Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: MrsMitch on February 03, 2025, 06:18:13 PM
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So I had my appointment with the GP today for my smear test. She was going to use local anaesthetic as I've had a bad flare up of VA and she had a very long vial of it waiting for me. But we had a good talk through what's been going on with my bits and she said she'd have a look at the external bits first. I didn't tell her I've been using 2 estradiol pessaries each night for a week for obvious reasons.
Apparently my labia and some other bits at the entrance to my vagina I've never heard of, were very pale and shiny. So I suggested she try to have a look internally without anaesthetic first and low and behold, no pain! She said the walls of my vagina look really good and no sign of atrophy, so she said the estradiol is obviously working well for me. She also did the smear which made my cervix bleed slightly but I wasn't bothered, just chuffed not to have pain!
She's also taken a swab to see if I have any trace of BV but that may have gone as I've treated it for 7 days now. She suggested that sometimes a course of antibiotics can 'reset' that and keep it at bay for a long time.
She's prescribed steroid cream for Lichen sclerosis. I saw her about 10 years ago and had forgotten how lovely she is. So I'll see if the cream gets rid of the remaining discomfort at the entrance to my vagina and the itching that's started in the last couple of days.
Bit naffed off I do potentially have another condition, but glad a flare up of VA can be treated with an increase of estradiol short term.
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How do U feel?
Using VA treatment is essential to keep symptoms at ease.
Did the GP explain the effects and long term treatment that LS requires? There are several threads about it on the Forum. How long did she suggest using the steroid cream for and do U have a follow up appt with her?
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Hi MrsMitch, sounds like you've had an eventful day. Really pleased you managed to have your smear test and without the local anaesthetic and no pain, that must've been a relief for you. Mine is due and I'm not looking forward to it ....I will go of course but my previous 2 have made my cervix bleed like you today.
Hope your BV has gone and the LS is treated quickly
Really pleased you seem to be getting things under control.....slowly but surely xx
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Hi Northerngirl 👋👋 how are you? I hope you get on OK with your smear, I've only got one more to go before I don't need them (according to the surgery I think). But yes, glad they managed it.
CLKD: I have been using both ovestin cream and estradiol pessaries daily for almost 12 months and still had a horrendous flare up, hence doubling up on the pessaries for a week, so there isn't any more I could have done to avoid it tbh. I don't know how long to use the cream for yet and I have no idea about the condition long term, so I will be reading here, for sure. She's going to call me once my swab results are back so I will be making any relevant notes in case I heed to find out more about it when I speak to her. The wording of your post about effects of Lichen are making me think 'oh dear, what am I going to find'!
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MayB put LS into the search box on here ......... there's been discussion over the years about diagnosis and treatment etc..
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Yep, just had a pretty quick read on here and Google about it. After reading the symptoms, and I know I'm always saying it and I know none of you mind, but sorry tmi again : I've had an itchy bottom for about 30 years! My dad had the same and could never get a diagnosis. I wonder if it's possible that I've had LS for that long but it spread to my other bits around 14 years ago when my VA began?
Just thinking out loud, ladies because you're all such good listeners ;D
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Hi MrsMitch, I am glad that you had a pain free smear today and what sounds likes a positive experience with your GP who actually listens to you, in fact does more than listen, she sounds like a keeper and she even suggested using anaesthetic to help your smear test along (I didn't know that was even possible - thanks for sharing, so it is a possibility for any procedures "up there"). Hopefully now you have a diagnosis, you can get successfully treated and find improvement from now on.
Northerngirl, even just putting pessaries "up there" for 2 weeks before your smear would help you, that is what I did and I think it prevented it being painful for me
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Thank you fiftyplus, I agree re pessaries as no way was anything getting up there prior to 2 per day for 7 days. The difference was incredible. I ordered Gina from Boots because it would have left me short for the rest of the month otherwise. One of the ladies on another thread kindly told me she uses extra for a few days during flare-ups.
The local is apparently what they use to catheterise people and it was in a big syringe. I've got to the stage now where I refuse anything in that area without pain relief. I've had triage Dr's wanting to do an internal and test for sti's (unexplained bleeding) in spite of me telling them I'm married and sex is impossible. When he tried to insist, I told him I would only agree if he let me shove a cheese grater up his back side first, so he could understand the pain. He no longer insisted.
It seems it is possible to give us pain relief but they just like to cut corners in the hope you don't know.
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https://vulvalpainsociety.org/about-vulval-pain/vulval-pain-conditions/lichen-sclerosus/
I highly recommend the Vulval Pain Society website. Lots of good information and links to helpful resources. Quite a bit about Lichen Sclerosus.
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Hi Northerngirl 👋👋 how are you? I hope you get on OK with your smear, I've only got one more to go before I don't need them (according to the surgery I think). But yes, glad they managed it.
CLKD: I have been using both ovestin cream and estradiol pessaries daily for almost 12 months and still had a horrendous flare up, hence doubling up on the pessaries for a week, so there isn't any more I could have done to avoid it tbh. I don't know how long to use the cream for yet and I have no idea about the condition long term, so I will be reading here, for sure. She's going to call me once my swab results are back so I will be making any relevant notes in case I heed to find out more about it when I speak to her. The wording of your post about effects of Lichen are making me think 'oh dear, what am I going to find'!
I'm good thanks MrsMitch. Struggling a bit at present but nothing compared to you and many other ladies. I think I've got 2 more smears(this one and 1 more) I'm 56.....don't know why we don't have smears after 60....do we not have a cervix then😂. Take care MrsM x
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Hi MrsMitch, I am glad that you had a pain free smear today and what sounds likes a positive experience with your GP who actually listens to you, in fact does more than listen, she sounds like a keeper and she even suggested using anaesthetic to help your smear test along (I didn't know that was even possible - thanks for sharing, so it is a possibility for any procedures "up there"). Hopefully now you have a diagnosis, you can get successfully treated and find improvement from now on.
Northerngirl, even just putting pessaries "up there" for 2 weeks before your smear would help you, that is what I did and I think it prevented it being painful for me
Thanks for the advice fiftyplus x
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We have to request mammograms too >:(
Itchy bottom = worms. Or dryness. My GP recommended Anusol.
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CLKD : worms, you do make me laugh 😆😆
I've tried anusol and it never worked, although it is meant to shrink eye bags! But thank you.
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Good old baby appropriate lotion applied every hour until symptoms are eased?
Yep - bottom itching = worms. ;)
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I've slapped everything on that bad boy for years and nothing has worked! Stop it with the worms 😆 if I start scooting across the carpet like the dog, I'll take some of his wormer 😁
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:scottie:
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Well, CLKD, since you've mentioned the subject, I will share a story, I hope it will bring a smile to us menopausal worn ladies!
There was a bit of an out break, if that's the right term, of worms at my infant school. A letter was apparently sent home and all the parents had to dose the children and I seem to remember it was in the form of a powder mixed into a drink. I don't believe I actually had any worms but had to take it as I precaution I suppose. So mum gave it to me one morning. Later that afternoon we were due to go round to the new neighbours who had invited everyone from the road for afternoon tea. There were quite a few children there and I remember all of us being told to sit on the floor because the adults had the chairs. I didn't like it because they didnt have carpet, just polished floorboards.
So I was sitting cross-legged and obviously the wormer was having an effect on my tummy because, and I can remember it to this day, I let out the loudest, longest, uncontrollable fart ever!! Mum said it rattled the windows it was so loud! I think the floor amplified it too! She said the whole room fell silent for what seemed like ages and just as she was about to make her apologies, the hostess turned and scolded her dog and put him in the garden 😆😆
We never did get invited back though 🤭
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Well I've been using the Dermovate for Lichen Sclerosis now, but having been told to use it daily for the 1st two weeks, I can't actually use it for more than 3 days before I'm really sore.
I do wonder if I'm being told to treat something I don't actually have. Can anyone shed some light on how this condition should be diagnosed, please? My GP said there is a slight 'pearly' appearance with a bit of a sheen, to my vulva, which us why she decided it was Lichen.
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Sorry I missed that little Gem ;D
Your GP should refer you to the appropriate Consultant. Hopefully some1 with the condition will be along with advice.
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Well I've been using the Dermovate for Lichen Sclerosis now, but having been told to use it daily for the 1st two weeks, I can't actually use it for more than 3 days before I'm really sore.
I do wonder if I'm being told to treat something I don't actually have. Can anyone shed some light on how this condition should be diagnosed, please? My GP said there is a slight 'pearly' appearance with a bit of a sheen, to my vulva, which us why she decided it was Lichen.
Dermovate is one of the more potent steroids that is prescribed for LS, there are less strong ones so it could be worth going back to your GP and ask for Betnovate which is less potent.
A good GP can diagnose by sight, and white pearly patchy are definitely one of the symptoms that some people get, for me intense itching and red 'tramlines' down the labia were my main symptoms. If you google Dr Jill Krapft she does some great videos on how to effectively use the steroid cream and there is a wealth of information in the FB group for this condition:- https://www.facebook.com/groups/221930761513570/?ref=share
It's a horrible condition but lots of us manage to keep it under control with a maintenance dose of weekly steroid cream once the initial treatment period is completed.
Hope you get yours under control
Suzie
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:thankyou: Suziemc
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Thanks for the information, Suziemc. All my problems seemed to be VA, or so I thought and apart from a flare up a whole ago, that was pretty well controlled. My GP said the whole external area was pale and at the time itching was my only symptom not under control ( but it had been until the VA flare-up).
I will get in touch with her to see if she thinks I'd be better with Betnovate. I have got Locoid that I use off and on for itching which sometimes helps without any soreness. I do wonder if if I need to ask for it to be diagnosed by a specialist maybe. But my worry is that would be a referral back to the gynae I saw for years who misdiagnosed VA and refused to accept my symptoms were menopause related. I really have no confidence in her and I don't think there is anyone else, unfortunately.
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For your own peace of mind a gynae referral might not be a bad thing, you never know you might get someone different who knows what they are talking about!
In the meantime, try and get a steroid cream that does agree with you as untreated LS can get pretty horrible. I'm very fortunate, mine was 'just' unbearable itching and not being able to tolerate underwear touching my vulva and was quickly addressed by using steroid cream. Now I only do the weekly maintenance regime to try to avoid any more fusing and I can pretty much forget I've got it. Hopefully you'll be the same too.
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Again, thank you, Suziemc. My favourite time of day is evening when I'm just in my nighty with no underwear. Interesting to hear you've been similarly affected and that you're treatment works well.
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Hi Mrs Mitch.. would it perhaps be possible to ask if rather than a general gynae appt your GP might support a referral to a Vulvoscopy clinic if one is available. It's my understanding from my own experience that they are the vulva specialists and can do any further examinations to rule lichen sclerosus in or out. Also, have a look at a company called Dermasilk - they make medical grade silk knickers that are very good (comfortable) for a number of vulval conditions including LS. Might be something to try...
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Mrs Mitch , I was told by my GP in December that I had lichen . She prescribed dermovate . The diagnosis didn’t feel right so I sought a second opinion via a private gynaecologist. She said there were no signs of lichen just severe atrophy . Not to use the dermovate as it’s a very strong steroid that can thin vaginal walls further .
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I've had similar worries with VA and the thought of a smear was stressing me out big time, so it’s super reassuring to hear it went smoothly for you without anaesthetic. I’ve also found that a short boost in estradiol can make a big difference pretty fast. Fingers crossed the steroid cream sorts the rest out
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Well all thus time in and I'm not convinced it's LS. The steroid cream is too strong and just ends up making me sore. I need to get my GP to refer me back to the meno specialist as I'm bleeding twice a month so I may ask her to investigate this or refer me where necessary. I still think this is just VA because if I use x2 estradiol pessaries when I'm really sore for 3 nights a week and 1 for the other 4 for 2 weeks, things calm down. I think the dermovate has just added problems tbh.
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U know your body. Sometimes there are popular diagnosis in the medical and veterinary fields ::) so medics don't investigate further.
Steroids 'down there' are to B avoided if possible. The vagina is too delicate a flower to put up with anything that doesn't help ;). One cannot overdose on VA treatment. Let us know how you get on.
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I agree, CLKD, if I can avoid using steroid cream I will. I know over time it makes already dry delicate skin even thinner and my once blooming flower is now a-kin to dried flowers 😆😆
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I was told to use no more than a pea-sized amount of steroid cream on the 'sun burnt' area after radiation for 5 days then stop.
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Well I've been using the Dermovate for Lichen Sclerosis now, but having been told to use it daily for the 1st two weeks, I can't actually use it for more than 3 days before I'm really sore.
I do wonder if I'm being told to treat something I don't actually have. Can anyone shed some light on how this condition should be diagnosed, please? My GP said there is a slight 'pearly' appearance with a bit of a sheen, to my vulva, which us why she decided it was Lichen.
I was diagnosed by a consultant many years ago for Lichens schelerosis but have never been 100% sure it was that. I was struggling with atropy at the time and he said I had "features" of Lichens but not active at the time. The only way to be certain is with a biopsy. I've never had the white patches, shiny skin or constant itching. Although I do get sore when having a flare up, I think is atropy, it's only for a few days and extra local estrogen and Dermavate sort it quickly. The consultant also said I may not have a flare up of Lichens again for years or never again, which I thought strange.
If it was Lichens just extra estrogen wouldn't clear it up and I'd need a longer course of steriod cream. I didn't use the Dermovate last flare up, just doubled up on vagifem and estriol and it did the job so I'm convinced it was misdiagnosed.