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[ClumpyClaire]

Dear Ladies of MM,

I think I've come to the end of the road with Menopause...I'm confused and rather upset.  To give you a slight snippet of my "journey" into the Menopause.

All of what I'm about to say below, I didn't realise was Peri-menopause.  In 2009, it started, itchy/burning skin, painful joints, weird periods etc..by the time we go into 2012 I notice more symptoms, anxiety, fuzzy brain, mood swings, palpitations, the list is endless and I'm tired of repeating myself. May 2015 my periods stop and without a bloody test (Dr doesn't test it) just assume you're menopausal (woman of a certain age...GRRRR!)  I went a whole year without taking HRT, because I wanted to research other options and see a genetics consultant, as my Mum passed away at 58 of breast cancer, and I was approaching the age of my Mum when she first had a mastectomy 49.  To cut a bloody long story short...(apologies) I went on HRT 2016...the list below tells you what I've been on...some have worked in some symptoms, but not all.

Feb 2016:
Evorel Conti patches
Femseven Conti patches
Femoston Conti
Trisequens
Indivina
Livial (Tibolone)
Kliofem with Tostran 2%
Estradot 50mcg with Utrogestan 100mg & Tostran 2% - Started September 1st 2018

I also have been experiencing some vaginal problems, other than the dryness...urgh!  It's a feeling of having an episiotomy every time I try and have conjugal unpleasantness  So my GP sends me to Gynae. During the consultation he asks me why wasn't I put on Mirena coil and patches...I said, I don't know why??  Then he asks about my pregnancies - two, both were C-Sections, because my pelvis was too small.  He tuts and says, that will be why. So he then takes a look at me and says we have three options...

1/ Cream Ovestin (Estriol) every night for two weeks then twice a week. And Instillagel (local anaesthetic) as needed
2/ Three sessions of ThermiVa - non surgical procedure to rejuvenate your vagina. Not covered my private medical or NHS. So a cost of £1800 for three session...however he said, looking at your "cough" I would say option 3
3/ Surgery...remove the skin area affected and bring your vagina down. I'm affraid I didn't ask what the procedure was called or go into it in  more detail, because I was feeling upset and shocked.

Consultant said...all options (avenues) as he put it, lead ultimately to surgery.  I said, that after the menopause symptoms fade you almost feel normal again...No he said, this is a major event and you'll never feel like you were before.... Now I have a sense of humour, and was trying to be light hearted.  But as I type this...I feel absolutely horrible. On Monday, I had bloods taken to check my estrogen levels as my Nurse Practitioner at the Meno Clinic wanted them checked as I've got the symptoms back and she thinks I'm not absorbing it very well. She then said she would be guided by me on what HRT I'd like to take...How the hell would I know, with so many products on the market...that's why I go to her. 

Im confused and very upset and I'm sorry I've offloaded all my crap in your general direction.  I've left her a voice message so we can discuss this and will call my Dr later for the blood results and hopefully after a very large Gin and Tonic (much later this evening) I will feel a bit more like me, but right now...no 

Thanks for listening...

[Dancinggirl]

Hi and welcome to MM

Firstly - I really wouldn't have surgery to help with your vaginal area/ perinium. I find that specialists attitude very strange as surgery should be a last resort. There are some ladies who have had a type of laser treatment that they found helpful ( Mona Lisa treatment) so perhaps do a search about that. Local oestrogen would be helpful and should be your first treatment approach (Vagifem pessaries are the most popular as easiest to use). Alongside local oestrogen it is essential to use vaginal moisturisers ( SYLK or the YES products are best). I would try massaging your perinium regularly with coconut oil - ( gently stretching it) and when attempting sex use a good lubricant ( I use Durex Pefect Glide nought in-line).
I found the Mirena with Oestrogel was the best hrt regime I ever tried so do seriously consider this option.
Most of what you are experiencing will be as a result of oestrogen deficiency as systemic HRT doesn't always help the urigenital area. It'll be interesting to see what your oestrogen levels are even while using systemic HRT.
 Keep us posted.

[ClumpyClaire]

Hi Dancingirl,

I've just had a telephone conversation with my Meno Clinic & feel so stupid!! In her letter she did prescribe vaginal cream & I started to take it with the other hrt product. However, when my hrt changed I stopped using it. This is where I get very thick and stupid, as she didn't mention to continue to use it, I stopped it. I'm to use it indefinitely alongside ANY hrt product...😬

I've been walking around like a fart in a trance...I feel so ashamed 🙁 No wonder walking and chewing gum is so hard for me.

[Dancinggirl]

Don't be so hard on yourself - menopause messes with our heads and so many of us become fuzzy headed.
The whole hrt thing is tough to understand and doctors are not good at explaining things. We often forget what has been said during any consultation with our doctors.
Do try to learn some relaxation techniques to help you through all this. DG x

[Ladybt28]

  ClumpyClaire - as one who can spout crap with the best of them, I'm a pretty good crapcatcher (it's only right that if you dump yours, you should catch someone elses  .
As you will see when you poke around the forum there are plenty of cases of Dr's giving terrifying suggestions, poor explanations
and just generally trying to get us poor meno girls heads to explode.  Don't feel ashamed, remember its defo not your fault, they are supposed to be the experts they should do it better, that surgery idea has to be a very last resort. When hubby hears expert he says "you know what that is don't you - an ex is a has-been and a spurt is a drip under pressure.  Bout sums it up!

I don't think any of us can conquer all our symptoms, wow that would be some job, its about getting rid of the ones that bother us the most.  The best HRT for you will be trial and error.  Maybe write down all the ones you have had and what was good and bad about each if you can remember.  I think dancinggirl is onto something - why reinvent the wheel - find someone here who is having similar problems to you - see if what they are doing is working - and then give it a go yourself.

[Dancinggirl]

Ladybt28 - I love your last post - particularly your husbands interpretation of an ‘expert' 

The menopause can crush our confidence and the mind blowing difference of opinion from the medical profession fuels the confusion and uncertancy. There can also be a very broad mix of advice for the members on this forum due the wide range of experiences.
I had a premature menopause so I have over 25 years of menopause experience, have seen so many ‘experts' and tried so many treatments, so I try to offer support to the poor ladies coming to this site in a pragmatic way.
I still get really shocked by the appalling advice and treatment women recieve from doctors - the ignorance and arrogance of many doctors is staggering. My dog had a mystery illness earlier this year and he had far better treatment from the vets than I have ever had!
DG x

[NorthArm]

Hi ClumpyClaire

Is it possible for you to see someone and get a second opinion?

I was offered a Mirena (chose not to take it as everything was still so new to me), and like you, had 2 c-sections because my pelvis was too small....

And I have heard we'll never go back to our old selves too. My hope is, once this crap is over, we'll be a better version of ourselves. Although, I've just had to up my patch to 75, because my oestrogen levels were through the floor, and I'd been feeling like the worst type of premenstrual, constantly

Anyway, see if you can get a second opinion - surgery should always be a last resort xx

[Ladybt28]

Appalling advice and Dr's - well my pet bugbears!  If I knew how and what to do to become a meno activist to spread the word and get Dr's better training and raise awareness of the issues outlined on this forum I would be right on it immediately but I don't mind you any suggestions welcome!  Activists and marches usually go together just imagine thousands of menopausal women marching on the Health Minister with pictures of Jenny Eclaire and her "bothersome vagina" (if you haven't seen the add its on tv for Vagisan moist cream) and other "explicit" explanations of meno! He'd be having a good day wouldn't he 

I've had a mirina in the past once before meno when periods were ok but I couldn't tolerate it.  I had one put in post meno but they took it out after two weeks because I was hospitalised with sepsis and they thought it was the cause but they were wrong. They can really work but it is a faff putting them in and then having to take them out if the don't but if you have tried everything else I would always say its worth a go as a last resort when other progesterone options are exhausted.

hey dancinggirl - dont you just wish Supervet - Professor Noel Fitzpatrick would diversify into humans! Wow the centre is supurb all that equipment and he does cutting edge stuff to animal joints that surgeons never do to humans!  If he was a human Dr, I bet he'd have meno sorted just like that - and the consultations and examinations would be very pleasant too

[ClumpyClaire]

Thank you everyone with advice and understanding. I've had my recent blood results back for serum oestradidol levels and it says 55pmol/L. I've sent this info to my meno clinic and will wait for comment/where to next...

I'll start keeping a record of my symptoms on the different hrt/thoughts/feelings. If I can find something that reduces joint pain, anxiety/mood swings and gives my”bothersome vagina” a boost, then I'd be happier than I am now.

Love Jenny E'claire, and I for certain would join the march! 😊

Claire X

[ClumpyClaire]

PS: Had some other bloods taken and it showed a raise in white blood cells, enlarged red blood cells and high cholesterol. I don't have an infection, weight is slightly increased but nothing major, exercise and have a drink or two. my question is can Menopause and taking HRT have an effect on blood results? 

X

[Dancinggirl]

ClumpyClaire - hrt should actually improve you well being. Part from the oestrogen in your loud hrt should not effect anything else - although I think hrt will often help to keep
Cholesterol levels low.

What hrt are you on now? Is it the patch with Utrogestan?
I personally found Utrogestan very challenging as it gave me erratic bleeds and I felt sedated most of the time when I used it continuously. It could be worth switching to a sequential regime and use it vaginally for 12 days each month - this would result in a monthly bleed though. Unfortunately I couldn't use Utrogestan vaginally because it aggrevated my urogenital atrophy.

I notice you have only ever had conti hrt types. Many women do better on a sequential hrt and put up with a monthly bleed as taking progesterone all the time can give more side effects. You also haven't tried the Mirena with either Oestrogel or an oestrogen patch - this is a popular hrt regime and might give you fewer side effects and problems. Transdermal hrt is better overall and if you had a Mirena you could safely increase your oestrogen usage which might be beneficial for you.

I don't know if you are using local oestrogen ? I would suggest you start something like Vagifem ASAP and also use vaginal moisturiser as well - either SYLK or the YES products can be bought online.

As for cholesterol  - what was the reading? A slightly high reading is usually not a concern provided there are not other issues that put you at risk of a stroke. Cutting out alcohol or reducing it to a couple of glasses a week would help.
It's very easy to overthink things and I'm afraid hrt can only do so much.
DG x