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[nothappybun]

Keep adding to that list ;-).

Browse round.  Make notes.   My VA presented with bladder irritation which seemed like urine 'infections' but my GP realised that it was VA.  For me it felt like razor blades up there  ! but after 2 weeks load of local oestrogen symptoms went away.  If it is getting a nuisance it starts under my belly button with 'heaviness' and an extra need to pee …… so I up the loading again.

Chlamydia is a 'hidden' condition which gives no symptoms.  It can cause problems with fertility and both partners need treating once it's been diagnosed.

Sounds more like a 'special clinic' than one knowledgeable about menopause.  So now you know a lot more than the medics you have seen, if you look on your Surgery web-site it should give details of any of the GPs interested in female problems.  Maybe there's a Prescribing Nurse who would be more knowledgeable?  Perhaps send an e-mail to the Surgery and ask? 

At the very least, have a look-see at your local Hospital Gynaecological Dept. and see if there is information about special menopause clinics?  Some Hospital web-sites are more detailed than others so it can be a bit of hunt!

Now you are here, you are less alone  :for you:


Ask, ask, ask!!

I moved to Wales last December and it took 10 months to be seen at the meno clinic which I go to by train in another town after insisting a lot as my GP wouldn't continue prescribing the pill I started in October when I turned 51 this January, I had to get the prescription being persistent every month. I saw the nurse when the vaginal symptoms started and she agreed the patches weren't enough and maybe should change to a pill form and said I needed a vaginal cream or tablet. She went to get the prescription and the GP said I needed a routine appointment for that sort of prescription so I turned up the next day for an on the day appointment and saw the locum after waiting two hours as I couldn't wait up to three weeks to see a GP.

I get the belly button "heaviness"  you describe and my belly gets like a balloon, bloated and feels as if I've drunk a barrel of beer and a strong urge to pee and then nothing, I have to sit on the loo and concentrate to pee.

Do you stop the vaginal treatment when it clears and then restart when it comes back or increase the dose depending on your symptoms?
Two weeks sounds good, already been a week so if I get another prescription, next week while on holiday will feel a bit myself!
Thanks again and loads of hugssssssss xxx

[Dancinggirl]

Nothappybun -  To answer your question about stopping and starting local oestrogen, do read through the info below from the NICE guidelines:  - it clearly states that symptoms may well return if local oestrogen treatment is stopped - if you want the discomfort to stay away then ongoing regular use is necessary - DO NOT STOP USING VAGIFEM/OVESTIN IF THE DISCOMFORT GOES AWAY..   DG x

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.

[nothappybun]

Thanks Dancinggirl added that to my list
xxx

[nothappybun]

Hi,
I've just received the letter from my meno clinic and this is what she says:

"Thank you for coming back to my clinic. I am sorry to hear that you had some difficulties getting your patches to stick and they did not really help your flashes and sweats. In addition to that you had some bloating and general cystitis type feelings.
I am switching you to Sandrena gel satchets to use 1mg once a day and Utrogestan tables to take 1 tablet from the 1st to the 12th of each calendar month. I anticipate that you will probably have a bleed somewhere around the 15th of each month.
I would like to see you in 10 weeks time to see how you are getting on.
Best wishes
Yours sincerely "

I really don't know what to think, the sticking of the patches was when the sweats started to be severe, they peeled off but they weren't working and she did take note of the vaginal symptoms but doesn't address them in any way, the nurse did a urine test and I had no infection. It just made me mad reading this. I even bought a canesten cystitis kit and took it for four days just in case and no improvement or change.
 No treatment for the Vaginal symptoms and they are in addition as if it wasn't related.
Good I came on here!
Thank you for letting me vent! I'm mad today, hot flushes a lot worse and V discomfort doesn't help!
xxx

[Dancinggirl]

Nothappybun
This letter is just outlining what they have prescribed and a copy will go to your GP fro their records and so you can get ongoing prescriptions.  You do need to give this new regime at least 3 months to settle and do it's magic - flushes etc should settle.
The patches often don't stick so this will mean you are not getting the hormones - so this would result in the flushes returning.
I would still go back to your GP and ask fro more Vagifem to take alongside - you don't need to go to hteh meno clinician fro this - just go armed with the print outs I have given you.  DG x

[nothappybun]

Thank you Dancinggirl, I know you are right.
The main problem is I didn't want to go back to this stage, coming off the BCP onto a low HRT have made the symptoms come back worse.
I've been on Sandrena now 12 days at night as I have more time to sit around waiting for it to dry as she told me to apply it on both arms from elbows to wrists    and this weekend I had insomnia, only slept two hours, the hot flashes in the evening have been very frequent, yesterday and they are today, no sweats  that's good and the vaginal discomfort is getting worse, also because I've used less Ovestin just in case they won't prescribe anything tomorrow for it.
We are going on holiday on Thursday and it stresses me as I don't want to spoil it for my hubby being anxious and depressed as I am right now.
I've printed out the NICE protocol info about vaginal treatment, MM check list of symptoms and the NHS http://www.nhs.uk/Conditions/dry-vagina/Pages/Introduction.aspx#oestrogen one I also checked if there is a Menopause Clinic in my town and there isn't one, not even near. Strange there are so few in Wales, none on the MM Specialist search.
I keep my fingers crossed 
hugs xxx

[nothappybun]

Back from the GP!
It wasn't a Locum in the end who saw me 
I was lucky to see a young male YES MALE doctor who has been more helpful than the meno clinic! He explained to me exactly the same things you girls told me on here   

My printouts and sheets stayed in my bag,  I didn't have to show him anything!

I said I was having problems with my hrt and the vaginal issues and he immediately said I needed to use something vaginally and that I could use with the other topic hrt as it wasn't absorbed by the system and could/should take it as long as need and as long as I wish!

He explained everything so well and it was exactly what you girls have told me and what I've read on here . When I mentioned the Consultant was giving me low dose  because of my auto immune disease he said there is the same risk as anyone else of DVT and that's what I've read on the NICE guide and that it shouldn't be a reason to be excluded! And that shouldn't stop me having the right HRT to minimise my symptoms as much as possible.
I was so surprised and felt so understood, I told him I would like him to deal with my meno/peri.
Then he said he thought my hrt might be too low and too drastic from the pill and we should consider changing it, he mentioned maybe continuous progesterone but would have decide on what form of oestrogen. In the end we decided to wait a whole cycle and see if it there is any change with the Urogestan that I will start on the 1st for 12 days and if the hot flashes, sweats (returned real bad today) and insomnia (returned this weekend 4 hours sleep in the last three days) he will change it or increase it.

He's given me a prescription for two Ovestin to use  everyday for two weeks and then twice weekly and he will see me in four weeks or before if they worsen!

I am very happy knowing someone is addressing my problems and got the feeling he is going to take into consideration my symptoms. I trust in time his advice and treatment will kick in!

Thank you girls who have helped me over this week and opened my eyes.
Hugssssssssssss
                  xxx

[Hurdity]

Hey nothappybun

I hope you are now a bit more of a happy bun having seen that great GP!!!

Such good news that the doc is knowledgeable and willing to help and such a contrast to some GPs we read about on here!

re the Ovestin - it's actually a cream not a vaginal tablet like Vagifem. It comes with an applicator so presumably he means double the dose to start with? I haven't used this one (I have Gynest - now generic estriol) - but Ovestin is more concentrated so will be less messy and smaller amounts are needed to give the same dose.

Do let us know how you get on and so pleased you sound to be in safe hands on NHS as you and all women should be

Hurdity x

[nothappybun]

Thanks Hurdity 
I went on the surgery web page to see his speciality and found out he has this https://www.rcog.org.uk/en/careers-training/drcog/
It is for GP concerned in woman's health and they do training and an exam in the Royal Collage of Gynaecologists and Obstetricians we should all look for those initials at our surgery DRCOG  and his up to date, only 38

[Hurdity]

That's interesting nothappybun. I didn't know you could look up about docs on the practice website. Last time I looked at ours it was out of date and wasn't really being maintained by anyone - still had docs on there who had retired several years ago.

Incidentally - I had a look at the DRCOG syllabus by following the links. There are seven modules and it gives a summary of what medics are expected to know. The word MENOPAUSE is not mentioned once!!!!!!!!!!! However at least it means that a doc is interested and will have covered some aspects I presume!!

Hurdity x