vaginal infection?

Dear Doctor,
Approx 15 days ago I woke up with a burning/irritation around the opening of the vagina and near the urethra. This occured after intercourse (the night before). I didn't think much of it and didn't worry about it until 3 days later I started feeling like I had urgency and a little burning. By the end of the week I saw my nurse practitioner/gyn who did a vag exam and found a bacteria and gave me metrogel. I used it for the 5 days and the burning got worse (oh, she also told me I had some vag atrophy, I am 48 y/o). Now I have noticed that the rt side of the perineum? is swollen to the rectum, but, I must say, I noticed a slight swelling in that area almost 4 wks ago. It is definately larger than the left side, and I can feel the "buldge" to the rectum. When I was examined, she didn't say anything about it. I still feel like I am "onfire" in that area, now using Mycolog II. UA and wet mount is normal.
Is this possibly a s/s of early menopause, as I skipped my period last month for the first time in my life. All of this seems timed with the fact that my primary increased my Armour Thyroid to 1 gr (I had been on a very low dose for one year). I am on no other meds. I don't know what else to do, or have checked. Can too much thyroid cause this? As I know it affects women's cycles and such. Any info you can give me will be helpful. I am having to resort to ice to the area as the burning is unbearable. There is only slight redness around the vagina. The feeling to urinate increases at night, Please help,
On Fire in California, ~
Xedowner

[Forum-M.D.-DT]

Thank you for visiting the Family Practice Forum.

You poor thing! It really sounds like you are suffering here.
Lets get to it. What could cause your symptoms? Lets list them in the order of LIKLIHOOD.

1. Dry vaginal mucosa (seen at or after the time of menopause)
2. Vaginal infections including yeast and gardnerella as well as STDS. UA and wet mount is normal which would rule out a urinary tract infection and a yeast or gardnerella infection, but has she checked for STDs such as Gonorrhea or Chlamydia. Listen, these are less likely, but if she was thorough, these should have been done as well.
3. Urinary Tract Infection - But UA was normal.

The signs here keep pointing to a dry vaginal mucosa which literally can become very raw during intercourse due to decreased lubrication of the area which is seen in women at or after the time of menopause.

The answer ... Estrogen Cream. Not only do I suspect this will help alleviate your symptoms now, it will also make intercourse more confortable in the future and you will be much less likely to experience this discomfort again. This is avialable by prescription only so talk to your doctor. I really think this would help you.

Oh, and while I think a thyroid imbalance is an outside possibility here, I doubt that is the problem. However, if you haven't had a TSH in 12 months ... get this checked.

I hope this proves helpful!

Dean M. Tomasello, M.D.

[rascal]

Dear Doctor,
Thank you for your response, I will follow thru. I should have stated that I have been married for over 20 yrs to the same, wonderful man. No STD's here.....
I am high risk for breast ca and cannot take estrogen in anyform, I am followed closely by a breast surgeon.
But,
thank you, again.
Xedowner

[jocelyn777]

If you have thyroid problems (esp. hypo) I suggest you get a book by Dr. Ridha Arem or go to your library and read about it... I can't remember the name of the problem, but it can be cured by using cortisone.  Like the kind you use on bug bites.  It happens to those women with thyroid disorders and occurs in the area around/between the vagina and the anus.

I wish you luck, and hope you feel better.