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[Kimmyb]

Hi everyone

I've been reading posts on here since 2014, which has helped me immensely. I would appreciate any input offered to me based on my journey and I do hope that my experience might help somebody in a similar situation.

My history is as follows:

2014 - diagnosis of premature meno (aged 42 but with symptoms since age 38 although still having periods)

As a fit and youthful woman, this came as a massive shock to me and I was reluctant to take HRT for the first six months, as the pill never agreed with me and caused weight gain/depression.

After not sleeping properly for a year and being exhausted, I finally relented and took Elleste duet 1mg - six months after GP's advice that I need HRT to protect my bones etc.

 I was ok on this regime at first and experienced minimum weight gain however, I did have an upset stomach each morning & the progestin made me irritable plus I felt my sex drive declining. I therefore did some research and decided that the transdermal route might suit me better and my GP agreed to prescribe an estrogen patch plus utrogestan for 14 days.

Unfortunately, I couldn't get on with the patch: I was very thirsty and swelled up like a balloon, plus my hair started falling out. I also started to feel depressed. At this stage, I started lowering the estrogen whilst remaining on 14 days of 200mg utrogestan. I began to feel awful and the patches kept falling off. I asked my GP could I try the gel and she refused - telling me to soldier on, which I did for a few months until I'd had enough and went back to the elleste duet 1mg tablets for a month (interestingly I lost a stone in this month). I ran out of progesterone and I had noticed that I'd been having my own cycles without the progesterone so I tried just taking estradiol 2mg tablets for a while ( I quickly re-gained the stone I lost) and started getting backache and foot ache. I felt I might have become estrogen dominant so I  started taking utrogestan again whilst having my own cycles. I ended up back to see my GP in tears due to irritability and depression and she decided to refer me to a menopause specialist gynaecologist.

The specialist prescribed estrogel plus the mini pill. As I was still getting my own cycles I asked could I take the gel only for a short while and he agreed as I was going to have a scan. He said I might not be menopausal and he'd do a test to check. He even suggested I take a break from HRT to see how I went on, which I did for a couple of months ... towards the end of the break however, I became irritable, anxious, was losing things and my joint and body pains upon waking were unacceptable for a woman of my age. I also gained four inches on my waist overnight!

Meanwhile, the specialist  wrote to me to advise me that my blood tests had revealed that my ovaries were not working properly and that I definitely needed HRT. I therefore carried on with estrogel 2 pumps and added in the mini pill for 14 days (norethisterone) he advised me to start with 1 tab and increase to 2 tabs and then 3 , which I did over a few months. I did find that the 3 tablets made me very irritable. Besides, I was still getting my own cycles so I decided to take  a break from the mini pill for a while as having a natural cycle plus a progestin induced one was hard going. I went back to the specialist for a review and he insisted I began with progesterone again, which I did and which caused a rapid half stone weight gain in my breasts and across my back 😔 This was utrogestan 100 mg x 10 days. I was therefore surprised that I had experienced such a rapid increase in weight.  I was still getting my own monthly cycles so I carried on with just one pump of estrogel and no utrogestan for a while. When I saw the specialist for a review, he insisted I take 100mg utrogestan for 10 days, plus 2 pumps of estrogel, which I agreed to. I told him about my exhaustion and he agreed to prescribe testosterone. I was advised by the pharmacist that a sachet of Testogel should last 5-7 days.

I began the Testogel and this is what happened on one sachet over 5 days:
Greasy hair/ acne/ more perspiration & body odour / bruising on application site / extremely sore and enlarged breasts

After about a month, i  made the sachet last 7 - 10 days which reduced the side effects. However , after 2 months on Testogel, I gained half a stone and it was in my lower abdomen and pubic area 😔
I felt a lot better in myself energy wise , so I decided to persist with the treatment.
I wasn't noticing any hair growth or voice changes and I figured I could lose the half a stone.
After 4-5 months I did notice that my face had changed shape in a subtle way: my chin was more prominent when I smiled and the fat from under my eyes seemed to move to my mid face,  making my face wider and my eyes appear more sunken and hollow. I also developed fine blonde hair all over my face and above my lip / chin and more hair in places I didn't want it!!! It's not a disaster but I look better with completely smooth skin!

I was very worried about this so I cut my dose to a sachet over 14 days and this year dropped my dose to every 2-3 days (tiny amount) Eventually coming off it completely pending a blood test - my GP agreed to do a comprehensive blood test and the results are as follows:

SHGB 96 nmol
Serum testosterone 0.4 ml
Free androgen 0.4
FSH 47.8 is/L
Plasma glucose 5.1 mol/L
Serum free T4 14 pro/L
Serum TSH level 4.7 mu/L

I was hoping that some of you might have some knowledge of blood results and could offer me some insight.

I definitely feel different since commencing  HRT and I have a feeling that it's the effect that it has on the thyroid and SHGB levels - free testosterone being bound up. I have gained one a half stone over four years and I've lost muscle tone; I also get tired easily and have less motivation.

I appreciate that this is a long and detailed post and any input or pearls of wisdom would be gratefully received. I also hope that my story might help somebody else along the way.

Thanks ladies 

Kimmy

[Dancinggirl]

Hi and welcome to mm
The Menopause does horrid things to our bodies - oestrogen is a vital fuel that maintains skin, muscles, bone density and regulates so many things .
I had a premature meno and really understand your problems.
I have never use testosterone ( I got bad spots anyway and I knew testosterone coukd make this worse) but I know there are some that find it good.
From what you are describing, it sounds as though it's progesterone that is your main problem and I also struggled with this. Utrogestan gave me the most problems out if all the progesterones I tried and Norithesterone is the most powerful progesterone there is and many women struggle with it. Your doctors should have known this!!!!
There are other progesterones eg Provera which many women find good.
Look under TREATMENTS to see your options.
Having a Mirena fitted was my best option as this delivers the progesterone to where it's needed with minimal systemic absorption.
You could then use as little or as much oestrigen as you need to protect your body for the future and improve symptoms . Why not use a lot less testosterone to see if this helps things. I think you would probably benefit from a bit more oestrogen.  Perhaps add in a very small amount of testosterone after a few months to see whether it truly helps.
I personally think you Need a gentler approach.
Weight gain and muscle loss is often part of menopause and we simply have to change our diet and increase exercise I'm afraid.
I always like using the gel but found anything above 2 pumps per days didn't suit me. Some women need much higher doses so it is trial and error.
I do think that going back and starting fresh would be a good idea - so start with one pump of Oestrogel per day and perhaps 10-12 days of Provera each month, might be worth trying and if it gives too many side effects then try the Mirena.
Have a good look at your lifestyle to see how you could adjust your diet and exercise to improve things. Small highly nutritious meals regularly through the day and lots of brisk walking with maybe swimming or dance classes thrown where you can might make a big difference generally.
Keep posting - we are here to help. DG x

[Perinowpost]

Hi Kimmyb

What a journey you've been on!  I echo a lot of what Dancinggirl advises. I would start slowly with a low dose of Oestrogen. O is the feel good hormone and should improve your symptoms. I had immediate relief when I went on patches (evorel 50) and even now can feel when they run out.

Progesterone is the hardest to get right due to the side effects many of us suffer with. I'm currently on a low dose of utrogestan vaginally (to minimise side effects), but it's not perfect and I'm about to trial Provera. (I will post once I've used it). Luckily my GP's are very good and supportive.

Re Testosterone I find I only need a small amount, I get through 1 tube per month and I find that is enough to improve energy and response.  Too much and I find it can make me depressed (see Tempests post). So balance with T is the key.

I hope this helps and do keep us updated x

[hoping4best]

KimmyB, mostly here to sympathize. I had an ovary removed when I was 38 (now 43), and the other ovary almost immediately “failed”, and I was in a rapid peri and post-meno by about a year later. They spent a year or two not knowing what to do with me. I also cannot do BCP.

I don't absorb gel and am on patches. I gained 5 lbs and was told by a doctor I trust to just accept this as the new normal, and I'm ok with it now. I am not overweight and it gives my body more fat in which to store estrogen. I think my body needs it. I walk at least two dozen miles per week and eat well. The patches make my hair shed like crazy and I hate it, have lost tons of hair, am on minoxidil and still struggling with that.

For progesterone, I have a poor history with IUDs so I have done oral and vaginal, am currently trying vaginal utrogestan on a cycle (prometrium in US) and my first go went well.

I was taking like a tiny lentil sized dab of T for a year or so, but I took a break to see how I feel and to see if my hair sheds less. So far, shedding is still terrible and I miss the T but we will see.

I do feel like the patch regimen with cyclical progesterone is best for me, but it's trial and error and it definitely totally changed my life to go through meno so early, so suddenly. My body is totally different and it's hard. Hair loss, libido loss, muscle loss, and adenomyosis cramps and bleeding are my new normal, but I'm working on everything as I can, and there are times when things are stable and I can enjoy life again.

Sorry this may not be the most encouraging post, but you're not alone! POF is rough. Hang in there and keep experimenting! That's my plan.