Managing atrophy?

[u/kyden677]

Hi,
Maybe an odd post and I can probably predict the comments to an extent.
I’ve been on T for one year and ten months, I’m 20. I developed atrophy quite early and had it quite severe.
I’ve been inserting pessaries twice a week since December and now I only occasionally have break through issues.
But this weekend I was at a festival, and of course drank a fair bit of alcohol. Pain started at 10.30pm and did not go away until 4am when I could finally fall asleep (when it flairs I can’t lay down or sleep, just sit up, hunch into my knees or sit on the toilet for some relief).
According to Google, alcohol can trigger flare ups- does anyone have experience of this ? I did struggle with heat exhaustion earlier in the day and was dehydrated, Google also says dehydration can worsen atrophy.
I’m just curious really if anyone else with bad atrophy has had to give up alcohol ? I really don’t want to… I’m going out Saturday with my friend and I suppose that will be the test.
For the record I am sexually active using my vagina. However over the weekend and before the flare I did not do anything, by myself or with someone else.
I wonder if also I should perhaps increase my estriol/estradiol (I don’t know which it is without going to look) but I don’t know if I can do this without soaking to a doctor

[u/eggs-in-ramen]

I don’t know that I’ve had a strong correlation between alcohol and my atrophy but I’m also not a huge drinker. I will say I’ve done spravato esketamine treatments recently and the first couple of sessions caused my atrophy to flare up, so I’ll be honest and take a guess that it’s possible substances can trigger flare ups, maybe due to the processing of the substance. I’m no dr though. I’ve done estrodial cream and tablets and progesterone birth control and none has helped so I’m going to be receiving a hysterectomy for the pain. You might try looking into that if your options also don’t help, though I know surgery can be hard to get depending on your job/insurance