-6 weeks after being on the Mirena.
Today I visited my regular male GP for an unrelated matter and discussed my issues with VA, being on Provera etc and not knowing my status re menopause. He seemed quite knowledgeable about the topic and said I could be tested right away i.e. I don't need to come off Provera first. He said that if I am in fact menopausal I wouldn't need the Mirena. This has totally confused me as it totally contradicts what the GUM clinic GP said about when the blood tests could be done. I had the blood test today and go back for the results Monday. Wondering if anyone can advise on this? Which GP is correct about the blood test timing? (and therefore its reliability/accuracy?) Appreciate any info. Thanks once again :)
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Sorry missed your response on 5 July - use SAVLON or ANUSOL on any affected areas, the former is probably kinder on broken skin. Has there been improvement there?
Welcome to the world of Peri-menoapuse confusion. [pity that I can't type, blaming the heat :sweatdrop: ]. Your VA will not be medication induced! The condition is due to the drop off of oestrogen which may make the body dry: inside and out; deep in the ears, skin, vagina, anus, between the toes, eyes .....
If a lady continues to have periods these need to have stopped completely B4 1 can consider being in menopause. Peri are the years leading up to that final bleed = menopause. My periods waxed and waned for several years: regular, then nowt for months etc.; I knew it was The Change so wasn't worried. Sometime during 2002 I realised that they had disappeared :bouncing: and fortunately, other than a few flushes for a few months followed much later by VA diagnosis, I have in the main been fine. I know that I am very LUCKY!
Hormone blood tests are reliably un-reliable. Certain tests need to be done at certain times of the cycle. Let us know what the results suggest.
Do U have a particular reason to stop the Provera for the Mirena coil?
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Thanks for replying CLKD.
The GPs I've consulted tell me Provera suppresses estrogen and can therefore mimic menopause symptoms. That is one reason moving to the Mirena has been suggested as a good idea i.e. to find out whether or not my menopausal symptoms are actually caused by the menopause or instead the medication. Also, taking Provera 10mg tablets daily is considered a high daily dose and not ideal health wise for the longer term.
I've been taking Provera tablets and it's been explained that the progesterone affects my whole body (systemic is the term I think?) whereas the progesterone in the Mirena is targeted at the uterus and that is better healthwise. My understanding is that any fake/false menopause symptoms from the Provera would subside when on the Mirena if indeed that is what's going on!
I have not had a period in 2.5 years (because of the Provera) and have no sense of cycle so cannot time blood tests right now.
Thanks for asking. Since using Ovestin I no longer have any irritation/burning on the external areas. I only have a slight itchiness internally and externally that I try to ignore. Using Ovestin twice a week. I have used it a couple of times externally for tender areas in the last month or so and it has fixed them up after one application :)
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Don't ignore any sensitivity! Ovestin can be used every night if necessary , internally with a little smeared on the labial areas to stop those feelings. Any hint of symptoms becoming troublesome, slap it on ;)
Tnx for the comprehensive explanation. It's all technical to me :D ::)
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Hi ladies, thought I might give a quick update. Still feeling the occassional irritation around the underwear trim area but Ovestin seems to fix those up. Fwiw moisturiser doesn't help and previously the steroid cream didn't either so quite sure it is dryness I'm dealing with.
My inner thigh irritation has gone completely. I wore the cycle shorts for a few weeks and moisturised several times a day which seems to have worked. Don't worry I didn't put Ovestin on my legs!!
My regular GP who offered to test my hormones (fsh, LH, SHBG and oestrogen) advised me I am not menopausal. I didn't get the figures as it was confirmed on a quick phone call. I have to say I was a little disappointed as I was kind of hoping perimenopause was done and dusted already after all the burning down there! Seems I might have to suffer some more before I come out the other side!
The same GP said he doesn't think my symptoms were dermatitis. He was convinced dryness. He gave me Ovestin on repeat, two tubes at a time ;D
He said my ultrasound showed adenomyosis which he said is common as you get closer to menopause.
So there you go. Mirena to be inserted in the next few weeks to see if that helps. To be continued....
P.s. he thinks my rosacea is simply rosacea rather than part of some big mystery involving my downstairs, phew!
Would be grateful to hear what you think about the blood test results considering I do seem to be suffering from low estrogen ???
Thank you :)
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Glad things are working out ok below stairs but I see your journey continues and I hope the more knowledgeable ladies will be along to help you re blood tests.
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I get two tubes with each prescription. U may need to use every night even after getting a regime as oestrogen levels continue to drop. I can judge my requrieemtns because my lower belly feels 'odd' when I need to up to more often.
U seem to have good support from your GP. Peri-menopause are the years B4 we have our last bleed = menopause. After 12 months we can believe that we are 'there' ::). However, Mother Nature can throw in the odd bleed in later years which needs to B checked.
My periods waxed and waned until I realised that they had disappeared. I had a few hot flushes after my bath, as well as itchy insteps at the end of the day which didn't last 4 many months.
It's The Change - does what it says on the tin ::)
Elissa - let us know how you get on!
I believe that a few Members have rosacea - if U put it into the search box you can read appropriate threads.
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Hi ladies, thanks for previous responses.
Just hoping to check this symptom please? I have slight redness and soreness along the crease where my abdomen meets the top of my thighs (groin/bikini line?). Sometimes it hurts without any redness.
Does anyone else get this? Is this low estrogen? What do you treat it with? Thank you.
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Hi everyone, wanted to post an update on my situation in case it helps anyone out there reading this thread.
Since I last posted I have had a mirena inserted, have come off the daily 10mg of Provera (used for heavy periods) and have started HRT!
My dryness issue was not causing me any issues by the time the mirena was put it (the ovestin was working) so I assume that dryness due to low estrogen has been my problem. It's not atrophy as such as there's no shrinkage or physical change but all the itching, burning down there plus all the skin sensitivity on bikini line, inner thighs etc have all been down to dryness/low estrogen. The ovestin really fixed up everything at the 3 month stage so hang in there if you've used it for less time and are suffering from similar symptoms.
Unfortunately my night sweats, rage, low mood, itchy scalp and poor sleep didn't resolve after stopping Provera, in fact things got worse. My dryness symptoms reappeared for around a week also post mirena (although very minimal compared to previously).
My most recent blood tests were normal (again) but the GP at the family planning/GUM clinic suggested that I give HRT a try. She said blood tests are useful if they show someone's gone through menopause but not that helpful whilst still in the process. She then asked me to do a questionaire and my score was 36. She said anything over 20 indicates perimenopause ;D
So pretty sure I'm in perimenopause, age 42. Although this has been working on me for years now, from my late 30s.
I've been using one pump of Estrogel for roughly a fortnight now and although I have suffered a really rough few days during that time with low mood and rage, my night sweats disappeared almost instantly and my sleep has improved. I haven't felt any dryness issues also. Hopefully better sleep helps with my mood/rage issues as time progresses as they are now my biggest issue.
Thanks for reading and for all your advice to date. I'm sure I'll be back with more questions :)
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Thanks so much for this great update on your journey and for one so young too!
I've been reading through the whole of this thread and it makes such interesting reading and its great to read that you are getting amazing help from the medics, hopefully things will be so much better for you going forward, they are certainly sounding good so far!
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Thanks so much for this great update on your journey and for one so young too!
I've been reading through the whole of this thread and it makes such interesting reading and its great to read that you are getting amazing help from the medics, hopefully things will be so much better for you going forward, they are certainly sounding good so far!
Thanks for responding Ayesha! I have to thank you once again for pointing me in the right direction (towards a GUM clinic) a few months ago, as I don't feel I would have progressed as much as I have without that information. That was truly great advice and thank you for taking the time to suggest it to me.
As per my story, the female GP reluctantly gave me Ovestin after over a year of skin irritation/itching/burning (which she was adamant was dermatitis despite it not responding to the steroid cream!) The male GP was more supportive and convinced my issue was dryness but he would not have prescribed me HRT. The GUM clinic, on the other hand, seem to be far more knowledgeable in these areas. My local clinic has both a vulva and menopause clinic :)
I really feel this has been quite a journey so far!! Suffering for over a year has taken its toll for sure, but from what I gather from reading online it's quite common to be misdiagnosed and treated for the wrong condition. It's a pity it is often not the first GP that helps with a correct diagnosis. Instead we end up going around the houses before 2 and 2 is put together. Despite that, I am thankful I feel I'm on the right track now.
Incidentally my mum had a hysterectomy at age 39 (now in her 70s) for heavy bleeding that had caused her to become anemic also. Unfortunately back then there were no IUDs so I recall her having the hysterectomy then onto HRT. So a slightly earlier transition to menopause was not a total surprise to me but the burning was :'(
Thanks Ayesha, thanks ladies :)
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I was recently given a reminder of how awful VA (GSM) is and that horrible burning and pain that comes with it. Symptom free for three years and suddenly a very bad flare up. This time I knew what was happening and applied extra treatment but thinking back four years ago with none of the medics knowing what was wrong with me, I was given three lots of antibiotics on the assumption it was a bladder infection.
One thing I can't get my head around, how on earth did GSM treatment become available to buy over the counter when no one around me including all the medics had ever heard of this condition, including me at the ripe old age of 70 when diagnosed.