Vaginal atrophy even though I am on HRT, anyone else?

[Redfox]

I had a hysteroscopy yesterday for some post menopause bleeding. While the Doctor said my womb was ok, I did have vaginal atrophy ( just great!)

I thought would be covered as I have been on HRT for around 4/5 years. On a patch 100 and take Utrogestan 100 at night. Have regular sex ( once a week is regular isn't it?) Use lube.

My vagina/ vulva has not appeared sore or dry, however I have been having some urinary issues recently - you know, urgency and dribbling and all that stuff so I suppose that is related to the atrophy. Yep I suppose my pelvic floor has gone off slightly for a burton too ( but sex still feels good)

Has this happened to anyone else?

I do have some Estriol cream and I have a bit lax in using it so will start using it regularly.

Does anyone know if estriol cream comes in different strengths? Mine is estriol 1mg.
Can the doctor prescribe anything extra for me?

Does anyone else know what I can do/ use to help with the blasted atrophy?

Any tips welcome..

I have this and have had it since I went through menopause aged 37 due to autoimmune issues - I’m now 43. (Weirdly enough I’ve just yesterday had a hystoscopy myself)! Anyway, the only thing that’s helped is Ovestin. Systemic HRT doesn’t tend to do much for vaginal atrophy and most women need to use both types- I can’t use full HRT anymore due to lupus related issues but I can still use the Ovestin as it’s low dose but enough to “work”. You do need to use it consistently though- it only works if you use it 2-3 times a week and every single week. If you stop it will come back.

As the poster above says.

You have to use vaginal estrogen, regularly, and not give up on it.

A lot of women use both- systemic HRT and local estrogen.

It can take 6 months of using it regularly to make good changes.

The dose you have is the highest. It's not 1mg. The total amount of cream per application is 1mgs but the actual amount of estrogen is 0.1%.

If you've not used it for a while, start with the 14 days loading dose- daily for 14 days then 2-3 times a week.

There are other more holistic options available which can help with dryness and atrophy.
using thermal treatments ( High intensity Focused Ultrasound) can help with the increase of the collagen’s. These then “plump” up and give more elasticity.
it’s quite amazing really.

Just be aware that HIFU and laser are very different - laser won’t get as deep as you need to help with atrophy.
If you need any more information feel free to drop me a message.

Yes, you need topical estrogen as well as hrt.

Not available on the NHS though and not all are as good as they sound.

Vaginal estrogen is very safe so why would anyone look for an alternative that's invasive? Genuine question.

You’re absolutely right not all treatments are as good as they are advertised, that’s why it’s so important to do the research.
your also right with the fact that these treatments are not currently available on the NHS, although I believe some areas have arranged charitable treatment's - sorry I don’t know the details just something I heard- fingers crossed.
The HIFU is safe and builds up the deep areas providing a kind of scaffold so help with other issues like the incontinence. It’s also rejuvenation of the body and so can remove the need for the use of the estrogen which has to be used regularly.
its also not really invasive. The probe is inserted in the vagina ( like an internal ultrasound) but that’s all.

Hope that helps.

I guess it depends on how bad it is. Some women with advanced VA can't tolerate smears or probes as they've shrunk too much.

Thanks all and I have started to use the estriol cream lying in the drawer. I have made an appointments with Dr too, to see if there is anything else they can prescribe.

But wondering if there is another cream would be more effective.

I won't be going down the invasive treatment route.

I am pissed off about it as I don't appear to have any other symptoms ( not counting the boring minor urinary issues that need addressing I know & I have downloaded the Squeezy app)

I wonder why this happens to some women and not others...

With the cream, I was told to use it every day for 2 weeks and then twice a week after that. I use the cream on the day I change my patch. It has made a massive difference. I was having so much pain and discomfort, lower abdominal aching, UTIs, itching... just awful. And the cream has made a massive difference.

I know, the sad thing is if we were more aware before it got too far advanced there are things that could help. Its lack of education with the healthcare sometimes that lets us down. whilst women’s health is becoming more talked about and educated it’s still no where near enough.
😪

Maybe because they are told thrush/irritation down there is a sign of diabetes.
5 years ago I believed repeated thrush was just type 2 diabetes onset.
Despite having the most excellence of blood sugar control and the last routine lab result classification was actually that of a pre-diabetic.

Most recently a GUM clinic / sexual health clinic were like no wonder you can’t tolerate internals. How did I get through all these health professionals / surgery down there without this known.

Yes I have this with a host of symptoms (urinary leaks, dryness, painful sex etc) - I use HRT patches + utrogestan, AND estradiol pessaries!

I remember noticing a significant difference after the loading dose, but the benefits dwindled once I reduced to twice a week. Perhaps I'll have to try it 4 times a week or something, but sex is back to being almost unbearable. I use silicone based lube and a lube launcher and everything!

There is nothing else they can prescribe.
The options are Ovestin or Vagifem.
Vagifem is a slightly different form of estrogen and a tiny bit stronger but women tend to make the choice based on whether they want a cream or a tablet to insert. And cream can be used externally.

It's not worth wondering why some women get it and some don't.
Many do, but don't know what it's called, or what it is, and don't get treatment.

The key to getting better is to use it regularly and long term.

Have had two abandon two smear tests because of this, sheer agony as well.

Ask for an Estring - it's the equivalent of 5 doses a week in a silicone ring which you leave in for 3 months before changing. Or ask your gp to up your prescription to 3 or 4 times a week.

I use it daily as private gynae gave me a prescription for daily use via GP.

It has saved my life. I could barely sit on a chair before.