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[Mav196]

Hi
I haven't been on the forum for a long time...hope you are all keeping well.  I am looking for some advice.  I am not on HRT, am 49 and in perimenopause, am still out of work after 2+ years with daily headache and dizziness.  Now I have a new symptom.....

Since last week I have woken up a few days between 4-5am with an extremely painful bladder.....even after I go to the loo it remains extremely painful for about 20mins after, it is so painful I am rolling around the bed in agony and then it stops....  During the day I would have gotten a few stinging twinges but nothing as painful or as long lasting as the morning incidents.   It didn't happen over the weekend mornings but I went to doc on Monday anyway, he did a urine dipstick text which was clear so he concluded that I prob had had an infection which had gone away.  He sent the sample to the lab to be tested anyway and the results should be back this coming Friday.  However yesterday  morning and this morning the same happened, waking up very very early with excruciating pain and then pretty much ok over the day.
Does anyone have experience of this? could it be VA.....
Thanks for your help
Mav

[Dancinggirl]

Yes it could be urogenital atrophy (VA).  The bladder does weaken as oestrogen levels drop and this will cause some bladder pain at times. Is it painful when you pee first thing in the morning?
Do you open your bowels first thing in the morning? It could also be bowel issues!  Are you constipated? I got severe lower abdominal pain which was diagnosed as diverticulitis.  Diverticuli are small pockets that form in the lower bowel and can become filled with waste matter which can then become infected. I was told that if you do suffer with constipation then this would put pressure on the lower bowel and compromise the bowel wall resulting in these pockets.  They are very common and are rarely a real problem (sometimes needs antibiotics to clear infection) but I can get flare ups for no real reason. I am a life vegetarian with a very high fibre diet so constipation is simply not my problem. In my case I believe they are probably caused by the bowel loosing strength due to oestrogen deficiency. The bowel is skin and muscles and with oestrogen deficiency the loss of collagen means the muscles and skin become weaker, so these pockets appear - this is just my theory.      If I eat too much fibre then I am opening my bowels too often and this can cause a flare up of pain.

I am not saying you have diverticulitis but the pain might not be your bladder.  Try drinking a bit more water - avoid caffeine, fruit juices and alcohol.  Starting some local oestrogen may be a good idea - Vagifem can be helpful.
If the pain continues then you need more investigations.  DG x

[Mav196]

Thanks DG for your post
it's kinda painful to pee but more painful afterwards.....I am not constipated but I have noticed that I am getting pressure pains in the rectum as if I have gas but I don't - I typically get that pressure/gas feeling when I have my period but I am not due my period at the moment.
Perhaps it's time for me to revisit HRT - I am having so many random issues that perhaps estrogen deficiency is at the root of it - headaches & dizziness for 2+ yrs, now bladder pain, achy legs, generally feeling awful, but no hot flushes or night sweats.  I didn't have a good experience on estrogen and utrogestan before - I ended up in the ER with palpitations, so I guess I am scared to try again.  I think if I was to try again I would prob go the patch route instead - do you have any recommendations, I am still getting a regular period (28 days, 44 days, 15 days so a bit all over the place)
Thanks
Mav

[Mav196]

Thanks country girl, are you on HRT also? Do you have other menopausal symptoms....I ask because I am trying to figure out if the doc would give me vagifem when I don't have obvious menopausal symptoms - I don't have flushes or night sweats.
Thanks
Mav

[Tc]

Hiya May. Other ladies have experience of vagifem and so can give better advice than me on using it but I have been suffering bladder issues which haven't been helped with estriol cream and so have been reading about vagifem and  As I understand it the NICE guidelines say that topical eastrogen like vagifem can be prescribed for VA in the absence of other menopausal symptoms and might be the preferred choice if you have no other symptoms.
As i understand it The topical eastrogen is very low dose compared to systemic and works locally so isn't absorbed into the wider body.tissues.

Maybe take a look at the NICE meno guidelines on VA. I don't know how to post link. Sorry..

[Mav196]

Thanks ladies for your responses....I called the doc to let him know how bad the pain has been this morning and yesterday and he has given me an antibiotic for a week - if no improvement after that I have to go back to him.  I will ash him then about Vagifem - in the meantime do you know if Vagisan that you can buy over the counter (no hormones in it) would have any effect in helping to support the bladder?

[Mav196]

Hi Birdy
What is a GUM clinic? I am based in Ireland
Thanks
Mav

[Mav196]

Thanks Birdy
I am ok during the day every day with the exception of the odd twinge here and there, the real pain is first thing in the morning - I wake in the early hours, which is very unusual for me, needing to pee and the pain is really bad and lasts for about 10 mins after I pee - it's very strange as you would think if it was an infection that I would have pain all during the day too.

[Mav196]

Hi Birdy
When you say scan do you mean a pelvic ultrasound scan.
Thanks
Mav

[Mav196]

Hi Birdy
Thanks for your reply.  I was woken at 2.30am and 4.30am last night with pain but it wasn't as intense as the previous nights.  I can't figure out why I have pain only during the night and am fine during the day - could it be something to do with the fact that I am lying down?
Thanks
Mav

[Mav196]

Thanks Birdy
Still the same today - at 5.30am again I had pain before and after going to the loo for about 10 mins but then I was fine all day....it's very strange.  Am on day 3 of antibiotic and no real improvement so starting to suspect it's not an infection.....it must be something to do with being unable to “hold” it for so long overnight given that I am ok during the day....going back to doc next week and will get him to send me for a scan.
Thanks for your help
Karen

[Hugsneed1958]

I am new to but have V.A and have had hystorectomy 20 yrs ago I have my ovires and am 63.i have used vagifem for over 12 yrs on and off but more in last 2 years .I use it twice a week but sometimes if I get bladder pain I know estrogen dropped so I up it to 3 or 4 for a week. It's life long maintenance. But still worry about what damage it may do to bladder or vagina I am very anxious person.dr don't understand how horrible this bladder cramps are please help.

[Flossieteacake]

I am new to but have V.A and have had hystorectomy 20 yrs ago I have my ovires and am 63.i have used vagifem for over 12 yrs on and off but more in last 2 years .I use it twice a week but sometimes if I get bladder pain I know estrogen dropped so I up it to 3 or 4 for a week. It's life long maintenance. But still worry about what damage it may do to bladder or vagina I am very anxious person.dr don't understand how horrible this bladder cramps are please help.

Hello Hugeneeded1958. You have replied to an old thread so your post may get missed. Vaginal atrophy will need to be treated for life. I would not worry about vagifem doing any damage. It is designed especially for the use of the vagina. I find I need to use treatment every single day. There is also ovestin cream which you could ask for. You could apply it to the outer area.

[Dancinggirl]

Hello Hugsneed
When you had your hysterectomy the doctors should have given you proper systemic oestrogen as well as Vagifem to prevent future problems like atrophy and bladder issues - s also to protect your one’s and heart. Vagifem is a very tiny dose of oestrogen and should be used for the rest of your life - it can only bring benefits and will certainly not damage your bladder or anything else.
 At your age, it’s still possible to start using some systemic oestrogen - either pills or gel - and this might help your anxiety and could benefit your bladder. Ask to speak with a menopause nurse if your Gp practise has one.
If you continue having cramps then this needs to be investigated. Perhaps try doing Pilates classes - these can help many things - even your pelvic floor muscles. DG x

[Hugsneed1958]

Thanks dancing girl we don't have menopause nurse and I have bladder cramps when estrogen drops I mainly use 2 week which don't think enough to keep on top.i have been for lots of tests but just say use more vagifem so see how we go