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[Gracie]

I've been to the GP today due to a few symptoms, the worst being absolute fatigue. I can be alright one minute then the next wonder how I'm going to put one foot in front of the other. I try going to bed in a darkened room but never manage to sleep.
I know I'm definitely peri menopausal as I've had a 14 months break from periods, couple of periods recently. I had regular hot flushes, mainly just heat no redness, but they aren't too bad. Bad head, can be debilitating at times. Constipation, I go about every 3 days, cramp in my feet and a rubbish nights sleep.
Now whether these are all a result of the menopause I have no idea and in truth I wouldn't consider HRT as it's all bearable in my case except for the fatigue. I'm going for blood tests tomorrow, GP said possibly under active thyroid but he said if nothing shows up maybe I should consider HRT. He said I would know within 3 months whether it helps the fatigue or not.
In a way I'm hoping for the under active thyroid as I've read that's just a tablet a day, may live to regret that thought, but I feel it would be preferable to get a diagnosis rather than just messing with drugs to try to cure it.
Any thoughts or experiences are most welcome.

[Dancinggirl]

Hi Gracie
I'd keep an open mind if i were you. The treatment for thyroid isn't necessarily as easy as you think and I don't think it's good to think of HRT as a 'Drug'.  HRT is about replacing the hormones you are missing. However, HRT isn't for everyone - it's a personal choice and depends on how much the meno symptoms are effecting your life. I had to use it for years because of premature meno but I can't say I was problem free and I am now 8 months into another break from HRT (I'm 58 now).  If I can conquer the sleepless nights and fatigue I won't rush to go back to HRT but if my bone density and aches and pains get any worse I will certainly consider HRT again.
Constipation can make you feel really sluggish and if you aren't sleeping it's no wonder you are suffering fatigue.  You're lucky your GP is actually recommending HRt as an option as many GPs are very anti HRT.
I'd have a good look at your diet to see if you can sort out the constipation - bran for breakfast and do you drink enough water? Constipation can cause headaches but hormone fluctuation can also be a trigger - I got terrible heartaches through my peri meno stage, sometimes for several days at a time - really horrid.
I take Nytol every 3rd night or so to give myself a better nights sleep but I have to say my energy levels have dropped dramatically since I came off HRT.
It sounds to me as though you are in a vicious circle. So tired during the day you are not getting enough physical exercise to be ready for sleep at night.  Plenty of brisk walks will protect your bone density, improve mental health and help you to sleep.
DG x

[Ju Ju]

Dear Gracie,

I never wanted to take HRT, particularly as my sister died of breast cancer. I was fortunate that I could cope with most meno symptoms apart from insomnia and extreme exhaustion. I also have IBS like you constipation, though it can swing to diarrhoea. The only thing that showed up in all tests was that I have had is very very low testosterone levels. As I was nearing 60, I was initially told HRT was out of the question and that I should consider CFS as a diagnosis. However, at the grand old age of 60 I have started HRT as I was fortunate in seeing a very supportive doctor who suggested I see a private gynaecologist, who she had worked with. I started with low amounts of oestrogen and started feeling more energetic. I then had to add in progesterone to the mix to protect my womb and have had a few problems with that hopefully initially. I have started testosterone therapy a few days ago. I am definitely feeling better than I did.  I am following a low carb diet as I have been advised to do and I am able to exercise more. I have followed a consultants advice to try Fybrogel twice a day, though it didn't help before. I go to the loo more often and it is easier to go when I do. Overall, I am feeling much better. No longer is it exhausting to shower and get ready for the day. I have quality of life. A year ago I could hardly do anything. Yes, there are risks, but I would rather have a shorter quality life than years of living as I was. I still have to pace myself and say no to things I would say yes to if I could. I don't worry now as I am busy living. This was my choice. It is up to the individual. This site has lots of helpful information. Ju Juxx

[Dancinggirl]

Hi Gracie
It is frustrating when you are doing all the right things and still feel dreadful.
Ju Ju has given some lovely feedback  - pleased it's going well JuJu.
I think it is easy to underestimate the effect of falling hormone levels and when you are in the peri stage, as you are, the hormone fluctuations can really cause trouble.
If you do want to try HRT perhaps try a low dose of Femoston as it is tolerated very well by many women.
You are right to be wary of the internet - this site is very good and the info can be trusted - have you read all the stuff under the headings to the left of this screen - all very informative?
I'd still try to sort out the constipation - perhaps up the roughage?
DG x

[Ju Ju]

Are you getting a full blood count? My fatigue last year was extreme. I had low energy for many years, but last year was bad. I was seeing a new doctor, who sent me for a full blood count. The results indicated something was not quite right, but before this could be followed up, I had a virus, which in turn became a chest infection, complicated by asthma, which necessitated a shirt stay in hospital, copious amounts of antibiotics, etc. When I eventually recovered, I was better and suspect I had a low lying infection before, which was sorted out by the antibiotics, but HRT has lifted me higher in the energy stakes. The trouble is you have to be persistent and assertive, when you haven't got the energy for this. The fatigue was blamed on the IBS before. I really appreciate the trouble and care that my current GP has taken.

[Rowan]

I get days when I have fatigue, I always say to OH I feel as if I have no blood I have had a full blood count and about eight other blood tests this year, all came back normal. I am on estrogen too.

I am not sure HRT would help with fatigue, my fatigue comes and goes, I think its something that many people have of all ages, Doctors call it TATT (tired all the time) http://www.patient.co.uk/doctor/fatigue-and-tatt

I remember when I was in peri menopause having bouts of fatigue in the afternoon and wanting to just lay down and sleep, I think its normal.

It did pass, the fatigue I get sometimes now I think is just getting older and maybe not sleeping so well some nights, one day I can take on the world, the next I want to lie low.

[Ju Ju]

The extreme fatigue and exhaustion I am talking about is not normal. Which is why CFS was being considered. Why I wrote the post is that I do feel better since starting HRT. Better than I have for several years.

[Hurdity]

Hi there Gracie

I pretty much agree with everything that's been said.

In terms of the blood test - when I went to the doctor complaining of tiredness especially in the mornings (and not fatigue like you describe JuJu - but definitely unusual for me) - I also had a the three tubes blood test - which covers many things - full blood count, renal and liver function, and oestrogen etc. One thing they do not routinely check for on NHS is testosterone levels - because so little is known about this.

I mentioned to my doctor GP who said we can't go round testing every women for tesosterone who comes complaining of tiredness! OK in many cases it may not be extreme but may well be low enough to cause some symptoms.

All I'm saying is - if your blood tests come back "normal" - it will be within the normal range for the tests they do. If you don't get a satisfactory explanation and treatment I would insist on a referral as JuJu has done, and ask for them to test for testosterone. The other thing about thyroid is - do ask for the actual result from the tests. Sometimes there is an issue between being within the reference range (1of normality) but getting obvious symptoms.  The test is also for TSH and there are more detailed thyroid tests that can be done. However there are often other symptoms associated with underactive thyroid eg weight gain and feeling cold - low body temperature, as well as exhaustion.

Hope you get an answer soon so that you can work out the best treatment to give you more energy.

Hurdity x

[Rowan]

I was in no way undermining your post ju ju, just relating my experience of fatigue.

[Ju Ju]

Thanks silver lady, I am a touch sensitive after years of not getting help, once initial blood tests would come back normal. I learnt that you have to think about the vocabulary you use when you see  the doctor. So many people have remarked how much better I look, even without makeup on!

[Limpy]

HRT certainly reduced the level of fatigue that I felt.
After I started using it I kept getting told how well I looked.

[Rowan]

Having Glandular Fever in my mid thirties certainly contributed to my bouts of fatigue. It took a while to get over, personally I think its always in your system, luckily the bouts only lasted a day or two and lessened with the years, except when I am brewing a virus, then I notice it.