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[peegeetip]

Very well summarized DancingGirl and covers all the topics really well.

I would not expect too much from the docs. Have a particular HRT from the MM list for Peri/premenopause.

http://www.menopausematters.co.uk/perimeno.php

Don't waste your time on the postmeno options as your still having periods.

If I was to approach the my Doc from the start again then I'd go with the advice of some of the other ladies.
FEMOSTON as with all in the list (except Prepak options) are bioidentical estrogen and the progesterone in this one is known to be the kindest too.
Estradiol 2mg
Dydrogesterone 10mg

If you take a look at the youtube list that was posted on MM too.

http://www.menopausematters.co.uk/forum/index.php/topic,26537.0.html
https://www.youtube.com/watch?v=PZSztD9p4co&list=PLAjwoYuItHS-4jvjL6gJgM7o-vpr0PVk6&index=4

The latter link actually talks about the benefits of Dydrogesterone based HRT also.

Given that your showing a lot of signs then I'd say you probably need to think about a medium dose HRT to start with at least.

So going into the doctor and asking for FEMOSTON 2/10 would be a good starting point I'd go if I was starting again.

From there once you've taken religiously for at least 6 months then you can look to adjust and customise to a patch/gel or other route.

Doc will probably say try for 3 months but this is way too short to kick things back in. But thats very unlikely and far to short a time.

In my opinion don't waste your time and money on the private route till you've tried the above.

Your choice but we can only try and help you avoid extra cost and wasting your time.

 

[BrightLight]

I feel quite upset reading these comments, I do understand where you are coming from and appreciate your viewpoint but it's still upsetting to me.  It may be that I am at a very 'firstt stage' getting my head around all this and not really knowing what this change means to me and how to 'treat' it.  I am hearing warnings about the results of not taking HRT and what that will mean and a pressure to DO something quick.  It's not that I want 'natural' Id just like to approach this without feeling I am ill or in danger somehow.

I may well be over thinking things with the HRT or otherwise, simply because I have no idea what it all means and am struggling.  Your information might sink in later on, but for now I feel almost as if I have an illness that I better quickly sort out or else..........I am doomed to future health issues, atrophy etc etc  I guess HRT is a solution to prevent all of those - but I don't really feel it's that easy, or maybe it is.

I am going to a private GP purely because my GP will not talk to me about anything, not the symptoms or other health concerns or lifestyle situations that come into the mix.  I thank you for trying to educate me and as I said, perhaps it will make more sense to me in a little while.

Peegeetip - I am not having cycles, as far as I know I am showing signs of post menopausal status.

DancingGirl - I tried for 4 days to find a relevant menopause doctor or nurse to connect with and couldn't, I will try again.  There is nothing in my area and I joined the DaisyNetwork and have not had an email yet with contacts on it that they offered.

[honorsmum]

BrightLight - I really feel for you.
I know there's a wealth of info on the left hand side, regarding HRT options, but the idea of almost self-medicating, ie going to your GP and telling them what you want, is pretty terrifying to me, and while other people's experiences are helpful, it's still a big thing to have to face.
Personally, I'm taking one step at a time, which for me means keeping a mood/symptoms diary and waiting to see a specialist. I'm trying to keep in mind that period/meno is not an illness that needs an immediate cure - a bit like adolescence, it's more of a marathon than a sprint...hard, when you're feeling rubbish!

Whereabouts in the country are you?

[BrightLight]

Thank you honorsmum - it really is a big thing for me, the changes in myself as well as the idea of going to the GP and asking for what I need when I don't know yet. I am in the South East/Sussex.  Going to take a step back for a bit and hope my body doesnt fall apart before I get my head straight

[honorsmum]

Have you tried the Find a Specialist search?
Are you anywhere near Surrey, or could you travel there - there seems to be a couple there.

[peegeetip]

Hi BrightLight

sorry you feel upset. If particular comments upset you let us know?

I too felt upset at the time when I first started to understand that my "illness" as you've put it too was actually something the doc was not explaining to me either. Sending me for tests that were not needed for other illnesses I didnt have.
A lot is down to the "dismissive" nature we find around "peri and menopause".
Unfortunately your seeing that first hand.
 
Sorry but there have been quite a few different posts recently and I was sure you'd said you still had a cycle of sorts more recently.

Others have said going private is expensive and you might only end up with the same options you'd have had on the NHS if you had a "proper" doc.

Its quite hard trying impart our experience and what we found best in the short time we have on the forum. In real life we could talk things around the block till the next cup of tea or coffee or till you were more comfortable.

Personally I'm just glad I didn't let my body slip any further than it had already.
From your posts that seems to be cornerstone of your own fears. 

If you want the time to step back, make up your mind, take as long as you want then your most welcome to.
But no point any of us not mentioning some of the problems/chronic conditions and further illness that can occur later.
I certainly wish my doc had.

I wish you all the best for your next step.

 

[Dancinggirl]

Hi Brightlight - I am very sorry if you feel upset - I never wish to make any women feel things are urgent or indeed that they must pursue a certain course of action.  When I first started posting on this site I did get a response that upset me - sometimes things can get quite passionate on here.  The menopause and how to treat it is a very emotive subject and many people have very strong ideas.
You are certainly not ill or indeed unusual as the peri menopause phase often starts in our 40s and it can take many years before we are out the other side into post menopause. Over the years I have tried so many things and have experienced good and bad advice regarding menopause treatment but generally I took a pragmatic approach - did my research, looked at my options, took professional advice and then made my decision. This is what  you are doing which is quite right. Maybe your private GP will be a good sounding board and be able to refer you to the right specialist.  I just get very upset when GPs don't address the issue of premature menopause correctly, so feel a strong wish to direct any women facing this issue down a positive road to finding the support they need. When I lived in Germany, if you had a gynaecological issue you simply went straight to a gynae  - probably a far better, more cost effective way of dealing with things. Finding a specialist gynaecologist here in the UK can be challenging depending on where you live.
I so, so wish I had found this site sooner as I have put myself through some unnecessarily tough times and I've learned so much from everyone on here. The more you know the empowered you will feel.
Do keep us posted about your progress.  We all wish you well and are here to support you.
 DG xxxxx

[Hurdity]

Hi Brightlight

I completely understand your concerns, confusion and turmoil.

When I first became peri-menopausal - or knew that I was - ie I missed a period - I thought - here I go, menopause. I may have said earlier or on another thread that I knew very little about menopause (despite having studied Biology)  apart from the basics and there was no way I was going to use HRT. I wanted to do everything naturally to the extent of using "natural" plant compounds such as Black Cohosh which were not as safe nor effective as bio-identical hormones. I later realised that only HRT would help and that by using "body identical" hormones, in the most natural way possible (transdermally) this would involve least risk.

I can see that you are still struggling with the idea of starting on the menopause journey so that you might not want to think about specific types of HRT yet - but at least the information is here for when you are ready. However you have been recommended specific products because of your mention of bio-identicals and the others were just clarifying what these are.

I really wanted to take up your point about these which Dancinggirl has already mentioned too. All the products you will be prescribed - whether privately obtained "bio-identicals", or NHS bio-identical HRT - are artificial in that they are synthesised in the lab to produce the chemical hormone in the right formulation.  There is a really good article here which explains it all better than I can - it's an American site because there are so many more paractitioners there trying to prescribe "bio-identicals", due to the different health-care system.
http://www.womenlivingnaturally.com/articlepage.php?id=177

I think elsewhere you were talking about health and menopause and asking for other women with an early menopause to give their experiences. I thought you might like a link to this paper which was posted as part of World Menopause Day in October - on this site. Called "Prevention of Disease after Menopause". It's quite technical but skim through it and you will see evidence of the importance of HRT in this especially amongst younger women:
http://www.imsociety.org/downloads/world_menopause_day_2014/white_paper/wmd_white_paper_english.pdf

It also stresses the importance of a complete assessment of lifestyle at this stage in our lives - the holistic approach - which I remember you mentioning and which is so important that it is now recognised as key to our good health as we age:

Evidence-based prevention for the diseases noted above include lifestyle management,  cessation of smoking, curtailing excessive alcohol consumption, a healthy diet and moderate exercise, as well as mentally stimulating activities.

This approach is also recommended by Dr Currie too on this site - a short section on diet exercise and lifestyle: http://www.menopausematters.co.uk/diet.php

There is a lot more I could say but you've probably got enough information at the moment. As you will gather all of us on here are very keen to share our experiences and recommendations on here and to help you at the stage in your journey where some of us may not have had help - and to save you time and perhaps money too!

It's your journey though, and take from all this what you want, and if you need any more help, hope we can give it!

Take care

Hurdity x 

[BrightLight]

Hello

Peegeetip - yes, it can be very hard to communicate on a forum and I am seeing that this issue is so personal and unique it makes it harder. 

I can also see that you are all sharing straight forward information that I never in my wildest dreams imagine that women had to learn, discover and share for themselves regarding starting a medication regime (HRT)

Dancinggirl - Germany sounds enlightened   Part of getting through stages of life well is empowerment.  If I had trust in my GP and the NHS, I guess I would have more confidence as I start this process.

Hurdity - you describe the process I am going through very well, it has to be me that works out the options and whittles them down, even if I end up coming to the same conclusion you all have   I do see that people are trying to help, save me time and money. I appreciate you sharing how you came to the knowledge that only HRT would help and the way to do it in the safest way - I had that exact conversation with the Private GP that I saw today.

I am aware that no HRT is natural - I totally get that, which is why this is hard for me, because I am weighing up risks and it's just a challenge. Prescribing from compound pharmacies is different though. I can make a good call on many things but this is the first time I have felt very nervous about doing so.

I also appreciate that the whole of ones life needs to be looked at as this phase signals a shift in how the body work in many of it's systems - I mentioned this on another thread.  It's a point in time to reassess everything and check all risks and I do that on a regular basis and know where my weak points are and this extra piece of the puzzle means I need to re-jig a few things, which is fine, I just wasn't expecting too.

Interestingly both these aspects of 'concern' where what led me to seek help today from a private GP.  I had 1 1/2 hours to talk things through and come up with a plan.  I had no confidence that my GP would have the time or energy to talk through my risk factors, all the products available, where my health is at this point, why I might not have realised the menopause was coming and the options I have to choose from in how to approach this.  If I use HRT I also want to know it isn't too much or too little and my interest in biodenticals from compound pharmacys was because in some ways this offers a more bespoke prescription.  The private GP today thinks that at present my symptoms are more indicative of stress in my life than typical menopause symptoms (things could change) so the HRT would be for preventative reasons.

I feel much better placed to move confidently forward since my appointment today which includes going back and working with my regular GP to get the tests I need, the risk assessment done and the choices of products he will offer.  I then have a choice to make as to whether to continue with him or use a pharmacy.

In my case I am on the cusp of the 45 year old parameter and it does make the choice less black and white - there are risks for HRT and there are risks if I don't use it.  The one thing I want to discover is my current estrogen level which I will attempt to ask my GP for. 

Does anyone have info to share on how the GP assesses risk and suitability or is that down to research and reading as well? 

[Hurdity]

Hi BrightLight

Your GP will (or should) assess your risk of using HRT, based on the latest evidence from trials which gives an objective assessment. Therefore this will be based on your age, stage in menopause, time elapsed since menopause and the type of HRT - bio-identical ( ie estradiol and progesterone) vs synthetic/animal based such as Conjugated equine oestrogens (from horses) and synthetic progestogens.

S/he will then look at your medical history and see if there is anything that could increase the measured risk (which is extremely low) - such as a very close relative (eg mother) who died from breast cancer, stroke etc.

Assuming you haven't yet gone through menopause and the last period that you had was not your last - then you are likely to be over 45 when you actually reach menopause. If it does turn out to be your last period then you would definitely be advised to take some form of HRT.

Any research or reading you can do will only help you in your understanding of all of this - and you are giving yourself a crash course in what took some of us several years to accumulate!

Hurdity x

[BrightLight]

Thanks Hurdity - yes its a crash course.

I do have history that raises my risk, my mother had a brain hemorrhage with the primary cause being uncontrolled high blood pressure.  I had mentioned this to my GP in passing last week and she said these risks are somewhat cancelled out by the fact I am younger so they are replacing what should be there. 

I have not had blood pressure taken for a year, so I don't know about that either.  I had a knee jerk reaction last week that I would not be allowed to take HRT even if I wanted to but it sounds as if I can albeit with a known risk.  I sure hope after all this that if I do go ahead that these things won't send me back to square one.

GP today suggested I ask for Estrogel and Utrogestan.

[Dancinggirl]

Hi Brightlight
AS Hurdity has said, you have done a real 'crash course' on the menopause and I really hope this newly acquired knowledge will help.  From the little you have told us about your NHS GP it sounds as though he/she is a bit more up to date in their knowledge than most so will hopefully be able to offer the support you need now you are armed with the info you need. Regarding your oestrogen levels, it could be worth phoning your GP surgery and asking if the oestrogen level was done at that last blood test and if so ask what the result was - you are entitled to be given this information.  Sadly time is something NHS GPs do not have and it was clearly worth having the in depth discussion with the private GP. 
You said that the doctor you saw today believes that stress may be causing many of the symptoms you are having and there is no doubt that stress and anxiety tends to be heightened when peri meno begins.
If you do decide to try HRT the combination the doctor recommended today is what I am using and I have to say it's the best I've had in over 20 years - and I've tried just about everything. Dr Currie describes Utrogestan as 'Breast Friendly'.  If you don't like it then you can stop - HRT is not an all or nothing choice.
Do keep sharing your progress and thoughts.  DG x

[Hurdity]

Hi BrightLight

I would have thought your doc should take your blood pressure as a matter of course especially as you went about menopause - or perhaps it's just for women on HRT or over a certain age (I'm over 60!)? My doc says something pops up on her screen when I go to visit as it is a very simple preventative tool ie can highlight potential problems before they get too serious.

When you next go do ask for it to be done but beware white coat syndrome if you are an overly anxious patient!

Hurdity x

[Rachie060507]

Hi, good evening from Wales, UK. I am 39 and new here, suggested by my GP.

I was preparing to have sperm donors over the last 18 months, no luck of a stable relationship. I then discovered the contraception in my arm had run out and had it removed last October.

I also have wondered about having my eggs collected, seems not available on NHS, is it too late for that?

I seemed to experience pains which I thought related to my Kidneys. I had no periods for 4 months and returned to my GP.  I had a blood test and GP suspected I was having an early menopause. After my 2nd blood test 8 weeks, both showing an Oestrogen Low and FSH high and also had a bleed induced in the middle. I am waiting on a scan...soon I hope.

My GP said I am having an early menopause. It is suggested I take HRT.

I have been reading and firstly the 'possibility of getting pregnant' does not seem very positive. What are the possibilities?

I am understanding that a low dose of HRT will help the above levels, just as thyroxine I take for an under active thyroid. My brain seems to be suffering.

I had registered here when I found out last Friday and have been focused on my job since I finished at midday today.

I... Again... Trying to come to terms with something... Anything... It could be devastating...

[mandy43]

Hi I missed 2 periods last Xmas and that's when my symptoms kicked in:night sweats, hot flushes etc... then my periods returned, but up in the air: 11 days apart, six weeks apart.  Then they went ok and then I skipped another 2 this Xmas and then they came back normalish and then the most recent was what took me off to the docs.  Apparently this can go on for years and if you ovulate you can still get pregnant, my mum did with me at 42.  Don't give up hope.  If you know when you ovulate, as I do by the pain, then discuss with your partner if you should actively try now.  Lots of older women are having babies later in life, so it's very possible xx