Embarrassing female health problem

[HildaWasALondoner]

I have name changed for this, as there is one aspect that I can't even tell my DH! Before I start and to give you a clue, I am not a piss troll.

I am pre-menopausal, and on some very light HRT to manage symptoms such as hot flushes, brain fog, irritability etc.

My Mirena coil is overdue for replacement, by about 4 months. I'm having some additional symptoms now like breast tenderness, mild pelvic pain, and pain during/after intercourse.

I have some bladder weakness which the GP felt was probably menopause related (softening of the pelvic floor muscles) - I wear a pad during the day to catch leaks, but I don't use one at night. The old fanj has to breathe once in a while, but I'm mainly self conscious and I don't really want my DH to wonder why I'd be wearing a pad at night. He's a massive pisstaker, pardon the pun, and I'd never hear the end of it. Plus, you know, sexy-time spontaneity. The embarrassing bit is that I must be leaking tiny amounts overnight, so in the morning...well, I'm damp and smell like a camel barn. And even if I DO wear a pad, the morning problem is the same.

DH is baffled as to why I avoid any closeness etc first thing in the morning or keep the covers clamped over me as he's getting up - I told him that I prefer to stay covered as I'm self conscious about my body, but really it's because I'm panicking that he'll get a waft of ammonia and fall unconscious before I can dash to the shower and remove the offending underpantage. If I wake in the night for the loo I sometimes change, but he has been known to wake up and say, "Why are you taking your pants off??"

To add to it I have an long term waterworks problem - for some 20 years I've been getting repeated "infections" (painful bladder and cloudy offensive wee), but 90% of the time there is no infection, just a high white cell count, and routine investigations many years ago yielded nothing. I had a few years respite, but recently this issue has returned - I am soldiering on with bladder pain and leaking foul pee. Gosh I'm so attractive right now.

If you've got this far, I have approached the GP again, however;

1. They cannot remove and refit my mirena because they are not doing such appts at the moment, plus one of the few GPs trained to do so has retired. When they start scheduling appts there is a long backlog.
2. I cannot have antibiotics for my malodorous bladder as there is no infection, and they are not moved to investigate further.
3. The bladder weakness is perceived as "just one of those things", even though I have never given birth so technically my pelvic floor should be pretty good.

I have private insurance so I could get all of this looked at privately - but I'd need a referral. What type of referral do I ask for though? Can a gynaecologist deal with all of it, including the bladder thing? Lord knows a private doctor might get to the bottom of it if an insurance company was paying.

Opinions and advice welcome, if you're not all asleep...sorry for TMI. It's the first thing I've ever felt too mortified to reveal to my DH, and he's seen and heard far worse from me...

Make sure your gp tells you the type of consultant you need referring to as your insurer will need to know this. Bupa consultant finder will tell you if someone is recognised if that's your insurer

Just as an aside, I did the full set of kegel exercises yesterday and had pretty bad pain all night and this morning. Took some paracetamol and it disappeared enough for us to do 5 miles with the dog this morning - so I risked doing them again this afternoon, and now I have that same low pelvic pain again.

Is that normal, for someone just starting who doesn't routinely do the exercises? I downloaded an app, followed them carefully for the requisite time periods, checked my technique and wasn't holding my breath or clenching stomach/buttock muscles etc...?

I would stop if they are causing you pain, a little bit of soreness is normal to start with, but not if it’s so bad that you need painkillers. I would suggest waiting until you’ve seen consultant to get a proper diagnosis, and/or seeing women’s health physiotherapist ASAP. Could you afford to see the latter privately? Mine has been worth her weight in gold.

Hmm, yes it's similar to period pain but lower - where I tend to feel what I think is bladder pain. It's through to my back at the moment, it isn't excruciating but it is at constant and nagging level. 🙁

I should get to see a consultant uro-gynaecologist, covered by my insurance - if they then send me to a physio that will also be covered by my policy, so yes I will hopefully have all that available to me.

I'll be glad to get it resolved, whatever is going on.

No not normal Hilda, normal is not being able to do them very well to start with.

I'd maybe mention that to your doctor.

I would second those saying that this could be a UTI, especially if pelvic floor exercises hurt. A couple of years ago DS suffered two or three times with symptoms and they always responded to antibiotics within a day or so despite nothing showing on dipstick or lab tests. Thankfully the GP did continue to prescribe as I was probably quite bolshy in insisting that it wasn't normal for him, and the antibiotics worked each time as they were a bit reluctant in the end. Over a year since the last episode and all good.
There have been studies showing that not all its show up on tests, I think about 20 per cent - there is an article somewhere in the Guardian about it if memory serves and I think the initial study was published in the New England Journal of Medicine. I ended up quoting this in desperation.
Perhaps try to get a decent course of antibiotics if possible to rule this out.
If it is weakness of pelvic floor muscles, I think you can see brilliant results with exercise and/ or the relevant gadgets to help. I think I heard about some cycling shorts which have electronic bits to help which you wear for an hour a day and they work miracles but not sure of the details.
Whatever it is OP, I'm sure you can sort this.

Sorry utis, not its

I am the third to recommend Professor Malone and his research. Also google a Guardian article about persistent utis. Your symptoms are not normal and do not need to be tolerated. Lots of different symptoms which could all be linked to a long term uti. The nhs do not test for every type of bacteria and can be quite dismissive which can then affect your mental health too.

Fortunately I have not suffered but my poor dil has. 14 months of antibiotics, she gave up her job and it has really affected her mental health but she is at last seeng things improve. After no joy with nhs she went private. Got referred to someone in Harley Street.

I will Google, thanks to everyone who suggested!

I have a referral to a uro-gynaecologist 17 miles away which is covered by my insurer - I've just told my GP who it is, they will write the letter.

Unfortunately, I have used up my entire allowance for 6 specialist consultations in this policy year, thanks to recurrent trips to see the surgeon for a claim on a 5 year foot problem, so although all treatment is covered, the consultations are not! Not until a new policy year starts in November anyway.

I can sense this getting expensive...

One thing which can help is to increase the amount of water you're drinking. Try Evian because it's the least irritating and most bladder friendly. Things which can make your pee smell a bit mousey are: coffee, fresh fruit juice, alcohol, tea and orange juice.

Shaving the whole area can cut down on odour too, although just do the underneath bit if you don't want the whole pubic area off entirely.

Actually, another thing I've just remembered is that a water wash next to the loo is great. It's what muslim people use to keep clean. You can order them from amazon for about £40 and it's not a difficult thing to fit. They tap into the hot water tap and you can wash thoroughly when visiting the loo.

www.bigbathroomshop.co.uk/milano-mirage-modern-wall-hung-douche-spray-chrome-69108?gclid=CjwKCAjw9vn4BRBaEiwAh0muDFcEAVXAE2nXlNq-SNPGB6nMPe28H7tzz4UG2D5V-BgAPI_yxzk7-BoCKBgQAvD_BwE&gclsrc=aw.ds

This sort of thing. We have one upstairs. They're great.

Not sure about evian water - I went through a weight loss drive and was drinking 3 litres of water a day, it did cut down on the pee aroma a bit (didn't eradicate it) but it also irritated my bladder going every 20 minutes and made it ache!

"Mousey", interesting. DH asked me what I thought it smelled like today, I really don't know so I just said death.

OMG, an on-loo wash, brilliant idea!

You can get a portable squirt bottle which I have if you don't want the full installed thing as well

I've just been looking at that very thing Queen...

Oh OP, I've not read RTFT but you did make me lol with 'My crotch smells like a ferret hutch!'

I hope by the end of the thread you've got some help.

I've been poorly with covid for months. Still no sense of smell. Yesterday DC1 told me my feet stink. Then the other 3 agreed. DH too. Apparently they often stink. I had no idea. DH still lovingly rubs them every night for me, stink an all. Bless these men.

'Stinky minge'. You two are great. I wish you were my mates. Glad you're on your way to getting sorted.

Haha! Oh dear, poor you (and poor family having to inhale your stench ) - I hope you're feeling better though!

DH saw me looking at the portable bidet on Amazon and pointed out that the aroma will be accumulating on my pants as I sleep/leak - so no amount of washing my actual body is going to help if I'm just pulling the same kecks back on again. Errr...oh yeah

I was really hopeful about the referral but knowing I'll have to pay £200 for a 20 minute meeting has taken the shine off it a bit.

Thing is, I'm uber clean and never normally have stinky feet. They must be winding me up.

Ouch to the £200 but think how much you'll save on panty liners/plastic bedsheets/lenor/douche water and the rest once you're fixed. You're worth it.

No news from the surgery yet on the sample - last time they texted me within 24 hrs to say it was negative for infection. Surely it takes longer than that to grow a culture, but anyway - they've had it for 48 hours this time, no messages and no results showing in the NHS app yet.

Kegel exercises are still difficult and uncomfortable, but the pain afterwards is getting less severe, so that's a good sign.

Urine still smells like actual death.

Hope you get your results back soon. I had several years of UTI symptoms where my samples always dipped positive in the GP surgery for leukocytes (white blood cells) and blood but never ever grew anything in the lab. When I eventually couldn't stand it any longer and self-referred to Prof Malone-Lee's clinic, he said this was a hallmark of a bladder wall infection. At his clinic they don't send samples off for culture and sensitivity as they consider the findings to be unreliable. Instead, they count leukocytes and cells that have been shed from the bladder wall in fresh urine samples, prescribe long-term antibiotics if the findings suggest these would help, and monitor progress using the same techniques. I'm sorry if I sound like a broken record, but I've been where you are and it definitely only goes one way. The fact you have offensive smelling pee which is full of WBCs screams infection and you need to have this either properly ruled out or addressed appropriately or it will severely affect your quality of life. I ended up in extreme pain, peeing 20-30 times a day including 10 times overnight. The cost of a consultation at the clinic is the same as you've said you'll be paying for your private appointment and there is a urogynae consultant on the team (she is brilliant).

Ps the antibiotics prescribed are usually cheap (e.g. cefalexin) so don't be put off by the idea of having to pay for treatment

Thanks AHF. I had a cystoscopy many many moons ago, which isn't the most fun I've had with lube on me mary, but it showed nothing of interest.

Will go and check out Prof Malone...

I had a cystoscopy too. Ugggh. Sympathies.

Hope you get some resolutions soon. Have you tried roll on deodorant in the groin creases at night. That would eliminate sweat anyway. The specialist women's physiotherapists are well worth a visit as they are very knowledgeable on all things pelvic floor.