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[Sfifties]

Hi everyone,
I have started experiencing leaks of urine which in the past were only happening when sneezing but now i found myself to have to wear sand change panty liners twice a day  minimum .
I am doing the pelvic exercises and was wondering if there’s any other treatment anyone has tried that can help.
I have read some posts about vagifem , i do not suffer from vaginal dryness though which seems the main symptom that would be prescribed for??

I am in menopause not had a period  for a year and using 2 pumps of oestrogel and 100mg utrogestan vaginally .
I have my first hrt  review with my Gp tomorrow and when i asked her last time she only suggested the exercises , so tomorrow i would like to be a little more prepared about alternatives.
One more things; since starting  hrt hot flushes have decreases during the day but still have nights sweats with palpitations, any advice please ?
Thank you

[Joaniepat]

Bladder leakage can in part be down to Genitourinary Syndrome of Menopause (aka vaginal atrophy or vaginal dryness) so local oestrogen such as Vagifem would be an appropriate part of treatment. The whole area, including lower part of bladder, urethra and pelvic floor, needs oestrogen.
Just doing kegels may not be a good idea without guidance from a women's health physio, as your PF may be hypertonic and kegels could make it worse. Better to get an assessment of your PF from a WHP.
If you are still having night sweats, maybe it's time to up your oestrogen to three pumps.
JP x

[sheila99]

It was testosterone that sorted mine out. I had problems with weakness in other muscles too resulting in frequent pulled muscles, T seems to have muscle tone overall and that includes pelvic floor. I'm not sure if it will help you or not if you don't have other muscles problems. It would be better to increase oestrogen first, you need oestrogen levels to be sorted out before starting T anyway.

[VictoryV]

I agree with Sheila99, I didn’t have leaky but I did have frequency issues through the night. Testosterone sorted that.

[Eviepf]

Just wanted to agree with Joaniepat about GSM, which is the updated term for vaginal atrophy and definitely better and more all-encompassing, as it covers all the areas which can be affected by reduced oestrogen.

I never suffered from actual vaginal dryness, but was prescribed Vagifem to help with the awful watery discharge which so many of us seem to suffer as a symptom. It cleared the discharge up within weeks and has also helped with bladder issues too (in my case, UTI-type symptoms) although this has taken longer. I've read about other women who have found it's helped with leaking. I have no experience with testosterone, but it's interesting to read pp who've said this has been helpful for them. Definitely worth you pursuing the hormonal angle with your GP.

Also re the kegels - the issue can certainly be muscle overtightness, rather than the opposite. I believe that women's physios are available on the NHS, but I just Googled and saw one privately, which wasn't terribly expensive.

[Sfifties]

Thanks for your replies.
Joaniepat forgive  me what WHP stands for ?
Eviepf maybe mine is water discharge
I can’t tell as the only time i have felt leaking is when sneezing but lately in find panty liners wet with a faint urine odour .

I am pretty sure that tomorrow at review  Gp will say that i haven’t done pelvic floor long enough to see difference but now i am worried and confused as if the opposite is true ( muscle over tightness) i might be doing more harm than good ..

I am finding this all hrt process very hard because i am learning so many new things that my Gp doesn’t even mentions ( only gp in practice with women health experience) .
I need one of you tmrw at my phone consultation!
Plan for tmrw is: mention night sweats still presents on 2 pumps ( do i need more).
Regarding the leaky bladder how would you approach the conversation if gp says keep the pelvic floor for longer ?

Sheila99 : very interesting about testosterone which is something i have been thinking about for libido as non existent and husband getting frustrated , inferl when i talk to my gp that i am “suggesting” her what to do or what to prescribe and not sure her reaction .
So many things to adress in a 10 min phone call !

[CLKD]

Women's Health Physio.

No woman has to put up with leaking!  We have the right to be dry.  There are several reasons for leaking so don't be fobbed off by your GP.  Ask for a referral to a women's physio or source one locally for advice.  GPs often don't know much about below the belly button! which is why we sometimes have pay for that advice.

I wouldn't worry too much about pelvic floor exercises at this point until you have found an appropriate physiotehrapist.

[Sfifties]

Clkd thanks for your reply
Will the physio be able to ascertain wether the leaking is due to the pelvic muscles overthightness  or opposite or is there any tests that can be done to understand what triggers the leakage to start with ?
I will be asking to be referred to a menopause clinic as dealing with other issues as no libido and doubt i can ask for two referrals at once .
Would be useful to hear from ladies who have been to a menopause clinic and understanding if that should be my first referral as both leakage and libido might be addressed in clinic ?
Thanks

[Elizabethlovejoy]

Yes do book an appointment with a womens health physio. I had three appointments altogether as she taught me how to do pelvic floor exercises properly.That,combined with vagifem, followed shortly after with  oestrogel utrogestan and now androfemme , added up to a five year [!] journey of discovery as I adjusted to various doses. But success at last! No more leaking no more suspected UTIs.Testosterone was the final key to unlocking it all.

[CLKD]

Get the appt with a woman's physio first.  You could ask at your Surgery or local leisure centre or Hospital.  Your GP should be able to refer you to her as well as a menopause clinic.

Some find that keeping a mood/food/symptom diary is useful.

[Sfifties]

Thanks for all advice will ask for women health physio referral.
Elizabethlovejoy: may i ask how u got the testosterone, were u referred by u gp to a menopause clinic ?

Thanks

[sheila99]

I would ask for both. There's quite often a long wait for a meno clinic so better to get on waiting list ASAP. If you have zero libido you would benefit from it anyway, mine was zero too.
VictoryV did you have other muscle weakness too?

[Sfifties]

Thanks sheila99, dreading tmrw phone call but will try to address both issues and ask for both referrals ,
some gp have a way of making you feel like u are “demanding “ to much.

It was certainly the case while i was in perimenopause and no treatment was offered at all , so now i come across like i want to tackle and solve all my symptoms at once ( and it might be true) , but after 2 years in peri and poor quality life , and only been taken seriously now that i am officially in menopause and more symptoms appeared which i could not  accept, i feel like I don’t want to waste any more time feeling miserable if there’s help .

It’s inspiring to read here so many stories here and how many of you have managed to regain your lives, i have lost a bit of confidence but i am determined to have some results tmrw !

[VictoryV]

I would ask for both. There's quite often a long wait for a meno clinic so better to get on waiting list ASAP. If you have zero libido you would benefit from it anyway, mine was zero too.
VictoryV did you have other muscle weakness too?

Hi Sheila, no, not that I know of but I’ve noticed I’ve got better muscle definition. It’s weird as I wasn’t expecting anything from T. I don’t do much work or exercise with my arms (I run, walk and hoop) yet I’ve got more shape/less slack sort of thing. Have you noticed bodily changes please? I did have joint aches which have gone.

[CLKD]

Have a list by the 'phone to discuss with your GP so that you don't forget anything.