Interesting article on UTIs, menopause and estrogen

[WhereAreWeNow]

https://www.theguardian.com/society/2023/dec/17/millions-of-women-are-suffering-who-dont-have-to-why-its-time-to-end-the-misery-of-utis

I thought this was really interesting. It makes me wonder if I should ask the GP for estrogen cream/pessary. I'm on HRT (Mirena and patches) and I don't generally get UTIs - although I did all the time in my 20s - but I do still need to wee A LOT. I go 2 or 3 times before going to bed and I still often wake up in the night for a wee. I have to limit my liquid intake if I'm going to be out and about without a toilet nearby. Is that reason enough to try the estrogen cream?

I use Ovestin cream for other reasons, & I don't think it made a difference to how often I needed to wee. I was having exactly the same issue of needing to get up in the night several times & tried bladder training (not via the doctor, just following instructions online) and it's worked really well for me. It took a few weeks, but most nights I don't need to get up at all now.

It's basically a combination of doing lots of pelvic floor exercises plus gradually building up time between visits to the loo. Link to one explanation of how it works.

Thanks @Sadik - I'll give bladder training a try. Glad it's worked for you.

UTI's were a major factor in me starting HRT (Elleste Duet + Ovestin). Never had one in my life and then 3 in 12 month period (age 48) Not had one since HRT started

I started ovestin before I started HRT. I was the aame, always weeing. Couldn't do an hour long dog walk without needing several wees.

I now go 8hrs at night without waking for a wee, and I wee about 5 times a day instead of about 15.

I still have a sore vulva though. In fact it's worse than before I started!

I started Ovestin cream in an attempt to try and improve how often I need to go to the loo but unfortunately it didn't help. I'm still up about 3 times each night to wee-it's awful! The cream has been fantastic for vaginal dryness though so I'm happy to stay on it.

@Sadik It's good that you have found a solution but there there are different bladder conditions. Bladder training works for over active bladder. This is a muscle-type of problem where the bladder gets used to working overtime.

Bladder training alone won't work when the bladder lining is thin because of loss of estrogen.

GUS is what happens then is the lining is so thin (because estrogen keeps it plump and healthy) that the urine (acidic) irritates it.
It can't hold as much, it shrinks, and it feels the need to empty more often.

Using vaginal estrogen restores the the tissues of the bladder and the surrounding tissue to keep them healthy. It works at a cellular level, changes the structure of the cells from fragile, and liable to damage, to how they should be.

I got a really bad UTI a few years back, days before Christmas, that absolutely floored me. I’d never suffered with them before so thought it would be a one off, but it wasn’t. 6 weeks later I got another, which meant more antibiotics and it went on like that for over a period of 15mths in which I had 9. I ended up on a daily dose of antibiotics to try to prevent them, was never referred and no one ever mentioned the menopause to me, although I was on HRT.

18mths ago I moved doctors which meant a check up so I spoke to the female GP about antibiotic resistance. She straight away said I needed to come off the antibiotics and try Vagifem pessaries instead which we did. I haven’t <touch wood> had a UTI since. I take a daily dose of d-mannose too.

It really annoys me that I spent almost 2 years of my life on antibiotics unnecessarily. I’m sure if men went through the menopause there would be more knowledge about how it affects so many different functions of the body.

Exactly! I think the issue is that many of us myself included use vaginal estrogen but still don't see an improvement. Which is why it's worth knowing that lack of estrogen isn't the only potential cause of the problem.

Ovestin does totally solve my soreness & itching. But again other women might have other causes for a similar problem, like the pp who still has a sore vulva.

@Sadik It's probably better to always try topical estrogen first because 'holding on' with bladder training won't help and can make things worse, as the urine irritates the bladder the longer it's in there.

@Moredarkchocolateplease Have you used Ovestin on your vulva? It can be used there as well. The guidance is to use a pea-size blob every day until you start to feel some improvement.

For sure - and for the other benefits as well

Im at my wits end with getting broken sleep by needing to pee twice a night. Ive used vagifem for years and tried oxybutynin, which i didn't like the side effects, so am now trying solefenacin. Hrt didnt help either ..

@Moredarkchocolateplease it might be worth adding a vaginal moisturizer a few times a cc week to your regime as well as topical oestrogen cream. Can I recommend Yes Organic? Saw it recommended in a menopause book.

@Amara123 and @JinglingSpringbells yes, I use ovestin on my vulva, I smother it at least twice a week if not more.

I also have some yes moisturiser, although I hate the consistency, I'd much rather use a cream. And I'm still itchy.

I've changed to Trevarno soap this week which doesn't contain glycerine.

I can't use cetraban or those medical emollients, they make me feel queasy, I don't like using liquid soap.

I've also had a lifetime of excema and I hate emollients anyway, they always made my excema roar, so I instinctively don't trust them! (which is a bit nuts but things you hate as a child, stick!)

GP says I'm fine (I've seen several female GPS over the summer as I had sores on my vulva and needed trimovate and eumovate, so assume if there was anything wrong like lichen S, they'd had spotted it).

Anyway, didn't mean to derail OP!

OP, have a look at Kassie Dewitt an American pelvic physio, also follow Kelly Casperson and American uro gynae. Both women could help you a lot, their advice is amazing. Kelly Casperson has a fantastic podcast 'you are not broken'. Which can be eye opening at times!

@Moredarkchocolateplease Has no one suggested that you stop using any soap at all? Medical advice is women clean their vulva with warm water, not soap. And you don't need to slather Ovestin on- just a small amount, rubbed in daily might work better.

@Moredarkchocolateplease thanks for those tips. I'll look those people up now and listen to the podcast.
Next time I see the GP I'll ask about getting some estrogen cream.

Hi. I’ve been using Ovestin cream since March and it’s changed my life. I had one UTI after another. Endless antibiotics. Constant weeing etc. I’ve now been UTI free, no burning or stinging. I’ve retrained my bladder to hold the wee for up to 4 hours. Honestly I was going like a waterfall before. It’s the Ovestin that has plumped up the cells. It’s been like a miracle. Do give it a try x

@JinglingSpringbells yes, and I have tried that. It didn't make much difference and more importantly I felt like I wasn't clean.

After I exercise I get really sweaty in the pubic hair and leg creases and I am also prone to a bit of urinary incontinence, and I feel like I might smell without soap.

It's only the last year I've been itchy really. Though I had loads of thrush after I had my children in my 30s. I've been using non scented soap with no issues for years. Hoping the Trevarno makes a difference.

And re the ovestin, I use about the same amount as I use internally, externally using the applicator as guidance.

GP tells me I look dry, hence telling me to use emollients. She also told me to use vaseline which made me sore. But honestly I think it's mainly caused by the fact that my labia have disappeared (I bloody well wish someone would have told me this would happen!!)

I followed the thread about the lady with the bike and sore vulva earlier this year. I'm now roughly in the same position, wearing jeans is so uncomfortable!!

And re the ovestin, I use about the same amount as I use internally, externally using the applicator as guidance.

That sounds a lot.
The applicator dose is for internal use.
I use about 1/3rd of that externally if I need to.

It's worth considering that the Ovestin might be setting up an allergic reaction. Some women do find it can make them sore to start with but as the skin thickens, it eases.

Thanks @JinglingSpringbells I've been using it for a year, so I don't think it's an allergic thing.

Hi, please listen to this brilliant award winning new podcast on chronic urinary tract infections (CUTIs), highly recommend if you're wanting to learn more about the little know topic of CUTIs. Its brilliantly researched and a really important topic everyone should be aware of that aims to help women advocate for themselves in the face of stubborn GPs and a medical world that has historically ignored womens health.

https://open.spotify.com/episode/54Thd0K0vAkSeJrZGoyz56?si=jtGi8mVRRG-DlnxLbwajbg