So, so sore 😭 Periperineum.

[collectiveideasneeded]

Hello all.

46. HRT (sequin patches) for 3 years. Testosterone for 6 months.

Had to see the nurse as I had been suffering mad, crazy itching for 8 weeks. She said I was raw, it wasn't LS but the skin was looking that way in places. Had to stop using soap/shower gel - used by whole life- and use dermol for showering and eumovate 2x per day. After 2 weeks, she said all looked good and prescribed estriol (daily for 2 weeks and then 2x per week).

I also had to have a cystoscopy and a colonoscopy in the time.

I'm so sore. Especially my perineum. Multiple grown kids (so multiple tears/stitches and an episiotomy re-do 20 years ago).

I used the estriol around the vulva rather than using the syringe. It's my perineum, though. It feels so sore, I flamed, swollen and after DTD it hurts to even cough.

The nurse said to use a really thick emollient. I've not tried that yet.

Any ideas? Is it something I'm using that's making it worse?

Jeeeeeez, this is the gift that keeps on giving, hey?!

Periperineum? From Nando’s?

Absolutely not. That would hurt even more. 🔥 Peri(meno)perineum

No one else? 😭

Sort of. It’s called Genito urinary syndrome of menopause- GSM - and you really need to ask for a referral to a specialist.

How much estriol cream are you using? You may need it on a larger area and inside as well. Plus lots of women need it everyday for longer than 2 weeks and need more than twice a week as maintenance.

Yes I’ve had similar - though just the itching not soreness. Plan to use vaginal oestrogen (vagifem) forever now. It helps prevent a lot of other problems in the future and I’m surprised you were told only to use it for a few weeks and not long term. Maybe it was just to see how you got on with it?

I did use special shower gels and emollient at the start but once the itching calmed down I find I can now use normal shower gels and bath oils etc without any issues

I was told to stop using dermol couple yrs ago as too harsh. You can use epaderm ointment which is a faff but it's just a more greasy feeling, yet it washes away pretty well. I also then apply a bit after patting dry as a lubricant around that area for comfort.
I was using epimax too after being told dermol too harsh for about a year, epimax excetra.
It's not as drying as dermol.

Recently through googling I've swapped to the epaderm.

The reason I say specialist referral is that there MAY be other things going on here which need different treatment like steroids and which may need a specialist to have a look. I am currently sitting in the gp waiting room to discuss my sore undercarriage so solidarity.

Thank you ladies. I've just been googling the best moisturisers- so expensive! I think I'll try epaderm. The nurse said to use that but her hand actions and description of 'goose fat' put me off 🤣.

I continued the dermol because of the antibacterial properties - I have a bit of a hygiene thing- (started with hand washing as a kid) and it's really important to me that I feel clean (I know this is a me/MH thing but it's not going to change now when I feel more out of control of my MH than ever) but I think it may now be making things worse.

Do you use the thick pot or the pump thinner one?

Also, I've ordered more estriol. I will try using internally and externally for a while.

I feel like I'm falling apart. Tell me it gets better?! 🙏🏼

Have you tried vaginal moisturiser? Might be more helpful. Yes is a good make and you might be able to get it on prescription.

I had some eumovate for a couple of weeks and she said that looked to have sorted the issue. But things still aren't right 😭

🤣🤣🤣🤣

I can’t help with a long term solution but when my meno itching gets bad I take two ibuprofen. It’s been surprisingly effective for calming things down. Lots of solidarity and sympathy 💐

I use the ointment epaderm in a pot.
You have to scoop a lump out and work it around your fingers to spread.
Like I said it's a faff cos it's slippery but get it on your body quickly.
I'm.just put off anything with the word cream in it.
My dryness has got worse the last few weeks.
I'm seeing my GP next week to ask about lichen thing.
I am not on hrt yet I'm so scared, it's sitting in a box and I'm trying to mentally prepare for the effects it might have.
I use the vagifem pessary 3 times a week and I tried the estriol cream externally but got very red.
Then I bloody googled and it can cause this.
Apparently there's a weaker form I'll ask my GP.
The worst thing for me is a specific itch/soreness near my urethra. I'm going to ask about the steroid cream.
I'll admit I used a tiny bit of betamethasone there and instant relief. It was prescribed to me for use sparingly for that issue around anal area.
Grim sorry. It's not as strong as the steroid they can prescribe for lichen sclerosis so gp might say I can use it.
It's a bloody nightmare.
Op you're not alone xxx

@Tcateh ❤️

To give you some hope OP my itching was unbearable and wearing jeans or tight trousers was agony. But after a few weeks of using the dermol shower gel, emollient and vagifem it did clear up and is now just an unpleasant memory. I hope it will be similar for you but just keep going back to the GP if it doesn’t

How long have you been using the estriol for? If things are really irritated then sometimes the improved blood flow to the area makes things a bit worse before it gets better

@collectiveideasneeded Have you had a swab for thrush or tried thrush treatments? You can buy them OTC now,
It could be that. Thrush doesn't always have to show a thick white discharge- it can be 'just' redness, soreness etc etc.

I had something that sounds similar a few years back and it turned out (after a few visits to the GP) that it was thrush. It wasn’t at all like I’d had thrush in the past, so definitely worth ruling out, if you’ve not already.

Hi, when it started, I treated it as thrush but it didn't clear up. I had swabs and an inspection. Defo not thrush or anything else. It's related to peri. A family member has LS so I worried it was that but the nurse said it wasn't, although areas were becoming lichenated. When I went back after the steroid treatment, she said it was almost healed and it felt so much better.

The only really sore area now is around the perineum where it's been traumatised/scarred so many times from births. It feels inflamed and is so sore, especially after sex.

hang on - it responded to steroids, and had lichen areas, but it's not lichen? I am not a medical professional but that sounds a bit odd to me. And if it IS lichen, it is not going to go away, it has to be treated regularly to keep it under control. I really would ask for a referral.

May sound silly, but just because it wasn't thrush before doesn't mean it isn't now.

TBH it would be best to avoid sex until it's cleared up because it's just 'traumatising' the skin and delaying any recovery.

If it is loss of estrogen, using estriol cream should work as long as you apply the cream externally daily and also insert it 2 x a week, or 14 days to do the loading dose.

If youve done all of that you should see a dermatologist experienced in women's health.

I asked her what she meant and she said that there were areas that were traumatised and the skin was shiny (like LS) but it wasn't LS and when she checked 2 weeks later, the skin was mostly healed. A few weeks after stopping the steroid cream, the perineum feels 'fleshy' (swollen) and sore. Every other part feels ok. I tried some epaderm today- that's was soothing and I'm going to apply the estriol religiously as I must admit, when everything felt better, I was a bit hit and miss (and didn't use the syringe, only applied externally) and basically ignored the instructions.

I'm menopausal, but not on HRT. I get a sore and itchy perineum. Sudocrem sorts it out overnight for me. It comes back but another night of Sudocrem and it's ok for a few more days.

It's worth taking this seriously and considering topical estrogen.
What's happening can become worse - and it's harder to put back to normal. Topical estrogen is very safe and there is some 'talk' now among experts in menopause that all women ought to use it before symptoms start.