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[Dalhousie]

I started with menopause symptoms about 2 months before my 49th birthday.  I'm nearly 50 now. I have a long history of spine & chronic pain problems which is making me very disabled & feeling unwell so the menopause was the last thing I needed.  I also have IBS.

I started quite suddenly with menopause symptoms - irregular periods, hot flushes & huge increase in muscle & joint pain in my back. After 3 months of menopause symptoms my periods stopped which was last July so I've got three & half months to go & it will be a year since my last period.  I read that sudden onset menopause symptoms are more severe & difficult to cope with.

Currently I have PMS/PMT symptoms for most of the month now - hideous bloating, PMT, increased back pain.  I just get odd days when things are a little more normal.  Before the menopause I used to get PMT for about 3 days a month.  Now there are only about 3 days a month when I don't have PMS/PMT.

My main question is:

After July (ie. without a period for a year) will my distress ease a little.  I read that after a year without periods you've made it through to the menopause?

I take Red clover complex for the hot flushes but it's been rather less effective lately.  I also take Confiance but I don't know whether that does anything.  HRT gives me side effects - diarrhoea.

Thanks for any help/tips/advice.

[Sarah2]

Hi
Sorry you are suffering. What type of back problems do you have and are you having treatment? Have you had X rays for your back to make sure that your pain is not caused by osteoporosis due to low oestrogen levels? It's possible to have low levels and not have many symptoms until the levels suddenly drop right off and regular periods are no sure sign of oestrogen levels. Many cycles as we near menopause are anovular- so you will have a bleed but you aren't ovualting, so your oestrogen levels will be low.

Sadly, the symptoms do not go away after a year of no periods. All that means is you are post menopausal and this stage lasts for the rest of your life.

You may have no more periods this year until July but you might have stop-start periods for another year or even 3-4.

Once you have no progesterone in your system then you won't suffer with PMT symptoms. But you may find that other symptoms do not go away- many women have flushes and sweats for decades- my mum had them into her 70s or longer.

What type of HRT did you use and for how long?
Many women find they need to try several types to get the right 'fit'- my consultant compares it to buying a pair of shoes!

[Dalhousie]

When I went for a smear last year the practice nurse told me that if I didn't have a period for a year I'd reached the menopause but if I did have a period after that time I should contact the surgery as there might be a problem.

The hot flushes are easier to deal with than the PMT & bloating - I feel so up tight/wretched & feel about 7 months pregnant & about to pop.  When I'm very bloated the muscle pain in my back is very bad too as my back gets very U bend shaped as I'm so bloated.

I tried Climagest & I'm not sure what the other one was it was a patch but I can't remember the name.

(I've been having treatment for my back since age 29.  Had 2 major surgeries anterior lumbar fusion at L1/2 with a floating rib removed & a few years later artificial disc replacement surgery at L4/5.  I've now got a chronic pain problem related to my fusion surgery which seems to be facet joint related & also rib pain).

[Sarah2]

I think your nurse is a little confused. There is no need to make an appt if you have a period after a 12 month gap if you are under 50 ( someone correct me here if this is wrong.) This is for the same reason that you have to continue to use contraception for 2 years after a final period if you are under 50.

If you are over 50 and have bleeding after a 12 month gap then sometimes this can be a sign of uterine cancer, polyps or cervical cancer. However, there is no fixed rule for this. I had light periods off and on for 18 months after a 12 month gap, right up to the age of 54/55.
I see a consultant and he was monitoring this.

If you had a period at 14 months after the last one or even 15 months, it is highly unlikely you had a serious illness- hormones are funny things! The biggest concern is if you have gone 2 years or more with no bleeding at all then you start again.

This is not the same thing though as saying that you will always see the end of your periods after 12 months from missing a few. There are lots of women who get to 11 months then have months of regular periods again and have to start counting again!

I really think you ought to try HRT again and try to find one that suits.

Just out of interest if your meno symptoms have just kicked in suddenly over the last 3 months when and why did you try HRT and for how long?

[Dalhousie]

To clarify things:

The menopause symptoms started suddenly last April.  Between April & July I tried 2 different HRT drugs.  They both gave me diarrhoea after a few days of each which became intolerable so I stopped them & thought HRT wasn't for me.  (My GP never offered to try any more).  In July my periods stopped & I haven't had one since just lots of PMT & bloating.

[Sarah2]

You might get on better with transdermal HRT because tablets can cause digestive issues.

I don't understand how you are getting PMT symptoms if you are not having any periods. What kind of symptoms are they?
PMT implies your body is going through cycles still - but it could also mean your symptoms are down to lack of oestrogen.

[Hurdity]

Hi Dalhousie

 

Sarah has given you the picture.

Just to clarify:

Menopause is the date of your last period which you can only date in retrospect.

And - as far as I understand any bleeding beyond 12 months since last period whatever age shpould be investigated. I think this has changed since I was first on this forum - it used to be 2 years for under 50 but is now 12 months for all.

Here is the information about post-meno bleeding ( this site):
http://www.menopausematters.co.uk/postmenopausal-bleeding.php

There has to be a cut off point but as Sarah says doesn't mean to say there is anything wrong and far better for the docs to err on the safe side and investigate more than necessary, than to miss a cancer.

Also - oestrogen levels continue to decline from the time of the last period for the next 2-3 years when they reach an all time low (for you) and stay there (if you remained at the same weight - if overweight you have a bit more oestrogen). For many women symptoms don't begin, or start to get much worse, at this point - so having thought they were through the worst, then get a shock. Some symptoms such as vaginal atrophy - don't begin for many women until well past menopause.

To reassure you - if you use hormones that are identical to those found in our own bodies, you are not using drugs or medication when taking HRT - you are merely replacing what has become deficient - and causing you symptoms. Many of us take HRT long term - - eg I am near 61 and maybe 6 years post-meno?

If you are having true pms symptoms this implies you are still ovulating ie having a cycle but maybe not producing enough oestrogen to build up any lining? There is an excellent article about the peri-menopause on this site here which explains the ins and outs of what's happening to your hormones:
http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

Some women also begin to get problems with thyroid function around menpoause so maybe a blood test would be a good idea if you haven't had one recently?

As Sarah says transdermal HRT is not likely to cause diarrhoea/digestive problems.

I would suggest that HRT would make you feel a lot better and good to start before you reach menopause while your body still has some oestrogen. You would kick start a monthly bleed again though - but the benefits are worth it! Here is the info about the different types - scroll down for the transdermal types.
http://www.menopausematters.co.uk/perimeno.php

If you have any more questions please ask - there is a huge amount of experience of all the different types on here.

Make an appointment to see a doctor/GP in your practice who you know is sympathetic towards women taking HRT and is experienced with the menopause - and print off anything you want from this site before you go to take with you.

Good luck and hope this is helpful!

Hurdity x

[Dalhousie]

The date of my last period was 13th July 2013.

I've tried an HRT patch (I forget the name) when the tablets didn't agree with me & they gave me diarrhoea just the same.  I'm the same with other drugs - topical things I still can't tolerate any better.

I read that when symptoms come on suddenly they are more severe & you can still get PMT.  Sarah said it should stop when the Progesterone stops being produced.

I also read that when symptoms are sudden & severe you can have wildly fluctuating hormone levels on a daily basis.  You don't know whether some information is legit on the net though.

The short time I was on HRT it was an improvement but aren't they synthetic hormones & not as good as human ones.   I try to consume phytooestrogens but there again plant oestrogens aren't as good as human ones either.

I've had blood tests done recently which were normal for thyroid levels.  I was under a gynae man for ?ovarian cyst & he did bloods for hormone levels which proved I'd started the perimenopause/menopause phase.

I presumed it was normal to still have PMT & bloating during the perimenopause phase but from what you've written you're puzzled by it.  Before the perimenopause I had it for 3 days before a period & it carried on like that when my periods first stopped.  The last few months it's got worse.  As I said before I have about 3 days a month when I feel normal-ish & the rest of the month I have PMT & excessive bloating.

[Sarah2]

Hi again

Why do you think your symptoms are sudden? If it's 9 months since your last period then it would be quite normal to be having symptoms now.  You may have had a slow decline in oestrogen for many years and not known about it until the levels dropped enough to give you symptoms. I had no peri symptoms at all until I was almost 53 then missed a couple of periods and had hot flushes on the hour and poor sleep. Up till then I'd had nothing except a bit of bad-temper maybe like worse PMT! I wondered if I was going to sail through meno with no symptoms at all then bang- hot flushes almost over night.

Everyone's hormones fluctuate wildly during peri which is why blood tests are unreliable.

HRT in the UK now is mainly bio identical. That means it's made mainly from plants and the molecular structure is the same as you'd produce yourself-usually oestrodiol or oestriol.

In the US they use(d) mares' urine to make oestrogen and this is found in products like Premarin.

PMT can get worse in peri meno but  I'd have thought it was if you were having cycles, even if they were far apart. I think Hurdity linked to some info on this in her post.

Have you had treatment for your IBS? My daughter follows the FODMAP diet under guidance from a dietician and she has had some improvement on it. Are you managing your symptoms with diet?

Are you sure that the symptoms you have are PMT and not IBS because that can cause bloating too. What other PMT symptoms are a problem?

[CLKD]

PMT can only happen BEFORE a bleed ……… and will stop once the bleed stops.  I had it terribly  - I was helped by NAPS so you may find advice on symptoms there.  If you are in peri then you may have enough cyclical symptoms that react like PMT and because you don't bleed then it doesn't go away.  It is SO uncomfortable, I remember it well  .  Drinking plenty is important even though you feel bloated, because the kidneys will need support too.  You may need Motillium or a similar medication which can help ease food through the 'system' which may ease the bloated feelings.

Bloatedness can be a sign of ovarian cancer.  Something to talk with your GP about?

Keep browsing on here!  There is a mine of information and a funny room too!