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[Ecl]

Hi, after some advice/help if anyone can?
I have been on HRT for a while - evorel 50 and utrogesten for about 6 months now, sandrena 0.5 for nearly a year before that. I am also on vagifem which they dont know I take 3 times a week instead of 2 as thats what I need to resolve my leaky bladder issues.
My latest difficulty is that 5 weeks ago I started with burning and stinging and a really frequent need to pee. The burning and stinging isnt worse when I pee but isnt relieved from it either. Its taking over my life as when its there I cant think of anything else. It stops me from getting to sleep at night and wakes me up when I do. I am alternating paracetamol and ibuprofen every 3 hours in order to have a life. As it didnt go away after a couple of weeks, I went to the GP who did a dip test which showed leukocytes but nothing else, so she sent some for testing (negative) and gave me 3 days of antibiotics.
nothing has changed and have been back to Gp today - different doctor, urine still showing the same, being sent off again today. She is giving me a longer course of antibiotics, and also ovestin. However she has said to stop the vagifem to use the ovestin, is this right? can I use the ovestin on the outside too? (the part that hurts?) can I not use the vagifem inside and ovestin outside?
Is there anything else I can do? I am really struggling with even getting out to walk the dog as concerned I may need a loo rapidly. Work is hard anyway but so much harder when all you can think about is going to the loo. is this more likely to be menopause or are there other causes to look into?
Any help gratefully accepted xx

[Joaniepat]

The NHS testing for UTIs is not very good, so you may have one anyway, especially if leukocytes present. Three days of antibiotics is not enough, so hopefully a longer course will help.
You can use both Vagifem and Ovestin, many do. Vagifem internally and Ovestin externally is a good combination as they are two different oestrogens. Three Vagifem a week seems barely adequate to me (I use 5, some folk on here need daily). You could try the Estring, which is equivalent to 5 Vagifem a week. It sounds as though your surgery doesn't know much about VA.
An emollient such as Epaderm or Hydromol, or maybe an oil-based moisturiser such as Yes OB  or Olive & Bee, would help protect the vulva from any stinging produced by urination.
If you are not already a member, the private Vaginal Atrophy Facebook support group is a good resource.
I hope you feel better soon.
JP x

[Flossieteacake]

I am so sorry to hear how much pain you are in and how clueless your GP is. Although the leaflet says to use Ovestin and Vagifem everyday for two weeks and then drop to twice a week, this is rarely enough for anybody and the symptoms will return. As Joaniepat says, you can use both ovestin and vaigem together. If you get on with vaifem then I would insert it every single day and use Ovestin every single day on the outer area.

Have a look around at the VA threads and you will find you are not alone.

[CLKD]

U can use 'vagifem' internally and 'ovestin' on the outer labial areas.  One cannot 'over dose' with these products which is what too many GPs believe!

When I get the need2P I take 'nurofen', 2 caps 3 times a day, to ease the nip as the bladder shuts off urine flow.

[Ayesha]

A year on from my VA diagnoses I am using Vagifem internally and Ovestin topically every day to keep my symptoms under control. Moisturiser is very important too.

Follow all the great advice given above and you should soon start to feel much better 

[Ecl]

Thank you all, just waiting for pharmacy to tell me its ready. Please can I ask how you get enough vagifem/ovestin to take daily? is it through your gp or did you need to see a specialist? I will be fine to start as there is the loading dose but cannot order more vagifem until it is due?

[Flossieteacake]

Thank you all, just waiting for pharmacy to tell me its ready. Please can I ask how you get enough vagifem/ovestin to take daily? is it through your gp or did you need to see a specialist? I will be fine to start as there is the loading dose but cannot order more vagifem until it is due?

I get mine through the GP. You do not need a specialist but if they are funny about it you could request they ask a specialist on your behalf. You could send a message to say you need to take it daily due to the severity and hopefully they will just do it for you.

[Ayesha]

You won't need to see a specialist. If after using the loading dose of daily vagifem for two weeks and then reducing to two a week and you find your symptoms are not improving, you can inform the surgery and tell them two a week is not enough and you need to use more, meaning your prescription will have to be changed.

I had no trouble with my surgery agreeing to this, but I know from other women on here they had trouble getting the extra pessaries.
Even the Vagifem you buy over the counter, called Gina, says if symptoms are not improving, do another loading dose of two weeks. What I am trying to say is, take no nonsense from your surgery, if you have to have vagifem every day so be it! VA is not something you can live with!

written before Flossieteacakes post, but we are singing from the same hym book 

[Ecl]

Thank you so much for your kindness. Just back from pharmacy and despite her saying a longer course of antibiotics, i have another three days only.

[Ayesha]

I would concentrate more on getting your VA symptoms sorted and not worry too much about the antibiotics. By all means take them but its VA that is causing all your problems I am sure of that. I have been in your position, and I was prescribed antibiotics that proved to be totally unnecessary.

[CLKD]

Too much AB treatments are making the World at risk when viruses appear. 

Let us know how you get on, 1 can use VA treatment every night if necessary. 

[Ecl]

Thank you both, at my first visit I suggested it was perimenopausal but as the dip was positive they think infection. I have the ovestin and will start tonight ( even though I had vagifem today too). would I be right in measuring the dose then putting a bit from the plunger on my finger for the outside and putting the rest inside?

[CLKD]

Vagifem internally, 'ovestin' as much as you need to smear around the outer labia areas.

Dip stick urine tests can show what might be infection, so should always be sent to a Lab for growing so that the appropriate AB can be prescribed.  7 days is best though I've never been able to tolerate more than 3 

[Joaniepat]

Too much AB treatments are making the World at risk when viruses appear. 

What have antibiotics got to do with viruses?
Short courses of ABs, which are not long enough to kill off the bacteria causing a UTI or any other disease, allow the pathogens time to evolve into antibiotic resistant forms. This was what Fleming was afraid would happen if patients felt better before the end of the course and stopped taking them. When taking ABs it used to be stressed that one should complete the course. This is basic biology, and I seriously wonder if the GPs who prescribe 3 days worth of ABs for a UTI have their heads screwd on.
JP x