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[MIS71MUM]

Hello

After a couple of difficult months with anxiety and depression, I had made my mind up to restart HRT.  My depression seems to have lifted but still have a bit of residual morning anxiety which I can cope with and doesn't affect my life too much, as long as practise my CBT on it.
Although it's not perfect, it's a damn sight better than I was. However I do feel like my get up and go has left the building and did think HRT would remedy this. 4 weeks ago, I had a very light period after being off F1/10 for 3 months, and I took this as a sign that my periods were coming to an end and was perhaps, entering a different phase of the menopause. Anyway yesterday, I've started with my usual heavy period, exactly 4 weeks after my last one!

Therefore I'm thinking that I shouldn't be taking HRT whilst ever I'm having regular periods as my hormones are still doing something.

Also was thinking that my anxiety and depression were down to the menopause but again if my cycle is becoming more regular, this can't be the case.

Then if I'm not entering another phase of the menopause, how much longer will I have to suffer for??? The low mood, fatigue, anxiety are my worst symptoms. I take AD's and they have helped but are not a miracle cure.

I am due to get my FSH tested again on Monday since the last time it was tested 3 years ago, it was approximately 35.  I know this isn't a true test but it will tell me how much my levels have changed in 3 years.

Or am I just expecting too much, I want to feel 27 again instead of 97! I'm 44!

[Dancinggirl]

Hi Mis71Mum
My thoughts are: what you are describing could indicate you are getting deeper into peri menopause, your hormones will still be fluctuating so there will be highs and lows. If your FHS level was 35 three years ago then there is a good chance it will be higher now and, if it is, then would indicate you are very much peri meno - hopefully they will also check your oestrogen levels as well.  With an early meno HRT is advisable to prevent premature osteoporosis, heart disease and reduce the onset of vaginal atrophy and bladder problems. 
Hopefully you will be advised appropriately - how did you find the Femoston?
Anxiety is difficult to control but CBT and ADs are often needed alongside HRT, however, at your age HRT should be the first line of treatment if you are oestrogen deficient and HRT should help with mood, energy etc.
DG x

[Hurdity]

Hi Mis71Mum - if your depression has lifted recently for no apparent reason then this is likely to be due to the fact that your periods have returned albeit temporarily - and due to the associated rise in oestrogen - making you feel better again .

If you want to see what is happening with your periods then maybe wait another month, but if this has been happening for some time then your oestrogen is likely to be dipping low and especially if you miss periods. Blood tests will not be as helpful as symptoms/periods although if you are taking ADs this could be masking symptoms of flushes and sweats as these can be elinimated or lessened with ADs. Also one blood test won't necessarily tell you how your levels have changed - as it depends when they are taken! They vary so much when you are peri-menopausal. Mind you, you are still young and it's important to take HRT if you are going through an early menopause so if blood tests help to confirm this then that's good.

Otherwise why not start with the Femoston again? Not sure why you stopped?

Unfortunately at 44 you can't expect to feel 27 again - HRT is not a miracle cure, but you certainly don't want to feel 97!!!

Hurdity x

[MIS71MUM]

Thank you both for your replies.

I was okay on F1/10 for 3 months, then felt my symptoms returned and increased to F2/10 but never settled on it.  Restarted it again in September 2015 but I was suffering very badly with anxiety and depression, and was prescribed an AD. I decided to find out how I felt on the AD alone and give myself some breathing space to assess my next course of action. It is very strange though Hurdity, you have hit the nail on the head about the cycle re-starting and the disappearance of depression. For the past 3 winters, I've found it really hard to motivate myself in Winter, when my periods disappear, and always assumed I had SAD. That's why my GP tested me for Menopause in the first place.

Not sure which test my GP has requested, he said the nurse would do one which would say whether I had entered the menopause. He commented on that I seemed a totally different person and I realised that I felt so much better. Then my period arrived the day after.

I just know that my energy levels are low and that gets me down, not sure if the AD's may cause that with a sedative type effect.

[Hurdity]

I am not familiar with ADs but I gather they do dampen things down generally - ie designed to keep you on an even keel but in a numbing sort of way sometimes, from what people have said?

I presume you've had other things checked re energy levels - vits and minerals and you have a good diet with lots of fresh ingredients, and plenty of outdoor exercise if you can? Also has thyroid been tested - low levels can cause fatigue ( + dry skin, weight gain & feeling cold)?

I think many people have low energy levels at this time of year and low mood - due to lack of sunshine depressing weather etc so personally - especially in the winter I wouldn't be rushing to "cure" this with ADs - but we do need something to help oursleves through this time. SAD is a definite phenomenon! I'm a really positive person normally and although I'm a great worrier - would never ever say that I "suffer" from anxiety - I just accept that's how I am - but try to conquer anything that threatens to bring me down by looking ahead to something positive that I'm going to do - or just going out for a walk! Although there are still things that make me worry in the summer months I always feel fantastic overall and know that's to do with the warmth and sunshine, flowers, birds butterflies and all!

I can see if your hormone levels are up and down - so too will your moods and energy. As you said, your GP has requested FSH (and maybe estradiol) - but FSH levels vary enormously from day to day until menopause has been reached.

Hurdity x

[MIS71MUM]

Hi

I have just returned from my blood tests and am disappointed. Is seems my GP has arranged a FSH and a LH.  Am I right in thinking these probably won't prove a lot?  Can't understand why when the purpose was to find where I am in menopause, why FSH was done?

Hurdity - I had my iron, vit b, d and thyroid checked by my GP. The iron and vit d were low. I take vit d now but just stopped iron as been on it for 3 months.  I do feel like the ad's do dampen things down a lot but at the same time take away my energy.  My plan was to get a new HRT regime under my belt, then start to withdraw from the AD's. My CBT sessions finish at the end of the month, Spring will be here, my phased return will have ended and I will be back at work officially and it would seem a good time to commence withdrawal.

My diet is good with lots of fruit, vegetable, seeds and water. I try my best at mindfulness. I've had 3 glasses of wine in 6 months. But at the moment, I'm struggling to exercise due to a broken toe and being back at work. My only other downfall is chocolate but I'm allowed one small vice.

I'm definetly going to investigate a SAD lamp this year.

I was hoping that my blood tests might give an indication of my menopause but am thinking they may have been a waste of time now.

[Dancinggirl]

Mis71mum
Your GP is doing the right tests - you mentioned that FSH was 35 three years ago and this indicted that your ovaries were struggling although this is not conclusive for peri meno. FSH levels are often a better indicator than oestrogen levels.  However if your FSH is high now and your oestrogen levels are lower then can give a better indication of where you are in your menopause.  As you are still getting natural periods you are still peri meno but you may be further along the journey.  Bloods will never be truly conclusive and ideally they should be done a few times over a few weeks to get a better picture (this won't happen on the NHS) but hopefully this blood test will help a bit. DG x

[BrightLight]

Hi Mis71mum - just to re-iterate what has been said, the FSH is the correct blood test to determine if your body is in perimenopause and having trouble ovulating - the FSH rises when this happens.

Your questions is whether this is the menopause or not?  I think it is near on impossible to distinguish what is causing what.  No doubt that hormonal decline and the ups and downs that proceed an eventually low level can cause mood changes and the winter, as you say.

You mention having a bleed and thinking your hormones are 'back' - personally speaking I had a very high FSH reading last year, then a normal one and periods (bleeds) every month for a while, then erraticly and now have missed a period and only a light bleed before that.  My point is that there is clearly hormonal activity, that doesn't meant I am ovulating every time, that maybe some of the bleeds are annovulatory, which means little progesterone would have been made along with ovulation. All in all this means the 'system' isn't functioning as it was and there is a hormonal imbalance which can cause symptoms.

Whether you choose HRT or AD's or both is something to get advise on I think - what does the doctor say?  I do know that it is impossible to predict how your cycles will be in the future, or the hormone levels, once things start changing I think it's up to the body to decide   What I mean is, you won't get things back to how they were, periods might come back when you ovulate or when the lining builds up if you produce estrogen on your own but there will most likely be a continuing decline of function.  HRT should override all this - to help with all your symptoms or you can ride it out and just see what happens as the months go on.

It's a mindfield and very personal I think - do you like your GP?

[MIS71MUM]

Hi ladies

I have the results from the FSH test......and after 3 years it's gone from 35 to 27! The weird thing is that 3 years ago when it was tested, I wasn't having periods and this week when it was tested, I am back to having periods.

Could it be that I am only peri-menopausal when I don't bleed, ie winter? That sounds daft I know.

[Dancinggirl]

What were your oestrogen levels? FSH @ 27 is still a little high I think???
My understanding is that the peri stage can last some years and so the levels will go up and down during this time. The winter/summer thing does seem strange - I can't imagine why this should happen. I believe a significant loss in weight can result in periods stopping but temperature or season changes is odd!!!  - I think you should discuss what is going on with your doctor and see if some form of hormone treatment would be wise, maybe a BCP ?

[Hurdity]

Miss71Mum

It depends when in your cycle it was tested.

Here is the ref range for FSH:

 1-11 females; follicular and luteal phase
6-26 at ovulation
30-118 post-menopausal

http://www.gpnotebook.co.uk/simplepage.cfm?ID=436600899

You will see that it is on the borderline for normal range at ovulation - but I think it may well vary with time of day too - estradiol definitely does! Yes I agree it is puzzling the winter/summer phenomenon!

Hurdity x

[MIS71MUM]

Yes it's strange. I am going to give it one more month to see if I get a regular period, then will arrange to see my GP.  The blood test results were filed away as normal!

[MIS71MUM]

Hello

I have been having a quick think overnight. You know the values indicated in the GP notebook, are they at a phase in your cycle or in your life?

For example, my blood test was taken on Day 4 of my cycle so would be classed as high at 27 or is it 27 meaning I'm nearing the menopause?

Hope that question makes sense and apologise for my ignorance!

[BrightLight]

Hi - the blood test is to determine what your FSH level is during your cycle.  27 at the start of your cycle, day 4 is out of 'normal' range, so yes high.  But.....these values can go up and down for some time before menopause happens - which is when you will no longer ovulate or have periods.

Are you trying to find out where you are in the stage of menopause? If you google stages of menopause or the STRAW criteria you can find resources that explain some of the changes that are experienced, like irregular periods and hot flushes.  However, every woman is different so it is very hard to tell.

Where are you with your cycles, when you say you missed some over winter, does that mean they go back to being regular for the rest of the year?

[MIS71MUM]

Hi Brightlight

Yes now thinking about it, 27 is high!  Yes my cycle since 2010 has stopped from Sept/Oct and restarts Jan/April.  The shortest break has been 3 months and the longest 6. Then for the rest of the year, it's a 28/29 normal cycle.

So now I'm going to go back to my GP to say that I want some oestrogel perhaps....and he will say, why do you want that when you have regular periods?  It's not going to easy I know.

I've started noticing some night sweats, mood swings and exhaustion. I'm on AD's but don't want to increase yet.  My usual 4 day period has now turned into 8 days and today I could have cried my eyes, luckily held it back, but it was a real hormonal feeling.  I just know that there's hormonal/cyclical element to all this and want to try a hormone to improve my situation.