Hi, This is Dr. C. Board-certified Ob-gyne. I can help you today.
I'm sorry that you're having so much trouble without solution.
The symptoms you describe might possibly be related to low estrogen levels or dietary bladder irritants. Or a combination of both.
Low estrogen levels can be found in women in their 40s or beyond but also in younger women who are on birth control, especially pills and also especially if they are thin. If this is the suspected cause, some vaginal estrogen cream or tablets will be helpful. The symptoms are very common inwomen who are in menopause or nearing menopause. It is usually quite easy to solve. Estrogen cream is cheaper but messier to use. Vagifem tablets are easier to use but more expensive. Women need to check with their insurance to see if they have coverage for both equally.If so, the Vagifem tablets are preferred. Although it's an estrogen product, there is virtually no absorption into the blood stream of estrogen. So even though the package insert (which is required for all estrogen products by the FDA) will say things about breast cancer, blood clots, etc., these warning do not apply to the Vagifem product. There is somewhat more absorption into the blood system with the cream. The only reason why women will definitely want the tablets is if a woman has a history of breast cancer, blood clots or heart attack. The proper usage is to use for the 2 products is as follows:
Estrace (estradiol) cream - use 1 gram nightly for 7 nights, than use 1 gram twice weekly
Vagifem pellets - use one pellet nightly for 14 nights, than use twice weekly
Most women will notice an improvement within 2 weeks.
Common food bladder irritants that can also cause intermittent urgency include citrus, coffee and food high in oxalates:
I hope this information was reassuring and helpful. Please reply if I can clarify anything.