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Bladder, early menopause, low estrogen

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  • Bladder, early menopause, low estrogen

    Long story short, I'm 34 and only ever had 3 periods in my whole life. No cause ever found, had every test. In my 20s I was prescribed various brands of the pill and never managed to take any particular brand for very long - bad depression and anxiety. I wasn't offered any other form of hormone replacement. I couldn't hack the depression on the pill, so I just simply didn't take it.
    Now I'm 34. I have Osteoporosis in my spine. My breast tissue looks like that of a 60 yr old. My memory is crap, I'm tired a lot and only work part time.

    So clearly lack of estrogen has affected me. But none so obvious as my bladder, at least I think that's what caused all this. Last June, I started to get the UTI bladder feeling - dull pelvic ache. GP prescribed antibiotics despite negative urine tests. Symptoms persisted. Urogynae felt it was a low grade infection and lack of estrogen. More antibiotics, and a prescription for the pill. Again. No change, and symptoms slowly got worse. The pill made me feel like utter ****, sorry for the expletive. July - investigations in hospital, cystoscopy normal but horridly painful on my urethra. Urologist blamed all my symptoms on a tight pelvic floor. Ok, I had a tummy tuck 6 months prior, tight abs = tight pelvic floor. I had been marathon training. Historically I had a tight pelvic floor (now I think due to lack of estrogen!). I started pelvic floor physio, not much change.

    By October, I could no longer lie on my side without wanting to scream my head off. Bladder just burning and felt like it was bursting against my body. Aiiiiiiii! Life was misery. I honestly thought at some points I'd be better off dead. Nobody could find out what the cause was, nothing was helping, the pain was unlike anything I'd ever experienced and consultants would say things like "you'll just have to live with it" and "did writing your blog cause you upset and stress? That can cause pain". Ah f*** off! Sorry.

    I saw a gynae who had better knowledge of menopause and finally put me on HRT. Very low dose estrogen patch, some progesterone. No change. Then the Monday of the second week of October, I found a box of Vagifem and thought what the hell, give this a go. Within 5 days, I could lie on my side again, just about, for about 2 minutes. Still painful, but not hurrendous. The Friday of that week I was booked in for a trial pudendal nerve block. My pain consultant felt it could be a pudendal nerve problem, although he couldn't figure out why. He tested the nerve and "it reacted". Had the block, kept going with the Vagifem but after the initial sudden improvement, very slow further improvement. 2 weeks after block and whatever was in the block kicked in - 90% of symptoms disappeared for a blissful 2 weeks. Then, it wore off. Misery!

    During this time I bumped up the estrogen patch another level, did regular physio, and the awful level of pain didn't return but I was far from out the woods. December was quite rough. January, had 2 lots of radio frequency on the pudendal nerve. No change in pain level, was quite surprised. But it did completely fix my slowwww start to peeing first thing in the morning.

    Saw Nick Panay, menopause specialist extraordinaire in London. Immediately put me on the full dose of HRT. Said I could use Vagifem twice a day, for a couple of months at least - I needed it. Kept up with physio. Gradually things improved, but still bladder pressure feelings with tight clothing & seatbelts etc, urethral pain. Felt like I reached a plateau.

    Then I asked my pain consultant to just do the same nerve block he did back in October again, to see what happened - nothing. He tested the pudendal nerve again and it didn't react. I had a full STI screen including ureaplasma and mycoplasma - all negative. Broth urine culture - negative. I forgot to mention that when I was in hospital last July, they did find ecoli and EBSL - treated.

    Now at this stage my pain was very manageable. I found myself no longer single. I found myself having pain free sex for the first time in my life. And no UTIs after!

    And all was good until... yesterday. Goddam it. Bladder burn is back! And I'm trying to figure out what I did. Some thoughts, in no particular order:

    * My jeans were a bit tight. Didn't hurt much at the time tho.
    * Last night I was working on the laptop in bed, and didn't realise I was resting the weight of it on my pelvis. I also had a heavy microwaveable bean bag thing warming up the bed - quite heavy, resting on my bladder area. My brain has gotten good at switching off from discomfort - although it was uncomfy at the time, I didn't do anything about it - call it autopilot! I noticed when I went to sleep on my belly, there was the dreaded bladder niggle.
    * I think my estrogen patch ran out. That has happened before but hasn't affected my bladder much. At the same time I hadn't used Vagifem for two days, was using Relactagel because of:
    * Broke up with the boyfriend. Did another screen and this time positive for Ureaplasma and Gardnarella (BV?). Is this now irritating? Is the Relactagel irritating? I got some of it on the skin externally which burned because of being raw from:
    * Severe itching externally. Arrrrrgh. Saw gynae yesterday, a few hours before the bladder pressure happened to return, she said probably thrush and gave me some cream. She said ureaplasma unlikely causing the remainder of my symptoms (slight bladder discomfort and urethral burning). She said that my bladder had been so long without estrogen that it still had some healing to do, she'd seen it before. The bladder just takes a long time to heal itself.

    But now my bladder is burning again. Whyyyy! Literally in the last few hours of lying in bed it's got worse, ya know the pain you get when lying on your back. Now I know I haven't regressed back to when things were really bad, I can still lie on my side quite comfortably. But any ideas what's going on! My tummy muscles have tightened up in response to the bladder being cranky. I'm scared, I thought the days of this bladder burn were numbered.

    Any ideas?! Sorry for the long post!


  • #2
    Re: Bladder, early menopause, low estrogen

    Here are some ideas...I hope this is timely and moved you up to a better level. Watching and resolving to reduce food triggers to the bladder, spicy foods- seasonings, oranges, vitamin c, caffeine. Bathroom hygiene, toilet tissue wasn't enough, feminine wipes are more efficient. Probiotics focused on female anatomy and probiotics for the bowels. I haven't used this idea however some compounding pharmacies use a vaginal syringe to lubricate with a hyaluronic compound. More ideas: supporting collagen. This is more vast in nature since there are vegetarian and non-vegetarian choices. Yes estrogens are suppose to add support providing they are balanced with the right dosage and delivery of progesterone as well as the female having a balanced endocrine system and digestive assimilation. Regards to you and I would care to hear how this made your day or month better.


    • #3
      Re: Bladder, early menopause, low estrogen

      For me,stress makes everything worse,so that can only get better. It's all a balancing act with diet/activity/stress/& stuff like tight jeans and computer pressure on bladder. If you get out of whack,just hang in there,do nice self care things,take meds if needed for flare and it will get better-getting upset will just increase all of your symptoms,so try hard to just take it in stride & tell yourself that you can manage things & get back to feeling (your best level of) "good".My uro strongly prefers vaginal estrace cream over vagifem,so I switched.It really does seem to have improved the tissue in my vulva & introitus much more than the vagifem ever did.(I think some MDs prescribe vagifem & women like it because it isn't "messy",but even as them small amount of estrace cream gradually comes out,I find it soothing to my vulva)Hang in there! Shorty