UTI, soreness - are my bike riding days over?

[mutterphore]

I'm nearly 60 and post-menopausal for 5 years (luckily sailed through that process with no difficulties). Unfortunately, I've had my first UTI for the last 8 weeks+ with incredibly and unremitting soreness too and am on my third set of antibiotics.

As a regular bike-rider - usually around 80 miles a week - I can't even imagine the possibility now of getting back on my bike as the soreness is so awful, all the time. Will I ever cycle again? It's my main source of exercise and one of my greatest pleasures.

All the creams the GP has prescribed so far haven't worked and in fact I'm slightly worried they may have made things worse. I've tried Canestan Hydrocortisone (although I don't actually have any of the usual thrush symptoms - eg no itchiness and no discharge) which I think exacerbated the soreness, Replens - which definitely made it worse and Sylk, which sort of relieves it a tiny bit for a few seconds but doesn't go anywhere near relieving the soreness.

As I had no problems at all before all this, I'm reluctant to try topical HRT.

Wise women, can you suggest something for immediate relief from the soreness - ideally a safe, natural product, as I think all these creams have just made it worse?

Has anyone suffered similarly but then the UTI and the soreness gone away completely without further more drastic interventions. Finally, if there are any other post-menopausal cyclists on here, can you give me hope for future bike rides?

www.bladdermatters.co.uk/content.php?id=164g=2/Role-of-Estrogen
This is another page in the link above.

If you ignore it, it's likely to get worse and then harder to improve. Some women use systemic HRT and topical HRT to manage the problem.

Yes, me.

Honestly OP topical HRT feels way less of an issue for me than the hydrocortisone I've been whacking on my skin since I was 5yrs old.

Just get some already. You don't need any more advice on this, it's like buying a pack of tissues when you have a runny nose.

I know you are very keen on keeping your body happy and healthy, me too.

I run, hiit, yoga, walk miles, eat well and hate taking medicines. But sometimes you just have to. And this is one of those times.

The topical HRT won't even go into your blood stream. It stops at your genital area.

Yes. I agree with you and I'm definitely planning now to try topical HRT. You've been really helpful and very convincing and thanks so much for the useful links, @JinglingSpringbells and your feedback too, @Dogsgottabone .

I've just been given a cancellation appointment for tomorrow the consultant urologist and will discuss everything with her. It's then too late to cancel my private GP appointment the next day but I can update her too. I think the urologist may however want to do one of those tests where they put a tube up your ureter, which sounds horrendous but I'll see what she says.

Anecdotal feedback from other women around my age is very affirming and I'm finding this thread and all of those contributing on it, very informative and reassuring. I'll update in due course and many thanks again.

That's really good news about the uro-gynae appointment.

Good luck.

@mutterphore I am going to send you a PM if you can access that as I've a lot of (painful) experience of all of this which I don't want to make public.

mutterphore I'm delighted to hear that you will get to see the consultant tomorrow. Hopefully they will be able to finally resolve your problem. Good luck and please let us know how you get on.

If you ignore it, it's likely to get worse and then harder to improve. Some women use systemic HRT and topical HRT to manage the problem.

I understand your concerns about medication (and note that Jingling does say "some") and please be reassured that you won't necessarily have to go on to the fully systemic HRT. I have been able to manage my symptoms with topical oestrogen alone. Jingling is right though that it is likely to get worse the longer you leave it.

I think the urologist may however want to do one of those tests where they put a tube up your ureter, which sounds horrendous but I'll see what she says.

Not necessarily. I was worried about that too, but thankfully didn't have one. The tests I can remember are a vaginal examination and full bladder test (ultrasound ?), but definitely nothing up my ureter.

Thanks very much once again, @Dogsgottabone , @JinglingSpringbells and @Boiledeggandtoast . You're all so brilliant! Thanks for the PM too @JinglingSpringbells and I've replied to you. You're very helpful.

My plan tomorrow is discussion and then requesting topical HRT either from her or the private GP at my appointment the following day. Hopefully that's all I'll need. I'd quite like to be checked again for infection though, just in case.

I suffer from UTIs/cystits. Early days but these tablets (although not cheap) are working..may be worth looking into.

bluegreenhealth.co.uk/product/uralix-capsules/

I thought I'd update on how things went with the consultant and GP. The consultant urologist didn't examine me or order any tests but prescribed Ovestin for three months. The first week I use it each night. The next fortnight once every 2 nights and then the next 3 months, twice a week. I think that's quite a conservative dose?

So I've started using this for the last 4 days. It may be helping a bit but I presume it's too early to say. As it contains alcohol, she did warn me that it might sting like wiping alcohol across a wound and maybe that's why it's not exactly fully relieving discomfort. Should that change in time?

She also said that instead of inserting the full 0.5mg of Ovestin with the applicator (which has a clear measurement system, to reserve a tiny bit at the end to put on the entrance to the ureter but I'm finding that the amount inserted is so so tiny that there's nothing left over to smear it anywhere else. I'm still quite 'sore and dry' but will that get better?

She seemed very clear about using no more than the prescribed dose so I can't just squeeze out more from the tube. I'll have to see how it goes.

Secondly, she prescribed 3 months of prophylactic doses of antibiotics - a different type each month - which hopefully won't mess too much with my stomach biome. This was in case I have an embedded infection.

I go back again in 3 months time. Meanwhile, the GP, who I saw again too, was surprised that the consultant hadn't examined me or ordered even an ultrasound but said maybe just wait for three months and see how things go.

So I'm on Day 5. Is this the usual protocol from others' experiences?

Is there any way I can better lubricate where it's sore or would anything else applied just interfere with absorption of the Ovestin? Everything the GP originally tried me on seemed to make things a lot worse (Sylk, Replens, Canestan with Hydrocortisone).

She told me not to try cycling for at least 6 weeks but to be honest, I still can't imaging being able to get back on my bike as it's so sore, even when doing nothing at all. Even walking a lot can seem to make it worse and so I'm slowly putting on more weight, which is not ideal.

I'd appreciate anyone's thoughts on my update. Thanks.

Thanks for updating. What you have been told to do is pretty standard, although I think they are being over cautious with the amount of Ovestin. (They are a uro not a gynae so not sure how up to date they are with this.) There is no harm in using 1mg internally and a bit more externally. A whole year of doing this (1mg internally) is no more than 1 day of systemic HRT.

The dose is nightly for 2 weeks, then usually women use it 2 times a week, but it can be 3 or even 4 in severe cases. It's all about seeing how it goes and if 2 x a week works. You need to keep going for life though- not stop after 3 months or it will just come back.

The antiBs- personally, I'd have foregone those. They do huge damage to your gut health, and if the Ovestin works you are using them unnecessarily if there is no infection.

If I were you I'd not take them, but carry on with Ovestin for a good 2-3 weeks and see if there is any improvement.

Not sure what you mean about using something for lubrication.

Do you mean for sex?

Gynaes say that YES is one of the best types.

If you mean external soreness, then use the Ovestin.

There is no reason why you can't use 1mgs inside and a pea sized amount outside, as needed.

Hi OP, me again!

You finally got some ovestin! That's good news.

I would just whack a bit more on the ureter from the tube. Its so benign.

Or when I squeeze it into the applicator there's always a bit sticking out - like when you've whipped cream and it goes into a peak. Just take a bit off the top before you put it in your vagina.

I haven't had any soreness using it at all, but I equally didn't know I had vaginal atrophy and prolapse until the GP told me so I'm not very in tune with my vagina.

I mainly stick mine inside or on the outside flaps which means I can sit on my chair at work without everything feeling sore.

I am sure the stinging will resolve once the tissues begin to thicken up a bit in the next few weeks.

I’m not sure why your Gp is being so tight about the amount of Ovestin you can use. The dose is very, very low. So low it won’t affect any blood test results (I know this because I have a condition where I have to stop anything containing oestrogen periodically for any tests I have and Ovestin is the only thing I can continue to use as advised by my specialist during these times. I have seen two separate specialists - an nhs one and a private one at Newson health and both have said Ovestin can be used externally as much as you like - so I usually use it every day externally, a good malteser sized dollop (!) and internally 3 times a week. I often fill up the applicator slightly more than the recommended dose by forcing the plunger backwards to pull up more. I have sjogrens syndrome and if I don’t use it like this it’s as a good as chocolate fireguard. (I am on systemic HRT as well).

You can also take Biokault or another probiotic alongside the antibiotics which will help with gut bacteria etc. I am on daily long term antibiotics for bladder issues.

Have you had a bike fit done so that they can analyse your bike set up and positioning. They will also have saddles to try out, will adjust all contact points and pedals etc to help with comfort. Not just for riders who race but for all cyclists.
Not the cheapest solution (£150-200) but well worth it.

I horse ride, not cycling, but can experience soreness, especially after a break.
I had a surgical menopause 8 years ago and was not given any advice or offered HRT. It wasn't until I had a smear a couple of years later when I cried with pain that the nurse told me I didn't have to suffer like that.
I have VA and a bladder prolapse, it took a while but I convinced my GP to prescribe me daily vagifem.
When I was on twice weekly my bladder went into overdrive at night, sometimes I'd be up every hour for the loo even if I limited fluids.
Now I can go from about 11pm to 7am.
As for riding I wear heavy flow period pants and a pad, and have a gel pad on my saddle.

Hallo again mutterphore. Thanks for the update; I'm glad to hear that they have given you some Ovestin, although I'm sorry your consultant was uro and not gynae as well. As a Vagirux user I don't have anything to add to the eminently sensible advice from those with experience of Ovestin. I can only send my very best wishes and sincere hope that the Ovestin will sort out your problem. I know it feels interminable when you are going through it, but it's still early days so don't give up hope yet.

Loading dose (when you take it daily) is usually 2 weeks and some women are told three. If you do decide to take the antibiotics it's probably worth taking a probiotic, I mentioned the one I take upthread. If your bladder symptoms improve on the loading dose but then come back when you reduce to twice weekly then do another loading dose and then try alternate nights. Some women need the topical oestrogen nightly (I am one) but hopefully you won't.
You could try Yes VM to moisturise (can use inside and out). If the Ovestin is stinging it might be worth mixing it with a bit of moisturiser before you apply it.

OP I am not a cyclist but had been suffering from pain and soreness after walking, so much so that it would be painful to sit down. I had tried various creams.
I also had bladder leakage and pain during sex.

Saw my lovely GP - she did an internal examination and diagnosed vaginal atrophy and a prolapse. The prolapse can cause the UTI type feeling - needing to wee urgently / not being able to fully hold it in. (She also sent off a urine sample to lab which came back normal so we could rule UTI out).

I am now on Ovestin and after a few days I am already less sore. I have to use a little bit of lubricant to get the tube in otherwise it’s painful, but I am hoping that will get better over time.

Like you I had been managing my other menopause symptoms fine, and was reluctant to take hormones, but I couldn’t carry on like this. My feeling is that if the oestrogen cream means I can stay active then that is going to be a huge health benefit.

GP also recommended pelvic floor exercises.

I am surprised that your GP didn’t mention vaginal atrophy in the first place.

I do hope that the cream helps you!

Also your post implies that still no one has examined you for atrophy? Neither the GP nor the urologist?

Yes good point - has anyone given you an examination yet?

My (female) GP gave me an internal examination and I was nervous but it was fine, she talked through it all and explained how she could feel the vaginal walls were too soft, and where the prolapse was pushing. It helped me to know I wasn’t imagining it all.

Maybe you could try and see a different GP who has more experience of women’s health issues?

If that's right, it's quite shocking.

Would a different saddle help? I'm no serious cyclist these days, but was in my younger days. There's no way now I could cope with a ling thin saddle, but I'm as comfy as anything on the one on my pashley princess which is short and wide. Just a thought. Also the oestrogen pessaries are brilliant and make such a difference, I don't feel I need a wee every 10 minutes any more!

So glad you're using Ovestin now, @mutterphore. I had recurrent bouts of perimenopausal UTIs, and topical oestrogen has reversed nearly all of the symptoms. Took a couple of months to really notice the difference though, so don't feel demoralised if it doesn't appear to work right away.