Avatar universal

Sore vagina and urethral opening

I am a postmenopausal woman (65 y). I stopped estrogen treatment in January 2013 but have sometimes used local estrogen and lactic acid. I have had problems with my urinary opening, vaginal atrium and vagina. My distal urethra has been swollen, sore and smarting. Today I have slight lower abdominal pain.

I have looked at my urine and vaginal samples under a microscope. There are sloughed epithelial sheets in my urine. I think that they have come from the urethral epithelium. Is it normal that there are thick epeithelial sheets in the urine sediment? They cannot be from vagina.

The vaginal smear showed plenty of squamous epithelial cells (due to local estrogen). There were also some crystalline formations, maybe from gloves or from Lactal balans or Vagisan. The concretions were much like some CaCO crystals but also resembled those of starch (from gloves).

I have been using Evorel patches (25 mcg) for over ten years. Because I have recently had polyps and overgrowth of endometrium, I had to stop using them. I was without estrogen for some time in this year, and then I used local estrogen (Vagifem) and Vaginal balans. My vagina and vaginal atrium  and urethra are in poor condition. I have also had osteopenia previously. And I have hypercalcemia, I should not use calcium pills.

Could it be possible that I have cystitis or vaginitis? I hardly have any discharge from vagina.  I had my first bacterial vaginitis in January this year. I had abnormal bleeding before it. With Evorel (and Terolut every second month) I was doing well. I have many other diseases. I think that I have got menopause now at 65. Will this condition continue till my death?
7 Responses
Avatar universal
I have vaginal concretions, but I don't know what they are. I have looked at my vaginal smear on a slide under a microscope. The concretions could be calcium carbonate crystals. Or are they from Vagifem or Lactal balans?
Avatar universal
Yes, the tiny concretions are from Vagifem! They may be crystals of one of its ingredients, maize starch.
4851940 tn?1515694593
I do not know much about the results that you have mentioned.

But with a lower abdominal pain together with your urethra being sore, swollen and smarting, these symptoms are very much like an infection in your bladder - Cystitis.

As you have been on antibiotics earlier this year, there is also a possibility of having thrush.

I would suggest you see your doctor with a sample of your urine, so that the doctor can get it analysed and prescribe you with the appropriate medication if this is required.

In the meantime make sure you drink plenty of water so you do not get dehydrated.  2-3 litres is usually recommended, but may be more if the weather is hot and you sweat.

Best wishes.
Avatar universal
Thanks! Today I have given a urinary sample. I'll get the results on next week. I wanted to have a sample taken from may vagina, but it did not succed today, maybe on next week.

Because I have polyuria, my urine is always dilute and I usually drink much.  Nevertheless, I often become dehydrated. Doctors do not care. I think that I do not have trush, my vagina is very dry, no white discharge. When I was on Evorel 25 mcg or when fertile, I had no problems. Problems started when I had to stop using Evorel. Is this vaginal atrophy?
4851940 tn?1515694593
As you are a mature person and past the menopause, the symptoms you describe with the dryness and no doubt thinning do sound that you have  vaginal atrophy.

Do not use any soaps or bubble baths, shower gels or any feminine sprays down below.  These dry the skin and can cause irritation.  Baby washes should be fine.

Was there any reason why you had to stop using Evorel as it was helping?

Wear cotton underwear, no tight clothing and use a non-biological washing detergent.  

See if you can also get a moisturising cream from your doctor that is suitable for use down below.

Make sure you eat a healthy diet (which no doubt you are).  You may benefit from some multi-vitamins.

Best wishes.

Avatar universal
I only use (and have used) water for washing down below.

Last summer I had an endometrial polyp (with no bleeding) and had a curettage. Then within half a year the endometrium thickened too much (which had not happened previously) and I had slight bleeding. I had to take another Terolut treatment. Then the endometrium was thinner but it had grown again a polyp.

I am allowed to use Femoston conti 0.5/2.5 (estrogen/progesterone) one pill per day and local treatment with Vagifem 1-2 times per week. I have purchased Vagisan moisturising cream and I think that it could help.

I have hypothyroidism (treated with Thyroid Erfa) and hyperparathyroidism (hypercalcemia) and other diseases. I am taking vitamin D, Marevan (coumadin), atenolol, sometimes selenium, vitamins B, lactic acid bacteria, and magnesium.

Maybe my thyroid medication is too low. On next week I'll see a gynecologist.
4851940 tn?1515694593
Sorry to hear that.
Good idea to see your gynaecologist as you are having problems.

Your hyperparathyroidism is causing the hypercalcemia so I presume that you have to be very careful for your kidneys not to form kidney stones.

You will need to get your doctor to order a blood test to check your thyroid level. At the same time it may be a good idea to have your kidney and liver function checked as well and any other blood test the doctor feels is appropriate.

I also take the lactobacillus acidophilus + others in a capsule as well as drink yogurt.  I also take Enzyme Q10, magnesium, zinc and Vitamin B12 sublingual capsules.  

If the Vagifem doesn't help, perhaps you could ask the gynaecologist to recommend something for your.  

Hope you get on OK,

Best wishes.
Have an Answer?

You are reading content posted in the Women's Health Community

Didn't find the answer you were looking for?
Ask a question
Popular Resources
From skin changes to weight loss to unusual bleeding, here are 15 cancer warning signs that women tend to ignore.
Here’s what you need to know about the transition into menopause – and life after the change takes place.
It’s more than just the “baby blues.“ Learn to recognize the signs of postpartum depression – and how to treat it.
Forget the fountain of youth – try flossing instead! Here are 11 surprising ways to live longer.
From STD tests to mammograms, find out which screening tests you need - and when to get them.
Find out if PRP therapy right for you.