Vaginal Issues on Tamoxifen

gb2115

I posted a little about this earlier (problems with pelvic prolapse have started--rectocele and cystocele). I'm in PT for this. I'm having trouble tolerating everything because the area is sooo irritated and (I guess) dry. It looks normal, but doesn't feel normal. The PT has me using a moisturizer for a bit to see if it calms down so I can do my exercises. It might already be helping. We talked about a pessary (which I know could be a big help and let me get back to normal activity), but I'm hesitant to even go to the doctor right now because I don't think I can tolerate the exam. I can't even get a finger in there to put the moisturizer inside without causing burning pain that can be agonizing. The idea of them even touching me to examine...or worse, start fitting me for a pessary, just sounds awful.

Has anyone else been through similar? I haven't discussed with my regular GYN because she's kind of rough, as a lot of them seem to be. Quick in and out (pelvic exam), you know. Her exams hurt so much, I even told her that before the last exam (in February), and it still hurt. She didn't do anything different. PT seems to think that urogyn is the best option, but I agree with her that if we can calm the tissue down first with OTC options, it might be a better appointment all around...

I'm not at the point of needing surgery yet, everything is still inside but causing annoying pressure.

All over the place here, but I'm wondering if anyone with a similar road can share. Anyone on tamoxifen get authorized to use vaginal estrogen? Anyone on tamoxifen with vaginal irritation successfully use a pessary? Do you think there's a chance that urogyn would kindly use some lidocaine during an examination?

Veeder14

Hi gb2115

My doctor ordered Estrace cream for me for vaginal dryness. I don’t have the issues you mention just dryness. I’m using it very sparingly. Its ordered for twice a week and I’ve only used it 3 times in the last year because it’s sort of scary using estrogen, even if it not supposed to go systemic. I used it for 4 years before dx with breast cancer and it worked well. I hope you find a solution soon

flashlight

gb2115, It sounds like you might have an infection. Does the moisturizer contain glycerin? Does it come with an applicator? It really doesn't hurt that much to have an internal exam and I had a stage 3 prolapse. Can you see a UroGyn? I don't think your Gyn is helping you deal with your issues. They do use a lot of lubricant and use the right size speculum when doing the exam. Lidocaine would burn. My UroGyn was very gentle and the staff was very supportive. Have you emailed your MO and asked for guidance on topical estrogen for atrophic vaginitis? I don't need it at this time, but my MO offered a low dose estrogen ring when I started Tamoxifen. Maybe you should start there while waiting to be seen by the UroGyn. Good luck!

gb2115

I honestly don't think it's an infection... looks completely normal with no discharge or odor. But, I have never had an infection there so I don't really have a frame of reference.

Unfortunately exams (and sex) have always hurt, it's just gotten worse on tamoxifen. GYN was the one that suggested it was tamoxifen but didn't say much else before she offered sympathy and then did the normal painful exam. It hurts right at the entrance, the tissue right around there. The pelvic exam the PT did really ramped it up, and she was definitely gentle. She had a name for the irritation I feel, vestibular something or other.

I'm probably going to be referred to urogyn soon, I am just dreading that exam with every ounce of my being. :-(.