GPs are really clued up about VA I'm afraid
Pelvic pain could be your bladder playing up due to the lack of oestrogen. Have a look at the forum list - there was a very good link to a film on Youtube about urinary urgency, atrophy and Interstitial cystitis. It's a Urologist explaining what happens with urogenital atrophy.
Drink plenty of water - not drink enough will make the urgency and frequency worse. If your urethra is burning then try having half a teaspoon of bicarb of soda morning and evening for a few days
Avoid caffeine, fruit juices and alcohol and anything too acidic.
Don't sit down for too long and wear loose clothing - getting hot around our ‘lady bits' can help bacteria develop.
Buy some SYLK and some Multi Gyn Acigel (get these online). The SYLK is for daily use and the Multi Gyn Actigel will help restore the flora balance in the vagina - so just use for a few days at a time when needed. The Multi Gyn may sting a bit at first but you only need to use it 2-3 times a day for a few days - this will help fight bacteria and thrush and reduce irritation to the urethra and urinary tract. It is the bacteria from our guts that can cause the problems so make sure you clean really well after opening your bowels.
See your GP about getting some Vagifem - this is the best thing to use but you will still need to maintain the other strategies I have suggested. Just don't use the Vagifem at the same time as the moisturisers as it can effect absorption.
If your GP doesn't understand or want to prescribe Vagifem, here is the section from the NICE guidelines on the treatment for urogenital atrophy - I'd print this off an show it to him/her:
Urogenital atrophy
1.4.9
Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.
1.4.10
Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.
1.4.11
If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.
1.4.12
Explain to women with urogenital atrophy that:
symptoms often come back when treatment is stopped
adverse effects from vaginal oestrogen are very rare
they should report unscheduled vaginal bleeding to their GP.
1.4.13
Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.
1.4.14
Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.
I'm afraid VA is very common but women are embarrassed to ask for help - poor things. So many older women appear to have continuous UTIs and are given antibiotics when all they really need is some local oestrogen, vaginal moisturisers and a few other strategies. Keep us posted. DG x
