What is causing this burning

[Kizzyma]

I’m literally in agony with vaginal/anal burning . I’ve gone through the menopause and suffered with vaginal atrophy before so took hormone pessaries for about a week . When I was still in pain I went to the doctor . She said it was Vulvitis and gave me steroid cream . I’ve been using it for five days and the burning has got worse . The doctor isn’t open until Monday so I thought I would use some canesten - just in case it’s thrush . Now I’m in agony - it burns so much I’m shaking . I’m not going to be able to to sleep tonight and have no idea what’s wrong . Has anyone experienced this . No discharge or itching . Just severe burning .

Can you take an antihistamine?

That’s the one thing I didn’t think of . Thank you x

It may also be worth trying an anti-inflammatory painkiller such as ibuprofen until you can get back to the doctor.

Vaginal atrophy requires regular, ongoing maintenance. It's not something that clears up or cures itself. It could well be that, as whoever told you to use oestrogen pessaries for a week was waaaay off the mark. You're meant to do at least a two week daily loading dose and then ongoing twice weekly pessaries and external cream too to treat that area. You need both pessaries and external cream.

During and post menopause the vaginal flora can be disrupted due to a decrease in lactobacillus, this can lead to different vaginal complications, look up aerobic vaginitis, but there are other possibilities.

In your shoes I'd want a swab done at the GP. Then my guess is your first course of action will be vaginal oestrogen. If you can afford it I'd see a gynae privately who mentions menopause as a specialism. The wait for gynae on nhs in my area is over a year and GPs aren't the best when it comes to meno/post meno vaginal issues.

I saw a gynae for similar recently, she suggested I add in oestrogen cream and then, if that alone didn't work, a course of lactic acid pessaries to restore vaginal flora.

Will try anything

Thank you for your detailed reply . Will ask for a swab as soon as I can get an appointment which I hope will be quickly . I just need to be definite to what it is

What are you using @Kizzyma
Is it Vagifem?

Sometimes this can cause burning at first, as can Ovestin cream. It can be a case of 'pushing through' while the skin thickens and becomes less irritated.

However, I'd suggest you ask to swap to Ovestin because it's a slightly different kind of estrogen (weaker) compared to Vagifem which may suit you better. You can also use Ovestin externally which may be more soothing.

As a PP says, this is long term treatment . You won't see much or any changes in a week.

It can take weeks or even months to reverse vaginal atrophy and you need to keep up the cream forever.
If you stop, it will all come back.

In the meantime, something like Sudacrem may help but I'd definitely not apply steroid creams to skin already sore. Steroid creams are usually for diagnosed dermatitis or maybe lichen sclerosis. If it persists, a dermatologist who knows about women's health can be the next step or a gynaecologist but choose both carefully- they all have their specialisms.

Can you try slathering coconut oil on? Are you on HRT? I’ve had this when my oestrogen levels fluctuate. Hope you find something that works.

I was on Vagirux pessaries and then Ovestin and then the Dr said she didn’t think it was atrophy and gave me the steroid cream so I stopped taking the pessaries which is probably a mistake but I listened to her

I am on HRT . I’ve been on it for years . Not tried coconut oil . I feel like I’m sitting in a bowl of hot chilli’s

I'd go back to Ovestin.

Steroids are very powerful and should only really be used when prescribed by a consultant dermatologist who has had a good look and made a diagnosis.

Have been suffering the same, now improving. This may be a long shot for you but I've put it down to wearing long sweaters and sitting on them that are made from certain man made materials that dont give my bits the chance to breathe coupled with memory foam mattress topper.
Canestan cream causing burning is a known side effect and advice is to stop using it. I have discovered an OTC product from same manufacturers called Canestacool which gives instant relief better than orgasm

I'd try using a cool/cold shower several times a day and if possible not wearing knickers in the house if you're wearing a dress or a skirt.

You can buy vagifem OTC. i think it is called Gina. You could try that

so took hormone pessaries for about a week

Vaginal atrophy does not get better, it is irreversible. If you need vaginal estrogen cream you will need to carry on taking it for the rest of your life. Go back to the GP.

Yes to antihistamine.
Also, check your washing powder, fabric softener, soap, shampoo, shower gel. Any of these things can cause horrible allergic reactions.
A couple of years ago I was travelling in the far east and had a reaction to something. Who in god's name decided that putting menthol in panty liners would be a good idea? Or making toilet paper scented?
We have to be on the look out for this sort of thing.
But also agree with pp - you have to stay on oestrogen pessaries permanently to maintain the benefit.

This is what the OP has already been using- Gina is another brand name for Vagifem/ Vagirux.

Yes but only for a week. She could buy some to keep her going until the GP is able to see her.

I had this a few weeks ago. I think I suddenly got a reaction to soap. I tried lots of things, most of them irritated further. What finally helped was Sudocream, and Actigel. Oh and, umm, this is weird, but makes sense if you don't have a bidet, pouring a jug of cool water over your vagina after going to the loo. Very, very soothing, and cleansing.

A lot of women find Vagifem irritating as it's a stronger type of estrogen to Ovestin. The main point though is it's a pessary so can't be applied to skin externally whereas Ovestin can be.

How long did you treat for thrush? I never itch with thrush only unbearable burning. Natural live yoghurt might help.

Advanced practitioner here. Vulvitis just means inflammation of the vulva, and doesn’t indicate the cause. It could be an infection (don’t panic I dont mean STI!) or localised reaction to something as yet unknown. I’d be tempted to treat it as thrush in the meantime and request a swab. Steroid cream would worsen thrush. So stop if not helped. You can buy fluconazole 150mg oral capsule to treat thrush in the meantime, as it is severe repeat the dose in 3 days or get a longer dosage schedule from GP. I say treat straight away as swabs take a few days and it sounds like you are very uncomfortable.

also - you must completely stop using soap, bubble bath shower gel to wash. Just use plain water or unscented moisturiser if you want a soap substitute. Pat dry gently, don’t rub. It looks odd and avoid doing in the gym changing rooms :D but you can use a hairdryer on cool to dry the vulval and perineal skin before dressing. No (or loose cotton) knickers, avoid jeans and leggings for now.

The other thing to consider as a diagnosis as you say it is burning is nerve pain (vulvodynia) but this would be after skin infections and skin conditions are ruled out. This needs different oral treatments. And the fact the doctor called it vulvitis makes me think they saw something inflamed on examination.

hope you get some relief it’s miserable

Keep on the vaginal estrogen…..never use anything topical for thrush, only oral….take a daily probiotic…..pay for a vaginal screening….I had a strain of thrush not normally detected by nhs testing….it required a different treatment …..the screening will also show your good and bad bacteria….so a starting point for managing this

That’s definitely worth a go !

Thank you . I’ve been sitting with frozen peas between my legs