Vaginal Atrophy

 and incontinence, which is exacerbated by the lack of estrogen, thin tissues. I am seeing a urogynecologist as well as beginning pelvic floor therapy in November. Menopause was 19 years ago, UPSC treatment 3 years ago, which removed my ovaries and estrogen. I have no history of UTI's, only had one in the 1980's. My atrophy symptoms are burning during a shower due to the soap to the external tissues, my pelvic exams becoming increasingly difficult and painful to the point of wanting to scream, and stress incontinence which I did not know was affected by lack of estrogen and vaginal atrophy. When explaining this they used drawings to show a healthy vagina and intact organs compared to post hysterectomy and vaginal atrophy, then talked about what each treatment approach needed to accomplish. Almost no burning upon urination, which seemed strange to me. The stress incontinence slowly gets worse every year and it was explained to me that the lack of vaginal tissue strength is causing me to leak every more. I was prescribed estrogen cream, expensive, but it seems to be working. I was cleared to use the cream by my oncologist as my cancer is not estrogen dependent. They told me it would take a few months to see any results because I was so estrogen deprived. The burning has gone away, I will have my next internal early November so we shall see if this cream has helped. I had been complaining about the incontinence since surgery as it definitely got worse after the surgery. I was unable to hold any urine for a week, and it has gotten better but still worse than before surgery. They explained that the nerves probably were slightly bruised and the fact that my insides had to settle back down after organ removal.

So yes, this is a thing for some of us, and I hope that through therapy I can get better function. They explained to me that often vaginal atrophy and incontinence go hand in hand. I don't want surgery to fix it at this time, so I am going down the list of treatments with the therapy and cream as a starter.

Denise

who prescribed the estradiol. I am three months into the cream regimen of twice a week. The cream seems to be doing it's job, no burning and my internal exam was fairly comfortable again. They indicated that the tissues look a lot better, not so gray. (!) The cream is expensive, but I was able to get it not using insurance at Costco for $31.00 a tube, about $125 for the year, so not bad. With insurance it would be $732!

My pelvic floor therapy is going well. I am doing numerous exercises which hopefully will help going forward. I was very hesitant to begin therapy, but I am happy that I took the step.

Denise

to access their pharmacy and immunizations, even though we are members. The Part D plan with Silver Scripts that I chose, is very inexpensive and all of my generic medications are either free, or $1.00 a month, this year I am using CVS. However, anything like the estradiol (which is also a generic, but expensive in my plan) I ask my prescriber to give me a paper prescription so that I can shop around, instead of them sending it to CVS. I also use GoodRx which has a pretty neat feature of giving you the opportunity of price checking your drug to any number of local pharmacies to see who gives the best price, Meijer, WalMart, CVS, Costco, etc. This works for me because all of my current meds are available as generics. I also was able to circumvent my plan's insistence upon a drug for incontinence that has bad side effects, but was cheaper, and if that did not work they would pay for the better med. I used GoodRx and was able to get the more effective drug with no insurance cheaper than the price I would have to pay with my Part D. The insurance companies obviously subsidize their cheaper plans when they gouge us for the newly prescribed drug that gets automatically sent to our providers. I had a tick bite that got infected and needed meds ASAP and was shocked at the cost of the topical drug so I decided to go this route of not allowing them to automatically fill the prescription. I discovered it was a fraction of the cost at another pharmacy, not using insurance. But you gotta shop around! It has saved me a lot of money.

Hope this helps.

Denise

I am still on my emploeyr plan so have deferred Part B & D as it is less costly for my husband and me to be on work insiuranmce than Medicare for now. 

But I recall when I took over handling my moms affairs about 8 years ago until 2019 when she passed away that the first time I went to do her Part D renewal with UHC, I saw that she had been paying for the top plan for 10+ years even though she could have been on the lowest premium plan which required using Walgreens which ironocally is where she had everythng filled.  She never com,parison shopped during open enrllement - same with Part B.

I have also speone with Boomer Benefits a few times to get info and they seem to be the best 3rd party in terms of getting info and rates on Parts B & D.