Crazy Itching , too much estrogen ? Lichen Sceloris?

[Maltybiscuit]

For background I recently 5 weeks ago started HRT patches 2 weeks estrogen and then two weeks combined estrogen and progesterone.
I've had vaginal and anal itching for years now I've never really done anything about it I just thought it was me and that's how I am.
Since starting the patches the itch has got worse and has taken over my life I'm just so uncomfortable it's making me cry. There's nothing to see no white patches ,.it's maybe a bit shiny on the perineum but the itch is insane.
I'm in the UK and it's a battle to get to a GP but I did get to one Monday and had an internal examination, she said everything looked normal , I talked about Lichen sceloris and a biopsy but she said I didn't need one.
I should add that I also use Ovestin everynight inserting with a syringe as advised 5 weeks ago , this has helped with my urge Incontinence that I'd also developed.
The GP on Monday prescribed Clobaderm ointment just for four weeks and if that's not helping to go back and we can 'talk' about a gynae referral.
I don't really know what I'm asking as I have no diagnosis.
I think maybe I'm on too higher dosage of estrogen in the patch ?? Or the crazy itching is something else.
Can anyone relate ?
Thank you

Hi! I think we spoke about our probs with these symptoms about a month ago? I started on the Ovestin around the same time as you. I smear it around the outside, over the urethra and then put a little bit inside. It’s stopped burning, urgency and constant need to wee. I suffered for 5 years and it’s made so much difference. Do you put it on your urethra or only inside with an applicator? If I have itching on the outside I also put it on that x

Hi @Tidsleytiddy yes we did ,.I've been using it as directed ans rubbing on the outside too ,.I think it's making things worse hence me going back in tears on Monday, I can't sleep ,.the pain and uncomfortable feeling is driving me mad. Ive washed all my underwear in just water on a hot wash , I'm eliminating sugar , I'm exercising more I just cant stop it , it's vaginal and anal , I'd say it's wrecking my life.
Maybe Everol 50 is too high for me ,.my anxiety is crazy but I think it's the itch that's making me so anxious.
I'm glad to hear its working for you

Have you been tested for thrush?

Why not try some Canestan cream locally and / or an oral tablet for thrush?

Using Ovestin can cause thrush (I think it's listed as a side effect) but it tends to settle down once the pH balance is sorted.

Why are you using it nightly for 5 weeks?

The dose is nightly for 14 days then 2 x a week (or more as needed.)

Even inserting it, some always 'escapes' and it will work its way down.

Maybe you need to cut back on how often you use it but also treat yourself with an OTC treatment for thrush.

Thanks @JinglingSpringbells yes I've been tested for thrush all clear.
After doing the two weeks loading with the ovestin I went on to 2 x a week for maintenance bit things got worse again so I asked for advice from the GP and she said to up it again as it wouldn't harm.
Things then got worse so I had an internal exam on Monday and she's prescribed Clobaderm just for four weeks before she thinks about a gynae referral.
I've also tried a fluconzole tablet and been treated for worms , this is over the course I'd the last few months.
I feel like I'm at the end of my tether.
You know when you have a UTI and you just can't think of anything else , the itch is like that it never goes away or settles down.
My sex life is no existent and I just feel at the age of 45 I'm totally defeated by this.

The nurse practitioner gave me hydrocortisone cream 1 per cent for this. Instant relief. You appear to be able to buy it online, indont know if you can buy it OTC but quite possibly.
You can only use it for a week so I am then going to be examined to see what the cause is. Whether it's atrophy or fungal.
I too was in tears with it, sending much sympathy.

Well, I'd cut back on the Ovestin and use it less. I honestly don't think a gynae referral will help because they have no other cards up their sleeves. There are much weaker forms of vaginal creams and pessaries for women who need less, but that doesn't sound like you.

I'd try another fluconzole tablet if it's weeks since the last one. You could try a very weak hydrocortisone- E45H is one - but you can't say it's for your bits as they won't sell you it!

Thanks @Snapfel awful isn't it , what's weird though is apparently there's nothing to see !
I've got Clobaderm ointment which is a strong steroid , it's not instant relief unfortunately and I'm still suffering. Don't know what to do with myself other than be at work and try and power through. I still think it could be LS but I need a referral for that and she was reluctant as of yet.
I hope you get some answers soon 🙏

@Maltybiscuit sorry to hear you’re suffering like that. Just an idea, but how about trying Optibac for Women tablets? They are proven to reach the vaginal area and help with the PH and flora etc. Truly when it’s happening to you you can’t focus on anything else. All you pray for is it to stop and each new “thing” you try you hope will be the “cure”. Remember: no baths, no soap/scented products anywhere near the area. When you wipe after a wee just dab don’t sweep the loo paper across x

@JinglingSpringbells I'm hoping a gynae could rule out Lichen Sceloris for me as it's definitely a contender.
If I cut back in the ovestin I get urge incontinence again which had settled down.
It's like a vicious circle with it all.
I can definitely try another fluconzole tablet for sure.
I am wary using the clobaderm ointment as I know it's very strong.
Maybe the Everol 50 patch is too high and I need a 25 ??
Non of my other symptoms have gone away five weeks in but maybe I've not given it enough time yet and just need to power through to three months and see where I'm at then ?
Thanks for all you advice

@Tidsleytiddy something to look in to ,.I'm so wary of trying new stuff as it generally makes it worse but I am open to ideas of course.
It's such a battle seeing a GP so doing what I can in the mean time.
I'm following your advice on swiping and no products and I've washed my underwear separately on a hot wash with no detergent or anything.
I pray something helps me soon

LS shows as white patches. You say you don't have those.
It takes years to develop usually. This is a risk factor as a very small percentage of women with it can develop vulval cancer which is why a diagnosis is essential early. But you don't sound as if you have that. Why do you feel you are a 'contender'?

I doubt very much it's the patch dose.

Do you have over active bladder? Have you had a proper diagnosis as urge incontinence and OAB are similar. Urge incontinence supposedly happens at any time often when you hear running water, or clean your teeth etc.

I'd still suggest cutting back on the Ovestin OR changing to Vagifem which is a pessary and won't 'leak' like the cream so you might see if that helps. You could be allergic to something in the cream.

You can buy Vagifem OTC if you are over 50. It's called Gina.

@JinglingSpringbells my symptoms fit with LS I have some shiny areas but no white patches , the doctor says people don't always present with white patches.
The ovestin seemed to have cured the urge I was having almost latchkey incontinence and some bladder leakage I was happy this seemed to be under control and also working on pelvic floor exercises as well.

I need to try and get another appointment as I clearly can't go on like this it really is taking over my life.

Thank you for your advice 🙂

@JinglingSpringbells I'm 45 so wouldn't be able to get the Gina

Yes it's horrendous! Nothing to see here either. Except now redness from all the scratching I think. I'm just so grateful for the hydrocortisone. I'm sorry the steroid cream isn't working for you. Another appointment sounds like a good plan, maybe a second opinion?
Best of luck.

OP

Have you had your blood sugar measured? Itchiness can be a sign of type 2 diabetes.

What ever it is I hop you get sorted soon.

@sashh I'm having my Hba1C done next week so hopefully can rule that one out or not as the case may be
Thank you

stupid question maybe but have you tried seudocrem? It works for me, no idea why or how.

@ghi thanks , yes.i did they this a few weeks ago but sadly made no difference , it was definitely worth a shot though

LS doesn't always show as white patches (and it doesn't always itch either).
You would be better off seeing a dermatologist than a gynae, IME gynaes
and GPs do not have a clue about vulval skin/auto immune problems.
In the mean time fexofenadine might help, (anti histamine which may stop the itching though the steroid should help) and worth joining the excellent Lichen sclerosus facebook group.

What are you washing your clothes in and what are you showering with? I (probably, it's complicated and the derm isn't 100% sure) don't have LS but my current diagnosis is eczema and a lot of the advice is the same: white cotton underwear washed in unperfumed non bio (most non bios are perfumed), no baths, shower using an emollient such as Hydromol or Epaderm (and use as a barrier if you have to wash your hair in the shower) and moisturise pre and post loo with an emollient. I have also found bamboo loo paper helps as paper stuff just feels like sandpaper.

I hope you start to feel better soon, it's miserable.

@Maltybiscuit I have just caught up with your post. Did the issue resolve itself or are you still looking for answers?

@Iloveanicegarden yes thankfully things have settled I went back to the GP and came off the HRT after 8.5 weeks we agreed it had made me feel worse than I felt before. I also went to a sexual health clinic and had a full examination and every swab and test they can provide there , she said she could see some paper type cuts which didnt surprise me as the itch had been insane, she also confirmed she could see no signs of LS. My GP also has referred me to a vulval dermatologist however the waiting list is long. I have ovestin , vagifem and clob if I should need them.
All of my peri symptoms seems to have completely vanished so happy days for now at least!

I had the biopsy last week and await results. The whole thing took years to diagnose and it’s driving me crazy

Yes it does suppress the problem but not solve it

Yes I treated worms, cystitis etc. took an emergency appt with doc to get anywhere after years. Not sleeping because of it. Wreaks your health.

no soap in the shower, no baths, change your underwear (cotton) several times a day.

E45 cream helps cool and can be added to the meds to help application.