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[jennyr265]

Hi everyone,
Anyone on here who was diagnosed with PCOS in their twenties and is now in the menopause. And if so which HRt helps you?
I was diagnosed with pcos in my twenties although I suspect that i was just very androgenic - very bad acne, very oily skin, hairy, extremely irregular periods etc. I had an ultrasound which gave me the diagnosis but I went onto have 2 children without fertility treatment. I'm not overweight and I'm not diabetic so I don't think my androgen excess came from insulin resistance but obviously that's not based on any medical evidence!
I had a mirena coil fitted in my thirties. The third one was fitted when i was 45 but by then i felt so bloated and my breasts had increased over the intervening years from 30 dd to 30 h so I had it removed. The bloating went away but the breasts didn't  so i had a breast reduction 2 years later.
Anyway fast forward and I'm now 54 and post menopausal. I'm struggling with all over body aches and joint pain, very bad fatigue, dry eyes and mouth, dreadful nasal congestion, no libido and just generally feel 'uninspired' by everything. I don't get hot flushes or night sweats. Generally I sleep ok and i feel quite energetic in the mornings but by lunchtime I am absolutely drained (not just a bit tired) and if I do anything physical my body makes me pay for it for days after. My mother in law who is 91 has more stamina than me.
I tried everol patches and utrogestran a couple of years ago but gave up after 6 months as they hadn't helped with the joint pain which was my main symptom then. And also I was starting to get other issues which it turned out were caused by hyperparathyroidism. So i had an op last year to remove a parathyroid gland and had hoped that my other symptoms would improve but sadly they haven't.
Anyway I am now wondering if the drop in testosterone rather than estrogen is my problem and whether something like Tibolone would work for me. So just hoping that someone may be similar to me!!
Sorry for the long post and thanks for reading!

[Hurdity]

Hi jennyr265

Your post got missed and probably as there was no-one in your position who has had PCOS and now in menopause.

If you are not currently taking oestrogen and you are post-menopausal then you would definitely benefit from replacing this - before thinking about testosterone as this would cause an imbalance.

Furstly I presume you are taking something to make sure your thyroid is functioning normally? Do you have thyroid function tests - sorry I don't know about hyperparathyroidism. Fatigue and joint pain etc are symptoms of low thyroid function - even sub-optimal, as well as low oestrogen or low testosterone.

Are you taking other regular meds for other conditions ? Some other meds can also reduce hot flushes so that they might be masked and would not be experienced as primary menpausal symptoms?

First off I would make sure everything to do with thyroid was working properly. Then I would look to oestrogen replacement but I would try it cyclically at first - you would have to have a withdrawal bleed though which if you had irregular periods might not be welcome. I say this (taking it cyclically) because progesterone which has to be taken to protect the uterus, can have a sedative effect so will not help with fatigue and lethargy. In your position it might be worth asking for tests of your oestrogen levels in view of the PCOS - to see whether they are still high or not? You could also ask for testosterone and SHBG tests but I doubt they will offer this with GP, unless you ask for a referral to menopause clinic if you can, given your history?

If you do take oestrogen/progesterone I would suggest Estradot patches starting at 50 mcg but increasing if you feel no better, with utrogestan taken vaginally on cyclical basis 11-12 days per month.

Yes Tibolone is also a possibility - it is not exactly HRT but has components in it that are similar so might be worht a try to start with as a compromise - I would still get the thyorid stuff sorted if it is still an issue.

Good luck and let us know what transpires and what you decide?

Hurdity x