Menopause Matters Forum
Menopause Discussion => Other Health Discussion => Topic started by: YvonneW on August 26, 2025, 10:39:51 AM
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Hi everyone, I hope that someone is able to help me as I really don’t know what else to do.
I’ve been having urethral burning and that’s constant during the day and gets worse after I need a wee for the last 4.5 years. I had endless appointments and tests at the hospital but no one really knows where the burning is coming from? I don’t have pain anywhere else, it’s just urethral burning. Constant. Like a UTI without having a UTI. They diagnosed me with IC and I’m currently taking Amitriptyline for that. I also had a prolapse front and back which I had surgery for last year. But no matter what, the burning is still there and it hasn’t changed. I was recently prescribed Estradiol pessaries (vaginal tablets) and I was told to also put Estradiol cream on the outside where the urethra is, so far no changes and it’s been 4 weeks.
Has anyone else got any idea what else I could do or how long this could take to maybe feel a change in the burning sensation? I just need and want this burning to stop, it’s affecting my daily activities and mood at times 😭
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Your issues are more complex than the usual symptoms of GSM but topical oestrogen treatment can take up to four months to take effect. It could be just that, waiting for the treatment to work.
Hopefully others with more knowledge of your symptoms will come along with advice.
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Hi Ayesha, thank you so much for your reply! 😊 This gives me hope knowing it could take months to work.
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Hello YvonneW & :welcomemm:
I was diagnosed with IC on cystoscopy 20 years ago. You have my sympathy as when the discomfort's bad it's hard to think of anything else. I was prescribed nothing for it for the first 10 years & had to manage it with diet & lifestyle measures alone until starting HRT several years postmenopause. As Ayesha says, topical HRT can take quite a while to work its magic on the GU tract, so please don't lose hope.
I use estradiol pessaries with a thin smear of the weaker estriol cream (0.01%) externally, as well as systemic HRT. I also use Sylk or Yes WB to help the estradiol pessaries adhere to the vaginal walls. This combination, together with the other standard IC diet & lifestyle management strategies helps me keep flares to a minimum & means I've been able to avoid the bladder instillations sometimes prescribed for IC.
There are quite a few IC related threads on the forum, so if it might help to read of others' experiences & you have time, you could do a search.
I hope you soon start to feel a reassuring improvement that will encourage you to persevere.
Wx
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Please remind me: What's "IC" mean :-\
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Interstitial Cystitis, CLKD.
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A painful urethra was my biggest va problem (just the end of it, not all the way up). Do you have the 0.1% estriol cream or the 0.01%? The 0.1 is better as it's stronger and I'd suggest you make sure it's dry every time you wee by dabbing not rubbing and apply cream every time it gets wet. Try it for a couple of weeks and see if it's any different. I didn't have vaginal soreness, it was just the end of the urethra and a dry patch on the labia. Is yours painful all the way up or just the end?
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:thankyou:
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Hi Wrensong and Sheila99,
Thank you both so much for the response, this is really so helpful and reassuring. I’ve been struggling for so long that I just want something to work. I’m honestly so glad to hear that it can take months for the creme to work. I just double checked, it was 0.01%. I’m not having any creme at the moment because the GP deleted it off my repeat medication list. I contacted them this morning and hopefully get it back on track. I’ll mention the 0.1% Estradiol, I didn’t know there was a stronger one. The vaginal tablets and creme are still something new to me. Something I didn’t know before. Also, no one ever mentioned that this could be menopause related. I’m 50 and have been on contraception for years so I never connected this to the menopause but reading some posts and through research, I found myself reading all these urethra pain posts that could be connected to the menopause and/or IC. I’m shocked that no doctor ever mentioned this to me before. I’m so grateful for any response or help as I clearly have to find the right treatment myself, doctors seem to not know…😩
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PS: @Sheila99
Hey! The burning is always at the end of my urethra. Sometimes it feels like it’s the entire urethra but I would still say it’s always the end 😵💫
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Yvonne, there are a couple of links here about GSM you may not have seen that might be helpful.
https://bssm.org.uk/wp-content/uploads/2024/03/BSSM-Position-statement-for-management-of-genitourinary-syndrome-of-the-menopause-GSM.pdf
https://thebms.org.uk/wp-content/uploads/2024/04/09-BMS-ConsensusStatement-Urogenital-atrophy-MARCH2024-A.pdf
Just to be clear, if you need to speak to a medic about the 2 creams, the form of oestrogen they contain is Estriol which is weaker than the Estradiol in Vagifem & its equivalents. :) A lot of new terminology we all wish we'd never needed to get to grips with in menopause! Do push to have the cream reinstated if there's any resistance to your having both cream & pessaries. I find it makes such a difference to comfort.
W x
P.S. stress that you need the cream for external use as sometimes it's declined under the mistaken belief patients are doubling up using it internally in the same way as estradiol pessaries. Not surprising, given the creams come with applicators for internal use as an alternative to estradiol pessaries.
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Hi Wrensong,
thank you again so much for your long and detailed reply, I really appreciate it! I’m so glad I came across this forum, for some reason I have a lot of hope now…that it can get sorted! I have saved those links and I will have a read. I will definitely stress about the cream for external use, the gynaecologist at the hospital said to use both - pessary and cream - long term. Thank you for clarifying the names as well, I did muddle it up earlier (still so new to this, even though I’ve been suffering for 4.5 years with this now).
So just to confirm, my pessary says Estradiol 10micrograms on the packet and the cream is called Estriol? I haven’t got the old tube anymore and currently waiting for the doctor to prescribe it, but it was a small purple tube with white writing on it saying Estriol 1mg/15mg tube?
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Don't stress or overthink the two treatments, just make good use of them. The pessary is Estradiol and the cream Estriol, both common treatments for GSM.
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Hi Ayesha,
thank you so much for your response. So grateful for this place. I felt so alone with this for 4.5 long years and no one understood what this is and now I come here and read so many similar posts! Phew! 🥺
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Dr Louise Newson has recently done another good podcast on Youtube. It's called hormones and urinary symptoms in women. She covers IC, UTIs, pelvic floor health & more & mentions that it can take months for vaginal HRT to take full effect. Well worth a listen.
https://www.youtube.com/watch?v=epMwOzhdBLA
W x
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Hi Wren,
thank you so much for this. I’ll have a look. I came across an older forum chat on this forum and I’m currently making my way reading through all 87 pages! There are so many women going through the same thing and the knowledge shared is so useful! I’m literally so grateful for this place! 🥰
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You're very welcome Yvonne. Yes there's loads of helpful info in the many threads on this forum & a lot of support & empathy from members.
I hope you'll find the podcast reassuring too.
W x
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Wren,
After 4.5 years I honestly feel like I’m on the right path and it feels so good reading other women’s experience and advice. Just when you thought that you’ll have to live with this pain forever and that there’s no one who can help and understands your condition (mainly Urogynaecologist at the hospital who’s been dealing with me since the beginning). All tests such as cystoscopy, scans, X-rays came back fine and nothing helped, such as bladder installations, antidepressants for the pain etc 🥺 you just start feeling lost. Not to mention how it affects a relationship. Luckily my husband is very understanding and feels for me, but it’s just horrid feeling like this all day long 😭 and not being able to enjoy life really…
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I know Yvonne, got the whole range of T shirts, but vaginal HRT is magical stuff & I do think in time you'll be so much better. :hug:
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I'll also add that in the BSSM link above there is a list of all the treatments available, its worth a read as well as being very educational.
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Ayesha - thank you, I’ll have a look 😌
Wren - I’m currently watching the video on YouTube and Dr. Newson mentions Intrarosa being better? Do you have any knowledge regarding this?
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You have my sympathies. I have urethral burning. I'm more comfortable before a wee than after it. I often feel like staying there and keep trying again and again.
I had this from age 27 though. Told it was urethral syndrome. I told the doctor I was worried about urine in the urethra leaking out, but I didn't have bladder urgency or anything, so I was only worried about a few drops of urine that felt like were stuck in the tube. Nothing ever leaked out, just very uncomfortable. After a while it would go away, until next time.
I asked for oestrogen cream then but I remember the doctor's words, she said at my age (then) I'd be 'dripping in oestrogen.' What a strange thing to say to someone with the problems described and the associated worry.
These days I do my best to ignore it, but while it's not painful or anything, it's very hard to ignore.
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Hi Julia,
Thank you for your kind message and omg, I’m so sorry that you’re dealing with this since such a young age 🥺
You’re saying it’s not burning anymore, are you still using anything for it? I literally can not imagine to live like this for the rest of my life and not finding the perfect treatment for me. This forum really helps me though as for the first time in 4.5 years I see that there are so many other women out there having the exact same thing or at least similar. It’s hard when even the specialists at the hospital don’t really seem to know what it is so they just tell you it’s interstitial cystitis 😢
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Sorry to hear you are suffering but urethra burning very often doesn't have a cause. Mine started when I was in my late 20s and I've never been the same since. It was caused by a latex cap and spermicidal gel which was OK at first and then I suddenly noticed a burning sensation and it was all downhill from then. I constantly had a burning sensation and felt like I needed to empty my bladder about 100 times a day. I was tested for everything and of course it all came back clear. I was up all night once with constant burning and urination and I was in such a bad state I had to call the doctor out which you could still do in the 1990s.
The only thing that ever worked to relieve the burning for me was a product called Azo (phenazopyridine) which dyes your urine orange and brings down the acidity.
I still have urethra burning from time to time and I always will but it's nowhere near as bad as it was. It does mean I can't use vaginal oestrogen because that causes a major flare up but I'm on two pumps of Oestrogel every day which I hope is sufficient for keeping the bladder healthy.
I think you can buy Azo online.
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Mary G,
thank you so much for your message.
I’m so sorry to hear about your suffering with a painful urethra, that’s really awful 🥺
I wonder what it exactly is in my case then, but for now I’m thinking it’s menopause related. I’ll definitely keep your advice in mind though in case my current treatment doesn’t work. I’ve read it can take many months to show improvement. Fingers crossed!