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[Maddie21]

Hi Everyone, I'm fairly new to this forum and I'm sorry for starting a topic that has probably been covered before, but I did a search and couldn't find anything.

I was wondering if any of you had experience of a very sudden menopause, without any obvious perimenopause symptoms, and feeling very ill after it?  I saw a lovely consultant back in January, but at that point I was still hopeful of HRT making a huge difference and didn't ask her all the things that I would be asking her if I saw her now!

I missed a period in July (at 48) and mid-August everything went completely crazy--my weight plummeted to below six stone, hot flushes every hour or half hour, dizziness, brain fog, dryness, etc etc.  I'm doing a lot better now than I was then and have been on HRT since mid-September--Evorel Conti first, then a double dose of it just before my appointment at the menopause clinic, and now I'm trying Utrogestan tablets plus Evorel 100.  The HRT has certainly helped, but I still have lots of heat (especially my mouth and lower back), which makes me worry about my bones (as well as my age, I have a naturally low BMI).  I'm still off work and will not be able to go back until my brain fog and anxiety improve.

I had a blood test done in January and I am getting what the consultant called 'a good dose' of oestrogen in my blood, and my hormone levels can't have dropped since then because there's nothing to drop.  I did think that I would be feeling better than this by now, given that I have been on this dose of HRT for five months.

The consultant said that it takes longer to recover from a menopause that is sudden, and also that HRT tends to be less effective with a sudden menopause.  I'm not sure if she meant less effective long-term, or just for the first few months, while your body tries to adjust to the loss of hormones.

So what I'm wondering is: did any of you have a similar experience?  How did you find HRT?  And--when did your symptoms start to improve to the point that you were able to return to something like normality?

Thanks so much for reading a ridiculously long post! 

[sheila99]

No advice re sudden menopause but have you have tests to rule out a different cause? Covid for instance? Thyroid? Just wondering as your journey seems rather unusual. The weight loss in particular seems a bit worrying (most of us have the opposite problem).

[jillydoll]

Hi maddie

I must’ve been in peri in my 40s. Periods were on and off for years, but because I was looking after my parents, I didn’t even notice.
Not until I hit at 50. That’s when all my symptoms happened. Nothing before, looking back, I sailed through peri,( just the odd heat moment)  then out the blue, anxiety, depression, mood swings, anger with a rage that I didn’t know I had, I truly thought I was going to die, with all the weird symptoms you get, no wonder.
I started HRT then. It’s been hard, but I’ve settled on Femoston conti, ..I’m 56 now.
For the last 2/3 years I’ve been more settled, still get anxiety occasionally, but it’s manageable. Nowhere near as bad as before, so, I’m thankful for that.
I did try to reduce it the other month, but the anxiety came back quite bad, and I started to feel like I did at the start of all this, so I went back to the original dose......I’m not going back there for love nor money.
So this, I’m thinking, IS my normality. Yes, sometimes anxiety gets me down, but I can handle the amount I get now, and it’s not everyday like before. I just have to remember what it was like at the beginning, and that’s what gets me through, it reminds me just how far I’ve come.

Keep going maddie, I’m sure you’ll  get to a place where your happy with the HRT.
And I wish you all the best.
Xx

[Wrensong]

Hi Maddie21    Sorry to know you've been having a rotten time of it, but you've come to the right place & will get lots of support on here.   Your post is not especially long & anyway the detail helps us to get an idea of what might be going on.

I second what Sheila said about testing for other possible underlying causes, especially as an overactive thyroid can cause some of the symptoms you've experienced, such as weight loss, anxiety & feeling excessively hot.  Please don't worry about that suggestion, if it were that it would be treatable.  I imagine it's been ruled out, but please ask your GP if it hasn't been mentioned.

I also wondered whether the cessation of your periods could be due to very low body weight, as you say you have naturally low BMI, so I take it that means the weight loss you mentioned in association with your symptoms occurred when you had already been naturally very thin for some time.

All that said, I also unintentionally lost around a stone in weight in the early years of perimenopause (went down to 6.5 st) when symptoms were shockingly extreme, though I'm long term hypothyroid (underactive).  I'm still underweight & it's said that women like you & I with very little body fat, do tend to have more extreme menopause symptoms compared with those of a healthier weight, as fat helps to produce a little oestrogen that would otherwise help keep us ticking over as ovarian function declines.

Another thought is that progesterone can cause pyrexia/fever & some of us find Utrogestan especially makes us far too hot, particularly overnight.  In fact I can't take it for that & other reasons.  So it might be that if your overheating/heat intolerance continues after a reasonable trial of your current HRT (sorry - not quite sure how long since you started the Utrogestan + Evorel 100) & other possible causes have been ruled out, you may need to try another of the synthetic forms, given Evorel Conti didn't seem suitable.

One more thing - testosterone is produced by the ovaries in significant quantities in fertile years & might help some of your symptoms, including dryness, if you continue with Utrogestan rather than going back to one of the more androgenic progestogens.  Many of us find we need this adding to our HRT regimen.  Something to ask about at the menopause clinic if it hasn't already been mentioned.  It's usual to try to get oestrogen up to satisfactory levels first (I see your Cons feels you have achieved this despite poor symptom control) & to test your testosterone levels before & after prescribing.

[Maddie21]

Hi everyone, thank you so much for the lovely and thoughtful replies; I definitely feel 'welcomed'! 

Sheila, my GP checked everything when I first went to see her back in September.  I told her it was the menopause, said I wasn't coping and could I PLEASE have some HRT?, but she thought that was the least likely cause.  And she was very worried about my weight.  But the tests all came back fine, and it was definitely the menopause.  I wish it was my thyroid!  I am stuck with menopause  .  I've always been slim but that's just my DNA (my dad also eats loads and stays thin) so it's never affected my periods.  The very dramatic weight loss happened when all the other extreme symptoms kicked in, and I think it was just my body going into shock at the sudden loss of all my hormones.  It was a couple of months before I started being able to get something out of my food again and put some weight back on.  My hair and nails also stopped growing during that time.

Jilly, thank you much for sharing that--it helps me to see that there is light at the end of this ridiculous tunnel.  My periods were actually fine up until June so I don't think that I can have had much of a perimenopause at all, hence the massive shock to my body when they stopped suddenly.  I did get some wee bits of heat, starting the week after the period I missed was due, so maybe that was my perimenopause and it lasted three weeks  .  I get acupuncture regularly though and that might have dealt with any other peri symptoms, over the last couple of years, before they had a chance to get started (acupuncture is MAGIC).  I'm sorry you had such an awful time but it sounds like you know how to manage your symptoms now.  The anxiety is so awful!  I tried to go back to work briefly in January-February--not my 'normal' job in the building, but just from home--and it was a disaster.  The anxiety and brain fog were awful.  It coincided with no acupuncture because of lockdown, though, so I'm hoping to try again once treatment resumes post-lockdown.  I used to get anxiety and general daftness with PMS but this is on a whole other level and it's hard to explain it to people.

Hi Wrensong--thank you for such a lovely welcome.  I am already feeling supported  so that's lovely.  I should have posted here sooner!  (The consultant I saw in January recommended this forum.)  That's interesting about body fat and severity of symptoms.  I had wondered if the heat was linked to having a fast metabolism as I've always (my whole life) got hot an hour and a half after eating meals and been generally hotter than other people--those calories have to be going somewhere!  Now my menopausal heat is worst at night and after eating, although the HRT has helped it a lot.  The lower weight than average is a healthy weight for me--it's a family trait and I've never had any thyroid issues.

I actually seemed to get more heat on the Evorel Conti than I did on the Uterogestan.  However... I've only just finished one cycle of the Evorel 100 + Uterogestan; and I ended up on a half-dose (1 tablet instead of 2) for the full 12 days, so that might be why I had felt less heat and felt generally more well than I used to on the 14 days of Conti.  (I started on one tablet in case there were lots of side effects, planning to go up to two tablets on day four, but the Uterogestan triggered awful thrush  and then on the 5th day I got a bleed anyway, so I stayed on one tablet for the rest of the cyle.  But I realise that I probably shouldn't take a half-dose next month.)

The testosterone i n Conti is why my consultant recommended switching--I spoke to her last month because I was still experiencing hair loss.  It seemed to get worse after I went on a double dose of HRT so she suspected that the Conti was responsible and recommended Uterogestan as it's the only one not derived from testosterone.  However, since yesterday I can really feel the loss of testosterone in my body--lack of energy, more fogginess, a general feeling of 'floppiness'--so now I don't know what to do  .  And--my hair is still falling out!  So maybe that had nothing to do with the Conti.  I wish I could do 100 of the oestrogen and half the dose of the 'bleed' hormone, but that's probably dangerous.  I'm so tiny, though, I wonder if maybe I need less hormone to get a bleed?

Sorry that really was a long post  !  It's such a relief to feel like I'm 'talking' to someone.  Thank you!

[Taz2]

I'm just wondering why you are on a conti HRT if you've not had a year without periods? Conti is for post menopausal women. Sorry if I've missed something in your posts. 

Taz x

[Maddie21]

Hi Taz, I suppose it's because I am post-menopausal in the sense that my hormones have all gone  .  The consultant said that what I've had is just like a surgical menopause.  There is nothing left!  Although--I didn't realise that about the Conti.  What do most women get at the start?

[Taz2]

Usually post-menopause is defined as a year without a natural period. Blood tests are unreliable in diagnosing menopause. Was it an NHS menopause clinic? If you are still having periods when you begin HRT - i.e. you have not gone a whole year without one, then you are usually prescribed a sequential HRT which will give you a monthly bleed (usually). You take oestrogen for the first two weeks then add in a progesterone and it is the withdrawal of the progesterone each month which causes the bleed. This is to protect your womb lining. If you are on sequi HRT then it can be difficult to know whether your are post menopausal so the guidelines is usually that by the age of 53 you would be post menopausal so you can then swap to a conti one. Some women stay on sequi even into their sixties as they don't react well to a continuous dose of progesterone.

My peri symptoms began when I was around 50. The first symptoms were missing periods. When I had gone six months without one I did have a blood test which showed my FSH level (the thing measured to see how your ovaries are functioning) was, in my GP's opinion, so high that I would never have another period. A month later I had a period and they became regular again for a few months. I then went eleven months without one before they began again. I started HRT a few months and a few more periods later as hot flushes had become unbearable and I was 53 then.

As far as I now there is no testosterone in the conti HRT so I'm not sure what your consultant meant.

Hair loss can have many reasons. I wonder if you have consulted a trichologist? It takes around four months for the hair to react to something such as a stressful event so you need to backtrack to see what may have caused your hair thinning/loss maybe?

I hope that you can soon sort this all out and get back to being able to work and feeling more like yourself.

[Wrensong]

Hi Maddie, I didn't realise you had hair loss when I mentioned trying testosterone.  I'm sorry to hear that - it's so distressing.  So now yes, I can see why your Cons felt you should swap from Evorel Conti to a regimen with Utrogestan as the Norethisterone in EC is, as you say, testosterone derived & some women find T causes hair loss.

Like Taz, I'm a bit confused by your being on conti HRT when you hadn't gone a year without a period and you are still in your 40s.

What you say here makes me wonder whether it is in fact a sequential regimen, i.e. you are only taking progesterone for approx 2 weeks of every cycle? 

However... I've only just finished one cycle of the Evorel 100 + Uterogestan; and I ended up on a half-dose (1 tablet instead of 2) for the full 12 days, so that might be why I had felt less heat and felt generally more well than I used to on the 14 days of Conti.

Was it Evorel Sequi rather than Conti perhaps - 2 weeks of Evorel 50 then 2 of Evorel Conti patches?  And are you only taking Utrogestan for 12 days per cycle, not every night continuously?

I actually seemed to get more heat on the Evorel Conti than I did on the Uterogestan.

 
Perhaps you didn't get very good absorption from EC - some of us don't, me included - in which case the overheating could have been due to insufficient oestrogen.

I'm so tiny, though, I wonder if maybe I need less hormone to get a bleed?

Funny you should say that as I've recently been wondering if that's why I get a considerable bleed (& full strength side effects) from a minimal dose of MPA.  But I'm only on fairly low dose oestrogen & you're on a high dose, so it's very important to ensure you are taking enough progesterone for that amount of oestrogen & I don't imagine your doctor would recommend deviating from the standard regimen that's been prescribed at the mo.  But do raise anything you need to with them so that you can work together towards getting your best fit.

The low BMI - I understand this is your natural condition, same for me, but being underweight for whatever reason is unfortunately known to lead to earlier than average menopause  & it's said, often more severe symptoms.  Frustrating for those of us who find it impossible to gain weight despite eating well.

Your losing more weight around onset of your severe menopause symptoms is again what happened with me, losing a stone, though I was in hellish perimenopause which lasted from 44 to final period at 50.5, despite my being underweight.

I think it should be possible to get you feeling considerably better on the right HRT, once your body has had time to adjust, so that you are back at work & feeling really well again.  So please don't give up hope.

[CLKD]

Menopause - the natural cessation of monthly bleeds.  1 is usually considered menopausal after 12+ months without a period.

Perimenopause - the years leading to the complete stopping of periods.  When many notice a change in feelings, it's The Change: does what it says on the tin!

Some ladies find keeping a mood/symptom/food diary of use.  To chart progress.  It is a worry if there's a 'sudden' move into menopause - hormone blood tests are reliably unreliable!  4 me periods waxed and waned for 2-3 years B4 stopping.  Even if thyroid function results are 'within normal limit's, it may be worth while keeping a chart about those feelings as GPs are reluctant to do further tests even when patients continue to complain of symptoms.

'a good dose' of oestrogen in my blood' - I wonder what this means exactly?  If you have gone in2 sudden menopause your hormone levels will be all over the place  .  48 is also a time when HRT will help heart and bones ;-). Have you read the daisy website, directed at women with symptoms B4 they expect them?


Let us know how you get on?

[Maddie21]

Hi everyone, thanks again for all the thoughtful replies.  They're really helping me to think through what's happening to me.

Thanks Taz for sharing what happened to you.  I'm not sure how the consultant diagnosed me--I had blood tests with my GP in September, and when she referred me to the menopause clinic she told them my history and symptoms and then the consultant asked me more questions when I saw her.  She said that often this type of menopause happens to women who had a similarly sudden/truamatic/difficult (can't remember the exact phrase she used) puberty, because it's how your system is--and yes, that was also me.  She did another blood test to check that the double dose of Sequi was giving me enough oestrogen, and then I had another blood test at my GP's last month because I had new symptoms and they wanted to check everything, including thyroid, again.  I don't think it was the emotional shock that affected my hair at the start, I think it was rather the physical shock to my body of suddenly losing all my ovary hormones, but maybe it's the emotional shock now--it did seem to worsen again in January, which would fit with the four-month time-span.  She said she could refer me to a trichologist but wasn't sure how helpful they would be.  I'm sure I could get referred now if I wanted to, but I suspect that she's right.  Sorry for being confusing about what I was prescribed--it says 'Conti' on the packet of the patches that I've stopped using, but the box says 'Sequi' and I've been given sequential HRT all along.

Thanks Wrensong for such an interesting reply--I am learning so much!  It's so interesting to hear from somebody with a similar history of low BMI and weight loss at the start of their hormones dropping.  I've not been able to get back up to the weight I was pre-menopause but I no longer feel weak and need two hands to lift the kettle  , so I might need to just buy some new bras and accept that this is the way it is now.  Sorry for being so confusing about my medication.  Yes I'm on sequential HRT and have been all along.  I am DESPERATE to get back to work!  I'm on half-pay now apart from anything else.  Unfortunately my job is quite intense and busy and involves thinking of many things at once so, although I love it, there's no way I'm ready to go back yet.  I'm hoping to try in June, assuming the HRT works out.  My boss is lovely and couldn't be more supportive and understanding, so I'm very grateful for that.

Hi CLKD, thank you for the helpful info!  This is pretty much what I 'knew' about menopause 9 months ago:
- Your periods go a bit irregular and get more irregular.  This starts sometime, and it lasts for a while.
- Your periods stop.  There is heat.  Something happens to your bones, and I'll need to take HRT because I'm skinny.
I thought that I didn't need to know more, and that I would bother to do some research once my periods started to go funny, which they never did.  So I knew nothing!  And I had no idea that what was happening to me was unusual.  I would love to get some natural hormones back for a while, but I don't think it will happen--everything feels pretty 'dead', if that makes sense.

The 'good dose' was based on numbers.  She said this when we had a phone appointment to discuss my blood test results.  I can't remember what the numbers were, but basically the test showed I had a bit more oestrogen in my blood than the 'standard' level, but she said that normally people go on to produce some oestrogen every so often for a long time, but that that wouldn't be the case with me and given my age and low BMI, we needed to err on the side of a bit more oestrogen rather than less.  I'll definitely check out the website you mentioned.  I'm quite keen to find someone with a similar diagnosis to me and see how they got on.

I'm going to arrange an appointment with my GP on Monday to discuss the HRT, whether I might need some testosterone and possibly to arrange another appointment at the clinic.  I'll also ask her how they know my periods are finished, but I suspect that's the clinic's diagnosis rather than hers (she hasn't had someone with my symptoms before so it's been a learning curve for both of us!).

I will definitely keep you updated with how I'm getting on!  Thanks so much for all your help.xx

[CLKD]

Morning.    .  HORMONES  !  I had heavy, painful periods for years until I went on the Pill.   Fortunately, peri wasn't a problem overall.

How is your exercise regime?  Brisk walking several times a week is good for over all bone health.

Browse round.  Make notes 

[Taz2]

Hi Maddie - thanks for clearing up the confusion on whether you are conti or sequi HRT. Yes the sequi HRT has oestrogen alone for the first two weeks then the progesterone (the Conti patches) are added in at the end. Once you begin the new pack of just oestrogen then you should get a withdrawal bleed to help keep your endometrium thin.

A lot of us are the same in not knowing what to expect during peri menopause which can last for many years after the first signs. You say that you were just expecting your periods to go funny but they never did. I think they have gone "funny" in the normal way to be honest. Lots of us experience quite a few months without a period which, I think, is what happened with yours? They start up again for months and then stop again and this can go on for years - with me it was around three years of stop-start while I was in peri before finally starting HRT.

It sounds as if you are being given the right treatment and I'm so glad you have got some of your strength back. Sorry to read of your traumatic puberty. I've not heard of this before. I wondered if you have you been offered an ovarian scan to see what state your ovaries are in?

I would ask for the trichologist referral. I found mine to be excellent when my hair thinned due to a long period of stress in my late forties. I wasn't fortunate enough to get a referral on the NHS though as this was not something that the NHS covered. If they are now offering this then definitely go for it. You will learn a lot about the make up of your hair, what diet you should follow and also offered treatments to strengthen hair and nourish the scalp. Well, that's what I had privately!

Please keep us posted on how you are getting on.

Taz x 

[Wrensong]

Hi Maddie, so many of us have very little idea of what to expect from menopause before it starts & sadly it can be a very bewildering & unnerving time.  I remember thinking so periods stop and you feel a bit hot now & then, well it'll be a welcome change from always being too cold & having long, heavy periods: bring it on !!  But when it happened I found the severity, range & duration of symptoms utterly shocking  & kept questioning & worrying about whether it could "just" be menopause.  Probably not with me, because of the thyroid complication which many hypothyroid members find adds another dimension to the experience! 

Then I read an article with the phrase "the menopause years" & I thought "years?? OMG - please not"  It was a horrible heartsink moment as I'd somehow expected minor changes & all over in a few months.   I couldn't believe how ignorant I'd been about a process so profoundly transformational that affects all women lucky enough to live to menopause age.  But there was a greater taboo surrounding it then than there is now, Mum had passed on a decade before & her menopause had happened when I was a little girl, I had no sisters or female cousins close in age to compare notes with & none of my friends had got there yet.  I didn't have access to MM until a few years postmeno, but soon learned how badly many women are affected & that I wasn't the freak I'd assumed, for by then far too many years!  HRT hasn't been a panacea & it's still a work in progress but I wish I'd started it in early peri rather than wasting a decade+ waiting & hoping it would all come to an end & then I'd be back to normal.  So I think it's really good that your GP has been looking out for you despite the extreme demands of the pandemic & that you were able to have HRT sooner rather than later.

I hope you will be able to gain some weight as this should help smooth the way with an extra buffer of oestrone on top of the oestradiol from your meds & any your ovaries may go on producing sporadically.  It should also help protect your bones.  Would be interested to know why your gynae thinks your ovaries have packed up altogether.  My weight stayed too low throughout peri & beyond during the worst years until symptoms were finally improved by starting HRT & now in late 50s I'm back to around 7.5st, though quickly lose lbs if for any reason I'm off my food.  Would like another stone, as at 5'4" that wouldn't be too much, better for bone health & I hate the too skinny look on me .

Try if you can to get as much sleep, R&R as poss to help your adrenals function at their best as this should make things easier for you in the long run.

I would maybe wait & see whether your hair improves before introducing any testosterone just yet, but of course talk it over with your GP & gynae to get their advice & maybe read around so you feel better informed & more confident in making decisions about your care. 

[Maddie21]

Hi everyone, thanks again for all your support.  I didn't post over the weekend because I wasn't doing great and couldn't think clearly enough to post.  My brain-fog and energy definitely seem to be worse at the moment  .

Hi CLKD--yes, HORMONES!  Such a nightmare.  I also had heavy, painful periods and couldn't take the pill, so I survived on a LOT of ponstan and also by planning my life around my cycle, which thankfully was very regular.  What was maybe even worse though was the PMT and I never found anything to help with that.  And then--a few years ago I started acupuncture treatment.  It was for something else, but he treated my periods and PMS and within two months, it was like a magic wand--hardly any pain, no clots and the PMS was barely noticeable.  I couldn't believe it.  Of course I feel a bit cheated now that my periods have stopped when I could have had my hormones for a few more years while also having such a manageable cycle. 

While I've been off work, I've been able to go for a good walk every day (even on days I'm very tired I walk for as long as I can) and I make a point of walking briskly to get my heart-rate up.  I'm lucky that I stay very near an absolutely beautiful park, and I like being active so it's easy.  How sustainable this will be when I'm back at work, though, I'm not sure.  My job is long hours and I need to be on my feet for most of the day so I come home exhausted!  I had a browse round back in January when my consultant told me about the site, but--I know this sounds ridiculous--I found that reading about symptoms I didn't have etc made me very anxious, so I stopped.  But now is probably the time to have another go  .

Hi Taz, thanks so much for the trichology info.  I'm still hoping that my hair will improve after I've stopped the Conti for enough time, but a referral might be good anyway.  I'll see what my GP thinks.  It's amazing what a difference hair loss makes to your mood--I keep thinking it should be the least of my worries, but it's impossible not to be very upset.  How did you get on after your trichology appointments?  Did your hair improve?  (Hope you don't mind me asking this.)

Wrensong, you had such an awful time for so long!  I can't imagine trying to do all this without any HRT.  The intensity and frequency of the hot flushes alone are so unbearable.  Yes I had no idea that things could go on for years.  It does make your heart sink a bit.  But yes--I'm very lucky in my GP.  She's been wonderful--so kind and supportive.  My 'healthy' weight was 7.5 stone.  I'm now about 7 (I think--no scales in the house but the nurse weighed me three weeks ago and that's what I was) and I don't think the rest is coming back to be honest.  I was very busty before and I suspect that that's gone for good!  I don't feel  weak though like I did when I was about 5.5 stone and I'll keep trying with the protein shakes and fattening food.  It would be great to protect my bones a bit more.  Do you only lose weight when you eat less?  Back in August-September I was eating more than ever but it just disappeared.  I've always lost weight easily, while still eating the same, whenever I've been stressed or anxious or unwell, but it's never been as dramatic as it was in the autumn.  It was really scary  .

I'm not sleeping very well at the moment.  The anxiety seems to be worse over the last few days (less testosterone?).  Of course that starts a vicious cycle as you start to worry about not getting enough sleep!  But: acupuncture is back and I have an appointment tomorrow  , and I know that that will help.

I'm hoping to speak to my GP today.  I'll keep you all posted on how I get on with everything.  Thank you all so much for all your help!!  I feel so much better for sharing.  People should talk about menopause more--it's still far too much of a taboo.xx