recurring uti/sore urethra - can I ask GP for estriol cream?

[EllenRipley]

Last time I was on here wailing I'd had two positive pregnancy tests - turned out I had uti and probable wonky/peri hormones. Anyway, things cleared up, got all clear from gynae consultation and have been referred to urology (not til late March). Meantime have been on regimen of supplements to support bladder health.

I've had another flare up - trace non-hemolysed blood in urine, sore urethra, general heavy/swollen feeling in ladybits. Got antiBs just in case (samples never come back from lab with any infection). I think it's due to a perfect storm of sexual activity and a period (first after 5 months of nothing, found tampons very irritating), plus getting dehydrated on a long haul flight.

Thing is, I'm more than sure, from all the research I've done, including asking questions on here (apologies if I've repeated myself, my memory is also shot 😆) that what's causing all this is low estrogen.

My periods are months apart and I've phases of hot flushes (tho none for a while, probably because my period has returned). Lots of other general peri symptoms. So I'm thinking that before I consider full hrt, vaginal estriol cream will help, or certainly be worth trying. But my GP & gynae consultant (who said my vagina looked 'estrogenised' - lovely) have been generally disinterested in my 'theory' or the fact all this bladder nonsense is coinciding with disappearing periods! I suspect the urologist will diagnose something like urethritis or interstitial cystitis or something. If my gynae doesn't want to consider a hormonal issue, surely a urologist less likely to?

Has anyone had these kinds of bladder/urethra issues with peri and have you used vaginal estriol cream? I don't think I have vaginal atrophy per se and I know self-diagnosing isn't always the way to go but I feel like the 'experts' are ignoring what I think is glaringly obvious. I'm 47 btw.

Thanks (again)!

You don't have to have a sore vagina to have vaginal atrophy. VA is when all the urogenital area suffers from loss of estrogen
This explains it well- written by a specialist GP.

Ask your GP for treatment.

menopausedoctor.co.uk/what-is-the-menopause/vaginal-dryness/

Thanks Polly, I'm going to take a copy of this to my GP AND the urologist. I notice that most of the info online about vaginal/urinary stuff talks about post-meno rather than peri. I don't have noticeable dryness, in fact the opposite (no BV or thrush either) but I guess there are degrees of estrogen deficiency.

It annoys me that my GP practice doesn't have a doc that at least pretends to specialise in this stuff.

Thanks for your help x

Actually....one of the symptoms of VA is- ironically- a lot of very watery discharge. You don't have to feel exactly 'dry'. In some women when it's very bad it can be pink tinged because the cells in the vagina are so fragile they bleed even when there is no 'extra friction' going on.

Your estrogen levels in the vagina are very sensitive to change so even a slightly lower level can start VA type symptoms. You don't have to be post meno; in the link I left, it refers to VA symptoms in women who are breast feeding too.

IME perimenopause is worse than post menopause.
Vagifem pessaries solved all my problems, plus a really good barrier cream until the oestrogen kicked in.

Such a simple solution I don't know why it is so much hassle to get GPs to prescribe.

I had little dryness and the watery discharge at the age of 48 but very red sore bits and the feeling of needing a wee frequently, especially at night...topical estrogen sorted it all out and I haven't looked back!

Wow. That pretty much cements my theory, at least in my own mind. I wonder if my urine dipsticks are sometimes coming up with blood traces because of the vaginal irritation.

Thankyou so much Polly.

Thanks everyone! Is vagifem an estrogenic treatment - is this what I should ask for? Have read estriol-based treatments are the best.

My entire GP practice seems to have a mental block when it comes to the menopause. It's probably sensible to wait til urology appt rules anything in/out before I return armed with my own research.

Vagifem is oestrogen.
Less messy than cream.

👍 thanks @endofthelinefinally