Medical menopause and HRT/vaginal estrogen

[thebird1]

Morning all,I have DIE and had surgery in 2016 to diagnose it. It was starting to go into my bowel and was wrapped around my appendix etc. I'm on the waiting list for hysterectomy/oophorectomy and endo excision ( over a year wait).

I'm struggling and I'd really appreciate your opinion. I've had X4 lots of antibiotics for a UTI. Last two urine cultures were negative mind. It felt like awful cystitis but with discomfort in cervix and vagina which they've now put down to vaginal atrophy. I've had 5 months of Decapeptyl injections and managed ok. Consultant didn't want me to have any hormones for first 3-4 months. Whilst on antibiotics I've started on Tibolone and vaginal estrogen cream.

I don't know what's causing what. My cervix feels swollen and sore. Mri has shown thickening in recto-vaginal septum and I don't know if the estrogen cream is making it worse. I have an urge to wee most of the time. I've even looked into hypertonic pelvic floor i.e. not being able to lengthen the pelvic floor muscles? If contributing to urge feelings. My bladder feels like it's going into spasm after I've had a wee.

I'm all for coming off injections and HRT and having very strong pain killers instead but know how poorly I felt before starting Decapeptyl.

Should I be on estrogen cream?

Will Tibolone trigger endo if I'm on injections?

I've been off work for two weeks because of the symptoms. They're a bit more manageable so back to work on Monday!

So grateful for this group x

[Sunset-lady]

Obviously I'm not medically trained but everything I've read suggests estrogen is not a good idea (or too much estrogen) for endometriosis sufferers. Estrogen feeds endometriosis. Also you'll be estrogen dominant by adding a cream as there's only small amount of estrogen (i think it only stimulates estrogen receptors) and progestin in Tibilone. I take more progesterone than estrogen because estrogen caused my issues. I'd get a second opinion and stop the cream immediately. I'm on zoladex and have not heard of anyone taking an estrogen cream vaginally. Read up on this as there's lots out there around estrogen dominance and progesterone therapy. I think if you stop the cream you'll notice a huge improvement xxx

[thebird1 in reply to Sunset-lady]

Thank you x That makes a lot of sense. I was given estrogen pessaries by a general gyne consultant in Feb, used one and reacted to it xCan I ask what you use to stay moisturised down below if on Zoladex x I'm struggling! Does Tibolone do the trick on its own?

[Sunset-lady in reply to thebird1]

I'm on utrogestan 200 mg per day which is natural progesterone not synthetic. I top it up with half a pump of Onas natural progesterone cream and I have one small pump of estrogen gel. Some women use progesterone pessaries. Go to Balancing Hormones on Facebook run by amazing woman called Gemma Banks. Read ALL the information there x also Lara Bridens books and podcasts x

[thebird1 in reply to Sunset-lady]

I used estrogen gel X1 pump before I was on Decapeptyl injections. The pain was terrible and I had haematuria too. I had to come off it at that point. I have the Mirena coil and now on Tibolone too.Thank you for podcasts and FB advise x

[Marcia71]

the vaginal oestrogen - either cream or pessaries is so low dose I doubt Tanja’s would cause endo to flare. I’m on it post hysterectomy for endo and adeno and her nurse told me a whole years worth of pessaries is the same amount of oestrogen as one single tablet of hrt.

I’ve found the pessaries helpful for what felt like constant thrush. Also I know they e helped others for urine leaks so they maybe worth another go. But yes pelvic floor physio is worth looking into anyway.

Tibolone didn’t work for me I needed a different hrt. We are all different so it can take a while to find the best for you. Key thing is to remember you must have a combined and continuous HRT. Both oestrogen and progesterone every day. Maybe try the gel and utrogestan or a patch like evorel conti or another tablet - like Kliovance. All are things I’ve tried.

I’d say hrt alone won’t help any vaginal symptoms so do try to persevere with the cream or give the pessaries another go whilst you wait surgery. And definitely look into a pelvic physio.

[thebird1 in reply to Marcia71]

Thank you for replying. I didn't use the cream for 24 hrs and it felt better. I have endo in recto-vaginal septum and this is where I'm getting most of the discomfort/pain. My cervix feels swollen! I don't want another UTI though! X