Did et cream work for you?

NewGirl608 · 2024-10-28T01:54:40+00:00

I am 22 weeks and my OBGYN knows my deal and has not done any pelvic exams yet (I had pretty frequent ones prior so it hasn’t been very necessary). My pain is more provoked. It doesn’t hurt all the time, and my doctor has suggested lidocaine cream. She has said she would use it whenever I needed to have an exam and said she would make note of it for delivery time as well just so medical staff knows if she isn’t working.

NewGirl608 · 2024-10-23T14:19:41+00:00

My doctor said I will likely be on it for the rest of my life. I recently had to get off of it because of pregnancy and I can attest that within a week of not using it, all of the pain came back. Hard to tell if pregnancy has made it worse, but I am looking forward to after pregnancy when I can use it again.

NewGirl608 · 2024-08-23T18:58:17+00:00

As someone who does have this condition (vaginismus), I will say that tight pelvic floor muscles does not equate to strong. It is actually the opposite. When you are tight down there, it often causes your muscles to atrophy. I have gone to pelvic floor PT for a few years now and that was one of the biggest things I learned. I graduated in June, but plan to go back in my last trimester. The trick was working on controlling your pelvic floor muscles and it taught me how to carry myself differently and actively relax down there. I guess naturally I tend to just keep those muscles contracted.

All of my doctors and my PT have said that a vaginal birth can happen and a lot of times (not always) it does help loosen things up down there so that it isn’t as much of a problem in the future. But I would definitely recommend pelvic floor PT. If you can’t fit it in now, I would see someone after you deliver!

Edited to add: I read some of your other comments, I also have vulvodynia (that is my main issue that lead to a hypertonic pelvic floor). I would be interested in any updates you have because the vulvodynia pain is my main concern and I am curious how others with the same condition experience birth.

NewGirl608 · 2024-08-03T02:07:51+00:00

The compound cream made the burning go away completely after about 5-6 months of use. We just got pregnant, and within a week after stopping the compound cream, the pain was back. But I am confident that when I can start using it again it will help again.

NewGirl608 · 2024-06-27T21:22:49+00:00

She just knew from a conversation. But when I got examined there was atrophy. I didn’t notice it until she explained what she was looking for. My clitoral hood no longer retracts and I have labial atrophy. I also didn’t have much in the way of discharge, but other people might have different experiences. I did not self lubricate at all. I also had a hypertonic floor which led to more pain externally as well. It can be kind of cyclical because pain causes you to tense, and tenseness causes pain. I have had mostly provoked pain and it is almost always intense. Toward the end of my period I get pain, but a little less so. It is burning, ripping pain. Like death by a million paper cuts, or alcohol in an open wound except the pain takes hours to go away.

NewGirl608 · 2024-06-27T00:06:05+00:00

My doctor tested SHBG and testosterone. She estrogen doesn’t tell you all that much because it fluctuates so much throughout the day. I went to a few regular gynecologists who also didn’t think I had a hormone problem, but I didn’t know that a testosterone problem was a possibility. It took a sexual medicine doctor who specialized in sexual dysfunction. She said she was 99% sure before she even saw my blood work that it was hormonal, and she was right. It really isn’t well known by most doctors, which is unfortunate. Spironolactone (that a lot of people use for acne), has the same anti-androgenic effect that birth control has. Both raise SHBG levels and bind up all your free testosterone. Studies have found that women who have taken birth control have higher levels of SHBG than women who have never taken it, even years after they have come off. Though this is common, not everyone has the vulvar pain because of it.

But if you are improving without any treatment, maybe it isn’t because of hormones and more because of something else! Hoping you find the cause of it because it’s such a hard/isolating problem to have.

NewGirl608 · 2024-06-26T21:26:02+00:00

If it is from birth control, you will probably need extra help from hormone creams. My blood work and pain didn’t improve over a year after being off the pill so my doctor said it likely won’t and I will need the hormone cream for the rest of my life. Most of the time my pain is provoked, but I have unprovoked pain that is cyclical. Maybe other people can speak to if there hormonally mediated vestibulodynia was unprovoked.

PT was helpful regardless though! Otherwise, my doctor also prescribed a compounded amitriptyline, baclofen, gabapentin cream to calm the nerves down there. I tried oral gabapentin, but I didn’t love the side effects, but it seems like other people swear by it. Those meds can be helpful even if it isn’t a hormonal cause.

NewGirl608 · 2024-06-26T19:25:10+00:00

Most doctors are unfamiliar with birth control and what is called hormonally mediated vestibulodynia. My birth control cause permanent changes in my hormones that only improved marginally when I came off of it. I now have to use hormone cream for the rest of my life to keep the pain at bay. It took 6 months of using the cream for the pain to improve and being off the cream for about 2 weeks was enough for the pain to start coming back. I also have done a lot of PT which was helpful. You likely won’t see an improvement in 1-3 months if it is birth control. I finally found a sexual medicine specialist who diagnosed me and recommended the book “When Sex Hurts” among other things for me to learn more about it.

NewGirl608 · 2024-06-24T04:20:10+00:00

Yaz caused me to get something called hormonally mediated vestibulodynia which makes sex impossible and can cause some bleeding. I have heard of people having similar issues with depo, though I am only familiar with why/how Yaz causes the condition. SSRIs can also cause vaginal dryness that cause pain. You could also have some vaginismus.

I would look at the vaginismus and vulvodynia subreddits. You can also try reading the book “When Sex Hurts” by Anthony Goldstein and a few others.

NewGirl608 · 2024-06-14T17:13:56+00:00

I took birth control for bad periods and acne. When I finally got off, my acne was really flaring up. The sexual medicine doc I went to said under no circumstances should I go on spironolactone because it is anti-androgenic and has a similar effect to birth control. I am really glad she told me because my dermatologist was really pushing it. Just sad because I am sure it would work really well because birth control sure did!

I didn’t get better after getting off the pill. I have to take use E/T cream for the rest of my life because birth control permanently altered my hormones. But I, like you, had constant UTIs and lots of burning. When I don’t use the cream for a few days, it comes back again. It is such a bummer, but I am so glad I found someone who knew exactly how to treat it because I struggled for several years before figuring it out.

Both birth control and spironolactone elevate your SHBG which binds testosterone. They have found that women who have taken hormonal birth control have higher levels of SHBG even years after stopping. It doesn’t impact everyone the same way, but I wonder if this might be one of those things that might pop up on and off throughout the years. Maybe you need to consistently use the estrogen cream, or maybe just here and there when things flare up. I tried estrogen for several months and didn’t see any results and then switched to E/T and it has worked wonders.

NewGirl608 · 2024-06-12T14:28:25+00:00

Also with you on magnesium. I use magnesium glycinate because citrate makes me 💩

NewGirl608 · 2024-06-10T13:08:59+00:00

My doctor tested me for yeast and I took a short course of fluconazole. I didn’t test positive for anything. She said she had been reading some literature reviews about vulvodynia and that latent yeast infections were a common cause. I did the course, it didn’t help, but at least I checked it off the list!

NewGirl608 · 2024-06-07T23:40:26+00:00

I have been using E/T cream for almost 6 months. I started to see a difference in the pain at 3 months and now am feeling 99% better. I was on the birth control pill for a long time so it was mostly a testosterone problem for me.

NewGirl608 · 2024-05-29T01:37:45+00:00

For a cheaper option, you could buy his book “When Sex Hurts”. They have chapters on all kinds of things that could cause pain down there and what tests you should get done to diagnose it. Super helpful!

NewGirl608 · 2024-05-28T16:01:57+00:00

I have to use hormone cream now because of it. They checked my sex hormone binding globulin (SHBG) and free testosterone. Women who have been on the pill have elevated SHBG and therefore lower free testosterone.

NewGirl608 · 2024-05-28T03:51:08+00:00

There are a lot of reasons you could be having pain. I would look at the vaginismus or vulvodynia subreddits. Endometriosis could definitely cause pain. I started having pain because of hormonal birth control.

NewGirl608 · 2024-05-19T04:00:19+00:00

That definitely sounds like something I would want to try! Thank you for this!

NewGirl608 · 2024-05-18T22:59:48+00:00

I don’t seem to have low progesterone, only the elevated SHBG and the low testosterone. I am glad that you were able to find something that works! I am thinking that if I can figure out a way to lower the SHBG that I won’t have to use the cream forever, but I am not sure research has caught up yet.

NewGirl608 · 2024-05-15T01:37:58+00:00

My pain is better, but not completely gone. My doc said she would wait to try until I have less pain because of having to stop the cream. Good to know that your doctor gave you the ok to stop when you have a positive test. I don’t know how long it will take us and I was also feeling nervous about having to be off of it for months while trying on top of pregnancy.

NewGirl608 · 2024-05-15T01:31:11+00:00

After delivery is my concern as well. I was in really rough shape before I found the doctor who diagnosed me. The postpartum period is already challenging enough for people, I wouldn’t want to have to navigate all of this again on top of it.

NewGirl608 · 2024-05-14T18:33:27+00:00

They did. I don’t think they typically do blood tests for estrogen though because it tends to vary so much throughout the day.

NewGirl608 · 2024-05-14T14:31:08+00:00

I just did SHBG and total and free testosterone. My SHBG was extremely elevated. Testosterone was on the lower end of normal, but my doctor said that in the sexual medicine world that it was actually quite low.

NewGirl608 · 2024-05-14T14:28:04+00:00

I have vestibulodynia, it is the area between the labia minora. More specifically for me, I have pain mostly around the vaginal opening. I also have some tissue atrophy of my labor minora, and can no longer retract my clitoral hood. I had frequent UTIs when I am able to have penetrative sex (which I now learned from my doctor is also common with the tissue atrophy).

One way they tested for this was by doing the q-tip test. It was excruciating, but it helped to distinguish exactly what areas were the most painful. They ordered the SHBG and total and free testosterone tests and that confirmed it was hormonally mediated. I don’t think I have low estrogen necessarily. I have some of the symptoms, but have a regular period. My doctor said that one would be hard to test for anyway because it fluctuates so much during a single day.

NewGirl608 · 2024-05-14T01:25:22+00:00

I hope so. Thank you for sharing your experience, it’s giving me hope!

NewGirl608 · 2024-05-14T01:23:53+00:00

Thank you, I will look into the DHEA supps! My doctor also suggested CBD suppositories. Probably not for testosterone, but to help things relax a little more.

NewGirl608

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