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[jessieblue]

Hi all.  I am fairly new to this forum but have been struggling on and off with symptoms I didnt realise were related to meno.  I recently had a couple of utis and in discussion with my doctor I asked about oestrogen cream to help avoid more uti.  I was given estriol cream 0.01% at first and after a few days of using it......I started with just a smear and built up.....I developed a very red and sore vulva.  Wasnt sure if it was thrush.  Wasnt really itchy but fely tender and was bright red.  So I discontinued the estriol and when I saw the nurse again I asked for another type of cream.  I was given ovestin.  Seemed ok and after a couple of weeks again woke up very red and sore.  This time I tried to treat holistically with some mumma nature candidals, salt sitz bath and as suggested on here got some multigyn active gel.  The gel stung at first but went off after a few minutes but Today I am very uncomfy again. I have taken a fluconazole tablet today in the hope that it is thrush and this will clear it up.  Im worried this causes me to have another uti!

My question is.....what can I do if I cannot tolerate the vaginal creams?  I really thought this was going to be a big help to settling my worries about uti, I tend to stress about any health problems as have health anxiety. I am willing to consider systemic HRT, but am worried for all the usual reasons.  I have a mirena coil that has been in for 6 years. Am I likely to have tablets next or is there any other way of administering the low dose topical type treatment.  I am not sure if this has caused my thrush symptoms or whether its just a coincidence.  Im a bit scared to put anything else down there such as creams or pessaries because everything seems to hurt me.  I used canesten internal cream a few months ago for thrush after antibiotics and it caused the same problem.. Burning and bright red what looked like burns on the vulva. 

Am just trying to get an idea before I try to book a private gyn appointment to discuss all this.  I am getting nowhere with my gp tbh.  I was just told that getting utis after sex was normal for my age and to keep antibiotics on hand at home for when it happened.  Im not too happy about that to be honest.  When I used the ovestin cream I rubbed half of it into the vulva, could that be why its caused the irritation maybe?

Im sorry for rambling, there are so many things I need to understand and am feeling quite low about it all at the moment.

[Dancinggirl]

I think I have given you advice before but here goes:
It's probably the fillers in the oestrogen creams that irritate.
I would try Vagifem local oestrogen pessaries as these irritate less - pop back to the nurse and get this.
Keeping the flora balance in the vagina can be difficult when the oestrogen levels drop in peri meno and adding in some systemic oestrogen might be a good idea.  However, using vaginal moisturiser daily alongside the local oestrogen is vital to help maintain the flora balance and prevent BV and thrush taking hold.  Some like the YES products, I personally love SYLK - I apply SYLK at least 2 times a day.  Multi Gyn Actigel is great for preventing and treating BV and thrush but only use this a couple of times a week or daily if infections take hold. Thrush treatments and pills are harsh and will irritate. Don't use Multi Gyn or any moisturisers at the same time as the local oestrogen.
Take showers not baths. Wash with gentle, unscented, products specifically for the ‘lady bits' area.
Never wash you hair in the shower - shampoo will really irritate the ‘lady bits'.
Drink some water with bicarb morning and evening if you are burning. Avoid caffein, alcohol and any fruit juices (too acidic) but drink enough water to help stop any infection taking hold.
After bowel movements, really clean well - most vaginal infections come from the bowel - we women are poorly designed. Eat plenty of yogurt to maintain a positive flora in the gut.
Vaginal moisturisers are often the best way to sooth irritation in the short term - get some YES and some SYLK and see which one suits best. Lots of local, and possibly systemic, oestrogen will help in the long term and should be used regularly. DG x

[CLKD]

Who ever told you to "keep a few ABs to hand" should have their head shoved down a toilet   .  Vagainal atrophy may present as repeated urine-type infections but if a urine test is sent to a Lab., the ONLY way to check for bugs and if there is growth then an AB may be required: generally once the test is negative treatment can be given for VA symptoms ........ I have used Ovestin1mg successfully - some ladies use preparations specific for VA as well as adding another moisturiser to the outer lips to stop dryness.  As oestrogen levels drop so the skin becomes dry and around the vagina gets thin and itchy = sore. [Sylx I think is one that is useful, I find KY Jelly helps.

When my symptoms get bothersome I do a reload, i.e. every night for 2 weeks then as necessary. 

PS - that's LIVE yoghurt, I find Greek really useful - applied and eaten ;-)

[Annie0710]

I have VA and it first presented with many UTIs which were tested on sticks in office and lab tested.  Every sample has always tested positive for infection

I use vagifem and Sylk and it was working lovely but recently I've been getting sore again so have ordered YES oil based moisturiser for external

[Hurdity]

Hi jessieblue - Presumably as you have a Mirena you don't know where in menopause you are yet? Do you have other symptoms of low oestrogen eg flushes and sweats? Even if not and you want to take systemic HRT - then as you have a Mirena this will be easy - you can either take pills, patches or gel (as well as local oestrogen) and they are all listed here: http://www.menopausematters.co.uk/treatafter.php

Maryjane takes systemic HRT as well as local just for VA problems and I think ancient runner also does now too.

Ovestin is 10 times the strength of generic estriol cream and from memory has different fillers so for rubbing in externally you could try the weaker generic (0.01 % I think) along with the Vagifem as Dancinggirl suggests.

Go and see a different GP! It is absolutely not normal to get UTI's!!! And as for the ABs - I agree with CLKD's comment!!

Hurdity x

[Tinkerbell]

I am another one who uses systemic HRT and topical oestrogen just for VA control. I have a Mirena and use Estrogel.
I would definitely get Vagifem prescribed and see if that helps, I have never found it irritating, but then again I never got irritated from Ovestin either.
I would also not wash your hair in the shower, had to stop doing that ages ago as the shampoo really irritated when it migrated down below!

[jessieblue]

Thank you everyone for your replies.  So much to take in......I have ordered the YES and have some multigyn, which I used yesterday and today.  It did sting a bit but settled so will continue with that.  I have actually seen 3 different gps.  I know it seems silly but none of them has mentioned any form or HRT.  I asked for the oestrogen cream having some some reading to prevent further utis.  I was scheduled for a urethral dilation due to my recurrent utis.....I have only had tw....but anyway.  I have a tight bladder neck which was to be dilated but i held off on this surgery as I felt it may not really address all the issues I have been having.  Without boring eveyone.....I also have a rectocele and subsequently have problems with piles and fissures as BM can be tricky.

I have been having intense hot flushes for probably 10 years.  I started with bladder problems without infection 9 years ago along with heavy and persistent bleeding.  Had a polyp removed and had some vaginal discomfort even back then. Bleeding continued and so eventually had mirena which stopped bleeding altogether.  Hot flushes headaches dizziness all continued.  I had various tests including mri brain scan urodynamics cystoscopy hysteroscopy but no one has ever mentioned HRT.  So my only understanding of it is what I am reading online and now thank goodness from you ladies.  I am also suffering with a lot of anxiety and it all started around the same time as the bladder bleeding hot flushes etc back 9 yrs ago.  At that time I was told I was too young for meno.

I will ask for some vagifem and give that a try.  I really hope I can find a topical oestrogen that I can tolerate as this would seem easy.  Trust me to not be able to tolerate the creams!

I now need to research a good gyn who deals with meno in my area and hope to get a more joy.  Thank you all. xx

[Hurdity]

The problem with the Mirena is that it stops bleeds before you get to menopause - but if you've been having hot flushes for that long then I am amazed you have not been offered oestrogen. Also it's not a good idea to have Mirena on its own without oestrogen when you are post-menopausal because you don't need the progestogen, and it can overthin the lining leading to endometrial atrophy and bleeding. Good news is that you can easily treat your symptoms with HRT - look at the products listed on the link I gave you. You will need a new Mirena fitted if you've had that one in 6 years as progesotgen is no longer sufficient to protect the uterus from stimulation from the oestrogen.

If you go for that, some oestrogen ( I would recommended a 50 mcg Estradot patch - but gel users swear by this too!) and some Vagifem - and you won't know yourself!

Definitely go to a different GP but you do not need to go to a private gynae - what we are all advising is on the NHS and should be offered to anyone in your position.

Let us know how you get on

Hurdity x