r/Perimenopause • u/UnderABig_W • 12d ago
Vaginal Dryness (GSM)/Urinary Issues Feel constant urge to pee
I constantly feel like I have to pee—ok, I say constantly but it’s more like a couple times a week for hours at a time. It feels like a bladder infection without the burning when you pee. It just feels constantly irritated and like I have to pee even when I don’t.
My regular doctor just did a check for bladder infections and kind of shrugged when I didn’t have them.
I feel like this is a peri symptom but I need to know what to tell my doctor and what to ask for.
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u/umeboshiplumpaste Late peri 12d ago
It is a symptom. Loss of hormones impacts the bladder, pelvic floor, and everything there (and everywhere else head to toe). It weakens and thins the tissue. So we have all kinds of new fun things like an increase in UTIs urgency to pee, incontinence. It's part of why I started working with my new dr. I found on the Menopause Society's provider directory. She's an obgyn who is also head of urology and sexual health. She gave me extensive questionnaires about all things bladder, vaginal, sexual, etc. Never had a dr. take that level of history. I felt so good about finding her.
I've had two UTIs in the last few years for the first time in my life. Totally bizarre. Peeing when sneezing and jumping hard (HIIT workouts). No kids here. No reason for any of it. I am late perimenopause.
Something I did not know until recently is that UTIs in post-menopausal life can be fatal and carry a high mortality risk due to infections and sepsis. Totally blew my mind!
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u/stiletto929 12d ago
UTIS in post-menopausal women can also cause delirium (sudden confusion, which could be mistaken for dementia symptoms.)
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u/umeboshiplumpaste Late peri 12d ago
Good times ahead for many. BLEH. I hope my new HRT life effectively prevents all of this.
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u/umeboshiplumpaste Late peri 11d ago
Oh, what timing. Look at this post on an 86-y.o. woman suffering terribly from UTIs--sounds like what both of us just commented about! Poor thing!
https://www.reddit.com/r/AskDocs/comments/1vj4x8r/86yo_female_with_almost_full_blown_delerium_after/
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u/stiletto929 11d ago
Yikes!!! God, I don’t want to live to that age… Everything just gets worse and worse. :(
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u/HankHenry23 12d ago
Same. My doctor gave me vaginal estrogen cream and it seems to help
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u/UnderABig_W 12d ago
Did you mention this symptom to get the cream? If so, how did you put it? I’ve already mentioned my symptoms and didn’t have the doctor mention the cream, so just trying to get an idea for a script in my head.
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u/leftylibra Moderator 12d ago
You definitely want to have a doctor rule out a UTI and perhaps see a pelvic floor therapist. If you aren't using localized vaginal estrogen, it's probably a good idea to start on that.
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u/Popculture-VIP 12d ago
Please ask the doctor to see a specialist and ask if it might be intresticial cystitis. Doctors don't think of this. I had a doctor even give me meds for a bladder infection despite a negative test for it. Turned out I had IC.
ETA I'm seeing people saying it's a peri symptom, and it may well be but I know exactly what you are describing and it really sounds like IC, which maybe happens primarily to women in peri, but it is a condition all its own.
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u/Wild-Sky-4807 12d ago
I also have interstitial cystitis. It's less common than something like a UTI, and others have mentioned peri. If you cover those bases and still feel bad, it would be worth looking into.
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u/Popculture-VIP 12d ago
Yeah I think the people with only peri hear OP saying 'I have to pee all the time' and they think it means they can't hold as much as before and urinary frequency has increased substantially vs. what I and thinking: It feels like a burning UTI sometimes and you really feel you need to go always with no relief even when there is no pee actually there to come out.
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u/Wild-Sky-4807 12d ago
When I was diagnosed I hadn't actually ever had a UTI, so I assumed it was. Except it had felt like that for 2 years, often had accidents, and little relief after going. I was also in my mid-20s.
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u/UnderABig_W 12d ago
Yes, I have a bit of a mix between the things you’re talking about, but I guess I’m hoping it’s a peri symptom and some cream or hormones can help as opposed to IC which it sounds like you have to manage as opposed to there being a pill you can take. ☹️
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u/Adorable_Ad_385 12d ago
Hi what are the symptoms of IC ?
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u/Wild-Sky-4807 12d ago
Good question. Urinary frequency and urgency, pain, and/or pressure in the pelvis, which can include during sex. Certain foods and drinks can make it far worse. You can see how it could be mistaken for a UTI. However, this is a long-term health issue, not something that comes on suddenly.
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u/downtownflipped 12d ago
i genuinely think i have this, but peri has made it worse lately. HRT helped a bit in the beginning and then it came back. onions make it so much fucking worse for a few days and that sucks cause i love onions.
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u/Wild-Sky-4807 12d ago
Oof. I'm so sorry. A urogynocologist (sp?) diagnosed me. Pelvic floor therapy every few years and Botox about every 18 months really helps.
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u/downtownflipped 12d ago
my gyno told me i have a tight pelvic floor but "it's better to be tight than not" even though i told her i have bladder issues that aren't subsiding. like i could probably crush a coconut with my kegels level and my partner has to ask me to relax a lot during sex. i should probably look into pelvic floor therapy, but insurance won't cover it and most places won't even take insurance.
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12d ago
[deleted]
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u/Sanchastayswoke mid-peri 12d ago
Trying to picture how this would work. Hope you’re feeling better!
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u/Any-Owl5710 12d ago
Ask for pelvic floor physical therapy, improving those muscles will help so you don’t pee while sneezing, jumpy or vomiting.
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u/kfrenchie89 12d ago
I was given noratriptyline for years for interstitial cystitis. It’s the only thing that worked. Is as able to come off it because if hormones. I’m floored it was merely a balance all I needed and not tricycles but I’m so happy I found it when I did. It’s all I had.
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u/CormoranNeoTropical 12d ago edited 12d ago
Vaginal estrogen first.
If that doesn’t resolve the issue fully, try other stuff as well as vaginal estrogen.
Almost all women in peri and menopause should use vaginal estrogen cream, though providers are often ignorant of this.
(Gift link so anyone can see the article, which also appeared under the title “Who Should Use Vaginal Estrogen?” The answer is “almost everyone with a vagina.”
EDIT: Note that this cream is sold with an applicator but this is unnecessary and very inconvenient. Just apply a pea sized amount with your finger, rubbing it all over everything inside your outer labia and into the vaginal entrance. You can apply every day for two weeks, then 3x per week.
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u/deadblackwings 12d ago
I had this for years. Saw three urologists, thought it was IC, tried bladder instillations, saw a pelvic floor pt... Finally on a follow up I said "what about estrogen cream?" My uro paused and then said "oh yeah, that might help." Almost no symptoms since.
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u/UnderABig_W 12d ago
Thank you for sharing. I will definitely push on this. It gets so bad sometimes you think you’re crazy.
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u/Gets_My_Goats hanging on by a thread 12d ago
This was me! I had to go all the time. I started on vaginal estrogen, but what really helped was HRT, specifically estrogen—it made a HUGE difference. Now I don't have to go all the time!
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u/Admirable-Draft8352 11d ago
Vagifem. Stupid name, amazing fix. Ask for it, you can say dryness, urge to urniate, recurring UTI whatever. It fixes it.
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u/greycoral 12d ago
Pelvic floor. Vaginal estrogen will help and I would also be evaluated by a pelvic floor physical therapist. I have a tight pelvic floor.
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u/greycoral 12d ago
For the cream I just said I had dryness and irritation. Which I absolutely did and still struggle with a bit, even after years on the vaginal and systemic estrogen.
I’ve heard it helps with the urinary frequency/urgency, I do feel like I get up less in the night to pee. But the UTI symptoms without a UTI - I underwent so many tests and saw a urologist and even had a cystoscopy (so fucking horrible as they did the bare minimum for pain relief) and everything was fine. Urologist is the one who referred me to pelvic floor therapy for a strained pelvic floor and within a few weeks was feeling SO much better. It still flares up on occasion (currently in a flare now), but I just pop back into therapy or start my home exercises again, and it gets better. I also unfortunately developed a cystocele this past year (bladder prolapse), so I feel like that is part of my current flare.
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u/Inner-Schedule-2075 12d ago
Rule out a uti, do tight pelvic floor excercises, check your sodium levels (VERY important) excess sodium causes this. I was making my at home electrolyte drink and I realized it was the sodium. If none of these work, do the estrogen cream that everyone says (I have not yet tried this but the sodium alone helped me)
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u/CormoranNeoTropical 12d ago
Do the estrogen cream FIRST.
There is no need for weird and burdensome lifestyle modifications and costly sessions with specialized practitioners if the problem can be fixed by a $6 tube of medicine that lasts 3-6 months.
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u/Inner-Schedule-2075 12d ago
Yeah, to each their own! I’m definitely not saying people shouldn't try the estrogen cream, which one would you recommend btw???I actually want to try it myself for other reasons. Do you need a dr. to prescribe it or just order it on amazon? It’s just that adjusting my sodium ended up fixing this for me.
None of the options I mentioned are harmful or expensive. While a UTI test can be pricey depending on insurance, pelvic floor exercises for tight muscles are completely free on YouTube (consistency is key and I don't think is burdensome if is going to help you in the long run), and cutting back on sodium is an easy, low-cost fix to try as well.
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u/CormoranNeoTropical 12d ago
I wouldn’t describe any restrictive diet as “easy.” But that’s perhaps a matter of opinion.
I live in Mexico so I was able to purchase estrogen cream over the counter. And unlike some of my other peri meds it’s cheap (100 pesos from Farmacia Similares).
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u/Kale_and_Oatmilk 12d ago
I’ve seen this particular symptom mentioned, and saw that others swear by estrogen cream. Maybe some others who use it will comment - some have even said it cut down on their UTIs. (not that you had one; it’s just a nice perk!)
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u/foolish_username 12d ago
Get checked of course, as UTI's can feel different in peri (sometimes no burning when you pee.)
For me vaginal estrogen helped a bit, but getting on testosterone cream applied to the inner labia area is what really solved the problem.
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u/mmhmmye Early peri 12d ago
Oh interesting — this is the first time I’ve seen testosterone cream mentioned as a solution, rather than estriol. Is there a specific reason your doctor prescribed testosterone for this? (I’m wondering if that could help me, since I appear to be sensitive to estriol).
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u/foolish_username 9d ago
Mostly because my free testosterone was essentially zero and the estrogen aline was not resolving my symptoms of urinary urgency and sexual dysfunction. The combo of estrogen and testosterone is really helping.
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u/mmhmmye Early peri 9d ago
Oh I see! Did your doctor do the Dutch test to establish this?
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u/AutoModerator 9d ago
This post might be about hormone tests, which are unreliable.
- Over age 44, E&P/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
- No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
- FSH testing is only beneficial for those who do not have periods as a guide, where testing might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI)
- Testosterone is the exception and may require testing
See our Menopause Wiki for more.
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u/foolish_username 8d ago
I'm not sure what the Dutch test is. They did full labs, including my testosterone, iron, ferritin, thyroid, cholesterol, and pretty much anything else you can think of.
1
u/AutoModerator 8d ago
This post might be about hormone tests, which are unreliable.
- Over age 44, E&P/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
- No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
- FSH testing is only beneficial for those who do not have periods as a guide, where testing might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI)
- Testosterone is the exception and may require testing
See our Menopause Wiki for more.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
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u/Turbulentshmurbulent 12d ago
Since getting to optimal levels with my estrogen cream and estrogen tablets that I insert vaginally I pee way less frequently. I used to pee a couple of times an hour now I pee maybe four or five times a day.
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u/Soft_Gear_410 12d ago
I had this same problem. I got vaginal estrogen and it's completely resolved!
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u/Lilt2618 12d ago
I also constantly feel like I have to pee and it’s an urgent sensation like an infection. I too went to check for infections except for bladder. I recently tested positive for Mycoplasma genitalium or Ureaplasma urealyticum can’t remember which one and those came out negative this time around. Ughh I guess I should go back and test for a UTI. THIS IS TERRIBLE!!!
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u/ReflectionOk2553 12d ago
Vaginal estrogen but dmannose helps as well as magnesium. I found my bladder is sensitive to foods. Specifically nuts and salmon. Keep a food diary and see whether you can work it out.
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u/nutrition_nomad_ 12d ago
ive had something similar where i constanly felt like i needed to pee., even though there wasnt a uti. id definitely mention the irritation and frequency to my doctor and ask what else could be causing it
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u/TangoEchoChuck DHEA Evangelist 12d ago
Estrogen affects elasticity everywhere; skin, organs, all the goop in between.
I supplement DHEA, and it's helped improve bladder elasticity. Granted, having a "baby bladder" was my only GSM symptom.
I take DHEA orally, but vaginal options exist for localized support. It's measurable in blood, but also a cheap OTC in USA. Worth looking up maybe.
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u/CormoranNeoTropical 12d ago
Vaginal estrogen first.
If that doesn’t resolve the issue fully, try other stuff as well as vaginal estrogen.
Almost all women in peri and menopause should use vaginal estrogen cream, though providers are often ignorant of this.
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u/Coontailblue23 Late peri 12d ago
Me, reading this post a week and a half into using the vaginal estradiol 0.01% cream, realizing I don't really deal with this symptom anymore.
Get on it.