Vulval pain tips please

[NotOldGregg]

I’m mid-40s, been on systemic HRT for 2+ years. (And name changed for this, I’ve been here since 2000s)

Over the last few years I’ve had a range of peri-meno symptoms. Some resolved with the HRT, some hang around for a few months and then spontaneously resolve.

Current main issue is vulval pain. Vagina itself is fine, and it doesn’t feel like “dryness”. But everything hurts my labia. All my trousers hurt. All my pants hurt. Walking hurts. And I ride horses and bikes and obviously those hurt too (but not as much as walking whilst clothed).

I mentioned it to my GP who had a look and couldn’t see anything. Swabs showed mild candida but I don’t have the normal recognisable itching. (Reading suggests this is indicative of an alkaline environment as a result of low oestrogen). GP recommended some “vaginal moisturiser”, which is due to be delivered tomorrow. But it’s definitely the outer areas that are sore, not inner.

Without being weird, can anyone relate? Any recommendations for underwear style that might help? (I’m not a dress/skirt wearer, and am not desperate enough to switch yet, so please don’t suggest that).

Buy some ovesse on the internet and see if that helps?

Maybe lichen sclerosus.
A lot of GPs don’t have a clue.

Thanks, I’ll see if the moisturiser helps first, the I’ll try ovesse if not.

I’ll ask about lichen sclerosis next appointment too.

No clothing tips to share?

Have you tried full cotton knickers and trousers? Could a reusable cotton sanitary towel placed in your underwear give more comfort when riding? Keep moisturised, even Vaseline should give some relief. I’d try the GP again, see if a cream could be prescribed. Wishing you well

Id say you need topical estrogen like estriol cream. GSM affects the outside parts as well.

You need vaginal oestrogen, if GP gives you the cream, it can be used inside and out.

I'm having a similar issue with a red sore patch on my vulva due to horse riding which I've taken up again. Think its wearing a tena that rubs me whilst the horse is moving under me. I've treated with talc which has reduced the friction

Same here. Ended up at dedicated vulva clinic. Topical oestrogen helps but they were adamant about no soap or washes and to use bland emollient Hydromol for washing. Made big difference.

100% topical estrogen. Cream and suppositories. My pain was all external, but it was suppositories that sorted it finally. My worst peri symptom, but now on top of it!

Ok, it looks like I’ll need to bring this up with the GP next time I see her, and ask for a hormone cream.

I’ll see if I can get the OTC one in the meantime.

Today I’m wearing a pair of DHs boxers and some softer trousers and it’s still a little sore (just pottering at home, haven’t been out to ride or walk) but just the sort of usual background discomfort.

Any other tips on underwear or trousers recommendations to get me through the next few weeks would be appreciated.

One thing that I remember being careful about was: when going to the loo, wet the toilet paper before you wipe to minimise abrasion/irritation. Wash only with water, and if you’re showering, be careful to avoid shampoo etc running down there. Avoid baths completely for the duration, as hot water can dry things out. And there’s a moisturiser called Yes (I think) which is useful until you can get to the gp and get on the good stuff. I’d call tomorrow; mine was happy to prescribe over the phone when I was struggling. Turns out it’s super common. Davina McCall talks about it in her menopause doc, if you haven’t seen that already!

I have Lichen Sclerosus. It has improved over the years but occasionally I still have vulval soreness (due to muscle tightness they think). My nurse prescribed Lidocaine which temporarily numbs the area. I save it for when it is quite bad and don't use it all the time. I believe you can buy EMLA from the chemists which does the same thing. Ask your GP first though. The Vulval Pain Society website is helpful.