Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Maryjane on September 26, 2016, 03:46:44 PM
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This is the Professor i have mentioned in the past on here , regards how inadequate UTI testing is.
Although this is The Daily Mail , this is written correctly from when I have seen him.
http://www.dailymail.co.uk/health/article-3804393/The-rise-super-cystitis-Poor-testing-leave-women-symptoms-rest-lives.html
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This is the Professor i have mentioned in the past on here , regards how inadequate UTI testing is.
Although this is The Daily Mail , this is written correctly from when I have seen him.
http://www.dailymail.co.uk/health/article-3804393/The-rise-super-cystitis-Poor-testing-leave-women-symptoms-rest-lives.html
so what is the answer? I got a negative test result back from the lab today but I am not convinced that I don't have remains of an infection which was first treated 3 or 4 weeks ago. I do have another course of Trimethroprim but can't decide whether to take it or not.
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At the moment nothing via the NHS.
Prof says and ( others slowly ) joining his way , that the patients symptoms are the best form of diagnosis . In other words listen to your patient.
Also GPs have been told to not follow the " krase criteria " for diagnosis, but they still do.
Problem is trimethopone is now resistant to a vast majority of UTIs, and should not be routinely given out.
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During the night I decided to start taking the AB again as it did at least partly do the job last time. I can't get a GP appointment until Friday so I will take them for 3 days to see if they start to work first.
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This business of three days of antibiotics is disastrous , as it's the quickest way to resistance why we are in the mess we are , never clears the bug properly and the bugs learn how to become resistant to it.
A family member is doing a degree in epidemiology and has been doing about , " anti microbial antibiotic resistance " and part of the work done was , on this nonsense of a short dose of antibs , making the whole situation so much worse.
Have you tried d-mannose ?
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General pain relief is better than ABs if there are feelings of urine 'infection' which can ONLY be diagnosed in a Lab. and can take 3-14 days dependant on what they are testing for.
I found taking Nurofen enough once I knew it wasn't an infection. Get thee some treatment for VA ????
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I get a fair share of UTIs, so far I've not been wrong when I call for an appt
The most recent one I left for 2 weeks, kept trying to flush it out as that sometimes works for me but when I phoned for ABs doc said it can't be infection as I had no pain, went to see her and the infection showed up on her test in office
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General pain relief is better than ABs if there are feelings of urine 'infection' which can ONLY be diagnosed in a Lab. and can take 3-14 days dependant on what they are testing for.
I found taking Nurofen enough once I knew it wasn't an infection. Get thee some treatment for VA ????
I have had a urine test but it was clear. However I still think I have an infection. I do have a VA treatment but i got it a year ago and it is not far off its use by date (in December). Also, with VA do you get a temperature? I have felt hot on and off for several days. If this AB doesn't work after 3 days (course of 5 days) I will see the GP on Friday.
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So have you used your nearly-out-of-date VA treatment at all Katejo? I don't think it'll impair it's performance if you were to crack it open now, and the symptoms are very similar.
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So have you used your nearly-out-of-date VA treatment at all Katejo? I don't think it'll impair it's performance if you were to crack it open now, and the symptoms are very similar.
I am going to ask a pharmacist a couple of questions about it on my way home. I nearly used it today but then held back. I haven't broken the seal so it should be ok. You say similar symptoms but have you had a raised temperature ? That suggests infection to me. Also I have no burning when passing water.
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You have had treatment but not used it :-\ …..
How can a urine test show an inf action in the Surgery? It can't be 'grown' in that short length of time, only be sending it to a Lab..
NOTE TO YOU ALL: VA mimics urine 'infections' …. so the bladder becomes irritated and requires treatment, GPs are too keen to hand out ABs rather than treat!!!! The initial 2 week every-night load should relieve those feelings which are kept under control by regular insertion of product.
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You have had treatment but not used it :-\ …..
How can a urine test show an inf action in the Surgery? It can't be 'grown' in that short length of time, only be sending it to a Lab..
NOTE TO YOU ALL: VA mimics urine 'infections' …. so the bladder becomes irritated and requires treatment, GPs are too keen to hand out ABs rather than treat!!!! The initial 2 week every-night load should relieve those feelings which are kept under control by regular insertion of product.
You have puzzled me somewhat. I didn't try the VA treatment a year ago because I wasn't sure that it was safe for me to do so then and the symptoms cleared up without any medication. My last urine test was sent to a lab and they didn't find anything but I do still think i have an infection. The pharmacist agreed with me . I will finish the current AB course and then another sample will be sent for analysis.
i did ask the pharmacist whether i could just try the VA treatment now but she thought it better to take the AB course first. I will however buy some of the KY and try that.
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One of the little squares on the dipstick checks for nitrite which is produced by some bacteria but not all that cause UTIs. Even then with these bacteria it is a fairly poor test and the nurse or GP should not be saying patients have a UTI without sending to the lab. Some dipsticks also test for white cells which if this is also positive would probably give more kudos to the UTI diagnosis but white cells can be there for other reasons too.
Some abs concentrate in urine which should be good for fighting infection but also cause problems in the lab as they interfere with the cultures hence no growth when the bacteria are still causing problems in the bladder. Flutterbyx
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One of the little squares on the dipstick checks for nitrite which is produced by some bacteria but not all that cause UTIs. Even then with these bacteria it is a fairly poor test and the nurse or GP should not be saying patients have a UTI without sending to the lab. Some dipsticks also test for white cells which if this is also positive would probably give more kudos to the UTI diagnosis but white cells can be there for other reasons too.
Some abs concentrate in urine which should be good for fighting infection but also cause problems in the lab as they interfere with the cultures hence no growth when the bacteria are still causing problems in the bladder. Flutterbyx
Yes I am aware of the need for lab testing but , in some cases the patient can't wait for test results due to acute discomfort and risk of kidney infection. My symptoms aren't as bad as that. I held off from taking more AB's as long as possible.
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I get a fair share of UTIs, so far I've not been wrong when I call for an appt
The most recent one I left for 2 weeks, kept trying to flush it out as that sometimes works for me but when I phoned for ABs doc said it can't be infection as I had no pain, went to see her and the infection showed up on her test in office
As we get older pain is often not present. This is how I developed a kidney infection - there was no pain to indicate that an infection was worsening and travelling further up the urinary tract.
Taz x
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I get a fair share of UTIs, so far I've not been wrong when I call for an appt
The most recent one I left for 2 weeks, kept trying to flush it out as that sometimes works for me but when I phoned for ABs doc said it can't be infection as I had no pain, went to see her and the infection showed up on her test in office
As we get older pain is often not present. This is how I developed a kidney infection - there was no pain to indicate that an infection was worsening and travelling further up the urinary tract.
Taz x
Thanks Taz, you know your own body don't you? Especially when you've had so many x
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Katejo I wasn't suggesting that where people are in discomfort they don't give out antibiotics. I've had to take abs without testing. I have seen second and third courses being handed out without further investigation, which is wrong. My post was just to give some lab info re CLKD's question about the dipstick, and also why sometimes results come back negative. Flutterbyx
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:thankyou: Flutterby.
If your GP prescribed treatment, why wouldn't it be safe :-\ ……. you are lucky that the symptoms went away, mine did for a while - I had intermittent feelings like a urine 'infection' but fortunately my GP noted my age and suggested localised VA treatment >PHEW>!
What have you decided Katejo?
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I was lucky because presumably whatever was causing the infection was sensitive to the antibiotic I was given ( I was abroad at the time).
If I'd been in this country I would have hoped that as well as getting some immediate treatment I would hope that a sample would be sent to confirm antibiotic sensitivity. Then if the antibiotic didnt work they would have the report to say what would. I do feel it is unsafe for the GP just to keep prescribing blindly.
CLKD - on the subject of VA since starting the menopause 10years ago my friend has had more or less constant UTI symptoms mainly without finding infection but not once has she been offered localised VA treatment which I find worrying Flutterbyx
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:thankyou: Flutterby.
If your GP prescribed treatment, why wouldn't it be safe :-\ ……. you are lucky that the symptoms went away, mine did for a while - I had intermittent feelings like a urine 'infection' but fortunately my GP noted my age and suggested localised VA treatment >PHEW>!
What have you decided Katejo?
because i read the leaflet in the packet which had warnings against using it if you were taking my specific medication. I needed to be sure that it was ok. I still think that what I have now is an infection. I am taking the AB without bad side effects so far. I will know whether it is working by tomorrow or friday. I will complete this course and then have a new urine test next week. I still think mine is an infection because surely you don't get a raised temperature with VA?
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I had all kinds of feelings with urine infections which were diagnosed in the Lab., slight flu-type symptoms, intense need to pee, shivering when I did …… awful. Let us know if the ABs start to relieve symptoms.
Flutterby - why hasn't your friend asked for treatment :-\
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CLKD I really don't know, but next time she mentions the symptoms I will definitely broach the subject if not before. I'm wondering if she is actually aware of VA. She tends to put her own well being last.
Going back to UTI symptoms - I find one of the first things is a really strange feeling in my chest before I urinate if I'm starting with an infection. This is there every time I go to pee until the abs kick in. Flutterbyx
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I had all kinds of feelings with urine infections which were diagnosed in the Lab., slight flu-type symptoms, intense need to pee, shivering when I did …… awful. Let us know if the ABs start to relieve symptoms.
Flutterby - why hasn't your friend asked for treatment :-\
With infections yes. I have many different ones but have you ever had a raised temperature/ flu like aches with VA and a negative urine test?
If I don't get any improvement from the AB, I will wait for the lab test and then discuss VA with GP.
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Not a high temp but a feeling of being unwell …….. at which point my GP suggested VA. Treatment stopped those feelings of razor blades up there.
How are you this evening?
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Not a high temp but a feeling of being unwell …….. at which point my GP suggested VA. Treatment stopped those feelings of razor blades up there.
How are you this evening?
Have a dull ache down below (similar to an old period pain but no razor blades and can pee without any probs) and just feeling a bit under the weather.
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Katejo glad to hear your symptoms are improving :foryou: Flutterbyx
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Hi Katejo
If you are feeling generally unwell and/or with a temperature then it is nothing at all to do with VA and could indicate an infection or bug - not necessarily UTI (but could be), such as a general virus or something. VA on its own is localised and limited to that area! Low oestrogen can also cause general pelvic problems and a dragging ache type feeling - which is what I got when I stopped HRT for 3 months and as well as the flushes, one of the reasons I went back on it. Due to general laxity and decreased collagen I think affecting that whole area.
Hope you feel better soon :)
Hurdity x
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I would just like to add some of my thoughts on the tho subject.
My father was a dental surgeon and a life vegetarian. He was very against the use of antibiotics unless absolutely necessary - I went through my entire childhood without a single course of ABs - my first course of ABs was in my early 20s when I had a particularly nasty chest infection. HE knew even back in the 60s that overuse would prove a problem. When it comes to UTIs it is clearly very difficult to know when ABs are necessary (the initial ‘dip stick' will only give part of the picture) and giving appropriate ABs for the right length of time is obviously crucial. The over use of ABs is being questioned but when it comes to UTIs there clearly must be a review on the treatment overall.
It staggers me that menopausal women keep turning up at the GP surgery with symptoms of UTIs - some with pain, urinery urgency and burning with no evidence of infection , whilst others show infection but have few symptoms - yet the medical profession hasn't cottoned on generally that the meno and these UTI type problems are linked :-\. the NICE guidelines do have a good section on this but I feel it isn't enough and the message isn't getting out there.
For years I had a horrible burning sensation in and around my urethra - initially my GP gave me ABs which didn't do anything and I asked several doctors (some gyanes at meno clinics) why I continued to have this awful discomfort - I was never offered local oestrogen as they all assumed the systemic HRt would be sorting any VA problems.
I am now on Vagifem and have used this for a few years now - what a difference it makes - I still get the odd flare up and have to manage things carefully with other strategies alongside the Vagifem but it is very distressing and often frightening to have this pain.
For me it is entirely logical that by maintaining a healthier environment around our delicate ‘lady bit's' this will act as a preventative against bacteria taking hold that is likely to cause infection. The use of local oestrogen will help the skin be more resilient and heal better - frankly if the NHS wants to reduce the use of ABs and reduce bladder and vaginal problems then local oestrogen should be the standard treatment for most women - NOT these 3 day AB courses that simply make things worse. PREVENTION is the key.
Rant over >:( DG x
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Katejo glad to hear your symptoms are improving :foryou: Flutterbyx
Not sure that they are improving. Felt worse after writing this. Suspect that the AB won't be effective. Already half way through course. Will hsve to wait until next Monday to get a urine test done.
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Katejo Oh dear, sorry to hear you feel poorly again :hug:
DG not a rant just a very well written case against the over use of antibiotics, especially for VA
Flutterbyx
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Thanks Dancinggirl. Having listened to a GP talking recently, the feeling in Surgery is that patients want a 'quick fix' and are unwilling to wait for Nature or over the counter remedies to take effect.
Also, wiping correctly can lessen the risk of bugs being passed back to front ……..
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Whenever I begin to get that burning sensation, I find drinking water with bicarb 2-3 times a day for a couple of days can really help.
CKLD - you are so right - part of my ‘management' to prevent problems is about keeping the whole area clean and balanced - making sure things are really clean after bowel movements is very important. Maintaining a good flora balance is also crucial - this is where the local oestrogen together with Sylk can really help. DG x
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Ahhhh, you've reminded me - good old bicarb of soda was Granma's go to receipe for burns and other ills.
Are U able to let us know how much you use in hot/cold water?
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I use half a teaspoon bicarb in a small glass of water - I usually add a bit of elderflower cordial to make it taste nicer :-X - As soon I feel the burning, I drink this 2-3 times a day for a couple of days and it usually clears things up nicely.
Vagifem 2-3 times a week and Sylk after every shower seem to keep the flora balance good. DG x
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Ain't it hard work sometimes to keep everything supple and soft ::)
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Thanks Dancinggirl. Having listened to a GP talking recently, the feeling in Surgery is that patients want a 'quick fix' and are unwilling to wait for Nature or over the counter remedies to take effect.
Also, wiping correctly can lessen the risk of bugs being passed back to front ……..
Was that on a BBC programme about reducing use of medication? I watched part of a programme filmed very close to where I live (Chingford/Waltham Forest) and heard the doctor saying this. I agree very much in principle but, in the case of a UTI, it could just spread to the kidneys and cause permanent damage).
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Katejo Oh dear, sorry to hear you feel poorly again :hug:
DG not a rant just a very well written case against the over use of antibiotics, especially for VA
Flutterbyx
But aren't VA and UTI actually different things which get mistaken for each other due to similar symptoms? Or does using an HRT local cream actually reduce the likelihood of an infection?
Re. general overdose of antibiotics: My impression is that GP's and pharmacists aren't entirely innocent. I have been to a GP before after a very bad cold or flu because I wasn't sure whether it had become an infection or not. I said to the doctor that I only wanted AB if really needed, not if it was a virus. i have been given one but later suspected that it had made no difference. In a similar way I have asked a pharmacist who gave rather dubious advice about how to tell between a bad cold and an infection.
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Ain't it hard work sometimes to keep everything supple and soft ::)
I have decided to try applying the Estriol cream because I have got irritation at the moment. Have also bought some lubrication jelly. How full should the applicator be? how many applications are required to feel any benefit (or is that like the question "How long is a piece of string"?)
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I'll repeat: as oestrogen levels drop off the body becomes dry, inside and out: skin, nostrils, deep in the ears, vagina ….. as skin dries it can itch which opens up the body to infection. Vaginal tissue is thin and gets thinner which causes irritation to the bladder. VA mimics urine 'infection' symptoms.
Initially the Nurse dipped the urine samples I took: fortunately not often: and gave me ABs for cystitis/infection but my GP cottoned on when 2 more samples were sent to the Lab. and reported as no growth and eventually suggested that it is atrophy. The prescription really did ease those feelings of razor blades up there!
So once the urine samples have been checked which can ONLY be done under Lab. conditions and when urine irritation is eased by over the counter pain relief then VA is in all probability the cause.
In answer to your question, it should tell you on the leaflet within the box how to apply ……… every night for 2 weeks is suggested to encourage suppleness of the vaginal tissue. I put KY jelly on my outer lips to stop itching there too ::).
Regular use of treatment to ease VA symptoms should lessen the irritated bladder feelings.
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I'll repeat: as oestrogen levels drop off the body becomes dry, inside and out: skin, nostrils, deep in the ears, vagina ….. as skin dries it can itch which opens up the body to infection. Vaginal tissue is thin and gets thinner which causes irritation to the bladder. VA mimics urine 'infection' symptoms.
Initially the Nurse dipped the urine samples I took: fortunately not often: and gave me ABs for cystitis/infection but my GP cottoned on when 2 more samples were sent to the Lab. and reported as no growth and eventually suggested that it is atrophy. The prescription really did ease those feelings of razor blades up there!
So once the urine samples have been checked which can ONLY be done under Lab. conditions and when urine irritation is eased by over the counter pain relief then VA is in all probability the cause.
In answer to your question, it should tell you on the leaflet within the box how to apply ……… every night for 2 weeks is suggested to encourage suppleness of the vaginal tissue. I put KY jelly on my outer lips to stop itching there too ::).
Regular use of treatment to ease VA symptoms should lessen the irritated bladder feelings.
Yes i have got instructions but wasn't sure how full to fill the syringe. I have just applied it. Possible slight relief straight away but perhaps I am imagining that. Also bought ky jelly today. After applying it for 2 weeks, how long do you leave it before doing it again ?
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Hi katejo
Have you read all the info on this site about VA? It starts here under menopause (top left tab)/vag problems/ symptoms but there are several sub tabs:
http://www.menopausematters.co.uk/vaginalsymptoms.php
Also treatment here: http://www.menopausematters.co.uk/dryness.php
And here: http://www.menopausematters.co.uk/local.php (some overlap)
Magazine article here:
http://www.menopausematters.co.uk/article-vaginal-atrophy.php (scroll down past the survey)
..another one here ( haven't read this one): http://www.menopausematters.co.uk/pdf/article-gsm-issue44.pdf
Just to clarify re the 2 weeks. The Vagifem or Estriol is applied every day for at least two weeks (longer if the VA is severe) and thereafter twice a week to maintain plumped up condition and keep VA at bay. This is for life if necessary as once you have VA it will return once you stop using local oestrogen. Some women use estriol cream on outer areas as well as Vagifem on an as and when basis although it is not designed for instant relief. if you find this it is because of the soothing effect of the cream - which of course you can't get with Vagifem as it is a dry tablet which sticks to vaginal walls.
I'm not sure about the other lubricants as I don't use them (except KY for sex) but you will see how others use them - some women use them daily so presumably as often as necessary.
Re the UTI issue - just to clarify - yes VA and UTIs do mimic each other but only locally. As I said before if you have a temperature and are feeling generally fluey/unwell then that is not due to VA. However as already said you can also have a UTI without having a temperature and feeling unwell! And of course the temp and feeling unwell may also be due to something else.
Hurdity x