Who knew your fanny shrivelled up and ran away when you hit mid 50s!?!

[shrumps]

I certainly didn’t and I miss it! The only part of my body to become skinny and Im absolutely pissed off. Why did no one tell me about this?? And now I feel I can’t tell anyone else in case it’s just me.

I agree with everything you say, by 'accommodating' I meant many people with hypertonic pelvic floors have vagisimus or difficulty using toys because their muscles overtighten to make up for laxity elsewhere.

In an ideal world, all women would have access to a pelvic floor physio after birth and premenopause, could get checked and get the type of valuable advice on this thread. I think that almost never happens and some won't be able to go private, but myself, I don't think that should put people off thinking through whether to try kegals, if you follow the Female Physio online then they are good at distinguishing stuff most people can try and when to seek help. I don't think it would have been sensible for me, with no history of UTI or burning/frequency, to have waited to start kegals and millions do do them, although you are right theye are not suitable for everyone and that's a danger with a blanket approach, but there's a danger in not acting too.

Many people won't even know you can book a pelvic physio at a local private hospital, it was very easy and pretty cheap for us.

The older forms of HRT like premarin oestrogen, taken orally, did increase cancer risk, as well as the synthetic progesterones.
As far as I understand it, topical oestrogen doesn't actually increase risk and might be slightly preventative. Bio-identical progesterone eg utrogestan does slightly elevate breast cancer risk from 5/100 to 6/100. However it's pretty vital for women that still have a uterus to keep the lining thin - taking unopposed eostrogen whe you have a uterus will give you a significantly greater cancer risk.

Topical estriol creams/oestrogen tablets use really small amounts, I think something like a year's worth of topical use equates to one day of systemic HRT, so the risks are very low indeed.

I had endometrial cancer and hence a hysterectomy in June. I'm allowed to have local estrogen but not systemic HRT.

The consultant told me the dose is so small that it's fine. It was estrogen-driven cancer. Opinions do seem to vary but I can't manage without local HRT.

I'm sorry about your experience @UnaPersson
However, if you feel you need HRT there is a different perspective on it from the BMS, which is worth knowing about.

You can read the guidance here in their report.https://www.bgcs.org.uk/wp-content/uploads/2024/08/BGCS-BMS-Guidelines-on-Management-of-Menopausal-Symptoms-after-Gynaecological-Cancer.pdf

There is limited evidence in the literature around HRT after treatment for endometrial cancer. A Cochrane review assessed the available evidence with data from one randomised controlled trial that closed early and two low-quality studies, and found no evidence of increased recurrence for use of HRT after endometrial cancer.36

The randomised trial contained 1236 participants who had FIGO stage I-II endometrial cancer and the rate of tumour recurrence was not significantly different during the 36 month follow-up (2.3% in the estrogen arm versus 1.9% receiving placebo (RR 1.17)). 37 A meta-analysis by Shim et al based mainly on observational studies showed no significant increase in recurrence with HRT use following endometrial cancer, irrespective of tumour stage or type of HRT.38

It is advisable to await final pathology and the potential need for adjuvant treatment before discussing menopausal symptoms and management with the patient. With low and intermediate risk endometrial cancer it is reasonable to discuss both systemic and vaginal estrogen.

@NancyThompson The stats you posted don't sound right (unless you have a link to it?)

There is no data about the risks of using micronised progesterone, other than for 5 years, where no additional cases of BC were found.

The stats that are available for the types of HRT that were included in the studies were all the older types of progesterone.

They show a possible extra 4 cases per 1000 women over a 5 year period.

Estrogen only is not shown to increase breast cancer, but combined with any type of progestogen it may.

Transdermal is no different in cancer risk to tablets.

@shrumps
Just wanted to thank you for this thread, and the hive-mind of MN. I read about 4 or 5 pages and realised I had the symptoms of this delightful condition. I had been ignoring them and putting all the extra weeing down to other things. Can't believe I got to 64 and didn't know it was a thing.
Anyway, just back from my GP. She checked me over, I do indeed have need of the oestrogen gel. Thankfully on free prescription.

I also had a hysterectomy in June due to endometrial cancer but I’ve been allowed Evorel Conti patches. Mine was caught early, it was grade 1 and stage 1a and I didn’t need any other treatment after the surgery so my surgeon cleared me to get the patches so I’m honestly so grateful to her for that.

I might ask the GP about a cream after reading this thread though. I freaked myself out the other day as I’d been quite sore and itchy and then when I went to the toilet there was a lot of blood. It was just from a little cut but after everything I’ve been through this year I straight away thought the worst again.

That's interesting, @JinglingSpringbells. The surgeon said a definite no for me, but the Macmillan nurse said a case could be made for HRT.

I'd be too scared, but we'll see how that goes.

I don't want to derail the thread everyone!

Ok
Nothing you have written applied to me so I wont be discussing it further

@Saltedcarameltiramisucheesecake just checking you know it's not gel for vaginal atrophy, it's cream?

Oestrogen gel is systemic HRT
Oestrogen cream is localised for vagina and vulva

Well mine went grey. The colour of a full body tick.

Its very pink again now!

I also never looked at my vulva. But the prolapses and atrophy made it necessary. I tell you what though, looking at my vulva post surgery made me feel very sick!

@shrumps Thank you for starting this thread, many of us will be feeling much more informed and physically comfortable after reading everyone's posts and getting the right support.

My GP prescribed Estriol without hesitation and I'm already feeling the benefits after 2 days. Am grateful, but also frustrated that often we don't understand what's happening to our own bodies and what to do about it!

The funny comments have made me smile, and made lots of fanjos, minges, fanjitas and foofoos across mumsnet will be much happier now. Will be spreading the word!

Oh god. I'm forty-one and after reading this thread, I'm dreading the aging process even more than, I already was.

Honestly this is a minor part of ageing.

WTF!? When you say it shrivels up, how bad we talking? 🫣 mine has always been…how do I put this….too puffy 🤣🤣 so I’m hoping mine goes nice and skinny

Wrong
Genitourinary syndrome of the menopause is causing severe discomfort and distress not to mention the catastrophic effects of Utis in older women
Confusion, delirium, renal failure, falls, sepsis and death
Not to mention the pressure on health services that is preventable

@Autumnallaround
Yes, she did say it was the non systemic cream, actually. Haven't got it yet, my pharmacy had queues out the door today with people getting flu jabs.

@Saltedcarameltiramisucheesecake phew!!! Enjoy your happy cream!

I actually have oestrogel systemic and Blissel gel for topical vaginal use, because I react to estriol vaginal cream.

@Changedforsafety it was a reply to @Saltedcarameltiramisucheesecake not a reference to you. 😊

Lichen schlerosus makes fanjos even more of a hotch potch...

Everything I’ve read on here is a minor part of aging?
Christ I might as well chuck myself in the local river now. Cos the future ain’t looking too rosy then!

I can’t remember who posted about inserting pessaries slightly lower?
I’ve done this for the last two occasions instead of high as previously instructed, but I have felt mild stinging/ burning shortly after?

I personally wouldn't. If you think about it, everything that starts up high eventually works it's way down, and using them low means the top section of the vagina gets no hormones.