I wanted to post this here just in case in the future anyone hears of another woman in a similar situation and wants to reference back or think twice before saying "you can't need HRT if you still have regular periods". The fact that some women (possibly a tiny minority) need HRT when their cycles are still very regular doesn't seem to be well recognised or understood (even among some, but not all, meno specialists).
At the age of around 37-38 I started experiencing surging Estrogen levels during the luteal phase of each cycle. I knew nothing about meno or Peri at this point - just that my boobs were getting incredibly swollen and painful every month like clockwork from day 14 until my period. I took a Rhythm saliva hormone test every day which showed that my natural Estrogen levels were way over the top of the range and particularly after ovulation were surging to very high levels (I only know the salvia readings and not equivalent pmol blood readings annoyingly). I had no idea at that point that surging Estrogen is often the first sign of Peri (along with the shorter cycles I was experiencing) so didn't make any connection and no GP I spoke to had any clue either, so I was just left to get on with it. The boobs were an annoyance but nothing more.
After about 2 years of this in March 2020 the monthly boob symptoms stopped happening and I started suffering with debilitating 3am insomnia instead. It took me about 6 months to clock that the two things had happened at the same time and that the insomnia was also ONLY happening from day 14 of my cycle onwards until my period. After about 3 months I started to get horrendous night sweats with it, and thankfully that was what allowed me to (a) make the connection between my period and that it was happening at the same time every month and (b) make the perimenopause connection. When I looked back over my diary it was like a miracle moment when I saw the exact pattern.
Overjoyed that I had found out what was going on, I took all of this info to the GPs and was distraught when I got absolutely no help. They only suggested the Pill - and I was repeatedly told that if you're still having regular periods you CAN'T need HRT. I was even told by the first meno specialist I saw that this was the case.
From a blood test the 1st meno specialist had done I knew that my Estrogen level had plummeted to around 250 - again I don't have like-for-like comparisons because the initial Estrogen test I had done in 2018 had been saliva but as a guide, the saliva Estrogen test was 4 times the top of the range during the luteal phase of my cycle.
After two failed attempts on the contraceptive Pill which didn't work at all, and then a prescription from one Meno specialists of Prog only which also didn't work, I eventually out of desperation prescribed myself HRT via the internet. This is absolutely not something I would ever recommend - hormones affect so many parts of the body and taking any hormone based product is not something to be taken lightly. I only did it because by this stage I was completely unable to function, work etc from only getting 3 hours sleep a night for 2 weeks out of every 4 for 6 months. After an initial very short trial of Estradot that didn't quite work, I tried Lenzetto. The relief was almost immediate - it took about 1 week for all of my symptoms to disappear. As most on this forum will know, there have been bumps along the road in terms of trying to find the right dose and of course Peri isn't something that happens once, your E will drop several times and you need to adjust your dose to compensate. So there have been bumps, some harder than others. But overall, one year on from starting Lenzetto, the transformation since starting HRT is tremendous.
Two months after starting Lenzetto I spoke to a meno specialist who confirmed from symptoms alone that I was in Peri and should start taking HRT, so there was nothing untoward from that moment and I now get it through my GP. She also said that if your E is less than 300 this is generally considered an acceptable level to start on HRT, contradicting what the first "specialist" had told me.
What I now understand through speaking to (decent!) meno consultants and a lot of research is that your E doesn't have to be clinically low for you to be highly symptomatic. For me it was the action of the fall from the "very high" Estrogen level (that occurred naturally as part of Peri) to the "low end of normal" that caused me to have a debilitating level of symptoms, despite it apparently not being low enough to stop or affect my periods. I'm not alone in this and there is research out there talking about it - but it doesn't seem to be widely understood or recognised and I will be forever angry at losing a year of my life because of lack of understanding and a refusal to prescribe HRT.
Every woman's Peri journey is unique and I'm not for a moment suggesting if you have any problems in your early 40s it must be the same thing. But I did want to post this as part of the "recognition" I feel it deserves that it
can be the case that some women need HRT before their periods have started to become irregular and in the hope that someone some day might remember it if they hear someone else experiencing the same thing!
Thanks to anyone who has managed to get to the end of this thread
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Topic: Some women need HRT when they still have regular periods - a 1 yr review (Read 2677 times)