pessaries plus estriol cream?

[TipsyLaird]

I have managed to win the fastest finger first contest with my GP and secured an appointment in 2 weeks to discuss my symptoms.

I have been on estrogen patches around 5 years and those are keeping me sane, non-suicidal, and have sorted out my insomnia and hot flushes. About 2 years ago, after repeated UTIs, the GP diagnosed atrophy, added in estriol cream and that has sorted out the repeated UTIs too.

But over the last 6 months or so I have been so sore externally. I thought it was thrush and treated it as such and it did subside after 2 canesten pessaries and two tubes of cream. What makes me think it's maybe not thrush is that I have none of the typical discharge, and I read it's rarer in post-menopausal women. I have been moisturising using cetraben cream and using sudocrem.

So my plan is to ask for the GP to swab me and see if there is anything going on with my biome. To ask whether there are signs of lichen sclerosus and if so, for a referral to a specialist (which will take 18 months at least and which I would probably end up going private for).

And finally, to ak to try a vaginal pessary for the internal estrogen, and to carry on with the cream for the external soreness.

Does all that sound reasonable and am I missing anything?

I have tablets - use 2 a week. I like it as not messy.

You didn’t mention progesterone…? Or testosterone.

No progesterone - I have had a hysterectomy.

It's perfectly acceptable to use pessaries and cream.

You can buy cream over the counter or online- it's called Ovesse and the criteria are you are over 50 and post menopausal.

This is my next option if the GP won't prescribe. I have had such poor advice and support from my GPs that I have lost all confidence in them to be honest. I do think I need to be swabbed and examined to rule out anything else before I go down the self-medication route.

https://www.bad.org.uk/pils/lichen-sclerosus-in-females

How will lichen sclerosus be diagnosed?
The diagnosis can usually be made from how the condition looks. This is done by a healthcare professional who is experienced in diagnosing and managing the condition.

TBH you need examining by a gynaecologist or dermatologist if you're worried as GPs are not experts.

You can buy tests in the supermarket to spot thrush. (Do the swab at home.)

Given it might take 2 weeks to get an appt, you could try the cream and see if it's helped in that time. It won't harm you and if you're still worried you can see your GP.

I technically didn’t need progesterone as have a mirena but I’m taking it orally as well - it’s helped with some symptoms.

The GP gave me a steroid cream and said if it didn’t work she’d refer me to gynae. No swab. It’s working.
Have you cut out soaps and bubble baths? That’s a first step.