Sore vagina - crap consultant advice

[Haggisfish]

Hello all
I have had a sore fanjo for years - specifically the back wall at the entrance to it. I have had all the tests under the sun, which have revealed nothing wrong. However, it is still red and inflamed and with small 'lumps'. After I gave birth and was breastfeeding for 7-8 months, the whole vagina was very sore and dry - due to lack of oestrogen. I have a replacement oestrogen cream which is working well to overcome this dryness and soreness. however, the entrance is still excruciating - I have only managed to have sex twice since I gave birth.

I am still BF 3-4 times a day, but with a good 8 hour break during the day while at work, and at night, for the past 5 weeks.

I went to consultant today and saw a trainee consultant.

She told me:

1. LO did not need BF past one year.
   
   
2. My bones would suffer and become weak if I bf past a year.
   
   
3. That I should put myself first now.
   
   
4. That BF is making my vaginal problems worse
   
   
5. Told me to ask for an address to get vaginal dilators from the hospital pharmacy - i did this, in front of several people, and was met with baffled looks. An exceptionally nice pharmacist recognised how difficult it was to talk about this in front of lots of people and took me aside to say she had no idea what they were or how to get them. WTF could the consultant not have phoned pharmacy herself to ask about this?
   
   
6. When I asked her how long she thought it might be before my periods returned after giving up BF, she said 'well, it has been so long now..it could be anything up to six months'. she made me feel I was very odd indeed for BF past six months.
   
   
7. When I voiced my concerns about something more serious, such as ovarian cancer, she told me I was being ridiculous.
   
   
8. finally, and the one that really made me think 'Eh?!' She told me I should go back to the local genitourinary clinic as they have 'seen more vaginas than we have'!?!?!
   
   Erm, really? More than the massive regional hospital gynaecological unit?!
   
   Sorry for the long post - am I right to complain, and can someone reassure me I am right that my bones will not suffer long term?
   
   thank you!
   Haggis

[RitaMorgan]

Well, a baby doesn't need to breastfeed past a year in that they will be fine if you give them animal milk, but breastmilk is still better.

I thought breastfeeding actually protects against osteoporosis? I think it effects bone mass while you are actually breastfeeding but they go back to normal afterwards.

Can you ask to see someone else?

[Haggisfish]

thank you for your reply. I had seen the high heejin consultant initally, and then been given appointments with the less senior consultants, but I am going to ask to see my original consultant again. The trouble is, it takes about 8 weeks to get an appointment.

I thought similarly about Bf and osteoporosis and I am taking a calcium supplement as well. It was just the very matter of fact way in which she said it - if I wasn't as assertive and well informed as I am, I would have given up BF today, on her crap advice. I have found some scientific papers which support our views on BF and osteoporosis and bone density,and will be printing a copy off to go with my letter of complaint!

Cheers again

[organiccarrotcake]

1) Yes, make a complaint.
2) See another doctor
3) BFing protects against osteoporosis. It CAN reduce the bone density while BFing, but this bounces back and more after you stop, so overall you get protection against osteoporosis.
4) Babies don't NEED to be BF at all. FF babies frequently do just fine from birth. However, BF babies will on average do better in a whole host of ways than their FF counterparts. Breastmilk contains components available NOWHERE ELSE including active support for their immune system which never, ever stops, no matter how old the child.
5) The longer you BF, the more protection you get from various cancers including ovarian.

The BF MIGHT affect your vaginal problems - or might not - I've no knowledge of that whatsoever. Whether this impacts your choice to stop BFing is entirely up to you, but of course you'd need to actually know the answer, and go from there.

I am absolutely shocked by the ignorance and offensive comments of this doctor.

[organiccarrotcake]

X post, sorry, but I was so angry it took me a while to post :)

[mamadoc]

What you need to understand is that there is NO training at all on breastfeeding at medical school or thereafter.
Anything a Dr tells you about bf is 99.9% likely to be coming from personal experience (if you're lucky) or prejudice and can be safely ignored.
I wish people would refrain from offering advice outside their competence.

[minipie]

Leaving aside the crap advice you got and just focusing on your fanjo (in the nicest possible way )...

Can you get yourself to London at all? I saw a specialist vulval dermatologist (Fiona Lewis) at this clinic. She diagnosed a similar problem I have, and that many other doctors had been unable to diagnose (or had misdiagnosed). (Turns out I have vulvar eczema which means I tear slightly when having sex ).

Perhaps worth asking your GP for a referral to her or to her colleague?

[Haggisfish]

thank you all - this is what I thought, too! Do you think my letter below is ok? I have several medical journal articles to send about calcium levels and breastfeeding:

'I am sorry for writing to you, but I had an appointment today at your clinic, and was seen by Dr . I am quite unhappy about my appointment and some of the advice I was given in it. My concerns are listed underneath my brief history below:

I have had a sore vagina for years - specifically the back wall at the entrance to the vagina. I have had many tests for infections, which have revealed nothing wrong. However, it is still red and inflamed, with small 'lumps'. After I had a caesarian and was breastfeeding for 7-8 months, the whole vagina was very sore and dry, at which point I was referred to you. You prescribed a replacement oestrogen cream which is working well to overcome the dryness and soreness throughout the vagina.
However, the entrance to the vagina is still excruciating painful - I have only managed to have sex twice since I gave birth. The doctor today agreed it is inflamed with an ?odd lumpy texture?.

I am still BF 3-4 times a day, but with a good 8 hour break during the day while at work, and at night, for the past 5 weeks, and I do not believe the pain at the entrance to my vagina is related to breastfeeding, given the pain started before I was pregnant.

I saw Dr _ today and she told me:

1. My baby did not need breastfeeding past one year old. I accept she does not get the majority of her nutrition from my breastmilk anymore, but she does still require calories from milk in one form or another, and I would rather it was my milk at this stage. She also still gains a lot of psychological benefit from feeding, and antibodies from me. Current World Health Organisation recommendations are to breastfeed a child until they are two years old as a minimum, due to the health benefits for both baby and mother. I left with the distinct impression the doctor today thought I should stop breastfeeding immediately and that there was no point in me still breastfeeding.
   
   
2. My bones would suffer and become weak if I breastfeed for more than a year. I do believe there is a temporary loss of bone calcium while I am breastfeeding, but that normal calcium levels are quickly restored after weaning, and there are several scientific papers to support this view:
   www.biomedcentral.com/1472-6874/9/19
   
   
3. The doctor told me to ?ask for an address to get vaginal dilators from the hospital pharmacy? - I did this, in front of several people, and was met with baffled looks, and a general embarrassed shuffle from the many members of the public in the pharmacy at the time. I was asked to repeat myself, and asked to write a note instead. I did this, and several members of the pharmaceutical team looked at the note and discussed it, with quizzical expressions. An exceptionally sympathetic pharmacist recognised how difficult it was to talk about this in front of lots of people and took me aside to say the pharmacy had no idea what they were or how to get them and advised me to go back to my GP or phone the clinic back.
   
   It was extremely embarrassing, and I do not understand why the doctor could not have phoned the pharmacy herself to check they would be able to give me this information, or written me a note to give to the pharmacy. I am not easily embarrassed, but even I was quite upset by this incident.
   
   Having done some research on the internet, I could buy some vaginal dilators, but they cost around £50 for a set. If it is possible to be prescribed them, I would rather have them on prescription and see someone regularly to check on my progress and make sure I was using them correctly.
   
   
4. When I voiced my concerns about something more serious, such as ovarian cancer or an ovarian cyst, she told me I was being ridiculous. No other assurance was given, or reasons for this not being the case ? given that I have other symptoms, such as bloating and back pain, I was hoping for more reassurance than simply ?Don?t be ridiculous?.
   
   
5. Finally, and the recommendation that really surprised me: the doctor told me I should go back to the local genitourinary clinic as they have 'seen more vaginas than we have, and may be able to help further'. Given _ is a very large regional hospital, this advice seemed a little odd, especially given I have already been to the GUM.
   
   I would appreciate it if you could pass on the information about breastfeeding and bone calcium to the doctor I saw, and let her know that the pharmacy cannot supply an address for patients to get vaginal dilators from. I would also very much appreciate another appointment with you, rather than anyone else. If the only way to guarantee this is to go privately, could you let me know how to arrange it, please.
   
   I am very sorry to be writing this letter ? usually the care I receive is fantastic, but today I left the hospital feeling upset (I cried for about an hour when I got home), embarrassed and angry.'
   
   Thanks for any feedback and thank you for feeling irate, too - I was furious when I left.
   
   So I came home and gave LO a lovely long BF and felt calmer!

[Haggisfish]

minipie - I am going to go and see my very supportive (and very BF supportive) GP, so will ask her about this. Thank you for recommendation.

[organiccarrotcake]

Good one Haggis.

[organiccarrotcake]

"So I came home and gave LO a lovely long BF and felt calmer!"
:) :) :)

[babartheelephant]

Sorry about your probs with sore fanjo but this struck a chord with me. I finally after years of going round the houses with GP, gynae appts etc was told by the Well Woman Clinic to ask my GP for a referral to a VULVAL CLINIC. They specialise in exactly this sort of thing. They diagnosed me at my first appointment with a condition that when I read about it made everything make sense. I was sore, red, sometimes tearing after sex, recurrent thrush, could only have sex with condoms etc. Now a bit of steroid cream and it's under control, sort of. I am going to ask for a second opinion from Fiona Lewis as I heard she is very good. A dermatologist with a speciality in fanjos!!! Good luck

[minipie]

Best of luck Haggis, hope she can identify the problem. It doesn't sound quite the same as mine but if anyone will recognise it I think she will.

babar is yours vulvar eczema or lichen sclerosis? I have the former and it has gradually been getting better over the past year or so - without using steroid cream (I was given some but forget to use it) - so there is hope...

[marzipananimal]

poor you. i think your letter is very good though. am surprised about the dilators, i bought some from my hospital pharmacy - can't remember what they cost but not £50! I'm not sure why they would help your condition but you can have mine if you want them (i don't need them any more). They're plastic so easy to sterilise :)

[Teapot13]

It's a good letter, and you make very good points. The only change I would suggest is to remove the opening apology -- you are the one that deserves the apology.

[Haggisfish]

Thank you everyone - a few good updates to post! I went to the GUM clinic today and was seen by the same guy I had four years ago when I first went with this problem. He completely revised his original idea about it being vulvodynia and said the area is definitely red and inflamed and thinks it is a skin condition. He thinks the lumps are just skin tags - this would make sense as I am incredibly moley and more so since having a baby (the glamour never ends, does it?!) He has given me steroid cream to apply and another appointment in two weeks time and promised to refer me to a dermatologist if no improvement - I will ask to be referred to the lady you mention above if no improvement, I think. Secondly, the hospital consultant's secretary phoned me and asked me to come and see the real head consultant on Monday afternoon - his secretary must have told him about the incident and he has taken it seriously. I will remove my apology from the opening sentence and hand deliver it on Monday.

Thanks for all the advice and answers - I feel a lot better now.

[minipie]

Excellent news, sounds like good progress and hope you get a diagnosis soon. (It may not be something that can be fixed easily, but just having a diagnosis you can trust helps a lot somehow). And hopefully you'll have saved some other women from being told claptrap too

[marzipananimal]

That's good. PM me if you want the dilators