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[RosieRay]

Thank you for taking the time to read my post, I am really at the end of my tether with all of this and I just can’t cope anymore.

I’m 44 and have been on HRT for 8 years. After having my son I went straight into perimenopause and after some blood tests started on estradiol gel at a low dose. Gradually this switched to the patch with cyclical progesterone - provera. We have gradually increased the estradot to 100 over this time.

I am a lifelong sufferer of hormonal migraines and so I have to be careful about my cycles in the sense that too much of a jump In hormones causes me to get one. That’s why I’ve avoided something cyclical which would withdraw progesterone. Last year I paid to see a private menopause GP and she suggested trying the contraceptive patch continuously. I felt really good for a couple of months but then I started bleeding. This went on for 6 weeks. So I’m now back on estradot 100 plus continuous utrogrestan 100 since September last year. I’m having a period every 2 weeks which lasts for 7 days. I am tired, have brain fog and hot flushes. I am utterly miserable.

My GP thinks the Mirena coil is the answer to all of my woes but I don’t know. I just want to stop the bleeding and feel like a human. I have had recent bloods which show normal oestrogen and testosterone.

If you’ve got to the end of this, thank you

[CLKD]

 

Who over sees your migraines?  R they hormonally related, sometimes they do get worse during peri.  .

Browse round.  Make notes.  We talk about everything on here.

Has your GP done blood tests to check for anemia and thyroid function tests, also low VitD levels can cause intense tiredness. 

[joziel]

I think your options are either the Mirena or you could just give sequential HRT a go and see if it affects your migraines. We can't always predict these things.

I have a history of endo and was told firstly that there was no way a natural progresterone like utrogestan would be effective enough and then I was told I HAD to take it continuously due to endo because sequentially would cause endo flares.

It turned out that both these things were complete bollocks. Utrogestan has been fine for me and after starting it continuously and then getting break through bleeding like you, I just decided for myself to switch to sequential - and it hasn't caused any endo issues at all.

We are all individual and the world knows sweet F all about how women's bodies work, so experiment and see what works for you.

PS if you still have brain fog and hot flushes it would suggest you need more estrogen. Many younger women need more than 100. If your GP won't prescribe you more, you might need to see a menopause specialist either privately or on referral. There are women who need 200+... You should also get your ferritin level checked if you are having heavy bleeding - ferritin should be over 100. If it's not, that can cause fatigue and tiredness by itself. Join the Iron Protocol FB group as they have excellent guides for increasing iron.

[RosieRay]

Thank you both. It’s overwhelming at times as I definitely know more than my GP or any gynaecologist I’ve seen. My GP said it’s not possible to see someone who is a menopause specialist 🤔. I can’t afford the private route again and I’ve worked through most of the list of options given to me. The last thing she said was to increase my oestrogen to 125 but my gp was reluctant to as my estradiol levels were normal in my blood tests.

I have had my ferritin done, iron etc but may get this rechecked. Thyroid too. All normal.

I too have endometriosis. Nothing stops my periods. I’ve done back to back pills in the past and other options. But every two weeks is a nightmare. I think trying sequential might be the way to go. I can only try and see what happens I guess.

Thanks for all the advice. I’m just fed up right now

[CLKD]

Do look at the websites for your local Hospitals which will say if there is dedicated menopause advice, or ring round to find out.  Your GP is very wrong, he/she should know of an NHS menopause clinic however, referral costs come out of the surgery budget which I believe is why many won't refer.  UK patients are entitled to a 2nd opinion which is why we have specialists 

How is your diet overall? 

Also, has any1 suggested hysterectomy?  You may well require HRT so that's a route to research, mayB have a lookC at 'hystersisters' website? 

[RosieRay]

Last year I had a prolapse repair and I kind of wish I had gone for a hysterectomy. I just wasn’t ready at that time but now I’m thinking maybe it would be a good option.

I’ll see if there are any referral services. My GP is usually pretty good but maybe not up to date

My diet is good - I’m a coeliac so I take care around it. I have just felt rubbish for 8 years and even with each increase of oestrogen have never felt much improvement. I don’t think the coil is for me - I suspect it would not stop my bleeding

[SarahT]

Hi Rosie,

The mirena coil took a while to settle down for me, but has stood full bleeds.  Get the odd spotting now and again. I think the coil is used also for heavy bleeding so may be worth just asking your g.p. Am not pushing you here obviously (!) But may me worth enquiring?

Wish you well

[RosieRay]

I'm not totally against the coil, it's just when they say "in the majority of women it stops bleeding".I know from experience that I'm never in that group!

Interestingly my ferritin at my last blood screen 2 years ago was 45, so I will check out more info on iron.

[CLKD]

8 years is too long to feel 'rubbish'  .  Quality of Life is important.  Perhaps write down how active you were years ago to what you can't do or avoid doing now?  Decide which hobbies etc. you would like to resume for example, what makes you lack energy.  4 me it was very low VitD levels.

[sheila99]

Increasing to 200mg utro daily is a known strategy for problem bleeding, better still if used vaginally. Another way to think of the mirena is 'the best strategy to stop bleeding' as it often works were other methids haven't. You may be unlucky but there aren't many times it fails. Agree with joziel about increasing oestrogen too.

[RosieRay]

Thanks everyone, these replies are so helpful!

It is hard to remember a time when I felt well to be honest. I spent my 20s battling endometriosis and migraine, then my early 30s having fertility treatment. My egg reserve was 'almost undetectable' and then bingo I had a natural pregnancy! But after that straight into early menopause and my oestrogen never picked up. I know now that younger women need much more oestrogen but GP's still seem to go with the slowly, slowly approach.

[Ermin2trude]

Oh RosieRay I empathise with you sooo much. I can’t remember a time I felt well either. Since puberty it’s been a battle with fibroids, cysts and migraines. Fertility treatment in my thirties (sadly unsuccessful), and now peri menopause has been going on for approx 15 years. Like you I’m also coeliac and like you I need continuous progesterone to stop the migraines which always happen when the progesterone stops during a sequi regime. I also have acquired a histamine intolerance (thanks oestrogel for sending my histamines into the stratosphere)

On a positive note though, I have had a Mirena coil fitted recently. My bleeds on HRT were very heavy and every 2 weeks, which made me anaemic and now I’m on heavy duty ferrous fumarate  indefinitely. I thought the coil would be awful because I’m hyper sensitive to any tiny hormonal changes, but it’s been a revelation. No headaches or migraines, no change in mood. I’m still spotting but that is to be expected until it settles down. I can’t go above a 50 estradot patch because of the histamine intolerance and have found I still need 100mg utrogestan continuously to keep on top of it.

Do I feel well? I honestly don’t know what ‘well’ feels like, but I do feel in control of my symptoms and optimistic. I feel like exercising, making plans, having fun. I feel human and not anxious about being a ‘burden’. The Mirena isn’t so bad. I have resisted it for years for the same reasons you have, and I really wish I had done it sooner.

I hope you find the answer for your hormones too. It is out there. Good luck.

[RosieRay]

Ermin2trude are we twins?!

Sounds like a very similar story and I always feel a little embarrassed going to the GP with yet another issue. I do think that the endometriosis and general trauma was a trigger for my relatively recent coeliac disease. My body just seems to react in extreme ways.

Sorry about your fertility journey. Due to my poor response I was told my chance was 1% at best of having a biological child but it seems I was one of the lucky ones.

There are lots of options on here, I just need to work through them but clearly my progesterone needs to change to control the bleeding, which is probably my most life limiting issue at the moment. I'm glad it had improved things for you.

[CLKD]

  Ermin2trude

[RosieRay]

thank you to all of the comments so far. I've been reading them carefully and taking notes.

It already feels better not being alone. None of my friends have any idea about menopausal issues. They will do in the future of course!