Vaginal atrophy or urinary frequency?

[trumpisaflump]

Strange question but bear with me. I started peri menopausal symptoms fairly early (age 42) and have been on HRT, Femoston 2/10 since then. I’m now 46. I’ve just read that vaginal atrophy can cause urinary frequency and urgency and I’m wondering if this is my problem as I just can’t hold my urine when I need it. I’ve never actually lost control but I NEED to get to a toilet when the urge comes. I couldn’t really go out much on my days off work in the full lockdown as all the public toilets next to parks were closed and I wouldn’t be able to hold my wee in 😳
Anyway I have no other symptoms of vaginal atrophy I don’t think. My vagina doesn’t feel dry, I have no pain and sex isn’t uncomfortable. Anyone more knowledgeable than me know if vaginal oestrogen may help urinary issues in the absence of classic symptoms like vaginal dryness? My GP is really understanding and I’m sure she would prescribe vaginal oestrogen if I requested this. Thanks

Yes VA causes that!

Most definitely.

Get your treatment! Might take a few weeks to see any difference so be patient.

Yes I believe so.

I was prescribed it for dryness I thought I had constant thrush but turned out not to be the case.

Thanks both. I was a bit confused as I have no vaginal dryness at all. Purely urinary issues. I would much rather use a topical treatment than systemic for urinary problems.

I had similar. Have chosen to go onto HRT tablets as I had other symptoms too. It has made a very quick and noticeable difference to the urinary frequency and urgency so I would have thought topical treatment would help you.

This could be caused by VA or lax pelvic floor muscles, also associated with peri-menopause due to reduced oestrogen levels.

I'd go for a two pronged approach: ask your GP for a trial of Vagifem and a referral to a women's health physio.

Not vagifem, ovestin then use on the vulva too. The incontinence is probably caused by shrinking of the tissues local to your urethra and vagifem may not help with that. You can apply Ovestin in small amounts to the vulval area including the urethral area to help with this

@takemetomars The OP says she is not having leakage.

The urgency is often because the bladder lining thins (it has estrogen receptors) when estrogen levels fall. This can cause a feeling of needing to go, urgently, as urine is acidic and irritates the lining. Exactly the same thing happens with the urethra- it's lined with the same cells that respond to estrogen.

When Vagifem is used it actually penetrates the vaginal walls and gets into the bladder lining and the urethral lining and this helps to rebuild the layers so they are thicker again.

Ovestin does the same, but yes, Ovestin can also be applied near the urethral entrance and may help any stinging etc.

@takemetomars that's really helpful thanks. I'll ask for Ovestin cream.
This is actually really depressing me. I feel like an old lady at 46! Not sure how I'm going to broach the subject with my DH. He's totally supportive but it's still a bit embarrassing.
@slidingdrawers I've been to a women's health physio as once I stopped breastfeeding ten years ago I noticed I had a prolapse. To be honest I don't think she did much for me. I saw her about 6 or 8 times and didn't really notice any improvement. I do the NHS Squeezy app and I think this helps but not completely. Caffeine definitely makes it worse but I only have one latte a day and as I've stopped drinking alcohol it's my only vice so I'm loathe to give it up!

@JinglingHellsBells thanks. Yes I've never had any wee come out unexpectedly. I can run, cough or jump on a trampoline without any issues. I can't hold urine for long though and need to find a toilet asap when I need it, pass urine frequently, and need to get up at night to pee.

I never have any stinging or pain either.

@trumpisaflump You might find Ovestin etc works but if not, you can get drugs for overactive bladder also called urge incontinence (different from leaking due to weak muscles.). You can also help yourself by not drinking caffeine or alcohol. Sadly both affect me and I had to give them up 20 years ago.

I went to see my GP as I was feeling very sore and experiencing dryness. But my big worry was suddenly needing to go to the bathroom constantly and felt as if my bladder was filling up straight after. I had never heard of vulvar/ vagina atrophy. Dr thought I had UTI at first. I have completed the 3 weeks nightly and now on 2 nights a week. I feel that it has helped a little with the need to go constantly but my GP said it can take a few months to fully work. I feel as I am am constantly over thinking about it all the time now.