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[Katherine]

Hi all,

I’ve been pondering this question for a while now and I’ve never found the answer when searching online so I’m hoping someone on here might know…

 I’ve read in some places that menopause symptoms last for a few years - but what is the mechanism behind the symptoms stopping? If you don’t take HRT, you never get the hormones back, so how do the symptoms stop? And why do some women have no symptoms ( my mother is one of these lucky people btw)?

 In Louise newson’s books she describes it as a lifelong hormone deficiency, and recommends taking HRT forever, so this also kind of contradicts the people who say the symptoms aren’t permanent.

Also, if you do stop HRT doesn’t it just delay the process of the body adapting to no estrogen? There seems to be so much conflicting information out there. I would be grateful if anyone could shed some light on this so my poor brain can have a rest 😂. I’m still persevering with the HRT anyway as the better sleep is just a lifesaver.

[QueenofReds3]

Hi Katherine
I am following with interest re your question. I am 7 years post meno, still looking for the right HRT after trying so many combos. I am on the waiting list for NHS clinic as my GP does not know what is the best way forward. Like you say some of my friends are sailing through no issues at all. I am fed up with it all. When I stop HRT I feel okay emotionally and clear headed but the aches and bladder issues kick in so back on HRT again!

[CLKD]

Peri-menopuase are the years leading up to the final period = menopause.  So we are 'in menopause' from then on.  Some have a lot of problems until menopause, others find that symptoms rise and fall for a while.

As the ovaries may continue to niggle away, symptoms may continue.  Personally I believe that is totally an individual issue.  My periods waxed and waned for 2/3 years (aged ? 48) then stopped.  After which I would get a warm glow every evening after my bath as well as intense itching across my shoulder area.  Lack of oestrogen.

Do U have symptoms?  Some find that keeping a mood/food/symptom diary of use.  May I ask how old you are and where you are with your periods?

[Katherine]

Thanks ladies for your responses, much appreciated 

Hi QueenofReds, I'm sorry to hear that. I hope you have some luck with the clinic. Have you tried any other remedies for your symptoms?

Hi CKLD, I'm 46, still have regular periods but they are heavy and I need iron tabs to prevent anaemia. My GP, who is fab, says I'm in peri menopause. My symptoms before HRT which I started in Feb were - feeling hot, insomnia or light/unrestful sleep, more irritable (but that could be down to other things), skin dryness, vaginal dryness and anterior prolapse, no sex drive, increased anxiety, and fatigue. The estrogel (2 pumps) and utrogestan has given me a bit more energy, less dry skin and better sleep quality but the other symptoms remain. I also take vaginal oestrogen which has reduced the dryness. However the other symptoms remain and I am considering asking for testosterone. The only problem with the utrogestan, which I take 100g of continuously before bed on the advice of my GP, is I feel slightly drowsy during the daytime and it makes me sleepy for 12 hours per night/morning in total so I'm undecided between persevering with the HRT and asking for testosterone, or stopping the whole lot and trying other remedies. I have tried increasing the Estrogel to 3 pumps but it makes me feel a bit unwell. I have been tracking my mood and it does have a cyclical element - I have v. low energy, poor concentration and feeling of negativity from 2 days before my period for a week or so, then a better two weeks with more energy and positivity - when I schedule more challenging tasks and any appointments. So I think my hormones are definitely a big influence. I feel like it could be all to do with serotonin levels. I have considered 5-HTP - has anyone tried it?

Hi jaypo, I think it was the fatigue and bad sleep quality that pushed me to ask for HRT initially. I was finding it difficult to function and work. If someone told me, you will have these symptoms but they will only last say, 3 years then you'll be fine, I probably would have just tried to plod on but its partly the uncertainty. I think that's why I'm trying to figure this out.  I read somewhere online that as your ovaries wind down your adrenal glands are supposed to take over but if they are already over taxed then they find it difficult and you get symptoms. That's the only explanation I've found as to what happens. I've noticed that the people I know who have no symptoms are quite laid back / good sleepers in the first place, so in theory I guess that means their adrenals do a good job of taking over. I want to find out more so I can make an informed decision rather than just treat symptoms in the short term. It's hard to look at the big picture though when you're in the midst of it! I'm glad you came through it alright, that is encouraging to know. Before I got symptoms I avoided medications if I could but by peri menopause I was suffering and thought it was worth a try. I was also reassured that the risks of the type of HRT I take are very low. I guess it's a journey and we learn along the way. I'm not sure what I'm going to do, at the moment just trying to figure it out..

[Katherine]

Just remembered (!) one other symptom - short term memory issues. I keep walking into rooms and forgetting why I went in, that sort of thing. I have got in the habit of writing things down as soon as I think of it otherwise it will slip away after a few seconds! That symptom hasn't been changed by HRT I don't think.

[Marchlove]

Hi Katherine

I’m sorry I don’t know the answer as to why menopause symptoms stop.
I suppose in peri it’s the fluctuations that cause many of the symptoms and for some when periods finally cease they find relief.
I think the reason why many ladies seem ok post menopause is because they have good adrenal function. Certainly for me  I know this is the main reason I struggle post menopause.

I’ve used 5-htp in the past but it has to be used with care. It’s contradicted in people taking SSRI’s.  It can work for depression but does not work if you suffer from anxiety or irritability.

I was interested in your description of the cyclical nature of your mood (2days pre period for about a week), this coincides of course with the drop in hormones. As you are taking Utrogestan continuously it’s unlikely to be low progesterone so could you try increasing your estrogen slightly during that time only until your own estrogen kicks back in? Just a thought.

I would certainly consider taking testosterone which you will certainly qualify for with low sex drive. But of course the additional benefits of increased energy and cognitive function, are not appreciated by many doctors as they should be.

X

[CLKD]

Agree with Marchlove - a big article in the Sat press stated that 5-HTP should never be used with other medications, prescribed or OTC.

Short term memory loss is common as we age.  We have a thread : doing stupid things : which will give you a giggle.  And look out for That Strange Woman ;-)

Your hormonal rise and fall is similar to how mine was during my menstrual years.  'normal' for me, I do think that as we go into peri we focus more on how we feel because hormones are more noticeable.  We also have 'the change' in the backs of our minds?

Let us know how you get on.

[Katherine]

Hi CLKD, thanks for the thread suggestions, I will take a look :-). thanks also for the heads up about 5HTP.

Hi Marchlove, Adrenal function keeps coming up as a possible reason, I will look into that. Have you found any ways to improve your adrenal function? I think worriers like me probably hammer their adrenalin more than more laid back personalities. So I guess stress reduction is a big factor. I tried upping the estrogel to 3 pumps for a few days but it made me feel a bit funny but I guess I could try 2 pumps in the morning and another pump in the evening. I'll try that a few days before my period. I think I will also ask for testosterone then at least I know whether it will help instead of wondering :-) It does seem odd that testosterone isn't mentioned so much given it is one of our main hormones that drop. I will let you know how I get on.

If anyone else has any ponderings about the why's and wherefores of how the symptoms end please let me know your thoughts, or indeed any links or articles. Maybe I should get a proper menopause textbook or something  .

[Hurdity]

Hi Kathleen

There are two main aspects to what are described as menopause symptoms which is why it is confusing.

There are the obvious physical (and mental) symptoms associated with fluctuation and fall in mainly oestrogen but also progesterone - such as hot flushes and night sweats (the classic ones) from fall in oestrogen and eg heavy bleeding associated with decreased progesterone (as a result of cycles where you don't ovulate and you start skipping periods). These may or may not be experienced ( lucky ones who don't get them) and they may last for example until periods cease, or for many years, but you do not know in advance if you're going to one of the very unlucky women for whom they last for many years!

Some women decide to start HRT at this point - ie during peri - purely to alleviate these  (and many other) symptoms), and then stop taking it.

For some women - symptoms return once they stop taking it and do not resolve even after a few months, but for others they may never return. I don't know the mechanism that determines which camp you will fall into (not sure if this is known anyway) and as far as I know taking HRT will not affect whether you are for example going to be a long term or short term flusher (I'm focussing on this symptoms because it is an obvious/classic example).

In answer to your point about delaying the adaptation to low oestrogen - I hope the answer re hot flushes illustrates that it doesn't. This question has been posed and disucssed many times on this forum and the key point is - that the whole time you are taking HRT, you have ( provided you get the formulation and dosing that works for you) improved quality of life during those years. This cannot be taken away from you even if you subsequently experience those symptoms later in life (eg after stopping HRT and you are one of the long term flushers). Does that make sense?

In addition to the more obvious symptoms, there can be long term consequences of the oestrogen deficiency which we will all experience from approx 2-3 years after menopause, for the rest of our lives. One obvious symptom of medium term oestrogen deficiency is vaginal atrophy or genito-urinary syndrome of menopause (GSM) - which is relatively easily sorted, and a long term symptom - osteoporosis - which susceptible women may suffer from - but which is not obvious in peri-menopause unless you have a bone can for some reason

Remember that some women may reach menopause at 45 and may live until 95 whiich is more than half your life in an oestrogen deficient state. There are other benefits of taking HRT eg cardio-vascular health.

Of course equally (or even more) important are lifestyle factors - diet, exercise, body weight etc - in helping us live healthily beyond menopause.

If your periods are still regular as in never skipped a period and less than 1 week difference in cycle length then you are not yet at peri-menipause according to the current medical definition - but in the late reproductive stage. However hormones do begin to go a bit awry at this point as the ovarian function starts to decrease, and for some unluckly women early peri-menopausal symptoms such as you describe, can begin, as well as worsening pms.

In your position - regular periods, still young - some meno specialists prefer to prescribe one of the contraceptive pills which are similar to HRT in that they contain the same oestrogen (estradiol) but also suppress the cycle which dampens down the hormone/mood fluctuations of peri-menopause. These are of course free on NHS - the two products are QLAIRA and ZOELY.

Utrogestan is notorious in being a sedative and having soporific effects.

Great to hear your sleep has improved...

Hope this helps....

Hurdity x

[CLKD]

Of course, that article is in the recycling bin with another which I meant to read - off with the grabber to search!

[Marchlove]

Hi Katherine

In general I would try to keep your estrogen hrt on the low side. You need to really feel it’s effect on you and supplement at a slightly increased amount when you feel it will be of benefit and decrease also when necessary.

This can’t be explained in a text book and certainly not by any experts, but they surely know that the supplementation of sex hormones is beyond current medical expertise to achieve a 100% success rate. But nevertheless great gains can be achieved.

Your adrenals are very aware of sex hormone fluctuations so this is a fine art I feel. One which I’m still on a journey with.
X

[Katherine]

Hi all, just read your latest posts and planning to reply properly tomorrow but marchlove I was struck by you saying to keep the estrogel on the low side- why is this? Is it harmful if you take too much?

[Taz2]

A really informative post Hurdity. Thank you.

Taz x

[Marchlove]

Hi Katherine

I’m speaking from personal experience that too much estrogen for me causes anxiety and histamine reactions.

Other ladies on this forum have been experiencing the same issues and some are opting to lower their estrogen because of this.

X

[CLKD]

Any alteration in HRT may through the body into free fall.  Little steps.