Atrophy - is it a problem?!

[Gardencraazy]

Any advice appreciated dear mumsnetters!

am late 50s, currently zero sex life (!!!) , on HRT patches, I do half patches to avoid migraine - at recent smear test, nurse said I had atrophy, ok no worries I said, feeling so embarrassed/ confused / worried! So she said nothing more! Maybe she mumbled about a cream but I rushed out 😳

Should I worry ?! Are there long term implications? Should I be asking for various meds or whatever to help alleviate?

Please help! Feel so embarrassed about it all!

Well not worry necessarily as that is not productive. But atrophy can affect your continence, can make the risk of prolapse greater, make you sore/itchy in your vagina, make sex uncomfortable and put you at greater risk of repeated UTIs.

See the GP for estrogen cream.

I never heard of vaginal atrophy til my late forties, and had already been experiencing dryness/discomfort for years.

I wish I'd heard about it sooner and taken steps to address it because it's a lot easier than walking around in discomfort, not wanting sex because it's sore, tissues damaging and all the other things that can happen.

I joke now that my vagina is the best kept part of my body! I do pelvic floor exercises every day which are easy (while I'm doing my make-up) and moisturise with cream every day (most people recommend estrogen cream from the dr, I just use organic coconut oil which I read about on here). I think the creams with estrogen are indicated where there's significant atrophy, so you should definitely go to the GP and investigate those, but if you think about it, you moisurise your face daily and take exercise for the rest of your body, so it's not that weird to have to do it for your vagina as well.

My sex life is 100% better than in my forties, when I didn't know all this stuff.

It is definitely a health problem and not just a comfort problem, as the thin skin can tear more easily, you can get infections, if you don't do exercises then prolapse or just incontinence beckon. I no longer leak ever after starting pelvic floor exercises, I wasn't incontinent at that stage, just the odd bit but it was persistent.

It's amazing to have it all tip top again and much easier than I thought, I thought going off sex and having horrible itchy feelings when walking were normal.

Big recommend for vaginal oestrogen cream. Throw away the plastic applicator and just apply with your finger, inside your vagina and all around your vulva. Keeps everything feeling comfortable and hydrated, and really improves sexual response

Definitely. Implicated in UTIs, but also can feel like a UTI when the area is irritated. A friend had several rounds of antibiotic, convinced she had a uti. Once she started vaginal oestrogen it cleared away.

ALso, embarrassment is a very weird reaction. This is a very common thing to happen in menopause, and is easily treated. It's not caused by anything you have done, or not done.

thank you for the helpful suggestions, is vaginal oestrogen cream from gp or over counter? Are additional supplements also recommended or would this be sufficient?

But auntie bionics that's not very helpful or kind telling me I'm weird for being embarrassed over this issue yknow?

Just get the cream. Either a prescription or from the pharmacy. It’s the same stuff.

You need a prescription from your GP. You can get vaginal oestrogen in the form of cream or a pessary. I've only used the cream

I've had a tube of the cream sitting on my dressing table for months and haven't used it yet. My menopause nurse recommended it as she said I had atrophy. I don't have dryness but do often get spots and sore down there. Also the skin has darkened in that area and she said that was a sign of atrophy.

I would recommend that you ask the receptionist which GP they would see for menopause related problems and ask to book in with them. They will prescribe some vaginal oestrogen cream, it’s really important to treat atrophy as can cause issues with bladder, prolapse, soreness etc. don’t be embarrassed, they will be happy to help you.

Do use it, @Bluemat !

OP you can get one over the counter I think, but your GP will proscribe it too. They don’t need to examine you. There’s pessaries and cream. Both work fine.

I know what you mean, I felt a bit embarrassed when I was speaking to my male doctor, whom I've known for years, about wanting some oestrogen pessaries as it was in the context of problems with sexual intercourse. I wish that this knowledge about vaginal health, exercise and the potential for atrophy was covered in sex education at school, although I'm sure if we learned about it age 13, it would have no relevance. Perhaps during/after childbirth, but many women don't have children.

I have started to wonder if this age-old trope that women always go off sex during peri and menopause is partly caused by not knowing how to maintain vaginal health as our hormones change. I thought it was just inevitable that it would decline, but looking back, I'm pretty sure that the decline was partly about discomfort and partly the effect of years on oral contraceptives. With minimal exercise and moisture, it seems to have reversed a lot of that. It's at least knowledge we should be able to discuss and share without embarrassment given it happens to pretty much all of us

I was diagnosed with atrophic vaginitis- my god l knew l had it, if lmwent for a bike ride or wiped too hard l suffered for the rest of the day. It only started out a bit dry so l am back on localised hrt/pessary which feels so much better. Doctor couldn't even examine me it was so painful.

Embarrassment is a very normal reaction. We as women are forever being told how we should and should not feed about our bodies, so it's very normal to be confused and embarrassed!! You were probably trying to be kind but telling someone their response is weird isn't it.

@Gardencraazy the cream is amazing, get on it!

It's very very common OP, cream and pessaries will make all the difference :)

there are ling term implications around recurrent UTIs (there's a reason old ladies in care homes always seem to be on antibiotics for UTIs), thinning skin which can tear and bleed and problems with recurrent chronic itching which is miserable and uncomfortable

If you want a cream with oestrogen in, which I think you do for the atrophy, that is prescription only. My GP did it over the phone. They don't need to examine you especially if you say the nurse says you have it.

Why haven't you used it?. It's great stuff

I've got the pessaries, they're great, highly recommended.

Get Estriol cream on prescription and you will be back to normal. Vaginal atrophy brings other delights with it, such as dryness and itching, pain on peeing, more likelihood of UTIs etc etc. It’s a simple and transformative treatment. You put a bit inside the vagina using the applicator, then also dab some on the skin all over the vulva. Honestly it’s amazing.

I use the pessaries, found the cream a bit messy and I reacted to it
You do a loading dose first then twice weekly

I find Gps are so hot on it now as a preventative for Uti they check at every appointment, even for other things!
Brilliant imho
UTI/ Sepsis is a major cause of ill health, confusion and death in elderly women and so easily prevented with oestrogen pessaries/ cream
Of course the urgency caused by lack of oestrogen means they avoid adequate fluids and its a vicious cycle

Those on estriol, do you use every night? If I drop down to 2 nights a week all the symptoms come back again.

I keep an eye on how I feel, if there is the slightest twinge I up the frequency for a bit.

Generally the symptoms shouldnt return if you are consistent but everyone differs
Are you on systemic hrt as well?
I know a couple of women on pessaries and cream to use externally

Get the cream