Intercourse and discomfort

[Lambside]

Can be slightly uncomfortable during and slight pink tinge to any discharge after.
I use multi gyn gel occasionally but think that although it soothes any irritation and seems to rebalance the internal flora it isn't actually preventing the discomfort.
Do I need an oestrogen product? Do I need to see a dr or can I buy from Boots or online?

Came on here because for the first time ever I bled after sex this weekend. No discomfort and no dryness but have been bleeding since.

I haven't had a period for about 2 years and am completely through menopause. I actually wept last night (probably fueled by 2 glasses of wine) at the injustice of it all. Have an appointment with my ob in early Jan so will ask for cream.

Pallisers sorry to hear that - it doesn't sound right at all though? Where's the blood coming from, surely not a tear? Can I you get an earlier appointment?

If anyone's interested my HRT has made a big difference & I've been updating all my girlfriends on dry vaginas - I think we owe it to each other to discuss this!
A friend who can't have HRT due to breast cancer says she hates having a dry vagina, so then she has no libido. The gels etc she didn't like because it stopped things being spontaneous.

some GPs are on the ball...mine was and I am in charge of a new Mirena and some pessaries...use everyday for a fortnight and then twice weekly

Giving the mirena a while to settle and then shall crack on!

and yes, for pallisers sounds like a medical opinion would be wise....I know how you feel, I was jubilant at a mere six months of no periods and devastated when October and the Full On Month of Menstruation caught up with me fucking hormones

Thanks Oxford. blood coming from vagina. no pain, no cramping, no fever. Don't feel dry and libido is fine. think it is my vaginal wall drying/aging. Very low risk for vaginal/cervical cancer and have regular checks. Cried properly last night about it and I'm not a crier.

If it doesn't stop tomorrow I'm going to insist on an earlier appointment.

Oxford many drs will allow vaginal HRT (estrogen) for women who have had breast cancer as so little is absorbed. Your friend should see another dr for another opinion. Lots of women who have had BC use vaginal estrogen.

Interesting thread - I have previously asked my GP for vaginal pessaries / Vagifem (basically i had dryness plus lots of UTIs but no night sweats or hot flushes) and she was negative about prescribing it on the grounds of an increased risk of cancer.

I have no family history of breast/cervical/ ovarian cancers and most people seem to think it's safe - so it seems strange to me that she is so reluctant to prescribe.

I don't understand these GPs, I really don't. I despair.

There is no cancer risk with vaginal estrogen. Using it for 1 year is the equivalent of one HRT pill.

There are women who have had B Cancer who are allowed to use it.

I suggest you find a GP who knows what they are talking about.
Presumably she'd not prescribe systemic HRT either if you needed it?

She offered me the combined contraceptive pill (Rigevidon) which to be fair has calmed down my periods but I still feel vaginal oestrogen would be better.

As PP said a total lack of knowledge regards local oestrogen which is extremely worrying , ladies in there are 90s are on it have been for 20/30 years non stop ....VA can’t be cured only managed and rheblonger it’s left the worse it gets.

Does she realise just how bad it can get ? My GP has ladies who vaginas have stuck together and they can’t have smears , due to not getting appropriate treatment ( not from her but just not discussing it ) .

I honestly don't know what to say about this. It's diabolical.

Not only is this GP ignorant, she is also happy to prescribe another drug which has more risks.

I think if I were you I'd change to a different practice, or another GP in the practice, but at the same time I'd make an appt with her and take along everything I could find online, print it off, and show her the facts before she carries on harming other women- because that is what is amounts to - harm.

As gettingold says [by the way - maybe change your username GO- far too negative!!] there are women using it in their 90s (my mum!).

Well the gp I saw has prescribed vagifem for me but said only to use it for the initial three months and then have a break. She said some women then find they are fine for six months to up to a year. I queried that but she said they don't recommend continuous use.
On another note, I would like to use a vaginal moisturiser for a bit until the oestrogen gets going. Will that be ok or will it interfere with the pessaries?

. I queried that but she said they don't recommend continuous use

They - who is they?

Unfortunately your GP is out of date.

NICE and British Menopause Society guidelines advise continuous long term use . Without this, symptoms come back and you then have to do the 2-week initial loading and so on again.

It's going to involve you in some work, but if you google all of the above there are numerous papers, advice from the above and so on which you can show your GP.

I've used it for 10 years , prescribed by a top UK gynae.

It's like putting moisturiser on your face- if you stop, the dryness comes back.

Yes, you can use other stuff at the same time.

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.

NICE guidelines- see 'managing short term symptoms'

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.

sorry- that's in the wrong order but all those points are from NICE.
But you get the point.

they I'm thinking are probably the doctors at the surgery. Who knows. Maybe just Us Doctors.
Thank you. I have since posting read the NICE guidelines and several threads on the menopause matters site regarding moisturisers and vagifem use. Some women have such a terrible time of it don't they and hardly any of advice is widely known.

One of the copies of the Menopause Matters magazine covers this issue in detail- you can read it online on the MM website- I think it's linked to on their Home page. There is a very good case study account from a woman who has terrible VA (and I think she has also posted on your thread here, actually.)

Unfortunately what your GP told you is believed by many GPs who are very out of date.

In the past, even when vaginal estrogen was used long term, the only precaution was to possibly give a short course of progestogen (once every couple of years) to 'clear' the womb lining if it had grown. (This was a very rare possibility.) You can see that the NICE guidelines say this is not necessary now but as a precaution they say anyone using it who has any odd bleeding ought to consult their GP.

There is no risk of breast cancer with it. You can see that NICE says it can be used with women who may have this history with agreement from their consultants.

I’m in my 4th month of HRT. Overnight the past few days I’ve noticed soreness and irritation during and after sex. I believe it’s the start of vaginal atrophy. I had a bout of thrush in November which I think was also probably linked.

I saw the nurse practioner last month who prescribed me a further 6 months of HRT and she did talk about vaginal atrophy and insisted I came back if I had symptoms.

I shall definitely be making an appointment to see her - she was really on the ball and even directed me to Menopause Matters!