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[MIS71MUM]

Hello Ladies

Can you please offer me some guidance/advice please for my next steps?

As I have mentioned before, my periods usually stop over winter.  I have now had two this year and will be due another in about a week.  Since my periods have re-started, I have noticed that my mood has lifted and this has been very welcome.
However, I have also noticed some other symptoms have started creeping back in.  Some of these I have had before, and went onto HRT.  For example, I am getting hot and cold sweats, my digestion over the last month seems to be playing up and get a pain under my ribcage after eating, body tremors/internal wobbliness/shakiness, my sleep isn't as good as it was, i seem to be more aware of my heart beat and keep getting headaches.

I have been on AD's for 5 months now, and although I know these can cause side effects, these have now subsided and I know which come from my AD's.

My question is, if I am having regular periods but really do feel like the physical symptoms are coming back, what's the best course of action for me?  I have booked an appointment with my GP next week to ask for a referal to the meno clinic because although I have my FSH levels checked (35 & 27) respectively, I have never had my oestrogen, progesterone, testerone levels tested. 

I really want to avoid anything detrimental happening to my mood, and don;t want to get into a position where I end up with too much of a hormone.

This month, I feel as though it takes me at least 10 days to get over my period, then have the middle section where I am well and then a day or two of pmt.  Today is Day 20 and my internal shakes have been the worst so far.  I have considered the Qlaria CCP as I was thinking that anything that made my periods lighter would be a bonus, but I have read the leaflet online and anyone who has had antiphospholid syndrome (sticky blood) can't be prescribed it.

I know I am going to struggle with my GP as she is the one who has flatly refused to prescribe me oestrogel before.

Also I would really like to avoid anything with synthetic progesterone included so it doesn't have a knock on effect of my mood.

Thank You

[MIS71MUM]

Forgot to mention that I am nearly 45!  And have heart disease in my family so am thinking about the protection of my heart and bones.

[Hurdity]

Hi there Mis71Mum

If you're sure your feelings are not due to the ADs then it could be blood sugar changes caused by hormonal fluctuations. Oestrogen and progesterone have different effects on blood sugar and many women notice low blood sugar and shakiness/light-headedness sometime during the second part of the cycle near to period time - I know I used to.

First thing I would do to minimise this is really cut out sugar if you can and cut down on carbs and eat more protein. Have a really good breakfast ( depending on which time of day you get the surges). Dietary changes have a huge benefit in regulating blood sugar and minimising any feelings due to this. Also cutting down on caffeine and alcohol.

Apart from that how about trying a low dose HRT if you are getting physical symptoms - eg an oestrogen patch with separate utrogestan (progesterone)? Your doc cannot refuse to give you a prescription for this if you are having menopausal symptoms. The thing is if you are on an AD this might be dealing with the hot flushes that you could be getting if you weren't on it - and these are the reason most docs will willingly prescribe HRT.  If you do ask for HRT, tell her you would like to use transdermal HRT because you don't want it to go through the liver but also don't want any synthetic progestogen, and therefore want to try micronised progesterone. If you really want oestrogel then she should prescribe this but rather than come away with something totally unsuitable I suggest a patch!

Sorry I can't be more help and good luck with your doc

Hurdity x

[MIS71MUM]

Thanks Hurdity.

You have raised a really interesting point. As I don't really drink anymore and only have 2 cups of tea a day, I have been treating myself to quite a bit of chocolate! Also a couple of weeks ago, I began having cereal for breakfast instead of my usual toast. I quite soon noticed that I was really struggling mid morning. As soon as I swapped back, my morning shakes disappeared.  So my first task will be to reduce my sugar intake.

My female GP was aware that the gel was very good for changing doses but when I asked about the non synthetic progesterone, that's when she was unsure.  At the very least, I will ask her about the blood tests or a referal.

Maybe I'll just treat myself to chocolate once a week instead of once a day 🙄

[Hurdity]

If you have 85% dark choc it's really low sugar - then you can still satisfy even daily cravings with a tiny piece! I usually have an egg for breakfast too. One thing I noticed about peri was that my previous breakfasts ( eg a slice of toast or small bowl of cereal) wouldn't do it any more (got the mid morning shakes) and ever since then I have to eat good helpings of slow release carbs (like oats or muesli) and lately (as I was trying to lose weight) cut out the muesli/oats and instead I have lots of fruit, and natural yogurt, and also eggs or lean bacon, mushrooms and tomatoes - and I can manage without anything until lunchtime sometimes or just a handful of nuts mid morning. That's going a bit off topic but I don't think women realise quite how much effect diet can have - well it has on me anyway!

Even if your GP is not sure, I would print off the section on progesterones here: http://www.menopausematters.co.uk/to_progestogens.php and suggest that it may be in her book as "micronised progesterone" - all she has to do is to prescribe the licensed dose. Also the full product info (SPC) is available on the web so there is no excuse even if she hasn't prescribed it: http://www.medicines.org.uk/emc/medicine/19895/SPC

Hurdity x