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[Blue Kingfisher]

Feeling relatively embarrassed that I need to ask this but I'm rubbish at anything anatomical! Last night was the 8th dose of using a 200mg progesterone pessary for me. Historically, I have been using the pessaires for 7 doses only so this is a new regime I am trialling. My gynaecologist has suggested I try upping the pessaires to 14 days.

I noticed yesterday that when I urinate, the flow is weak, less voluminous & feels channeled via a narrower path. When it came to the evening, & it was time to use my 8th pessary, I was unable to insert it as deeply as usual. I use an applicator & found it stopped about half it's usual deepness & just felt like I shouldn't perhaps push it up any further.

I just wondered if anyone could advise what is happening to my body? I also wonder if i should be a bit braver & try & push it up further? If this is perfectly ‘normal' this anatomical change, which I'm sure it is, it would be good to understand what this means in terms of the cyclical pattern we go through with the thickening & thinning pattern....Depending on the answer, this ‘could' indicate a positive sign for me & might even give me more confidence that increasing the length of pessary use is likely to move me in the right direction rather than the wrong one.

Ive just turned 50, been on HRT (5 pumps oestrogel & Utrogestan pessaires) for nearly 2 years. No idea if I'm still peri as was having irregular periods when I started HRT.

Thank you in advance for any replies :-)

BK

[Taz2]

Hi BK. Please don't feel embarrassed at asking any question.

I'm wondering whether your symptoms could be due to a slight bladder prolapse (cystocele) as this can mean your urination is weaker and can also cause an obstruction when trying to insert something. Sometimes the cervix also drops lower into the vagina if pelvic floor muscles aren't as strong  A thickened endometrium is a thicker womb lining and doesn't give any thickening in the vagina as far as I am aware. Were you lying down when you inserted it?

Taz x

[Blue Kingfisher]

Thanks Taz, no wasn't lying down. I've noticed that I do experience this ‘thicker' internal feeling at certain times of the month so perhaps it's just that. I do notice that when I bleed onwards....the issue goes away & the urine flows normally. I can only guess that it's the rise in progesterone thinking about it.

xx

[Taz2]

When you insert the next one try lying down. Prolapses tend to "fall away" when you lie down which is why they are sometimes missed when a GP examines a patient lying down instead of in a more upright position.

If you get similar symptoms just before a period then if the pelvic floor is a little weak the engorged tissue can put pressure on the cervix so it drops a bit and then returns to normal afterwards.

Taz x

[Blue Kingfisher]

Thanks Taz, I think I do have a weak pelvic floor. Probably due to pregnancy in which I carried very low (apparently) & had severe SPD (pelvic pain).

If I ‘did' have a prolapse.....does it matter I wonder? Do I need to get checked out? The problem (which is minor) only occurs as the progesterone builds up. It goes away shortly after I stop it.

Thanks for your words of wisdom, much appreciated xx

[Taz2]

If you do have a slight one the good news is that it can be helped by pelvic floor exercises. I can't stress enough how important it is that you do them daily. Being on HRT is also excellent for pelvic floor health. You don't need to get a mild prolapse checked out as far as I know. Many women have mild prolapse without bothersome symptoms but I would say be mindful of your pelvic floor when lifting anything heavy. Pull it up before you lift to protect the muscles.

Taz x

[Blue Kingfisher]

OK, pelvic exercises for me from now on!

Thanks Taz :-)

[Taz2]

You're welcome 

Taz x