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[Ohgoodnessme]

Ok, so I finally plucked up the courage to see GP the other week. I have a history of anxiety/depression, have previously been on ADs & was convinced it was that back again (have lots going on at the moment) Anyway running through the whole range of symptoms with her and she's certain it's the menopause. She sent me away with some reading but, basically, it's back on ADs or HRT. I'm going to give HRT a go and see if I can get back to feeling like me again instead of some moody, grumpy, shouty woman I don't recognise! Many years ago, whilst undergoing fertility tests, it was discovered that I have endometriosis. My question is, is there a form of HRT I can safely take? I know my doctor will advise me but I'd like to go to my appointment armed with info!

[Dancinggirl]

Hi and welcome to MM Ohgoodnessme
HRT is well worth trying but if you had endometriosis then it could trigger problematic bleeding.  I would mention this and perhaps ask for a referral to a meno clinic - or your GP could seek advice about what type of HRT would be best for you.  You don't say where you are in your menopause journey?  How old are you etc?
The Mirena might be a sensible option as this delivers the progesterone directly to where it is needed and could keep the womb lining thin and possibly prevent erratic bleeding.  If you have this fitted then you only need to add oestrogen in either patch or gel form (there are pills but patch or gel is best).  If you are still peri meno then do start on a low dose of oestrogen  - I have used Oestrogel for many years and it allows you to control the dose you use.
Do read up all the info on this site to get really clued up - particularly the section under TREATMENT.
DG x

[Louisa]

I did what the other girls suggested, do some research on this website then you can go armed with relevant information.  Knowledge is power. 

[Ohgoodnessme]

Hi ladies, thank you. I'm 51 and in the peri stage. Still having regular, heavy periods. To go with that I have low moods, tiredness,  a short fuse & I'm sweaty, spotty & anxious. I'm a regular joy at the moment!  Luckily I have two very patient boys at home in my DH & DS!
I've been reading up on the different types of HRT and was veering towards tablets. Every one I looked into advised caution if there had ever been endometriosis. I believe my GP was at a menopause conference last week so she should be armed with all the latest info by the time I eventually manage to get an appointment with her!

[Hurdity]

If you are having regular heavy periods ( ie no changes in cycle yet ie slight lengthening and sometimes shortening) then you are not yet truly peri-menopausal according to the definition. However many women do experience problematic symptoms before peri-menopause starts properly because the hormones start to fluctuate more dramatically. I know I certainly did - but I didn't know anything about menopause and as my cycle was regular I just went with the flow (so to speak!) until my cycle started changing and I began to get flushes too. We all seem to respond to the changes that occur differently and I don't really understand what is happening in the stage before peri-menopause. At this point adding oestrogen may not be the complete answer especially as it sometimes achieves very high levels just before peri-menopause and often the cycles become shorter at this time too.

Regarding endometriosis, this is what it say on this site:

There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis.
http://www.menopausematters.co.uk/atoz.php#GlossE

You can see from the above that a  Mirena coil would not be suitable because insufficient progestogen gets into the body systemically and in endometriosis the residual deposits could be outside the womb, so I understand.

Therefore the only tablet that would be suitable if prescribed would be continuous combined tablets such as normally given to post-menopausal women - but I don't know if this is normally what happens? A low dose conti preparation like Femoston might help if your doc would allow it but I agree with Dancinggirl I would ask for a specialist referral if you can.

Hurdityx