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Author Topic: Not sure what to do!  (Read 3685 times)

Babsm67

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Not sure what to do!
« on: January 03, 2017, 10:18:07 AM »

Hi,. I started Evorel 50mg in Sept on the advice of my meno gp due to severe pms & mood swings, amongst other symptoms.  Unfortunately, I had a really bad experience with Utrogestan in early Oct (I felt suicidal) so stopped everything & started a low dosage of AD's the following week.  For a few weeks, I felt much better & my pms mood swings during my cycle in early Nov, were reduced.
 After those few weeks, the low mood started to return & I had more pronounced physical pms symptoms leading up to my period on 1st Dec- sore breasts, bloating & a really bad menstrual migraine. My period finally petered out after 9 days.   My mood did not lift around day 8 like it sometimes does & something felt 'different' - I felt 'flat'.  Also, on day 8 of that cycle, I saw my meno gp again & she recommended that I use a 25mg patch from day 25 to the end of my period to reduce the pms symptoms & stop my menstrual migraines. The 50mg patch had probably been too high when I used it in Sept-Oct.  She said there was no need for progesterone  as I was only using the patch for a short time.
Despite peri symptoms, my periods have still been coming like clockwork every month.....until now.  During the 2nd half of my cycle, I experienced, what I think was, a short, hot flush.  Period was due Dec 28th & now it's day 34 & nothing has happened.  No bloating, no sore breasts but, on New Year's Eve, my mood plummeted & I have been a crying wreck along with having cramps, aching joints & mild headaches. I had a short hot flush yesterday (had to change top).
I don't know what to do now - I was supposed to stop the 25mg patch at the end of my period but it hasn't started.  I suspect I have had an anovulatory cycle & that my oestrogen levels are very low.  Should I increase my patch dosage instead?  The other problem is that I don't know what day to count as day one of my cycle in order to eventually start the progesterone part of hrt (I don't know what to do about that either after the experience in Oct - I used 200mg Utrogestan orally for 8 nights).  It will be ages before I can see the meno gp again & my own gp surgery doesn't deal with hrt (they will prescribe repeat prescriptions but that's all).
Sorry that this post is so long but I would be grateful for any advice - thanks X.
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Pam Madra

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Re: Not sure what to do!
« Reply #1 on: January 03, 2017, 10:49:50 AM »

sorry to hear all this. I am exactly in your position with my doctor giving tibilone for 3 weeks and still struggling with flat mood anxiety nausea and to top not hungry and if i eat diahhera starts stay away. I don't know if mine hrt will kick in too. Sorry cannot advice you too much but think you can try new 25mg and see if helps with right balance. I understand it is very hard to find right thing. Maybe find new gp surgery I have been trying new doctors as well. Hope find some answers from others.
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Elizabethrose

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Re: Not sure what to do!
« Reply #2 on: January 03, 2017, 12:28:59 PM »

Hi Bloss

What a bummer, thought you'd got all sorted! Don't despair, you will find a solution.

I didn't want to read and run but as I said before I'm no expert on HRT, no doubt a regular HRT poster will be along soon to offer advice. It sounds to me as if your own cycle is now doing the fandango which would indicate a move further into peri. Specialists tried everything to 'manage' my hormone rises and falls at this stage and it is awfully tricky. Trying to alleviate the oestrogen falls with gels, patches etc is very difficult as at this stage our cycles can be all over the place.

I'm flying out (hah, late should be there already!!) but will cut and paste from another thread a description of what happens to me in both ovulatory and anovulatory cycles, perhaps you can see some parallels. I would say that flushes normally indicate a fall of oestrogen in the early peri stages, thus just before a period, if you don't ovulate, the FSH builds again to try to stimulate another viable follicle so there can also be an oestrogen drop mid cycle too. Your vaginal mucus might be able to tell you what's going on here. (see my old post below)

Sorry to cut this short but friends will be cursing me!! I'll come back later.

Lots of love to you, you'll get this sorted! x

This is the old post.....

For many years I've had specialists from a number of disciplines trying to manage my chronic migraine. Bloods have been taken regularly; fertility monitors were used daily, temps were monitored and comprehensive daily records kept. All tests confirmed what I already knew was happening. I've been menstruating for 44 years now, despite the chaos of peri, I can still pretty much read my body like a book.

If I ovulate, slippery egg-white type cervical mucus appears just before ovulation, I get ovulation pain and a slight bloody show and front of breast tenderness. The mucus would last for about 2 days then disappear, as would the breast tenderness. The bleed would arrive about 13 days later accompanied by period cramps, swollen breasts, bloating and migraine that could rebound for anything up to 13 days. Then the whole thing would start again. If I ovulate, this happens without fail.

If the cycle is unovulatory, slippery egg-white type cervical mucus builds and front of breast tenderness starts. There is no ovulation pain and no bloody show. The mucus stops suddenly for a couple of days and then rebuilds, the breasts swell hugely, necessitating bigger bras and they become very, very painful. I start bloating and can literally put on half a stone. All can continue like this for anything up to 6-7 weeks. These oestrogen highs can be off the Richter scale, all has been measured.

A sudden drop manifests itself as a sudden cessation of all of the above symptoms: it feels like I've been slung against a wall. I pee constantly, a monster migraine kicks in which is what happened this weekend and which can rebound for ages. Sometimes I will then get an anovulatory bleed. The cervical mucus is still present and mixes with the blood loss. It looks different to the loss of a normal period. My body is pretty adept at shedding any endometrial build up from these oestrogen surges. It's had plenty of practice!
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Elizabethrose

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Re: Not sure what to do!
« Reply #3 on: January 03, 2017, 03:30:51 PM »

Hi Bloss

I just want to confirm what your HRT usage is. Are you only using oestrogen for the last few days of your cycle till the period ends?

This was tried on me with Oestrogel and in theory it should work if your cycle is regular but of course in peri it rarely is. I used to use a fertility monitor to tell me where I was in my cycle but to be honest they just can't cope too well with erratic cycles. I also kept a log of waking temperatures (pain in the neck!). The best way I found of identifying where I was in my cycle was by checking cervical mucus. This is usually very reliable; you just need to know what you're looking for.

Are you aware how long your luteal phase is usually? (The length of time from ovulation till your period starts.) This is normally consistent and between 11-15 days. If you know this, what you could do is monitor your cervical mucus to identify when you are ovulating in your next cycle then count out the days until you reach the 25th day of that cycle. Does this make sense? If you don't get a period this month then just stop the oestrogen and start again counting from when you next reach mid-cycle. However, if you have cramps you may just find that the period is coming but is late!

Oh I'm not sure you're going to understand this babble. Does it make sense to you?

Either way, don't panic: it's not going to harm you if you stop or start early or even later and your moods/anxiety are already being affected by the oestrogen fall you've had with your own natural cycle. Take a deep breath and try not to panic: the whole thing is a pain in the neck but if you become anxious it'll only make you feel worse.

Please please do ask if you have no idea what I'm talking about! xx
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Babsm67

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Re: Not sure what to do!
« Reply #4 on: January 03, 2017, 08:25:18 PM »

Hi Elizabethrose,
Thank you for taking the time to reply to me :). Yes, I do understand what you are saying so don't worry!  I was advised, at the beginning of December, to use an Evorel 25mg patch from day 25 until my period ended as my periods were still regular & usually arrived around days 28-29.  The meno gp (who is excellent) advised me to do this to prevent the drastic drop in oestrogen & subsequent migraine.  I had similar symptoms to you before my period started in December- sore breasts, water retention, pms & a horrendous migraine.  This month - no breast soreness at all & now, the cramping has stopped.  I did produce mucus around the time I started the patch & the same thing happened this morning. 
I think my luteal phase would normally be around 14 days but this month is a mystery!  My cycles started to shorten to 23-25 days around spring 2013 when I was 46 but started to lengthen to 28-29 days earlier this year.  It is the not knowing when my period will come that is the biggest pain - that's where hrt would hopefully help but, as we have seen from the forum, our own cycles can still create havoc in the background!  I will keep a lookout for the cervical mucus & thank you so much for your help as I felt totally confused as to what I should do!  ::) Xx 
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Elizabethrose

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Re: Not sure what to do!
« Reply #5 on: January 03, 2017, 09:25:25 PM »

Good, glad it wasn't total gobbledegook!

Just as an aside, it's the follicular phase that usually changes when cycle lengths change not the luteal phase. Though it's not infallible!

Good luck! x
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Babsm67

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Re: Not sure what to do!
« Reply #6 on: January 03, 2017, 10:08:29 PM »

Hello Pam Madra,
Thanks for your reply - it really is a pain trying to find the right balance of hrt, isn't it?  Yes, my gp surgery simply doesn't deal with hrt - they refer me to the meno gp, who is really good.
I hope you do get on well with the Tibilone - the worst thing is the wait to see if it will work but many ladies have had success with it. Xx
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Babsm67

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Re: Not sure what to do!
« Reply #7 on: January 03, 2017, 10:10:28 PM »

Thanks, Elizabethrose - I will wait & see what happens!  :)xx
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