General Questions About AV

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Hi there.  I've been a member of the Lichen Sclerosus group here but now feel the need to step over here for a bit.  Prior to menopause, I had all sorts of vaginal issues.  Burning, itching, pain, etc and then I'd be fine for awhile.  Several doctors in my practice mentioned lichen sclerosus.  One finally biopsied me and it was negative (which actually can be false).  Anyway, about 2 years ago I finally hit menopause and a lot of the issues I was having did go away.  Mostly, I think due to the lack of constant discharge I was having.  Now I am dry as a desert.  In some ways, this helps me, but now I have other things going on.  I feel as though I am disappearing in the vulva area.  To my view, it looks as if things are fusing/sealing up.  My doctor says it's not as bad as I imagine and he doesn't seem worried.  He now says I have atrophic vaginitis (I'm 54).  I asked 3 times during the last visit if he still thought it could be Lichens and he said no. I guess the skin is the proper color versus the discoloration.  He thinks my best bet will be estrogen cream.  I was already using Premarin cream but had stopped because it makes me feel itchy when I don't itch before using it.  It's not a horrible itch, but it's there.  So he changed me over to Estrace, hoping a different base would make a difference.  I've used it two days.  No itching but I feel some slight burning.  Now let me say:  I have the most sensitive skin on earth, all over so why wouldn't it be there.  I can only use vaseline on my face and Vanicream on arms/legs.  But part of me wonders if it might be normal to have some irritation from the estrogen creams as they do their thing?  Can anyone comment on that?

Also, I was hoping to hear others' experiences with the atrophy/shrinking/disappearing aspect of things.  

For the first time, after my GYN exam the other day, I had a little irritation.  When I go for my annual PAP smear he uses a lot of lube, so no issues.  But he was really trying to view the vulva without lube so I had what felt like some slight pulling in areas that seemed fused together and then I was irritated there for about 2 days.  Uggghhhh, I hate this.

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15 Replies

  • Posted

    Hi Chris!

    You just wrote my story except for lichen ... I'm 49, had a hysto 16 yrs ago but kept my ovaries. Woke up one day this past July with what I thought was a yeast infection and it spiraled out if control from there. Long story short, AV with rectal and bladder prolapse. Burning, not much itch, heaviness like my bag was falling out, the need to owe constantly and every thing sunken in.. literally over night.

    I've been on Estrace since Oct. I love it. Everything looks young and healthy again, more sensation and no dryness. I also have been going to pelvic floor physical therapy. I still have days where the full/heavy feeling happens but it's tolerable. This is probably TIM, but if I get constipated it makes it worse, pressure wise.

    This is how I started with the Estrace. First 2 weeks 1 gram nightly. Then 1 gram 2x a week. I also use a pea size amount on the vulva and urthera, concentrate on the folds. Give it a couple weeks but I think you'll be happy. My lady bits are very happy and plump like they used to be and the color has been restored.

    Good Luck and keep us posted!

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  • Posted

    So sorry! I forgot to add that the burning is pretty normal until the tissues start regaining moisture. A lot of women use coconut oil and other stuff to help. I didn't but within a week for me things started looking up so I just dealt with it. Hopefully others will chime in with suggestions.

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  • Posted

    I too have gradually got dryer and paler down there as perimenopause progressed. Also noticed things had shrunk down there. After having vulvodynia back in 2013, I was ultra sensitive to any creams, etc down there. Water based vaginal lube and moisturisers stung me, as did any containing hyaluronic acid. Vagifem pessaries made me swell up until I couldn’t even get a finger in there. I could only tolerate natural oils such as coconut oil, vit e oil and oil based lube. I managed with the oils for a while but eventually became so dry throat sex hurt. That was when I tried the vagifem. After my vagina had settled down after the vagifem reaction I tried ovestin cream. I wasn’t expecting much but it didn’t sting me or make me swell up too much. What it did do was plump up my vaginal and vulva and made me more moist. I produced my own lube again and my vulva and that whole area looked much healthier and younger. Plus sex was wonderful again (I seemed to be more sensitive down there with using the ovestin cream - other ladies have said that is the case for them too).
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    • Posted

      I have used yuvafem for over a year and now I am swelled so badly I can't get the applicator in. When you stopped did the swellling go away on it's own? Very depressing to feel great and now burning swelled and UTI symptoms

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  • Posted

    Thanks for your responses.  I feel a bit better about it hoping that I definitely don't have lichen sclerosus, but I am alarmed at the disappearing vulva!!! 

    As to the ovestin, I don't think we get that in the U.S. but it must be similar.  Ovestin is Estriol and Estrace is Estradiol.  Looks like the Estrace is going to be a stronger type of estrogen.  I'll try to keep with it to see if I can get the burning to go away!

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    • Posted

      How long have you been using estrace cream? The ovestin plumped up a made my vulva area much younger looking within the first two weeks of use (when I had to use it every day before reducing it to twice a week).
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    • Posted

      I'm with Suki.. by the end of my second week things were looking very normal.. we all react differently and it could take a bit longer or it might not.. my physical therapist said the average time of noticing major changes is about 6 months. I'm in the US too.. you can get the estriol but it has to be done in s compounding pharmacy and our docs seem very reluctant to prescribe it. I tried with mine and she wouldn't write the rx for it..

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    • Posted

      Just 3 days.  And I'm taking it *really* slow since I seem to have allergic reactions to a lot of topicals.  So I'm not to the point of inserting it yet, but just applying it to the vulva.  I am using a little more each night.  I had a pretty good experience last night with no burning so I'm hopeful.

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    • Posted

      Very wise. Due to my extreme sensitivity to any topical products I always tested a small amount externally first. If it stung, I’d wash it off and wait a few weeks before trying something else.
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  • Posted

    Indeed - everyone is different and responds differently to the same drug. Also, some women are starting from a worse condition of vaginal atrophy. I think the key message is to start with HRT when you first notice the symptoms rather than waiting until you are in horrible discomfort / pain. That is what I was advised by my GP. As soon as all the oils stopped helping and sex became painful I started on the ovestin. I didn’t wait until I was in discomfort on a daily basis. In that way there was no appreciable gap without sexual intercourse and I we able to resume after only a couple of weeks.
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    • Posted

      I have been having pain, burning, itching for the past 10 years (before menopause).  That's when they suspected lichen sclerosus.  Once I went through menopause many of my symptoms disappeared or were much less bothersome (the dryness seemed to help), but earlier this year I ended up getting a type of cyst within the clitoral hood (I believe now it was a pseudocyst).  It was at that time, when I took a good look, that I felt like the clitoral hood was fused a bit and my vaginal area looked like it was getting smaller and closing up.  I've been watching things and it just seems to be disappearing.  But, any pain or itching has been minimal.  

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