Vulva/Urethra/Vaginal atrophy

[Bestyearever2024]

My sister has been menopausal for 10 years and she has JUST been told that she has atrophy.

She's struggling to wee and weeing so often (like a uti although she doesn't have a uti) with low down abdomen and back pain

Has anyone else found that oestrogen pessaries helped with this and is it safe to start taking oestrogen pessaries at 63?

Shes never used oestrogen or any hormones, before

Thanks

Been using vagifem pessaries for a few years now - I'm 62. Can't recommend them highly enough - no urinary problems, no itching, no side effects

Thank you.

I think my sister is bothered by the idea of suddenly using oestrogen

Shes read about a connection to breast and ovarian cancer when oestrogen is started after 60.

Vagifem is a localised micro dose. If you took them as prescribed for an entire year it's the equivalent to 3 days of HRT oestrogen pills.

The risk is minuscule compared with the urinary problems and subsequent discomfort and antibiotics.

It's also recommended by NICE that every menopausal woman is on this.

I started on Estradiol (generic name for Vagifem, I think) pessaries a couple of years ago, aged 63.

I’d agree with spiggydit: they have done wonders for my urinary problems. I didn’t realise that NICE recommended them for all menopausal women: I wish they had been suggested a decade ago.

I can’t use hormones ( hormone positive breast cancer) so I use Hyalofemme a gel containing hyaluronic acid. It has maintained my vaginal mucosa. My gyni even commented on how everything looked when she examined me.
Hyaluronic acid is becoming popular as a treatment for a number of skin/mucosa conditions along with cosmetic uses.

I apply it twice a week and it is available from Amazon.

If she is very dry she may struggle with the pessaries. Ovestin cream may be a more gentle option - it comes with an applicator and you use it internally and externally. I have Sjögren’s syndrome and can’t manage Vagifem but Ovestin has been life changing for me.

There's also Estriol cream, (vaginal atrophy can be caused by lack of oestrogen).
Inserted with an applicator.

Wow! Thank you.

So..... as a post menopausal woman (with no symptoms), NICE says I should be on vagifem too?

That's really interesting. Thank you so much

Thank you. Maybe the Doc will prescribe my sister Estradiol as its less expensive?

Thank you! And is Ovestin also oestrogen, but it's a cream as opposed to a pessary?

Interesting. I wonder how it compares to oestrogen to help with urine atrophy? I'll suggest my sister has a Google. Thank you

I'd never had a UTI until I hit the menopause and then I had recurrent attacks for a few years. I finally saw a wonderful older women doctor when I was experiencing the third UTI in a couple of months and she recommended Vagifem. It's been an absolute game changer; I haven't had an attack since I started on it about 5 years ago (I'm 63 now) and I'm so much more comfortable! As a protectthesmallones said, it's a miniscule dose of oestrogen compared to more general HRT but it's made a huge difference to me and I can't recommend it highly enough. Good luck to your sister, I hope it helps with her problems.

Your sister might be interested in this article from The Guardian last year.

https://www.theguardian.com/society/2023/dec/17/millions-of-women-are-suffering-who-dont-have-to-why-its-time-to-end-the-misery-of-utis

This is so useful

Thank you

Good lord! I've sent it to my sister, but I'm interested too! That's an incredible article! Thank you. 🥰 Our Mum used to get totally confused each time she had a uti .....no one mentioned oestrogen 🙄

My sister hasn't got a uti but she might as well have because she's suffering exactly as though she has 😵‍💫

I use Ovestin and it's been an absolute life changer for me. I need to take it every day otherwise my symptoms come back, but my gp has said this is fine. The amount of oestrogen in it is so small it's fine to use daily.

I was honestly miserable without it. Felt like I had bladder cramps, a uti and thrush all in one go. That's all fine now, I also use coconut oil on my genitalia which also helps

Yes! Like bladder cramps. That's EXACTLY how Emms described the pain in her lower stomach, to me. This thread is like a revelation! Thank you 🥰

With any treatment, she might find the applicator difficult to insert at first, because of the atrophy. She can wet the applicator to make it easier to insert, and only insert it a couple of centimetres - just as far as feels comfortable. After a few doses, she will find that she can insert further and further.

This works with the creams, but I don't know about the pessary.

Thank you, @Dilbertian

I'm wondering if I should look into this for me (no symptoms).....but maybe getting ahead of the game is a good idea?

Absolutely. You may have no symptoms in the early stages, especially if you're not sexually active. If I have understood correctly, treatment removes the discomfort and improves the moisture levels in the vaginal mucosa, but cannot restore everything to how it was before. It halts the progress rather than reverses it. So the earlier you start treating it, the better.

My GP told me to apply the cream on the outside of the applicator too. This worked well for me, especially in the early days, when I was very sensitive down there.

*I think my sister is bothered by the idea of suddenly using oestrogen

Shes read about a connection to breast and ovarian cancer when oestrogen is started after 60.*

My personal perspective on this is that I'd rather have 10 more years functioning well and happy, than 20 more years of increasingly poor function and misery. That was my attitude when I started HRT 15y ago, and when my GP started suggesting it was time to stop (which they don't any more), and I've had more than 10y of increasing happiness and increasing ability to cope with the increasing decrepitude of my body. Because, sadly, HRT does not cure aging itself - just makes it easier to cope with.

Agree. Totally transformed my life. The cream is only absorbed where it’s put. It doesn’t enter your system

Thank you all so much

I'm really grateful for your help and wise words