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[SaraC2773]

Helllo lovely ladies!

So I've been a bit lapse on my estrogen cream (swapped as vagifem made me very itchy),  only using it periodically as it had cause some slight spotting a while back.

Over the last 7-10 days I've had a really watery discharge,  not smelly or anything just incredibly watery.  After a visit to this site I realised it could be symptom of VA but also took on board the advice ref the PH changes possible BV etc.  So I got the BV balance gels and have been using them over the last week,  discharge still there,  still v watery.

It is also making me uncomfortable so whilst it's wet, all down below I feel uncomfortable and a bit sore,  I also noticed when I first started using the gels they stung quite a bit for the first couple of nights.

So I thought I'd call the GP to see if they would suggest either an alternative to vagifem or heaven forbid speak to me or see me  and this is the story so far.

I call through,  give summary of details including using the BV gels,   feeling sore despite being wet etc and receive the following response from a GP practitioner via txt - "Hi would you like to pick up a swab".

I then reply saying no as I'm not sexually active and haven't been for quite a few years,  I've treated for BV and I've had thrush before and this certainly doesn't feel anything like thrush.

Then get a text saying,  ok but we could test for thrush and BV whilst we wait for a Dr's apt.  I then reply reiterating I've treated for BV,  it's not thrush and as I'd already stated I suspect it could be VA but would need to speak or see a GP to check what options there are etc. Also said I'm sore, uncomfortable and it's being going on over a week.

Then get a response saying,  ok well shall we do a swab anyway!!

I then responded with No,  I'd like to speak with a DR and get some advice,  I thought this was the purpose of the service as you are operating a duty team?

Nothing now for over 1.5 hours which I'm hoping means it's been escalated to a Dr, although not holding my breath!!

I get that the NHS are under incredible pressure and for the most part do a great job but surely it would have been easier to just pick up the phone and talk for a few minutes rather than waste time typing lengthy messages back and forth which don't achieve anything.

Aarghhhhhhh!!! 

Also quick question,  does VA affect the perianal region?  I've just noticed that I get incredibly sore and sometimes itchy in that area too and I can't use anything perfumed when I'm washing,  having to use emolients as barriers as even wiping irritates the area both back and front.  Also can't use cheap toilet paper,  only Cushelle.

Is this all normal for VA symptoms?  feels like my whole undercarriage can't deal with any kind of irritants.

[Ayesha]

You haven't really helped matters by saying no all the time, they are trying to help you under extreme circumstances.
VA (GSM) will affect all areas below and you need to use appropriate treatment constantly, its about getting a regime that works for you.
There is tons of info here, use the search box, it continues to help me enormously.

[SaraC2773]

The reason for saying no all the time is because I feel I've done what the NHS asks you to do before contacting them.

I've researched what it could be,  tried treatment at home which hasn't worked so I wanted to use their duty team which operates morning and afternoon.

If I do a swab it will just mean waiting around for how ever long to get results and then I'll still be at square one,  - that's if they don't lose it which they have done on more than one occasion.

I'm not trying to be difficult but as we always say we know our own bodies,  I know what thrush feels like,  I've had BV in the past and have treated for that,  I'm not sexually active so I just want to speak with someone to discuss whether there was an alternative to vagifem as that caused a lot of itching and irritation.

My point was that if they spent less time texting back and forth trying to fob people off they might not be in such a mess, as literally a quick phone call could have answered all of these questions or even reading the form properly in the first place.

The other frustraing thing is when you drive by the surgery or ever go in there,  it is always empty.

 I honestly feel that yes some things can be resolved by completing a form but there are times when you do need to speak to or even dare I say it see a GP.   I'm really not trying to be difficult but it is pointless doing a swab for things that I definitely don't or can't have,  besides from my perspective that's just more wasted costs on their part!

[Wrensong]

Hi Sara, I understand your frustration re the texting. This also seems to have become my surgery's preferred method for interaction in non-urgent situations  & I agree it can seem to prolong access to help.  I try to go along with it though because of the extreme pressures surgery staff are under, so I assume this works best for them & on occasion when I've needed help with a more urgent matter they have been brilliant at expediting the care I've needed. 

Really this post is just to say I don't know whether you are aware of it but thrush can have a different presentation at/post menopause, the classic white curdy discharge with maddening itching & soreness more common in pre-menopause years can be absent with only a thin, watery discharge, itching & soreness to signal that something is wrong.  This is documented on various sites if you have any doubts.  I got caught out this way some years ago & was astonished to test positive for thrush in such circumstances.  I'm not saying I think you have thrush, but the offer of swabbing as first step may be your fastest route to diagnosis & treatment whatever the cause.  I hope you manage to make progress soon.
Wx

[Ayesha]

Further to what Wrensong has suggested if you think you might be oestrogen sensitive there are other treatments like Blissel for instance which is lower dose compared to Estriol cream. You have other options too but its all about trial and error, ruling out what doesn't work and what does, I am afraid it takes a long time to get it right.

[SaraC2773]

Thank you both for the replies.

I actually did not know that about thrush Wrensong and when I've had it on the odd occasion many years ago it was the classic white/thick discharge. Hence my naivity in assuming it would present the same in older years.

In that case,  maybe I'll try a bit of canestan whilst I wait to hear back from the surgery.

Ayesha that sounds exactly the sort of conversation I probably need to have as I just found vagifem gave me the normal thrush symptoms,  intense itching,  thick discharge.  The Ovestin cream helps with things like my overactive bladder and urethral discomfort but when I upped the dose I had slight spotting so Dr said swap to moisturiser but as we know,  that alone doesn't cut it!

I just get so emotional and frustrated,  it's bad enough trying to navigate all these weird and wonderful symptoms and then to feel like you can't get help when you are in a lot of discomfort is horrible.  I did think about doing the BUPA menopause service as I do feel I need to see a Dr and get on a proper treatment plan.

Glad it's not just me that finds it frustrating with the texting Wrensong.  I really do understand their pressures and know that they need to assess for urgent/non-urgent cases and in the past it's worked fine when I've just needed a prescription for something but I just feel with my surgery it's their go to for eveything and normally if it is urgent they'll say "go to the walk in centre". 

It's a shame as it used to be such a good surgery but now they've merged with two others and it's like pulling teeth trying to speak to someone.

I guess it's like everything,  it works well in many cases but sometimes you just need to go back to basics to solve the problem!

Thanks again for the advice,  will keep you posted.

[bombsh3ll]

I would go back to using the estriol cream as it sounds like that was helping you.

Whilst unusual spotting does need to be checked out, it doesn't mean you have to have untreated vaginal atrophy for the rest of your life. Spotting can actually be caused by VA too.

Do the swab just to tick that off, and continue to insist on a face to face appointment for examination.

Alternatively there may be a women's health/sexual health clinic somewhere near you that may be able to help.

[Kathleen]

Hello SaraC

I completely understand your frustration.

I had an appointment with a Nurse Practitioner a while ago and I accidentally walked into an office that was full of staff who were talking on the phone to patients.  They are certainly making use of the technology!

I think treating yourself for possible thrush is a good idea but be prepared to jump through a few more hoops if you still need to see a GP.

Wishing you well and take care.

K.

[Wrensong]

Hi Sara, I don't think you were being naive re possible thrush; when we've had it before in younger years with the characteristic presentation it's well known for then it's only natural to expect the same signs each time.  As the others have said, it may well be that your symptoms are down to GSM alone (the spotting too as per bomsh3ll) & that there is no infection of any kind, but I imagine the surgery were probably just wanting to rule out what they could for you before involving a GP, especially if that could mean a lengthy wait for an appt before any treatment could be instigated.

I just get so emotional and frustrated,  it's bad enough trying to navigate all these weird and wonderful symptoms and then to feel like you can't get help when you are in a lot of discomfort is horrible.

Yes, I'm sure many of us have felt this way.  I think there seems a greater distance between patient & GP in these days when F2F appts are no longer the norm.   I find the sense of hurdles to jump can really ramp up the stress & lead to a sense of powerlessness & vulnerability.  But at the same time I know surgery staff are still as caring as they ever were, but simply forced to operate differently in order to get through an immense workload with too few staff.  It can be a difficult, frustrating & unsatisfactory situation for patients & clinicians alike.  I do find there are positives with contact via text & online requests too though.  We can do this more discreetly wherever we are, without the possibility of our medical details being overheard or our responses to questions constrained in order to maintain privacy.  Also, the online forms we have to complete for triaging give us the opportunity to state all we need to without interruption or being diverted by questions that can make us lose our train of thought.  I have had to take a deep breath at times though when it's obvious that info that's taken a considerable time to provide in the required format seems not to have been read carefully at the other end .  I count to 10 & tell myself everyone is doing their best, then go & lie down in a darkened room  .

I second what Ayehsa says in answer to your question about involvement of the perianal area too.  GSM can be horribly comprehensive in its reach, but with the right treatments(s) & perseverance it can be well managed.  In my early 60s now I've been on vaginal HRT for nearly 10 years & would not want to be without it.  Even before losing ovaries & later uterus & cervix I needed both vaginal & systemic HRT to manage GSM, but like many other women on here I can testify to its effectiveness given adequate time for fragile tissues that may be in poor, inflamed condition to recover & become more robust again.  Managing GSM becomes a lifelong project I think most of us never imagined we'd have to take on, but once you get on top of it you'll be very glad you made the effort.

Do let us know how you get on.
Wx

[SaraC2773]

Thank you all so much!

I picked up some canestan so will use that and doing a swab for the surgery on Monday.  They are then going to call me to do a face-to-face apt in approx 4 weeks to check for VA.

I will be sure to update once I've got results/seen the GP. 

[Wrensong]

Unless the surgery has advised otherwise I would have the swabs done before starting Canesten if you can bear the discomfort for another couple of days, then ask the practice nurse whether she feels you should use it pending results being reported.  It may well not be thrush & if the Canesten is topical (as opposed to oral) & the vaginal & vulval tissues are inflamed you may find the cream &/or pessary worsens the soreness.  Would be a shame to aggravate the condition if it turns out not to be due to thrush.

So glad you have managed to get a F2F  .  Please do also mention the spotting.
Wx

[MrsMitch]

Just to add Sara, you may already know, but the advice about VA or GSM now says that atrophy may not always be visible but it doesn't mean you don't have it. Mine went undiagnosed for years because there were no visible signs on internal exams in spite of me being in agony. I also had thrush recently which was only diagnosed by swab and I didn't think it was that because as others have said it is different when we get it at this stage in life. I've also had BV which took 2 boxes of pessaries with a week gap in between to get rid of.
Also my perineum was very inflamed in fact even other 'outer' areas were affected by VA.  It's taken months on daily treatment to get relief.
Hope that helps you.

[SaraC2773]

Thank you Wrensong and Mrs Mitch.

I haven't used the Canestan as the discarge seems to have eased up a bit and I'm not longer having the gushes that I was previously having. 

Will do the swab to be sure and see what they say before doing anything else.


Mrs Mitch no I wasn't aware and sorry you went undiagnosed for so long!  I definitely go through phases of having virtually every symptom,  itching,  soreness,  constantly weeing then feeling I need to go again,  having to be incredibly careful when using the toilet and wiping any area down there as the slightest thing will irritate me. 

It's certainly a rollercoster this menopause journey!