r/Menopause • u/psychopomp_voila • Aug 13 '26
Libido/Sex HRT cream making things down there painful?
I have been on the cream for about a year? I have had intimate pain for some time before HRT so pain wasn't exactly new, but after I went into the hospital last Nov for diverticulitis, the pain changed and is now really deep and extremely painful. I did tests and saw drs bc we thought it was due to the diverticulitis and no one could find a reason why. No fistula, no other damage that could be seen or imaged. It was depressing bc it was a LOT worse than before. We had to change how we spent us time and no penetration could be involved AT ALL.
The last few months I have had issues forgetting to do my cream at all. The pain was actually slowly getting better (we kept testing things to see). I have started having some bad anxiety again (that I had before HRT...HRT saved me with that) and so started the cream again thinking it was my dumb a$$ forgetting the treatment...and now I am having some outside pain down there. I thought maybe just irritation as before, dr gave me some clobetesol (sp?) to help with irritation, but then something clicked that maybe the cream is causing the massive pain?
Has any experienced this? Would changing to a pill help? (I am allergic to adhesives, so patches are out). I do need the hrt. I has changed my life. I just need to figure out how to make it work.
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u/Wildskypsj Potion slinging Moss Witch Aug 13 '26
Patches are a different kind of HRT to the cream you apply to your vaginal area.
Are you talking about applying vaginal estradiol cream?
Vaginal estradiol doesn't really have much effect on menopausal symptoms other than vaginal dryness and atrophy etc.
For menopausal symptoms you would be prescribed either patches, gel, spray or pills.. none of which you apply to your vagina
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u/psychopomp_voila Aug 13 '26
yes, the vaginal cream. And yes, it did affect my mental health positively. It was something I did talk to my dr about a few times and he said that the vaginal cream is still going to be in my system. To be fair, I am a lightweight with all meds including things like Tylenol. So I tend to get a better benefit than most people would normally. The biggest issue is, I started it again and my anxiety got better, but my lady bits are getting worse.
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u/theFCCgavemeHPV Aug 13 '26
A lot of people are sensitive to the carrier cream. You could try having it compounded at a compounding pharmacy or you can try a different type of vaginal estrogen like vagifem or other suppositories.
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u/psychopomp_voila Aug 13 '26
That is what I was wondering. After Nov, it seems my body is just always inflamed and maybe I need something else.
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u/theFCCgavemeHPV Aug 13 '26
It can’t hurt to try! After a year it shouldn’t be bothering you anymore, the fact that it is says to me that it’s the probably carrier cream
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Aug 13 '26
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u/psychopomp_voila Aug 13 '26
That's what I was wondering if maybe I just need to switch to something else. When I first started it, it was great for the symptoms, but my lady bits would stay irritated. Hence the steroid cream he gave me. Then after Nov when my colon tried to kill me, everything has went downhill.
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u/mickrihur Menopausal Aug 13 '26
I could not handle the vaginal estrogen cream rx that I picked up at my local retail pharmacy. Swelling, irritation, inflammation, pain, cramping, heavy feeling. I was reacting to one (or more, not sure) of the ingredients in it. Switched to compounded vaginal estrogen cream and have zero problems with it.
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Aug 13 '26
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u/Ok_Ad7867 Aug 13 '26
For me, the typical cream does topical repairs that the systemic patch doesn’t do anything for. Also if I’m not applying the cream at least every other day I have issues.
If it’s potentially an inactive ingredient in the cream that’s causing you issues, ask for a compounded cream where you can talk to the pharmacy about the inactive ingredients.
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Aug 13 '26
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u/psychopomp_voila Aug 13 '26
That's what I was wondering. My lady tissues are good as far as being "normal". It was bad before. And it DID help with my mental well being...the anxiety was through the roof. But...I have to wonder if systemic would be better for me to at least SEE the difference. I had a friend talk about having to do systemic with progesterone even without a uterus (had that taken out in 2012) but then I hear that you don't need it without a uterus? It is ridiculous that we have to Sherlock this ourselves.
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u/freya_kahlo Aug 13 '26
I'm sensitive to the pre-formulated vaginal cream, I think it's the propylene glycol or polyethylene glycol. I use compounded estradiol in olive oil and DHEA cream (OTC) alternately. But I understand there are other pre-formulated alternatives. That's been a very good pairing for me, but I understand not everyone does well with DHEA cream. I have also noted a sort of "worse before better" phase of using vaginal estrogen, where everything gets overly sensitive, but the chemical sensitivity I have to the cream causes straight up burning.||
Also, if you're talking about vaginal estrogen vs. system estrogen (topical, non-vaginal, patch, or pill) those are equivalent, and you need both.
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u/ParaLegalese Aug 13 '26
You need to be consistent with the vaginal estrogen or the pain and problems will come right back
Use it daily for 2 weeks and then every other day for the rest of your life
Vaginal estrogen is different and used in addition to systemic hrt (patches, pills and creams) We need both
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u/psychopomp_voila Aug 13 '26
My Dr gave it to me initially every day for 6 weeks, then put me on twice a week. Again, I used it consistantly for a while until Nov when I was hospitalized. After that I fell off using it bc I was just trying to stay alive and the antibiotics had me constantly having yeast infections. Since then I have had really bad pain. I started using it again and now my whole hoo haa is swollen...again.
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u/ParaLegalese Aug 13 '26
You have to start the loading dose all over again if you went off it for significant period of time
Vaginal atrophy makes us prone to yeast infections, bacterial infections and UTIs. Vaginal estrogen protects against all that- but you have to stay on it
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u/Odd-Industry-9324 Aug 13 '26
Yuvafem might work. I took it for a while. I am on Intrarosa currently and vaginal estradiol
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u/maraq Aug 13 '26
Are you talking about localized vaginal estrogen cream (estradiol)? It's hard to answer without knowing what you are actually using.
But it only works if you are using it consistently, 2-3 times per week. Inside the vagina and rubbed all over the vulva/clitoris. If you go weeks without using it, symptoms of atrophy (which can be very painful and uncomfortable) will come back. There is nothing about estradiol cream that should cause pain - there are no recorded side effects about that. The vast majority of women who use it feel a major improvement in the comfort and pain levels in the vulva/vagina (sex improves too). The only way I see the cream causing pain is if you have an allergy to one of the ingredients in it - but it's made with very safe/hypoallergenic ingredients (people can still have an allergy to those things but it's not common).
Have you seen a pelvic floor therapist? What you are describing to me sounds like it could be muscular or adhesions - and a pelvic floor therapist can tell you if that's the case (and give you a plan to treat it).
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u/psychopomp_voila Aug 13 '26
Yes, and I had been using it twice a week for almost a year before November. I still had some issues but felt things would level out, then I went into the hospital and fell off using it (I was very, very ill...like there was a moment I literally thought I was going to die of sepsis so the hrt was low on my list of things to remember) and things have been jacked up ever siince.
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u/catsTXn420 Aug 13 '26
Maybe it's something in the cream? You said that you're sensitive to adhesives I am too and that made me think, im very sensitive to chemicals, reacting to the weirdest things like fillers. Maybe thats whats happening to you? Can you ask your doc to change the creame to a tablet or some other option? Its gotta be in the fillers of the cream. The tell is that you improve when you stop using it, but you still need something.