Issues every period since giving birth. Getting no where with GP!

[Btowngirl]

Afternoon ladies, has anyone had anything similar happened or have any advice please?

I am having what I think are symptoms of low estrogen due to breastfeeding. It’s every month, 7-10 days before my period is due, I get so inflamed, red raw, dry and my skin is so sensitive and bleeds. I get some odourless discharge after a day or 2 but still feel swollen and dry. Discharge then goes away and I’m just red raw, swollen and uncomfortable. It lasts until my period comes and then alleviates over my period until I am back to normal when my period ends. I’ll put a timeline below:

Nov 24 - gave birth/started BF
April 25 - first period, completely ‘normal’
May 25 - no period
June 25 - thought I was getting thrush, treatment didn’t work but then came on my period and it went away
July 25 - thought I had symptoms again but tried BV treatment this time, didn’t work but then it cleared up during my period
August 25 - symptoms again so called my GP who said I need swabs but they can only do them on Thursdays, by this time I had come on my period. Swab was negative for anything.
September’s 25 - symptoms again, went back to the GP who gave me steroid cream and antibiotics which didn’t work and symptoms cleared once I had my period.
October 25 - symptoms started again 2 days ago. Saw my GP today who has offered vaginal moisturiser but can’t decide on which so it’s delayed until tomorrow. I asked to be seen again and they can’t until Monday, I know I am due on my period on Tues and there is another month gone with no resolve and I can just dread next month.

I gave them this link today, explaining (as I did at my first appt 3 months ago) that I think I have low estrogen due to bf & my period returning. They’ve said they aren’t happy to prescribe vaginal estrogen whilst I am bf, so am I meant to just continue to have this issue until DD is weaned? I get that she is 11 months old but I resent being forced to stop BF because we can’t get to the bottom of this. I’m feeling quite unheard by the practice nurse and GP who I have seen, they’re lovely but seem dismissive of how this is affecting my life due to their inaction. I’m so uncomfortable it’s difficult to wear trousers for 3/4/5 days at a time each month, I have an active job which I have returned to this week which is making it really stressful & upsetting.

gpifn.org.uk/reproductive-health/

please if anyone can advise I would be so grateful.

Oh wow, that sounds really tough and frustrating! What you’re experiencing actually makes a lot of sense hormonally. When you breastfeed, your estrogen levels take a big dip and stay low for quite a while sometimes for many months, even up to 6 or more depending on how much you’re nursing. This drop in estrogen can cause all sorts of unpleasant symptoms like dryness, swelling, redness, and sensitivity down there. It’s like your body’s way of saying, “Hey, hormones are all over the place!”

What’s tricky is that these symptoms tend to flare up just before your period when hormones fluctuate even more, then ease off once the period starts. That’s probably why everything clears up during your period but gets rough the week or so before. And because your estrogen is being kept low by breastfeeding, it can take its sweet time to bounce back.

I totally get your frustration with the GPs not being super helpful or quick with treatment. Non-hormonal creams and antibiotics often don’t do much if the root problem is hormonal. Vaginal moisturisers might help a bit with the dryness, but they don’t fix the hormone swings. A lot of doctors are cautious about prescribing vaginal estrogen while you’re breastfeeding, which adds to the waiting game.

The good news is that usually, as breastfeeding slows or stops, your hormones will start sorting themselves out and things should get better but yes, it can feel like forever when you’re dealing with the discomfort every single month. If it’s really impacting your life, it’s worth pushing for a referral to a specialist, like a gynaecologist, who might be more open to hormone treatment options or other solutions that your GP might not suggest.

Please don’t feel like you have to push through this discomfort alone. Keep standing up for yourself and your health, and maybe try to keep a detailed symptom diary to show your care team. Hang in there!

Thank you for taking the time to respond, I really appreciate it. I went to them explaining why I thought it was hormonal and what I had done myself to troubleshoot, I did also forget to mention in my OP that I dipped my urine too to rule out UTI (I am a nurse). However I feel I have been patient and accepted they need to follow their own process of elimination such as swabs etc and now they seem to just be saying there is no where to go with it.

DD does not even feed that much anymore (before bed/when she gets up/sometimes once overnight and I pump her 8oz for nursery) but I don’t want to rush the natural weaning process.

They are saying no estrogen gel for my age and because of BF but the only caution is that milk supply may be affected, but is unlikely when bf is already established. I’ve explained I understand and accept that based on benefit Vs risk and it seems like they are still reluctant. Just feels like we are going around in circles and instead of accepting they aren’t sure, they’re kind of passively telling me this is just how it is until I have stopped bf.

It really sounds like you’ve been so thorough and proactive with this, and it’s no wonder you’re feeling frustrated when the response from your doctors feels a bit dismissive or stuck. You’ve clearly done your homework, ruled out the obvious things, and shown you understand the risks and benefits of treatment, so it’s fair to expect your care team to meet you where you are instead of leaving you stuck in limbo.

You could try asking something like, “If this is hormonal and I’m happy with the balance of risks and benefits for using a local oestrogen, what’s the clinical reason for not trying it?” That sort of direct question can help them give you a clear answer rather than vague reassurances. And if they can’t give a solid reason, that’s a good argument for pushing for a referral to a gynaecologist.

It might also help to take a written summary to your next appointment, including your symptoms, your breastfeeding pattern, and the hormonal link you’ve already worked out. That way the conversation stays focused on a plan forward, rather than going round in circles. You’ve been patient and followed every step of their process, so it’s fair to expect either a proper alternative or a referral rather than being told to just wait it out.

Oh this sounds awful. I think you might need to see a specialist to get a prescription, is the GP able to refer you to a gynaecologist, or menopause clinic or something??

Found a bit of information here too, which you could share with the gp,

https://www.drlouisenewson.co.uk/knowledge/breastfeeding-and-hrt

I also wondered if its worth asking for your hormones to be tested generally, if you were showing signs of early menopause they might more easily be able to refer you to a menopause clinic who would be more likely to prescribe something. I'm POI myself and was breastfeeding when I was diagnosed but had given up before hrt was introduced so less complex.

Ok so it didn’t go well. The Dr was quite confrontational, said wait until next week to see the dr who 3 months ago said the estrogen gel was an option as todays gp wasn’t willing to prescribe it. I got emotional because I feel like that’s another month gone and I’ll be in the same boat next month. She said my mental state suggests I need help, have I thought about harming myself or my children etc. I explained I am completely fine other than this issue and feel completely gaslit by the whole situation and she said basically if I am not happy I can pay privately. She said she was signing me off sick for a week, I said no thank you, she said well you clearly can’t work and I said I can literally work, I just shouldn’t have to in this discomfort every month and I’d like support in fixing this medical problem or at least symptom alleviation. Basically another GP is going to take it on and contact me later today so we’ll see.

I am 34, though I know it could be early peri, I would be surprised as it’s my only symptom & only started when my periods returned which have been completely regular. I also had my fertility check and all was good when I had IVF to conceive DD. No one’s ever said they’ll check my hormone levels in any of these consultations 🤔

The thing is, its not normal to have such a low estrogen dip that you are having severe symptoms is it - so something is up! I really hope this next GP is more helpful for you, its not ok for you to have to live like this. I do wonder if this is a peri symptom?

I'm remembering now - I think in terms of hrt they only check hormone levels for your age if periods have vanished.

A lot of your story sounds quite familiar to me, with general irritation and thinking I had some odd strain of thrush/bv which now I've realised was just irritation because my estrogen was crashing. Obviously because I went into menopause at 33 I had much easier access to HRT, but another thing I did before that is start taking a intimate probiotic which made me a lot more comfortable, I use one by bettervits, but plenty out there, acidophilus alone is very helpful. Might be wise to check with gp about using it, as it has the usual warnings about breastfeeding, but I can't see how probiotics would be harmful.

I also use the vagasil ph wash with lactoprebiotic, its much gentler and is soothing when I'm feeling raw. I know most intimate washes are awful, but this one does seem to help me. I think a moisturiser or gel would be a much better option for you though!

Fingers crossed the next gp can save the day!

Thanks for your response! I have no personal preference as to what the reason for this could be, but I do feel a lot like it isn’t peri based on how I feel in myself and the fact this all only started when my period returned. I know that’s not bullet proof though and happy to be corrected if/when they come to a conclusion. I spoke with an ANP in place of the other GP who is requesting gynae advice. No one has suggested it could be peri, with the fact I am breastfeeding they agree it’s linked but can’t agree how to proceed. I feel like if they’re unsure surely checking my hormone levels would give them some insight…

I started probiotics 2 months ago! I do also use the vagisil wash when it’s not too tender but some days even the water is painful enough.

Hi, I know it’s a little late but I wanted to see if you managed to get this resolved? I’m having the same issues with irritation down there and have been breastfeeding for nearly two years. Gp refuses to prescribe oestrogen cream as I’m too ‘young’ (22) even tho symptoms flare up around my period just like you described

I too would love to know how it's going. I'm having the same dryness / itching / sore issue and having to bathe every night just for the relief. 7 months pp and still breastfeeding with period having returned.