Bladder issues

2021, Responses from: Dr Nick Bedford

I have had endo since I was around 21, with 2 laparoscopic surgeries. I used to have the Mirena but have been off birth control for 7 years. My pelvic muscles are not what they were after having 3 babies (I’m still breastfeeding), I can hold on but leak a little. Leading up to my period I often have urges to pee during both day and night. I also have constant burning sensation in the Vulva (not thrush, have been tested).
Finally been prescribed Noriday but am apprehensive to use it as my Doctor said it may flare up the urge to pee and a burning feeling.

Dr Nick Bedford: It sounds like there could be a couple of things going on.  If you are not having periods while you are breast feeding, the ovaries won’t be making much estrogen at all.  That can give symptoms a bit like menopause, which can include vaginal burning, and bladder symptoms!  So something to try is some vaginal estrogen cream 2x/week from your GP. The body only absorbs a small amount and it doesn’t interfere with milk production.  You can keep using this until your natural period starts.

The Noriday MIGHT make the burning a little worse if it is due to low levels of estrogen hormone but usually doesn’t make too much difference.  If you need contraception it would be a good option.  You could use the estrogen cream as well anyway.  The estrogen cream is not a contraceptive.

The other thing to check out is what is actually happening with your pelvic floor, with a review with a specialist pelvic floor physiotherapist.  Although you may think your pelvic floor muscles are weak or damaged after childbirth, the reverse might be true – you might actually have quite tight muscles, which can’t work properly when you want them to.  That can cause the burning sensation you describe, and usually responds well to trained pelvic floor physio input.

ENZ Response: We suggest you read through the bladder information (pg. 10 and 11) in the free downloadable e-book on our website to gather some more information to help yourself.

The Pelvic Pain Foundation of Australia has a wonderful page describing bladder pain, possible causes, self-management and when to seek further advice. https://www.pelvicpain.org.au/bladder-pain/

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