Getting diagnosed

[curlyrebel]

I am mid 40s and have been getting burning/itching/discomfort/swelling in my vagina. I spoke to my GP about it and suggested it could be peri menopause symptoms but she asked if I had any other menopause symptoms and I said no other than acne.

She thought it might be vulvodynia and brought me in to be seen by a nurse. At the same time she suggested I try vaginal moisturisers. Nurse took a look there and saw it was all irritated. Only said to try the VMs like GP suggested.

So I bought Yes VM and it hasn't really helped. Dryness hasn't really been that bad. I want to go back to the GP and get a proper diagnosis. What kind of tests could they do? And if it is vaginal atrophy, what could help?

Vaginal atrophy doesn't even look like it's officially recognised on the nhs website - they just say vaginal dryness! Which doesn't help me much.

On the acne, it wasn't something the GP took particularly seriously. She just suggested a cream which has helped a bit but not completely. Do any treatments for menopause help with this?

I don't know that there's tests for atrophy but I was having similar symptoms and my private Dr prescribed vaginal oestrogen tablets (in addition to 'regular' estrogen gel I've been taking) and it has helped significantly. I had a lot of acne flaring up in perimenopause but HRT didn't really help with that tbh, although I think oestrogen has helped with dryness (and trying to treat acne without irritating dry skin is an extra challenge that at least is mitigated).

Your GP seems pretty useless. I don't think there are any tests for VA, your GP should prescribe what you need based on symptoms you describe. OTC moisturisers are useless, at your age you need topical oestrogen. Go back and tell them you want a prescription for Vagifem or Ovestin. Follow the instructions to the letter - every day for two weeks, then two or three times a week. It should make you feel much better. If not, you might want to try HRT, but give topical oestrogen a try first.

You can buy vaginal oestrogen over the counter now. Why not give it a go for 3 weeks and see if your symptoms resolve?

Thanks for the advice. It's £50 for vagifem over the counter so I will try my GP again first. I have Mirena coil fitted - is that a problem to use these? Also seems like a few side effects with these. Anyone had any issues?

@apwilson1980 was it the estrogen gel that helped with the acne? Which one did you use?

Yes, I think doing the Oestrogel has helped someone with skin dryness overall. I do four pumps/day now but started at two/day I think. My skin was so dry at one point I couldn't wear any makeup and it seemed like no amount of moisturiser was enough (but I was worried that caking on the moisturiser was aggravating the acne...). So it's definitely improved some.

The progesterone, though, does make me break out grrr...

This is not as directly menopause related but the only thing that helped me with hormonal acne itself was going on Spironolactone. I don't think the NHS does it (got this private...) but it's an anti-androgen so it treats acne related to those hormones (often typcially acne on lower half of the face, chin, and back/chest acne and associated with PCOS). My dermatologist says that it's becoming quite common for women to use during menopause when the hormones start to go all over teh place. It can be a bit complicated though if you're doing testosterone with HRT since they would cancel each other out essentially. Anyway, just putting that out there in case it persists and you can't get anything else that works, perhaps it's worth looking into private dermatology at some point and asking about that as it can be quite effective for some hormonal acne.

Thanks @apwilson1980. Luckily at the moment my skin isn't too dry so I probably don't need the Oestrogel. I will keep in mind the spironlactone.

I ended up changing my skincare when peri menopausal due to acne. I now use Environ and within a month it had completely cleared. I never had any skin issues even as a teenager so it really blindsided me.