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[Ljp]

Further to my post 'need to rant…VA related'
I left a message with my surgery to request somee estriole cream for occasional use externally alongside my estring as I am having external soreness.
Just had a call from my GP. Basically she is waiting responses from colleagues and says the consensus seems to be not a good idea!
I mentioned menopause matters site and Dr Currie, she said she can't prescribe unless recommended by a Dr, specialist or gynaecologist, I explained Dr Currie is a specialist.
So feeling frustrated and unsure how to proceed, I explained I am sore and am using actigel, but feel some oestrogen cream around the outside would help.
I am wondering whether to go back to using estriole cream, it worked before I ever started on full HRT. And I can at least apply some to the outside.
The other thing she suggested was not using oestrogel, but having a patch or tablet instead. I said I prefer not to have stringer systemic oestrogen, all I want is a little external help on my lady parts 😟😢😟

[Tinkerbell]

I had the same trouble getting my VA sorted, being told like you, I couldn't use it long term, to take a break etc etc that I eventually had enough and paid to see private gynae. It was money well spent as she wrote a strongly worded letter to GP and I have had no trouble being prescribed the whole lot!
Why did she suggest changing to a tablet or patch?

[Dancinggirl]

Ljp - is your va mainly to do with urethral pain?  I found the oestrogen creams made that worse.
Now it's summer - do try wearing skirts and go 'commando'.
I am on 10mg amitriptyline for insomnia, headaches and back pain and feeling generally better but my urethra still burns if I drink tea. DG x

[Ljp]

Thank you for the replies, my main issue originally was bladder, frequency and very bad urgency, with urge incontinence. This has improved with estring and vesicare.
I do wear skirts in this hit weather, but I am no confident to go commando, as never know if and when urgency will strike, and hate the slight leakage that can bring, so I always wear Tena lights, probably not helping with soreness, but it's a catch 22.

Since March this year when I had a really bad flare up/thrush? Still not sure… I am now back using estring since beginning of April, but have external soreness and feeling of burning, which causes irritation too.
I just wanted some cream for occasional external use.

I don't know why she suggested stopping estrogel and trying a patch or tablet, she said better absorbency, more oestrogeln… I don't think I need more systemic oestrogen do I? Or would it be worth me upping my pumps?

Just unsure what to try, I'm using actigel, also tried vagisan.
If upping my oestrogel to 2 or 2.5 pumps might help, I'm willing to try. What are your views?

Which specialist did you see a Tinkerbell?

[CLKD]

You need localised oestrogen replacement, i.e. Ovestin or Vagifem - irritated bladder mimics vaginal atrophy!

[Ljp]

I have CLKD I have setting, I just wanted some estriol cream for external use as and when required

[Jenna]

I use Estriol Cream twice a week and then Yes water-based moisturiser on the other days. That is very soothing when used on external sore areas (as well as vaginally) - maybe worth trying? Their website has plenty of helpful information.

[Dancinggirl]

Ljp - I don't think a different type of oestrogen will make any difference.
The soreness and bladder urgency might be helped by a low dose of amitriptyline - so could be worth considering.
You could be helped by the incontinence clinic giving you help with retraining your bladder???
Don't use Multi Gyn all the time - do try SYLK or YES vagina
Moisturisers for regular use and just use Multi Gyn when you feel itchy etc.
I do sympathise - this is such a distressing problem and it's very difficult not to let it control your life. DG x

[Ljp]

Thank you for the help, the bladder and urgency is so much better than it was since being on HRT and estring AND taking vesicare. It can occasionally catch me out probably due to something I've eaten or drunk, or if I'm particularly stressed.

My main issue since March has been a burninig/soreness around external area of vagina and irritation on outer lips....which is why having started on estring again since April, and still having slight problems, I thought estriole cream as and when around outer area might help.

I have, today, upped my oestrogel to 2pumps, I was trying to reduce systemic oestrogen now I'm back using estring....but I now wonder if I will benefit from 2 pumps alongside the estring...does feel better down there today, so hoping it might just be a case of getting the balance right

[CLKD]

....... getting the balance right - which can be SO tiring 

Have you tried LIVE yoghurt applied down there, cool and soothing if slightly sticky ;-).  Lay on a warm towel and apply; doze .......

[nicolcarrie70]

Hi Ljp,

It's ridiculous that your GP is ignoring your suffering - I can bet they have never experienced what you are going through!!
Why don't you go back and insist that if they aren't willing to prescribe what is so clearly being prescribed by other GP's (judging by this forum) that you want a referral to a gynaecologist! 

[Julation]

Ljp - I don't think a different type of oestrogen will make any difference.
The soreness and bladder urgency might be helped by a low dose of amitriptyline - so could be worth considering.
You could be helped by the incontinence clinic giving you help with retraining your bladder???
Don't use Multi Gyn all the time - do try SYLK or YES vagina
Moisturisers for regular use and just use Multi Gyn when you feel itchy etc.
I do sympathise - this is such a distressing problem and it's very difficult not to let it control your life. DG x

Amitriptyline is great for bladder inflammation.  I've been on it for 4 years and 10mg works great.  During 6 months I thought is was V related but it was a complete different problem diagnosted by an urologist. 

[Ljp]

Thank you for your replies, two days of feeling more comfortable now since upping estrogel to 2 pumps, fingers crossed it might be a solution

[Dancinggirl]

Oestrogen is great stuff. Having a Mirena gives you the freedom to use as little or as much oestrogen as you need to keep everything comfortable. DG x

[Ljp]

Thanks DG, that was my understanding too, which is why I can't comprehend my GP being reluctant to prescribe estriole cream for occasional external use!
She said it could be too much oestrogen, fair do's if I was only using local oestrogen, but I have the Mirena to oppose any potential thickening of the uterus lining, so really don't see her problem!

Still if two pumps of estrogel plus the estring, and occasional moisturiser and/or actigel keep things happy, that's ok with me......just frustrated by my GP