Which Estradiol Gel?

Well who knew there were so many choices?

Dr. Goldstein prescribed Estradiol gel to me in April.  As I've said before, the gel at first was very irritating. Over time I got used to it more, but it still irritated me sometimes.  At this point my gel was 0.03% estradiol and 0.1% testosterone in a cellulose base.  I started reading on other blogs and on my vaginismus yahoo group that some people have Estradiol gel with an Emu oil base.  I called Dr. G. to find out more about this. His office called their pharmacy and the pharmacist explained that many people find the emu oil to be more soothing, but not necessarily for the right reasons.  It turns out that the emu oil absorbs more of the estrogen and testosterone, making less of it actually absorb into your skin, making it less irritating because it's the hormones that are irritating in the first place.  So I didn't want to go with emu oil because I want as many hormones as possible getting into my body.  They did have one other suggestion - to use the same ratio of estrogen and testosterone in a different base - I wish I could tell you exactly what the base is, but on the bottle all it says is "ACID MA# 100".  I have no idea what that means exactly, but the word "acid" sure is scary.  However, I do like this version better.  It is less irritating and thicker.  I still get irritated sometimes, but it's less than with the cellulose-based Estradiol.

So there's the rundown on Estradiol options.   Please let me know if you have any questions.  When I go see Dr. G. on October 21, I'll find out exactly what that "acid" base is.

Making Progress

I had my three month follow-up appointment with Dr. Goldstein yesterday.  It went very well.  Before I tell you what happened in the appointment I'll tell you the changes that I have personally noticed since starting the Estradiol:

-the overall burning problem has all but disappeared.  I occasionally have it, but that's a drastic difference from feeling the burning almost all the time.

-Sitting for long periods of time does not make my vagina burn (there's still a bit of discomfort, but no burning) - I recently went to Italy and the 9 hour plane rides did not cause burning.  :)

-My vagina feels more moist in general - it's not a "I'm turned on and my vagina is moist" thing, it's just a general moistness.

So when I had my feet up in the stirrups (they were animal print and furry this time, by the way, and quite comfy) the first thing Dr. G. said was that my vagina visually looked better.  He could tell just from looking at it that the tissue was healing. 

Then he did the Q-tip test.  In almost all the places that I had originally given a grade of 7 out of 10 on the pain scale had NO PAIN AT ALL when he touched them with the q-tip.  There was one area that is still sensitive and I know why, because I haven't been putting the estradiol there when it turns out I should have been.  But this is really something.  I mean, 3 months ago that q-tip made me cringe in pain and yesterday, other than that one spot, there was zero pain.  He also tested my muscles and even they were improved even though I haven't been doing PT in the last 3 months.  However, it makes perfect sense that when there's less pain, the muscles won't involuntarily clench as much.

They took blood in order to check my hormone status now.  I have a feeling that it may be higher, but still not as high as it should be.  In Dr. G's words, I did have the hormones of a 45 year old menopausal woman, so I'm hoping to at least be down to a 40 year old pre-menopausal woman at this point (I'm 27 in reality).  Dr. G. asked me if I've been feeling any more desire or even had any sexy dreams or anything like that.  Unfortunately, no.  However last night I had one of those naked in public dreams, does that count?

Dr. G. still doesn't seem like he thinks that there is any need for me to be on anxiety meds, but he said he was okay with it.  So I will continue to take those and see if they can just give me the nudge I need to break through my sexual fear.

So I'm supposed to continue using the Estradiol, especially in the spot that I've been missing, and I'm also supposed to start back with PT to get those muscles where they should be.  I feel very encouraged and hopeful about all the physical stuff.

And I continue to hope that once the physical stuff is solved, the mental stuff will start loosening up too.

Update

It's been a while since I wrote anything on this blog.  I guess I just wasn't in the mood.  But I do have some updates.

I started using the Estradiol gel about 6 weeks ago.  I'm supposed to apply it to the vestibule twice a day.  At first, I couldn't do it that frequently.  It burned and itched like crazy.  I was applying it three times on, one time off for a while, but it was still bothering me.  Finally, I called the doctor to find out if there was anything I could do to relieve the discomfort.  He told me to lower the frequency because the last thing he wanted was for it to become unbearable to me.  I asked him about using Vitamin E down there, but he said he really didn't want me putting anything down there except for the Estradiol.  So anyway, I don't know what happened, but it's like all I needed to do was talk to him and the irritation basically stopped!  It's so weird.  But it really doesn't bother me at all now.  So I've been applying it twice a day for several weeks now.  I guess I just needed to build up a bit of resistance for it.

On a possibly related note, you might remember that I was on my period (blah!) when I saw Dr. Goldstein 6 weeks ago, but the weird thing is that I haven't had my period since!  I stopped taking birth control about 9 months ago, but BC or no BC, my period has always been very regular.  I can only remember maybe one other time in my life when my period was this late.  Is it just a coincidence or could it be related to the fact that I'm putting hormone gel on my vagina?  If anything, I would think that the attempt to bring my hormone levels back to normal would help in making my period more regular because that's part of their job.  I dont' know, it's weird.  I keep feeling like I'm having cramps, so I put in a pad expecting it to start any minute, and then nothing.  I don't know what's going on with that.  In the back of my mind I'm thinking, okay well I'm going to Italy in a month so maybe if my period can wait another week or two I won't have to deal with it while I'm overseas.  But hey, do our periods ever choose the convenient option?  I don't think so!

On the emotional side, we are making slow, but steady, progress.  We have moved up to having genitals back in the picture.  Whoa!  It's been a long time.  We are doing what the therapist calls the "quiet hand".  This is where I place my husband's hand on the vagina area and he just rests it there.  No rubbing, no insertion of anything, it just lays there.  You wouldn't believe how emotional the first time made me.  It seems so simple, but it was really hard for me.  I don't know why.  I trust my husband completely; I knew he wouldn't go any further than what we agreed, but I was still scared.  I have built up some serious fear in my head through all of this.  After the first time we tried the quiet hand, I burst into tears.  At first I was disappointed that I didn't feel any kind of desirous feelings; even though I knew there was no possible way I would, it was still sad to me that I still can't feel that.  But we've done the quiet hand a couple more times and it's much better now.   Slow baby steps.

Lastly, Dr. G said that I wouldn't feel any difference with the Estradiol for at least 6 weeks.  Well it's been 6 weeks.  Sadly I do not feel any more horny at all.  I guess that part takes longer.  But I will say that my vagina is more moist these days.  Not a turned-on kind of moist, but just a general moistness.  So I guess that gel is doing something.

An itchy combination

I've been using the Estradiol gel for about a week now. I'm supposed to apply it twice a day, but when I first used it, it caused a bit of irritation so I decided to go once a day for a few days to get used to it in a more gradual way and try to prevent an amount of irritation that would make me stop using it. So on Tuesday and Wednesday I felt no itchy/burniness so I decided to start using it twice a day.



Then last night I went to a baseball game. I sat on a hard plastic seat for 4 hours. By itself, that would have caused enough discomfort, but in combination with the Estradiol, man, I am super itchy today! I hope it won't last because I have to use this stuff for 6 months and I really don't want to have an itchy vagina for that long.