UTIs and Vaginal Atrophy

[Siena62]

Good morning.

I normally post on the PMR forum but today I'm seeking advice about a UTI which has not cleared up despite two courses of antibiotics. The GP says that I have some vaginal atrophy and wants me to take vaginal estriol.

I was prescribed 3 days of Nitrofurantoin without a urine test. After about 2 days the symptoms had pretty much gone but 36 hours after my last (6th) tablet I started experiencing symptoms again. A day later I passed a lot of blood on 3 occasions close together. I was given another 7 days of the same antibiotic (my urine test subsequently showed an infection which is sensitive to that antibiotic) and appeared to improve for a few days but then I started to feel worse again whilst taking it (little pain though) with soreness and a feeling of downward pressure and a constant need to go to the toilet. 36 hours after my last tablet I started to experience pain again and I had a small amount of blood in my urine later. However, the urine sample which I took to the GP the following day (when I was actually feeling well) didn't show any blood and minimal signs of infection. The GP prescribed vaginal estriol. Today I am worse again and there is more blood in my urine. I have emergency antibiotics which I can take.

The strange thing about this UTI is how my symptoms fluctuate so much from day to day and throughout the day. It's not like any UTI I've had before.

I'm wary of taking the vaginal estriol because of the various risks plus I'm taking quite a lot of other medication. I have high blood pressure which I'm struggling to control.

I'd be grateful for people's ideas. I don't know whether to start the emergency antibiotics now or wait and see if things improve.

[Hidden]

Hello

Vagifem Pessaries (estriol) changed my life in terms of overactive bladder and recurrent UTIs. At the time I was prescribed these, I had Breast Cancer and the oncologist and Breast Care Nurse didn’t hesitate to recommend.

They’re lose dose. Use daily for two weeks and then twice a week

[bantam12]

I would definitely try the Estriol as it really can help, might take a few weeks for full effect and if one particularly brand doesn’t seem to work there are many others to try.

I’ve been on various sorts for absolutely ages and can’t manage without, I’m currently using Ovestin cream. I’m also on lots of other meds for thyroid and heart problems and there haven’t been any interactions or side effects.

[Shoeysmum]

I'm so sorry to hear about your ongoing UTI. I was in your position 6 years ago despite being on Estriol due to cervical atrophy which had been diagnosed by a gynaecologist.

Every time I went back to my GP because the last lot of antibiotics hadn't worked (I decided to make a nuisance of myself until they got to the bottom of it!) they were saying "but you're on Estriol and it should protect you from UTIs". I told them that it's obviously not working and I think my comment was falling on deaf ears.

Eventually I was referred to urology as well as the incontinence clinic. The extremely knowledgeable nurse who ran my local incontinence clinic switched me from Estriol to Ovestin which is a cream rather than a pessary.

After a small procedure to stretch my urethra and the ongoing use of Estriol I have been clear of UTIs ever since.

I was informed that Estriol was quite safe to use and, since Ovestin is the same thing but in a different format, I can only conclude that that too is safe. So don't be afraid to use either product.

By the way, the incontinence nurse told me that the dipsticks that they use at GP surgeries are next to useless.

Good luck.

[Siena62]

Thank you all.

I started the estriol last night but I understand that it can take some weeks or longer to have any effect (if it helps at all). Meanwhile I have all the unpleasant symptoms which fluctuate throughout the day. Looking ahead to my two holidays at the end of July and September I'm very worried about how I will cope if I still have symptoms then. This problem has been going on for nearly three weeks. I've never had a UTI (if that's what it is) go on for so long and I'm obviously worried that this is going to be a long term problem.

It's so good to hear different suggestions about what might help. It seems that people actually have different underlying problems and need different solutions but doctors seem to have a tick-box approach.

[montieth]

I was prescribed estrogen cream. I am in the U.S. and so I am not sure if this is the same as the vaginal cream you were offered. Since I started using it I have not had any more bladder infections. The doctor told me that the last one I had was becoming resistant to antibiotics. Also a nurse told me to be sure to wear loos cotton clothiing especially to sleep in and 100% cotton underwear every day. I have followed her advice. She said the clothing would make a huge difference. Hope this helps.

[Coco51]

I was reluctant to start using oestrogen pessaries as firstly I have had breast cancer, and secondly I have a large fibroid which may be contributing to my overactive bladder symptoms with pressure on the bladder. I worry oestrogen might stimulate cancer again or enlarge the fibroid.The replies to this post have encouraged me to try it.

[Siena62]

Thank you, everyone.

[McHargF1]

I had a similar problem to you. Initially diagnosed as a urine infection but, it kept recurring. It got so bad I ended up in A and E several times. They gave me stronger and stronger medication none of which worked. After a year of this I was referred to a specialist nurse. They discovered a tight pelvic floor, took me off my medication ( it was causing the bleeding). Prescribed hormonal pessaries, sertraline( to relax the muscles ) and gave me pelvic floor exercises. They saw me every month until I was completely better and were always there at the end of a phone.

I would ask your doctor to refer you to a specialist clinic. They are truly amazing and take everything you say seriously. They gave me proper examinations all in one day and diagnosed then and there. I've never felt better and rarely have any problems.

Wishing you luck as I know how awful this problem is and fully sympathise.