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[VanillaLover]

Hello, first time posting here. I’ve been reading the forum a while though and it’s helped me a lot.

My question is, I have been on HRT for three months trial now. The GP was reluctant to prescribe it as I very occasionally have migraine with aura. Maybe once a year maximum.  I also often get non aura migraines at certain times of the month, but that’s a different story…

I am happy with the significant  improvements the HRT has brought so far (Evorel 50 and utrogestan)  - but I am still struggling with hot flushes (now generally when I exercise) and night sweats/sleep disruption. My anxiety levels are much better but still highly linked to my menstrual cycle.

I really wanted to try a 75 mcg patch but the doctor refused as she said the extra oestrogen was far too risky as a stroke risk with the aura migraine. Everything I’ve read (including NICE guidelines) doesn’t seem to support this.

She has referred me to NHS menopause clinic and Im continuing on my current HRT for now (which to be fair is just about making life bearable again). I would obviously prefer not to have to wait for referral though to feel better.

Has anyone heard of this before or had the same problem? If it’s really universal not to go over 50mcg then I suppose
Ill have to get used to the idea. She did say that normally she would increase patch straight away. 

I am nearly 46, had very much shortened and/or irregular cycles for 2-3 years and suffered badly from peri symptoms for the past year to eighteen months.

Thank you all

[VanillaLover]

Also would anyone have an idea of rough wait times for the referral? Will be for clinics in the West Midlands I expect. Thanks again

[Limpy]

Hi VanillaLover,

Have you had any of Visual migraines whilst you've been on the patches so far?
Or indeed any migraines at all?

[VanillaLover]

Hi, yeah I have had one aura migraine which is the first I’ve had for a year ? Two years ? Possibly more.
 
Normal migraines yes - I usually have 4-10 of those a month anyway and these have continued. Always around ovulation, then from day 18 or so of cycle, through to period and maybe another during period sometimes.

[jillydoll]

Hi.

I get migraines. Usually just a really bad head, but about 18months, 2 years ago, started getting aura.
I only get aura without a headache tho, last about 20 minutes or so, then usually the headache comes afterwards which is not so bad as a migraine headache on its own.
My doctor knows about the migraines, and has never said anything.
Havnt had aura for a while now. But I have had a migraine. 🤷🏼‍♀️ My migraines normally last about 2/3 days.

[Limpy]

Have always had migraines though these have lessened since being on Evorel Conti. The GP who put me on HRT knew about the migraines which is why she felt patches were the best way to go.
Sometimes I get the aura thing without any headache, it's just very weird when small areas of vision go "pixelated". The aura thing passes in 20 minutes or so. The headaches used to be 2 or 3 days now they just tend to last a day.

[VanillaLover]

I rarely get the aura (zigzag, coloured flashes, blind spot) but if I do it generally happens on its own with no headache after.

Usually migraines start with me feeling dizzy and sick and then the headache starts. If I take ibuprofen and prochlorperazine straight away I can sometimes avert the whole thing (but not always). They have got gradually worse in the last five years I’d say …and always follow the same times in cycle (unless set off by something like vaccine booster or Christmas)

Hopefully my referral comes soon. If GP  is incorrect then at least she will be more clued up after which will help other women.

How long have you been on HRT StrongKat and how old are you ?  So glad your migraines are getting more manageable…

Can’t wait till my hormones get to a much welcome steady flatline and hopefully I will be free of the damn things. Reckon I have a few years to go before that though!

[VanillaLover]

I should say I totally understand the link between stroke and aura migraine, and I understand why it’s sensible to have transdermal rather than oral.

It’s her refusal to increase the dose that I’m not sure about ! On all the gynae clinic NHS info sheets I’ve seen and BMS website it just says HRT NOT contraindicated and to use the lowest dose for relief of symptoms

[sheila99]

I don't think she's right, I haven't heard of that theory before. Surely any risk (if there is one) will depend on the levels of oestrogen in your blood not in the patch. As you still have symptoms your levels must be low.

[VanillaLover]

I imagine at my stage I am still having far higher estrogen spikes than anything HRT can produce …

I wonder if she’s getting confused with the combined contraceptive pill. The BMS prescribing guidelines I was looking at said GPs often just lump HRT in the same category (I wouldn’t be allowed the ccp) despite the far lower doses, non-synthetic hormones etc

Thanks for replies

[Limpy]

I rarely get the aura (zigzag, coloured flashes, blind spot) but if I do it generally happens on its own with no headache after.

Usually migraines start with me feeling dizzy and sick and then the headache starts. If I take ibuprofen and prochlorperazine straight away I can sometimes avert the whole thing (but not always). They have got gradually worse in the last five years I’d say …and always follow the same times in cycle (unless set off by something like vaccine booster or Christmas)

Hopefully my referral comes soon. If GP  is incorrect then at least she will be more clued up after which will help other women.

How long have you been on HRT StrongKat and how old are you ?  So glad your migraines are getting more manageable…

Can’t wait till my hormones get to a much welcome steady flatline and hopefully I will be free of the damn things. Reckon I have a few years to go before that though!

I am 63 VanillaLover, went on HRT when I was 53.