Fear and UTIs
First I want to warn all my readers that this article is going to talk about female stuff. It is going to talk about urinary tract infections (UTIs) and other things related to female body parts. If you don’t want to read it – turn your gaze now …
One of the stupid side effects of aromatase inhibitors (AIs) is an increase chance of UTIs. These are horribly painful and require a course of antibiotics to resolve (and yet one more set of doctors appointments). Since starting on AIs in January, I’ve already had two UTIs. At first I thought I was tolerating the AIs well. Now, I get regular external vaginal pain – it is like my vagina is on fire. It sucks.
So I talked to my gyn – she is amazing – she recommended an estrogen cream applied externally. It has been shown that it does not get into the blood stream. To help make me feel more comfortable with it, I could do regular monitoring of my hormone levels. I actually already do regular monitoring of hormone levels – as the tests are needed to ensure that the Lupron (injected every three months to prevent my ovaries from producing estrogen) is working. I also need to do regular blood work to ensure my calcium levels are sufficient for my once every six month Prolia (denosumab) shot.
However, the entire idea of this estrogen cream has me scared to death. The whole idea of putting estrogen on my body scares the crap out of me. I’ve check with my onc, and he is OK with it. He said it is quite a common treatment for frequent UTIs caused by AIs. It is local not systemic. It likely would make me feel a whole lot better (burning when you pee is REALLY uncomfortable – and sometimes it is burning even when not peeing – so general unhappiness caused by severe drying that happens when your body has no estrogen in it).
In many ways the fear is pure emotion. There is no logic to it. All evidence says it is safe. But the fear is visceral. It is deeper than any other fear. I do wonder if it is more a sense of PTSD than it is about fear of using the cream. It is more that the idea of having to use it is a reminder of all the cancer crap. It is just one more layer of crap.
The only reason I’m considering it (filled prescription but still haven’t the nerve to try it – the instructions on the prescription don’t align with what my gyn said in her office, so I’m awaiting more detailed instructions) is because of the promise of normalcy that it brings. I want to feel comfortable. I want to be able to ride my bike without adding that little bit of pain to the equation (I already have upper body issues when biking). And I really don’t want to go through yet another UTI and round of antibiotics. But even writing this out I’m crying. The fear is overwhelming. Maybe I’m just not ready for this yet …