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[linfit]

Hi
I have posted before but although I have made some progress, I now feel a bit stuck.
As per my previous posts, I am 53, post meno. with uterus. Got suspected UTIs through August 2016, diagnosed with VA by GP in Sept. Only symptoms are bladder pressure and burning. Used cream for 2 weeks then vagifem twice a week upto Jan 2017. Symptoms reduced but not gone, some bad days. It got me down, went on Evorel patches for 2 months but felt very low and tearful so stopped at the end of Jan. Saw a meno. specialit in Jan 2017 who told me to increase to 5 vagifems a week. Seems bit better still but hanging on. Have been on 5 x a week now for 3 weeks. Can't seem to tolerate anything externally near vagina as it stings and sets off the symptoms again. I had a cytoscopy and dilatation procedure done on 24th Jan as urologist thought this might help and would rule out other things. I think that helped a little but still have bladder pressure and sometimes burning. GPs change at my surgery and each say different things about VA. My worry is that I have now been struggling with it for 6 months, largely bladder issues. GP says blood tests for hormone levels won't help. I have become very down struggling on with this and my question is...how do I know if I am on the right path and/or is I need systemic HRT. Any advice?

[CLKD]

Some ladies do find that patches or other HRT eases bladder symptoms.  Some find that applying Sylc or similar, I use KY Jelly, on the outer lips keeps them moist, less likely to itch and some ladies find sitting in a tepid bath with lots of Epsom Salts mixed in helpful.  The other thing that might help is LIVE yoghurt, applied - soothing and cooling 

[Dancinggirl]

linfit - I'm afraid there isn't a quick fix with these problems.  I've had exactly the same issue and it's taken quite a long while to get things comfortable and vaguely under control.  I did have systemic HRT for a year to get more oestrogen swimming around my system and that seemed to help but since I came off systemic I have managed to keep things comfortable with Vagifem and SYLK. Sometimes I feel I could go to the loo every half an hour but then I can go 4-5 hours with no problem.  Drinking tea is a disaster - this is such a great diuretic - I allow myself one very small cup per day. Training the bladder to hold more is possible and the GP could send you to a bladder continence clinic that would advice you about this.
I believe the pressure on the bladder, and indeed the urethral pain, is just gravity doing it's worst - I'm up at least 3 times each night as my bladder seems to fill up better when I'm lying down!!!. I try not to drink too much through the evening but if I don't drink enough then I get the burning because the urine becomes more acidic and strong. Of course if you have been low on oestrogen for some time then the whole bladder may be more atrophied - systemic HRT will get the the bladder better than just local oestrogen.
I find I can stop the burning etc. by drinking enough water, avoiding caffein, and when it starts to burn I drink a glass of water with half a teaspoon of bicarbonate of soda.  One simply has to avoid too much acidic stuff.  Also make sure you empty the bladder properly every time you pee - if one retains any urine then this can start an infection or the burning.  You shouldn't just do pelvic floor exercises to strengthen but also learn to truly relax the pelvic floor so you empty properly.
I had the cystoscopy and dilation - the dilation improved the urine flow for a few weeks but is now back to the way it was before. If I put my feet up for an hour in the afternoon then this can often help, as it reduces the gravity pressure on that whole area - it a good time to do some meditation.
Trying systemic HRT  again ( alongside the Vagifem) might help - I would perhaps try something like Femoston 1/10 - it is sequential HRT so you would get a monthly bleed but you might find you don't get the PMT type symptoms with this HRT.
Have you phoned the YES company for samples?  I love using SYLK but many find the YES products very good.
Hope that helps - I really do understand how tough this is.   DG x

[CLKD]

   DG

[linfit]

linfit - I'm afraid there isn't a quick fix with these problems.  I've had exactly the same issue and it's taken quite a long while to get things comfortable and vaguely under control.  I did have systemic HRT for a year to get more oestrogen swimming around my system and that seemed to help but since I came off systemic I have managed to keep things comfortable with Vagifem and SYLK. Sometimes I feel I could go to the loo every half an hour but then I can go 4-5 hours with no problem.  Drinking tea is a disaster - this is such a great diuretic - I allow myself one very small cup per day. Training the bladder to hold more is possible and the GP could send you to a bladder continence clinic that would advice you about this.
I believe the pressure on the bladder, and indeed the urethral pain, is just gravity doing it's worst - I'm up at least 3 times each night as my bladder seems to fill up better when I'm lying down!!!. I try not to drink too much through the evening but if I don't drink enough then I get the burning because the urine becomes more acidic and strong. Of course if you have been low on oestrogen for some time then the whole bladder may be more atrophied - systemic HRT will get the the bladder better than just local oestrogen.
I find I can stop the burning etc. by drinking enough water, avoiding caffein, and when it starts to burn I drink a glass of water with half a teaspoon of bicarbonate of soda.  One simply has to avoid too much acidic stuff.  Also make sure you empty the bladder properly every time you pee - if one retains any urine then this can start an infection or the burning.  You shouldn't just do pelvic floor exercises to strengthen but also learn to truly relax the pelvic floor so you empty properly.
I had the cystoscopy and dilation - the dilation improved the urine flow for a few weeks but is now back to the way it was before. If I put my feet up for an hour in the afternoon then this can often help, as it reduces the gravity pressure on that whole area - it a good time to do some meditation.
Trying systemic HRT  again ( alongside the Vagifem) might help - I would perhaps try something like Femoston 1/10 - it is sequential HRT so you would get a monthly bleed but you might find you don't get the PMT type symptoms with this HRT.
Have you phoned the YES company for samples?  I love using SYLK but many find the YES products very good.
Hope that helps - I really do understand how tough this is.   DG x

Thank you so much, so much helpful advice. I will take it all on and see what happens. I will let you all know. thank you

[linfit]

linfit - I'm afraid there isn't a quick fix with these problems.  I've had exactly the same issue and it's taken quite a long while to get things comfortable and vaguely under control.  I did have systemic HRT for a year to get more oestrogen swimming around my system and that seemed to help but since I came off systemic I have managed to keep things comfortable with Vagifem and SYLK. Sometimes I feel I could go to the loo every half an hour but then I can go 4-5 hours with no problem.  Drinking tea is a disaster - this is such a great diuretic - I allow myself one very small cup per day. Training the bladder to hold more is possible and the GP could send you to a bladder continence clinic that would advice you about this.
I believe the pressure on the bladder, and indeed the urethral pain, is just gravity doing it's worst - I'm up at least 3 times each night as my bladder seems to fill up better when I'm lying down!!!. I try not to drink too much through the evening but if I don't drink enough then I get the burning because the urine becomes more acidic and strong. Of course if you have been low on oestrogen for some time then the whole bladder may be more atrophied - systemic HRT will get the the bladder better than just local oestrogen.
I find I can stop the burning etc. by drinking enough water, avoiding caffein, and when it starts to burn I drink a glass of water with half a teaspoon of bicarbonate of soda.  One simply has to avoid too much acidic stuff.  Also make sure you empty the bladder properly every time you pee - if one retains any urine then this can start an infection or the burning.  You shouldn't just do pelvic floor exercises to strengthen but also learn to truly relax the pelvic floor so you empty properly.
I had the cystoscopy and dilation - the dilation improved the urine flow for a few weeks but is now back to the way it was before. If I put my feet up for an hour in the afternoon then this can often help, as it reduces the gravity pressure on that whole area - it a good time to do some meditation.
Trying systemic HRT  again ( alongside the Vagifem) might help - I would perhaps try something like Femoston 1/10 - it is sequential HRT so you would get a monthly bleed but you might find you don't get the PMT type symptoms with this HRT.
Have you phoned the YES company for samples?  I love using SYLK but many find the YES products very good.
Hope that helps - I really do understand how tough this is.   DG x

HI Dancing Girl
I just wondered how long it has taken you to get this problem to where you are now? As I said, I have been struggling for six months now. In truth I think this has lead me to suffer anxiety and I am worried that this will stay with me? It's so hard to separate the physical symptoms from emotional responses and the things going on in life that are hard. Hoe long did it take you to get through the anxiety surrounding this problem? I know we are all different but it's hard to see the light at the end of the tunnel.

[Dancinggirl]

On linfit - we are all different.  I started to get these problems in my early 40s when I had gone into post meno.  I was on HRT but only a low dose and going through a lot of life stresses at the time.  I queried my UTI type symptoms with various doctors (including gynaes at meno clinics) and none of them were helpful.  It wasn't until I moved to my current address 6 years ago in a seaside town that the practice nurse firmly told me I should have been using local oestrogen alongside the systemic HRT all this time!!!
The UTI type symptoms have tended to come and go over the years but I found SYLK and Multi Gyn ACtigel worked wonders in helping sooth things - I've been doing the bicarb drink when needed for many years.    The Vagifem has made a big difference but it's taken over a year to feel that the whole urogenital area is more comfortable.
There is no doubt that anxiety and stress will make bladder issues worse - can you learn some Mindful Meditiation - I find this brilliant - you do have to be disciplined about it. Your issues have emerged only recently, your atrophy is possibly less severe so it may take less time to get results.
I do get tetchy and low when I'm burning but now I have all my strategies in place, I know I can make it better - so I think this is the key. Try some of my strategies, try other things you think might help and find your own way forward.
If you have to use Vagifem more often, do so - you may have to discuss this with your doctor though.
Don't sit for too long - that always gets me burning - I go for lots of walks - I'm lucky to live by the sea and have a dog that is good company on a walk.  DG x

[linfit]

On linfit - we are all different.  I started to get these problems in my early 40s when I had gone into post meno.  I was on HRT but only a low dose and going through a lot of life stresses at the time.  I queried my UTI type symptoms with various doctors (including gynaes at meno clinics) and none of them were helpful.  It wasn't until I moved to my current address 6 years ago in a seaside town that the practice nurse firmly told me I should have been using local oestrogen alongside the systemic HRT all this time!!!
The UTI type symptoms have tended to come and go over the years but I found SYLK and Multi Gyn ACtigel worked wonders in helping sooth things - I've been doing the bicarb drink when needed for many years.    The Vagifem has made a big difference but it's taken over a year to feel that the whole urogenital area is more comfortable.
There is no doubt that anxiety and stress will make bladder issues worse - can you learn some Mindful Meditiation - I find this brilliant - you do have to be disciplined about it. Your issues have emerged only recently, your atrophy is possibly less severe so it may take less time to get results.
I do get tetchy and low when I'm burning but now I have all my strategies in place, I know I can make it better - so I think this is the key. Try some of my strategies, try other things you think might help and find your own way forward.
If you have to use Vagifem more often, do so - you may have to discuss this with your doctor though.
Don't sit for too long - that always gets me burning - I go for lots of walks - I'm lucky to live by the sea and have a dog that is good company on a walk.  DG x

Thank you..again. I will try these strategies. I think I might need a dog, friends and family are getting fed up of me asking them to come for walks!!