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[SusanMA]

Hi all
I wanted ask your advice re oestrogen pessaries for urinary symptoms. I have IC and my main problem is constant urethral burning , it is very painful and been off work with it since May 
I am post menopausal and been prescribed Imvaggis, has anyone used this or another oestrogen cream or pessary for bladder issues ? Be helpful to know how long it took to make a difference. Am planning to start it tonight !
Thanks very much
Susan

[robotwars]

i'm using vagifem, just waiting to see if it works?

[CLKD]

What's IC?

What's Imvaggis?  With 'vagifem' and 'ovestin' it is suggested using every night for 2 weeks or more if symptoms fail to ease, then several times a week as necessary.  A pain relief can be useful too.

[SusanMA]

Thanks for replies
Have heard Vagifem can help but my specialist recommended Imvaggis.
IC is interstitial cystitis, or also known as Painful Bladder Syndrome
Some practitioners and patients believe IC is actually an embedded infection rather than an inflammatory condition. The symptoms are same as UTI but constant ! It’s a horrid thing to deal with and the urethral burning which I have all the time is particularly hard to manage. The use of oestrogen is to help the health of tissues which become more fragile post menopause.
I understand there was a thread on burning , but couldn’t find it 
Can anyone point me where to find it ?
Thanks
Susan x 

[KaraShannon]

I can't help on this as yet, but I'm so glad someone posted about this.  I've had what they call 'urethral syndrome' for about 20 years now.  I was going to be tested for IC, but that was 20 years ago and I didn't want to be put under anaesthetic back then for the biopsy.  They did look inside the bladder and said no sign as yet, but that it didn't mean I wouldn't develop it in view of my symptoms.  Well, symptoms haven't got worse but .................well what's relevant here is the urethral burning.  Mine is such that after peeing I never quite know if I'm finished.  The flow stops but I can easily 'bring on' more of it and I don't have urine retention.  They said it's purely that the tissues are irritated down there and in a healthy person there would no longer be a 'signal' to keep trying to urinate.  In the end I have to mentally switch it off.

I have noticed since taking vagifem (recently) that the symptoms are a little better (this is interesting because I asked for oestrogen cream or something in my mid twenties to see if that would ease it but the doctor at the time said 'at this age you are dripping in oestrogen already,' and she may have been right but I wondered if perhaps my urethra just needed more or something.  Also it is always worse just before my period and I guess that's lower oestrogen then?

I really hope these treatments help you.

[SusanMA]

Thanks for your reply, yes when I had periods my pain was always worse before I bled but improved once period started then came back when bleeding finished. Glad to hear Vagifem is helping a bit , does sound like your symptoms are oestrogen related.
Can I ask when you first started using the Vagifem did it burn initially ? The Imvaggis did, started it last night and felt awful in my vagina , intense burning then that set of the urethra to burn even more than usual! Was horrified as hoped this would help things not make them worse! But guessing this maybe an initial side effect that doesn’t always happen when used to it ? Does say you can get irritation in listed side effects but this was more than irritation it was burning awfully ! Eventually it subsided enough for me to sleep and now back to my normal level of urethral burning. I know I will need to use it for a while before seeing any results but curious to know if others had similar experiences
(May start anyone thread re side effects of pessaries but would welcome any feedback on this one.)
Thanks very much
Susan x

[KaraShannon]

Susan, I would hope that it's an initial effect of your tissues just not being used to it, but I don't know.  When I first used the vagifem, this is going to sound weird, but I felt like all my insides were swelling up and as if there was a 'blockage' in the vagina.  Someone said it might just be that the tissues were depleted of oestrogen so this is just a sensation.  I persevered and I don't have that now, I think it stopped after a few days break and then continuing.  I don't take vagifem every day because I think it makes me slightly more prone to migraine, nothing major, and also notice I have more hair coming away on the brush.....so I'm being cautious.  Actual urethral burning?  Nothing specific, though I'm sure there was some discomfort at first, but not anything I remember....more the feeling of swelling, to the point where I thought I might be allergic    But I do think that overall, awareness of the urethra is slightly less with using vagifem now.  Hope that helps a bit.

[SusanMA]

Thanks very Kara, or is it Shannon ? Wasn’t sure which was your first name, apologies!
I tried half a pessary of Imvaggis last night, same problem of strong burning. Phoned company who make it but they said they can’t advise, very frustrating!
GP has suggested Vagifem , sounds like it didn’t cause burning for you , so maybe worth giving it a go.
Good to hear it has helped a bit,despite strange side effects you had at first, is this all you use for the urethral burning or  are you taking anything else ?
Thanks
Susan

[CLKD]

Because the vaginal tissues are dry and thin, anything inserted is likely to cause stinging  so advice usually is to insert as deeply as is comfortable.  Do read the vaginal atrophy threads, bladder threads as well as the 'sylc' and - can't remember the other one  .  Some find that using these products ah! 'yes' along side VA treatment is helpful in easing the symptoms.

Let us know you get on.

[SusanMA]

Thanks have swapped to Vagifem as GP and pharmacist both thought I was having an allergic reaction to the Imvaggis , the burning from is was very severe and started as soon as I put it in, even before I had pushed up, so there must be ingredients in it that don’t suit me. I contacted the company that make it to report my reaction , they weren’t that helpful tbh but did record that I had reacted to it. Am annoyed that was not warned that this could happen by the private specialist who prescribed it , it was an expensive consultation and though she wasn’t to know I would  react to it , be surprised if this has happened before.
How long should I use theVagifem for to see if it helps ? I have heard Estriol can be good but wanted to give the Vagifem a try first , especially as it causes no burning atal! And just to be clear re my use of oestrogen it is purely for urethral burning, I don’t have any vagina symptoms. Despite being diagnosed with BV I have no discharge or discomfort there, it’s just in the urethra which is constant and horrendous to be honest !
Thanks very much
Susan

[CLKD]

4-ever.  The idea is to insert every night for 2-3 weeks then as often as necessary.  Many cope with every 3rd and 5th night, some require it nightly.  You may find that there is stinging for about 2/3 nights as the area will be dry.  Gentle insertion every night should ease those feelings. 

Where you treated for BV?  I don't have vaginal symptoms per se, other than a very tender spot which hurts when touched.  My symptoms were repeated urine infection-type symptoms of repeated need to pee - ABs relieved symptoms but won't replace oestrogen which is what 'vagifem' attempts to do. 

Read our various threads  - make notes 

[SusanMA]

Thanks, didn’t realise have to take it forever!!
Would you say the Vagifem has helped your bladder symptoms a lot ?
Have had headaches and constipation since starting it, is that normal? Was bit concerned to read on leaflet that constipation is linked to high calcium. I have not used hormones before or only briefly when tried Overstin in 2013 which increased my symptoms. In my 20’s I did also try the pill but didn’t feel good on it so stopped. The headaches and constipation make me wonder if I am just not good generally with hormone medication, but so want to see if oestrogen can help!
I know there are other pessaries or creams to try , it’s just not knowing how long to try this one before trying an alternative, any thoughts gratefully received : )
Thanks
Susan x

[Joaniepat]

SusanMA, it can take a while to work, probably some weeks or even months. Think of it as a nutrient for the the urogenital area, with the tissues gradually improving as the layers of cells renew. Treatment is forever, as it is like watering a plant, if you stop the plant will die.
JP x

[SusanMA]

Thanks very much JP , which oestrogen do you use? Understand I need to do it a while for it to work but just wondering how I know which one is best ? Vagifem I know does help some folk but not everyone, when should I consider trying a different one if Vagifem no tworking? Reason I am anxious re time is currently off sick from work due to the IC and will go to half pay in a couple of months. Plus am considering long term AB’s if have positive result from bacteria broth test ( only waiting list for this with a specialist clinic ) Would however prefer not to use anti biotics , hoping oestrogen will mean don’t have to!
Susan

[Joaniepat]

Personally I use Vagifem nightly, and Estriol Cream externally at least every other night. I would say to give it at least a couple of months. It's impossible to say which treatment is best as some people like Ovestin, some Vagifem, and the Estring also has its fans. If you are very dry internally Ovestin may be better.

I am sorry to hear about your chronic UTI. I have the same and am on long term ABs (Macrobid) and Hiprex. So far it's going OK. Who are you waiting to see? Broth test sounds like Dr Anderson. I am with Prof Malone Lee's Harley Street clinic.
Best wishes,
JP x