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[dulciana]

Thanks, Joaniepat.
 
D.

[Bertha]

Hi there Dr Currie.
At first vaginal dryness didn't bother me, I just thought; oh well its all part of being a woman, heading into my menopause, however when I tried having intercourse that was when i realised just how dry dry was!! I stopped indulging in that department with my partner or 12yrs after much trial and tribulation, couldn't handle the pain.

Moving on, got myself sorted with HRT, this improved the dryness not entirely but there was some progress; then the itching: OMG it just won't stop. I have tried pessaries, replens and nothing seemed to work. it got so bad that i would walk around with a nail brush in my bag so i could clean my nails after a long and hard scratch as this would cause bleeding. Due to the dryness it would cause the itch and i would scratch the itch, nothing would help. I mentioned this to my Gp and also informed her of my use of Eumovate pointing out that it was the only thing that gave me relief even though I know that it thins the skin. My Gp has told me to continue with this if it helps, she has even prescribed Betnovate for me: which i have not touched as I am fully aware of how potent a steroid atopical cream it is!
Now I'm not saying that Eumovate is any better as I know it is not but I'm at my wits end with this vagina of mine I don't know what else to do with it. the Eumovate gives me relief for a few days 4 at the most but then the itching starts again which means reapplying.
I was told that the itching would stop once my oestrogen levels normalised but I have been on oestrogen and Progesterone since November 2017 and Testosterone from early June this year 2018.
Any advice, suggestions are greatly accepted.

Thanks in advance

[Dancinggirl]

Hi and welcome Bertha

You need local oestrogen e.g. Vagifem, and vaginal moisturisers - Most of us use SYLK or the YES moisturisers.

Systemic HRT is often not enough to help urogenital atrophy and the NICE guidelines give clear advice on treatment.

Avoid anything scented around your intimate area and wear loose clothing.
DG x

[Bertha]

Thanks Dancingirl.

Can I get these products on the NHS? My reason for asking is because I have a PPC which covers me for 3months otherwise the prescription payments can really add up!
Nevertheless I'll broach the subject with my Gp whom I'll be seeing on the 23rd, no doubt she will probably completely ignore my requests and discuss whatever she feels is necessary but I'll still approach the subject.
If I can't get anything constructive from my GP then I'll purchase it myself if possible. This scratching the itch is beyond a joke now.

Having a flush right Now, time for a little meditation

Thanks again dancingirl. Xx

[Dancinggirl]

Hi Bertha

Do stop using Eumovate as this could well make things worse. Have your tried a bit of coconut oil?  this is a natural moisturiser and may sooth things.

Here is a link to the section on this site that shows all the treatment for urogenital atrophy:

https://www.menopausematters.co.uk/local.php Urogenital atrophy

Here is the section from the NICE guidelines on treating urogenital atrophy:

Urogenital atrophy
1.4.9
Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.
1.4.10
Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.
1.4.11
If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.
1.4.12
Explain to women with urogenital atrophy that:
symptoms often come back when treatment is stopped
adverse effects from vaginal oestrogen are very rare
they should report unscheduled vaginal bleeding to their GP.
1.4.13
Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.
1.4.14
Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.


Print off all this information to show you GP

All oestrogen treatments have to be by prescription but the moisturisers aren't always available on prescription as this depends on the health authority but it's well worth asking for SYLK or the YES products. You can buy all intimate moisturisers online. Many women do not get on with Repens very well.
If you print this off with information on the NICE guidelines, then this should help you persuade your GP to address your problems a bit better. I would write down all the your symptoms and questions and actually show these to the GP, as I find this makes them address the issues I want sorted. Cortisone creams are really not a good idea if you have atrophy as it could make things worse.
Has Lichen Schlerosis been ruled out or any other skin condition? Has your GP actually examined you to see how raw and sore you are? Have swobs been taken to see if there is bacteria or thrush present as this could cause the itchiness.  It can be a vicious cycle with itching - the more you itch, the worse it gets.  If there is a bacterial infection (often emerges when menopause hits) then this will cause itchiness.  I use Multi Gyn Actigel (available online but not on prescription) if I get itchy, as this will treat and prevent bacterial vaginitis better than antibiotics - it can sting at first but is then quite soothing.  You shouldn't use Multi Gyn too much though as it is rather acidic and is only designed to restore the flora balance and help the body fight the infections - vaginal moisturisers and Vagifem help to maintain a healthy environment. 
Antibiotics will kill all the good bacteria in the gut and this can then cause more vaginal infections.  Cortisone creams will thin the skin and can result in things getting worse - also the more you use it the more you need!!! 
Do clean really well after opening your bowels as this is often how bacteria gets to the vagina.

It is a minefield and its about managing your whole urogenital area.  Avoid alcohol, caffein and fruit juices as these are all irritants. Cut out as much sugar as possible.

I think a referral to a gynae to have things properly examined and advice given is possibly a good idea.

Good luck. DG x

[Bertha]

Hi Dancinggirl.

Thanks for all the  information, really appreciate it.
I have been examined by my GP regarding the itch, her response was 'I can see you've had a real go at It'!

I have also seen a skin specialist who wanted to take a biopsy but I couldn't go through with it; the thought of a chunk of my vagina being removed didn't sit well with me. No thrush!

I told my Gynaecologist everything regarding the lower regions, she has not yet examined me, I believe this could be due to my last 2 appointments being stressed, tearful, overwhelmed and anxious. I think she just wanted to get my HRT in order as I was a complete wreck; not so bad now but like I said the itching is something I can't seem to stop myself from doing unless the eumovate comes out.
I will mention it again to my Gynaecologist when I see her next in September, in the meantime I will do whatever I can to not apply the steroid cream but it's a difficult one cause all I'm after is some relief.

Thanks again Dancinggirl.
Gonna check out the info you sent me. Xx

[Bertha]

Hey Dancinggirl

Checked out the link you forwarded to me; I forgot to mention that I did try Ovestim as well; I believe that was stopped because the Gynaecologist thought that my HRT was being changed so I wouldn't have the itch anymore and that things would settledown, however, that was not the case and Ovestin did actually give me some relief, i think i just didnt have enough time on it for my body to regulate so I will mention it to her again.

I have never been checked out for LS, I looked at some images and sadly it looks pretty familiar I will broach the subject with both GP and Gynaecologist on my next visit.

I'm guessing that the end result may well mean that I have to have this biopsy that the dermatologist suggested
Cross that bridge when I get to it.

My sleep is also annoying me, or should I say, my flushes annoy me as this causes me to rouse from my sleep, sweaty and restless. Another thing for me to look into; FLUSHES

Sleepy now and would like to drop off but i can hear mum calling out downstairs now. She has Dementia!!!

All fun and games here

Thanks dancing girl. X

[Jenna]

Hi Bertha,

You might find this interesting about LS, and it could even help you:

https://www.yesyesyes.org/lichen-sclerosus/

Good luck!

[Bertha]

Thanks Jenna,

Dancinggirl did recommend the same product

I intend to purchase it ASAP!

[Jenna]

You're very welcome, Bertha. The water-based 'Yes' is actually available on prescription, so that's even better!

[Bertha]

Excellent, Jenna; can't thank you, dancinggirl and this site enough!
Good to know there's always an ear hearing what your saying

[CLKD]

Hi Bertha, I do wish that GPs would realise that localised HRT in the vagina doesn't need to be stopped if one alters any other medications!  They really don't get vaginal atrophy do they!

Have a read of the various VA threads, i.e. "My Bladder etc." - make notes. 

[Bertha]

Hi CLKD

No they don't get it!
My partner keeps asking me what it is that I expect from my GP; as they're really no more clued up than we are (as he put it) they're just everyday people like you or I only their job title makes you think they should be more aware!

He's probably right but I am entitled to some form of care regarding my health as far as I'm concerned and if your job is within the care field then some standard of care should be delivered when your in clinic/on duty, supposedly playing your role, doing your job; or maybe a change of career!

I just wish my GP would listen to me sometimes and not rush me out the door with a script.

They open up a Mims book or go on Google  to try and find a diagnosis for your symptoms, I could do that myself especially if I had access to a Mims.

Sorry about the little rant there, i am flushing, anxious and fatigued, can't have a glass of wine, just makes the flushes worse
My Gp is not even worth discussing.

Gonna have a look at that link you sent me.

Appreciated CLKD.

[jgr]

I have just started using Estriol cream as i was at my wits end. Thought that i had managed to escape vaginal dryness but when intercourse became uncomfortable i knew i had not. I felt like i was going to rip on entry and a soreness on friction . Anyway trying this out to see if any difference, been on it a week so will keep you posted if any improvement. I am now 60 and i thought that all would settle down but it feels like you have good days and bad, is this it now for life ?

[CLKD]

jgr - usually vaginal atrophy treatment is for ever.  The area needs moisture replaced in order for the skin not to thin and itch.

Bertha - your partner is Oh So WRONG! let's hope that he never needs assistance from the NHS.  When I go to the GP I expect to be listened to and I have to admit, I never feel rushed in our Surgery environment.  I expect that my request/s are respected.  If I don't get what I think I need I go back a couple of weeks later, "I probably wasn't listening last time so could we go through X, Y, Z " - I have to remember that my GP may have given bad news to the previous patient or been up all night.  That opens up the next conversation .....

You rant!