Anybody struggling with vaginal cream or pessaries?

[SillyMillieMops]

I’ve been put on pessaries for urinary problems. (I’m already on HRT - post meno for 18 months). All fine for first month then I started having loads discharge and now it’s pink or brown tinged occasionally. Switched to cream last week but so far no change.

I really like it for bladder pain but not sure if it’s just not for me. The leaflet says you can have brown discharge for 3-6 months but wondering if anyone else has suffered the same?

Feeling really disappointed :(

Be patient these potions take time to work and reverse problems.

Thank you. I’m happy to leave it a few weeks but GP wants to send me for a hystoscopy. The urinary discomfort has actually gone, it’s the side effects that are worrying me. I just don’t know how common it is.

Go for the procedure

After reading the comments on here I won’t have it done without a GA 😔

If you’ve had kids it’s honestly not that bad OP

It seems a big jump from a slight discharge to a hysteroscopy. Why not a scan first? Far less invasive.

Maybe it's nothing to do with the vaginal treatment but more to do with the dose and type of your HRT. What are you using?

@JinglingSpringbells

Sorry, only just seen your reply. I’ve had a scan, internal and external - both fine. GP has done an internal and said everything feels fine and cervix looks fine. The side effects of estradiol cream and pessaries both say discoloured discharge for 3-6 months so I think hysteroscopy is strictly necessary just yet?

I was menopausal, went on patches 25, then 50 then 75 and take progesterone every night. When I went up to 75 I had a very light period but nothing since. About a month after starting pessaries, brown discharge started. I really think it’s due to that and would prefer to wait the 6 months to see if it settles down.

@SillyMillieMops Women on a 75mgs patch are advised to increase the progesterone if they have spotting (and that would include blood in discharge.) You'd use 200mgs a day (if taking daily) or 300mgs if using it on a cycle (12/14 days a month.)

This is in the BMS guidance an progesterone as part of HRT (it's a paper they have written and it's online.) If you want to show it to your GP I can link to it, but it's easily found by googling.

Your GP ought to do this first before an intrusive investigation.

If your uterine lining was thin and no abnormalities were seen, that's reassuring.

TBH I'm not aware of that info on the leaflets about bleeding for 3-6 months on vaginal estrogen. It's unlikely because it's not absorbed into the uterus.

The leaflet is the same in topical estrogen as it is in the systemic (full) HRT. I would think that guidance about bleeding is for women on full HRT.

Thanks so much @JinglingSpringbells - I did wonder whether progesterone should
be upped but when I googled it I got the impression that the jury was out as to whether it was necessary. I’ve found the paper so I’ll print out and read later.

If you Google side effects of vaginal oestrogen it does say bleeding or spotting for first few months, as does the nhs website. My leaflet enclosed in the box said it too. Apparently it’s to do with vaginal tissues adjusting to medication rather than uterus shedding.

GP is going to ring me at beginning of July so I’ll download the paper you refer to and ask if that’s the way forward.

Thanks so much for your help x

I know the leaflet (I've used the same thing for years).
The rest of the leaflet is about full HRT- all the side effects etc.

UK consultants have been trying for years to get those leaflets changed because they are incorrect; the listed side effects are for systemic HRT but the manufacturers have never changed them (using the same list for any drug containing any amount of estrogen.)

The NHS site is repeating what's on the leaflet.

Vaginal estrogen can be used long term with no added progesterone. This is because it doesn't thicken the uterine lining.

Usually the bleeding is to do with the 'trauma' of insertion because some women have very fragile lining to the vagina and even using the applicator can cause bleeding.

Hope you get it sorted!

Thanks Jingling, that’s really helpful.

The gift of menopause hey? It just keeps on giving 🙄