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[dangermouse]

Just to say hello and give some background info.

I'm 46 and think I'm somewhere in the mid to late perimenopause. I've had varying symptoms for the past 7 years or so but 6 months ago I suddenly started getting severe nausea, 5am awakening, adrenaline rushes of anxiety and tachycardia (120bpm constant), vertigo, head inflammation, itchy skin etc. which were put down by various GPs and A&E docs as... stomach ulcers??!!! The more meds I took for them, the worst I felt and the more meds I was ordered to take. (I live in London and endoscopy to show I don't have ulcers has been a 5 month wait). As the cyclical worsening of symptoms became apparent I realised it was hormome related and am now on the pill, which initially made things worse, but has now stopped the nausea completely and the other symptoms are subsiding, especially by adding compounded hrt I got years ago when investigating peri.

As the nausea was so extreme (I lost 2 stone as could only consume milk and juice for most days of the month) I had to give up my career for 6 months (I work for myself and support myself) so been hit quite hard financially as no sick pay for the self employed!

Think that's about it! Enjoying reading all your posts, I too can't believe how this hits some of us. One of the many things that put me off of having kids was the thought of the morning sickness and then I was hit by Kate Middleton levels as my punishment! Cruel world.

[CLKD]

I was the same, was totally unable to consider children because of morning sickness etc..    Never regretted it though ;-).

Have a good browse round, make  notes.   

[coldethyl]

Hello. I can relate to lot of that. It does seem that joined up thinking by doctors doesn't seem to happen when women of a certain age present with a host of seemingly unconnected symptoms. I know my GP got sidetracked by my diabetes diagnosis and everything was down to it even when it was things that were obviously related to my hormones fluctuating.

[CLKD]

So frustrating! so time consuming! at a time when the patient wants to feel well again 

[Halfpint]

Just to say hello and give some background info.

I'm 46 and think I'm somewhere in the mid to late perimenopause. I've had varying symptoms for the past 7 years or so but 6 months ago I suddenly started getting severe nausea, 5am awakening, adrenaline rushes of anxiety and tachycardia (120bpm constant), vertigo, head inflammation, itchy skin etc. which were put down by various GPs and A&E docs as... stomach ulcers??!!! The more meds I took for them, the worst I felt and the more meds I was ordered to take. (I live in London and endoscopy to show I don't have ulcers has been a 5 month wait). As the cyclical worsening of symptoms became apparent I realised it was hormome related and am now on the pill, which initially made things worse, but has now stopped the nausea completely and the other symptoms are subsiding, especially by adding compounded hrt I got years ago when investigating peri.

As the nausea was so extreme (I lost 2 stone as could only consume milk and juice for most days of the month) I had to give up my career for 6 months (I work for myself and support myself) so been hit quite hard financially as no sick pay for the self employed!

Think that's about it! Enjoying reading all your posts, I too can't believe how this hits some of us. One of the many things that put me off of having kids was the thought of the morning sickness and then I was hit by Kate Middleton levels as my punishment! Cruel world.

Hi Dangermouse, I hadn't even known of peri menopause until I went to the Dr last year with joint pain and dry mouth. He asked me a few questions and said it was arthritis but he also said the dry mouth could be menopause. I said 'aren't I too young for that' and he said 'no, anytime from age 45'! I had always assumed menopause was in the 50's. Because I suffer with Health Anxiety, I sometimes think that I am imagining I have most of the 34 or so peri menopause symptoms but they certainly feel real enough. I too have suffered with nausea and the early morning wakening. Lightheadedness and since January, terrible itching in differnent areas of my body plus of course the awful joint pain and many other symptoms. Quite a few of my friends are used to my health anxiety and me always thinking I have some disease or other so i feel most of them are brushing aside my menopause symptoms as if to say 'god, not another thing wrong with her'! I also don't have a very understanding husband which isn't helping plus we have two kids going through puberty with raging hormones so our home is not always a happy place to be at present!

[CLKD]

As oestrogen levels drop so the body can become itchy    - for me it's my insteps, OK all day but when I take off socks and get into the bath at 9.00 p.m., the insteps begin itching.  I can wake in the night with one instep scratching the other  .  For a few years it was an itchy back after my bath ……….

[dangermouse]

Thanks all! Yes the anxiety on top of the lightheadedness is a scary feeling for sure! Now I know what it is it's easier to ignore.

I do feel for you girls with kids to bring up as well, I could barely look after myself some days!

I'm playing around with two Norethisterone pills, as that prog suited me better when younger on the pill, and last night I tried the more oestrogen dominant one (Ovysmen) and the itching has been noticeably less today. So I think I need more oestrogen but I was also getting oestrogen surges which I think accounted for the churning nausea, but I think any pill will probably calm those down by making the cycle less volatile.

[Halfpint]

As oestrogen levels drop so the body can become itchy    - for me it's my insteps, OK all day but when I take off socks and get into the bath at 9.00 p.m., the insteps begin itching.  I can wake in the night with one instep scratching the other  .  For a few years it was an itchy back after my bath ……….

I've had the itchy insteps..really annoying! At present I have an itchy chest and wondered if it was due to the over heating at night? I used to be freezing in bed and have to wear socks...now it's no socks and kicking the covers off! I've also had itchy legs, stomach, boob!

[Hurdity]

Hi dangermouse

 

Thanks for introducing yourself - it helps to know where we all are re menopause!

What were your periods doing when you went onto the pill? Presumably if you were late peri they were few and far between? The nausea usually occurs with high oestrogen levels which often occur cyclically just before peri-menopause and also when the extreme fluctuations continue to occur in early peri as well. Yes absolutely - the CCP controls the cycle - by suppressing ovulation so you just don't get the fluctuations any more - but some women find the high doses of synthetic progestogens unpleasant.

I am not clear about what regime you are on? You said earlier that you were on the Pill + HRT - but surely not necessary to have both as the Pill gives high oestrogen and progestogen ( usually the synthetic kind)? Also I don't understand where the norethisterone comes in - you definitely don't need this as well as the Pill? I am wondering where you are getting your HRT advice from?

There is a CCP called Qlaira which contains bio-identical estradiol and which only has two (or maybe 3 ) tablet free days - which is ideal for women in your position, and if you tolerate synthetic progestogens? This should give sufficient oestrogen.

Hurdity x

[dangermouse]

Hey, sorry to confuse. Firstly, my periods were shorter and lighter but I hadn't missed any but the last few were longer cycles for me (28-30). I've fortunately never had heavy periods but was told years ago by endocrinologist that I had unusually low oestrogen in my 20s. So was advised to stick with oestrogen dominant pills. I came off the pill about 7 years ago when started feeling lethargic in my pill free week. Felt better off it for a couple of years but gradually got more and more lethargy and gut problems (slow transit mainly). Over the years I've tried Candida diet, every supplement known to man and nothing made me feel better. Magnesium and Vit D supps made my body bloat up and they thought I had some kind of odd inflammatory condition at Marion Gluck. I've since been reading that these lower oestrogen levels further so this may be why. I think they should have known that so not keen to return! Not that I can afford it now.

I am taking Loestrin or Ovysmen which both have Norethisterone as the progesterone, so can swap around with them to check which ratio is best, so not taking additional Norethisterone. As our hormones are still bubbling beneath, I guess it creates a more stable oestrogen dominance as no ovulation to release more prog but still reflective of our own hormone constitution? I know the pill won't be as fine tuned as only taking HRT so have been adding tiny amounts of BHRT creams (micronised progesterone and oestodial) that I got from London Specialist Pharmacy (via Marion Gluck) a few years back. I stopped taking them back then only after a few weeks as I felt worse on them, but I didn't realise then that it was a complex process to get everything lined up so had assumed my symptoms were down to diet etc.

I actually read today in Elizabeth Vilet's book, Screaming To Be Heard, that she prescribes the BCP plus oestrogen gel for the pill free week so that there is still a bleed and a gap to stop the progesterone building up but enough oestrogen to stay symptom free. I guess it's about being creative! I'd prefer to just go with the HRT but my GP said it wouldn't be strong enough to oppose the oestrogen surges and I just couldn't take the risk of the nausea returning.

I actually tried Qlara a few years ago but didn't like it, I think the progesterone in it didn't agree with me. Back in the day I tried lots of pills and much preferred how I felt with Norethisterone as opposed to Levenorgestol or the 3rd gen probs. I think it's more androgenic so perhaps that suits me.

Once I've run out of the compounded creams I'll try to get my GP to prescribe the Oestrogel with the BCP but can imagine they may not agree so might have to go private or back to the compounded.

Hope that makes more sense!

[Hurdity]

Hi again

I am still puzzled as to why you are adding extra oestrogen/progesterone to the BCP which has high doses of both, albeit synthetic. Yes the reasoning behind Qlaira is to prevent the dip in the pill free week you get with the other pills - because there is virtually no break from oestrogen - but as you say adding oestrogen would help. Depending on where you are in menopause there are plenty of HRT types that contain norethisterone as the progestogen - many of us like to avoid these though! There is another pill with bio-identical oestrogen called Zoely which has 4 tablet free days - I am not familiar with all the progestogens in the CCPs though. The one in Zoely is nomegestrol acetate. http://www.medicines.org.uk/emc/medicine/27581/SPC/


During peri-menopause when your own hormones are fluctuating you're never going to reach an ideal solution - although taking the pill is probably the best if you can tolerate the progestogens, since it suppresses ovulation.

Hurdity x

[dangermouse]

The additional hormones are to even out moods as the pill provides a set amount and as my own hormone cycle is doing its volatile thing underneath, I can add what I need each day.

I'd prefer not to use the synthetics but just couldn't risk the time it may have taken to control the severe nausea, which I'm now thinking was down to very low oestrogen. I'm also not taking any pill breaks.

Thanks for other pill rec., although I know I used to react terribly to any 3rd gen progesterones when younger, so the Norwthisterine is the best of a bad bunch for me!

[Hurdity]

If you are taking the Pill then your own hormones won't be doing their "volatile thing" although there may be some activity if you are on a very low dose pill - but if you are not taking pill free breaks then this is less likely (your own activity - at least to any appreciable extent). The volatile stuff is prior to and due to the surges of ovulation - the spikes of oestrogen and progesterone and their crashing. You won't be getting these.

Usually nausea is attributed to sudden high oestrogen - especially in peri-menopause - just as in pregnancy - although I gather some women have reported the reverse too.

Anyway I do hope you manage to find something to make you feel as well as you can during this time!

Hurdity x

[dangermouse]

I can really feel my own cycle underneath the pill, I posted earlier about an article that showed we still grow follicles when on the pill, albeit very small but they still allow the fluctuations. I wish it was as simple as the ovaries being put to sleep on the pill but I personally doubt this.

Yes I too have read conflicting views on whether high or low oestrogen causes the nausea, although I did have two different types, the churning and motion sickness, sometimes at the same time. At least that's ones symptom that has not returned since the pill kicked in. I can at least function with the other horrors!