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[Meadowblue]

Excuse me if I ramble but lots running round my befuddled brain at the moment.  I'm 52 and have been suffering from the most common menopausal symptoms for what seems like ages now, in reality about 3 years.  Last year I went 11 months without a period and coped (just about) with the hot flushes, joint aches, insomnia and awful acid reflux, occasional migraines.  Then in November back came a period out of the blue.  For a month I felt absolutely great, no symptoms at all and I thought wow this is wonderful.  However, now all symptoms back with a vengeance.  The worst at the mo. is the migraines which are now happening very frequently (each week so far with a threatening one in the background most days).  They are much worse than I've ever had them too.  If i take the triptans that the dr. gives me in time then no problem but (a) dr. only prescribes 6 at a time and (b) don't want to take them constantly.

Been to the drs. today and he is referring me to a chap who he says is wonderful at sorting out hormonal migraines.  He says though that he may recommend HRT as that could then hopefully sort out a lot of the other symptoms too. 

My question is which one, it seems a minefield.  What really concerns me and sounds really stupid is I am terrified of taking one which cause facial spots.  My skin has never been brilliant and suffered terribly in my teens with acne.  I know that Norethisterone causes my skin to flare up and tbh on top of everything else I just couldn't cope with that again as it made my life a misery.

Does anyone know of which one is best or is there an alternative to HRT for these awful migraines.

Should mention already on Vagifem which is working a treat.

Thank you if you've managed to read this far 

[rosie c]

Hi Meadowblue, You mentioned Acid reflux. Are you sure your migraines are "true "migraines and not "really bad sinus headaches" that can be caused by acid reflux ?  I was told I had menstraul migraine... was given  triptans, which are great, but then i realised that i was getting more "migraines" and not just when premenstral, but all over the month, but I was also suffering at the same time, with horrendous acid reflux. I now know i was suffering from really painful sinus headaches,( which can be as painful as a migraine.) The sinus headaches are caused by  the acid reflux, which gets worse with flutuating hormones. x

[Dancinggirl]

Meadowblue - go for bio identical HRT e.g. Oestrogel or oestrogen patch with Utrogestan as the progesterone - as they are more likely to help migraines and less likely to give you acne spots.
I have always found my skin is better on HRT - the only HRT treatment that did give me more spots was Tibolone which has Testosterone in it , so avoid that one.
I think you will be amazed at the benefits of HRT but you may need to kiss a few HRT frogs before you find exactly the right combo.  If the doctor wants you to try HRT pills you could try Femiston as the progesterone is kinder.
Read up all the info under HRT preparations and keep us posted about your progress.  Don't be frightened - just go for it!
DG x

[Hurdity]

Hi meadowblue

If you think your migraines are hormonal then do go for patches or gel as Dancinggirl suggests, rather than tablets as these can aggravate migraines.

This is what it say on this site ( A-Z of health conditions):


Migraine   
    Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine.

http://www.menopausematters.co.uk/atoz.php#GlossM

I am on patches and during peri-menopause suffered from bad migraines and also still do sometimes on HRT - but mine are linked to progesterone and alcohol (!). Now and again when I've tried to increase the dose a little ( eg leaving the old patch on when I've put on a new one) I do still get a migraine from the spike in oestrogen too.

It's just a question of try and see - and ride out the first week or so of symptoms if you can until your body gets a chance to acclimatise to the added hormones. Unfortunately alternatives didn't work for me.


Hurdity x

[Meadowblue]

Thank you Hurdity and DancingGirl for your informative posts.  I have printed them off to take with me when I get my appt come through which I'm told will be in about a month.  It certainly seems as if patches are the way to go then.  I suppose I am just taking time to come to terms with the need for HRT as I always said I would manage without.  Silly really when my Mum got great benefit from it.  However, she was on it for over 10 years and died in 2007 of cancer of unknown primary origin but suspected stomach which is always at the back of my mind.

RosieC thank you I am 99% sure it is migraine because my Mum suffered with them for many, many years.

Will let you know the outcome of my appointment.  Thank goodness for you wonderful ladies and this forum 

[Night_Owl]

Hi Meadowblue - the migraines are awful, I do sympathise - mine started up again at meno with a vengence.

As the others have suggested, for consistency dosage, estrogen patch and Utrogestan would be a good place to start (that is what I take, ultra low dose patch, Utro every 6 weeks).  You may have to experiment for a while with dosage, trial and error, see how your body reacts to the estrogen, maybe start low and work from there.  I found lower dose to work better but we're all different.

I had acne in my late teens/20s and have no spots whilst using Utrogestan, so hope this will be the case for you too.

My GP gives me a prescription of **12** Imigran 50mg.  I take just one half at onset - this reduced dose usually works well, as I don't like talking a whole tablet, especially if I have a bad run of migraines.  Wonder if you could ask for an increase in the prescription, I feel reassured when I have a supply.  I also see a hospital neurologist and attend a meno clinic - it's good that your GP is referring you to see the specialist, it's worth pushing for all referrals.

Good luck, let us know how you get on.

Night_Owl
x

[Night_Owl]

ps: just thought of something else - wonder if maybe the Vagifem could be triggering the migraine. 

I found this to be the case when I wasn't on systemic HRT - and taking just VF.  The tiny amount of estrogen absorbed systemically can create a spike - whereas when used with a patch, the fluctuation is less.

Good luck with it all.

[Meadowblue]

umm Night Owl I hadn't thought of the vagifem causing the migraine at all.  What a nightmare as really couldn't consider coming off the vagifem at the moment - it's working nicely and took a while to do so.  Perhaps if he does prescribe full hrt I will be able to come off the vagifem.  Is that what you did?

 

[Dancinggirl]

Often we need vagifem as well as full HRT.  I think Nightowl meant the full HRT would help reduce/absorb the possible small spike in hormone from the Vagifem that might trigger a headache.  I am using Vagifem and I haven't noticed any headaches as a result of using this.  So little oestrogen is adsorbed it is very rare to have this happen - night owl may be very sensitive to hormone fluctuations.
RE. cancer concerns; I believe stress is a big factor in triggering cancer and HRt can make us feel soooo much better and therefore relieve some of our stresses.  We all know HRT has had some bad press about cancer risks, however the risks are very small in comparison to the benefits one gets in quality of life  - this includes: no hot flushes, improved bone density, more energy, better sleep, less aching joints etc.
Good luck  DG x

[Night_Owl]

DG is right, I felt the full HRT helped reduce the VF spikes, the consistent background level of estrogen provided by the patch seemed to lessen the fluctuation. 

Of course this may not be relevant as you may not be as med / fluctuation sensitive as me.  It was just a afterthought re the VF as others have mentioned VF and headaches etc.

Hope you find some relief.