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[Kai_63]

Had a private appt with a menopause clinic.

I’m on Utrogestan, oestrogel and vagifem already. I’m currently 45.

Two years ago I had an FSH test following my first peri symptoms (reduced periods and hot flushes) which came up as 53. I told the specialist this result today and she said I am not peri, I am already menopausal at that rate of FSH.

It just seems like a very quick turnaround to go from first peri symptoms two years ago to menopausal now?

And three years before that I’d had fertility tests which said there was no natural issues for me with conception?

Should I just follow the new HRT regime (daily utrogestan, increased oestrogel to 4 pumps from 2.5) or get a second opinion?

[CLKD]

I don't think that if 1 is taking HRT that 1 knows if the last period has been and gone.

Peri are the years prior to the last monthly period = menopause.  We are advised to be at least 12 months without a bleed B4 considering that we are through The Change.  However, Nature can throw in the curved ball with another period so we have to count again 

Hopefully some1 with more knowledge will be along ........ Blood tests are reliably un-reliable!

Is the HRT regime helping?  Keep up with the vagifem as often as necessary to keep symptoms under control. 

[Kai_63]

Thank you. 2 years ago my periods were 8 months apart already.

The reason I went to see the specialist today is that the HRT wasn’t helping everything, still had bad VA and mood issues despite decent doses.

So I guess she’s taking all that information together and deciding I’m probably menopausal by now?

[CLKD]

I don't think that whilst on HRT any1 can suggest that you are through to menopause.

How often are you using the Vaginal Atrophy treatment, some require it every night.  Plus moisturisers on the outer labia to keep the dryness away.  I wouldn't expect a medic who specialises in menopause would consider VA to be part of finding out if a lady is through .........

MayB put the Utrogestan into the search box to see what pops up. Make notes ;-).

Some find that keeping a mood/food/symptom diary of use.

[Kai_63]

Thank you, Vagifem is twice weekly, she said I can take it nightly for a month to boost things. She’s suggested Blissell for the outside.

It seemed to be the combination of my blood test two years ago and my current symptoms that led her to say I am meno.

She has switched me from 12 days Utrogestan to daily. Will do a search.

She also said I should come off the pill (so will use condom) and within six months my bleeds should stop.

Presumably if they don’t I might still be peri?

[CLKD]

There seems a lot 'going on' here.  Why would you need to stop the Pill if she thinks that you are already menopausal?  If this regime is working for you, regardless I would continue until I'd had further advice  . I certainly wouldn't risk a pregnancy! 

If U are bleeding it's probably a withdrawal bleed from the HRT.   ??

I would be seeking a 2nd opinion.  Was she at a Menpause Clinic ?  or a GP interested in womens health.

Hopefully some1 with HRT knowledge or on a similar regime will be along.   In the meanwhile, do that search ?

[Kai_63]

Thank you, she was at a menopause clinic and is a specialist on menopause (one of the well known clinics).

She is saying that if I take Utro every day and stop the pill, after six months I shouldn’t get any kind of bleed because I’m menopausal and on Utro daily, not cyclically.

I wouldn’t say anything’s working for me on HRT so far, my VA and mood is bad and between Utro and mini pill she was saying I was getting a lot of progesterone so could definitely up oestrogel in any case.

It’s all very confusing.

[joziel]

You don't really need to know when you are menopausal. You can try taking continuous utrogestan and see what happens. If you get annoying breakthrough bleeds then you're probably not menopausal yet and need sequential, so you'd simply switch back again. It makes no difference really to treatment or health.... the only thing it affects is whether or not you get annoying bleeds which are unscheduled.

[Kai_63]

Ah Ok yes this makes sense. I’d be comfortable trying it out.

Although I don’t understand why I couldn’t just stay on 12 days a month (or 14 days) and just up the estrogel instead.

Especially given my age and the fact my symptoms only started two years ago, I’d have thought it would be fine to stay as I was on Utro before testing a daily regime. What’s the danger of a menopausal woman staying on a cyclical regime?

[CLKD]

MayB send me a PM as to which Clinic you attended?

[Dotty]

If you’re happy on a sequential regime then stay on it. You can increase the oestrogen up to 4 pumps and still be within licensed doses.

Post menopause is 12 months without a period. You can’t go on blood test results.

Which contraceptive pill are you taking ? x

[CLKD]

Let us know how you get on. 

[Kai_63]

Thanks both.

I’m on desogestrel (progesterone only pill).

It was just strange to me how quickly the doctor was keen to get me off the pill and onto the daily Utro. I don’t want to change things that seem to be working (12 days Utro, for example) and I’m not having side effects from.

[Dotty]

Hi I’ve just remembered more advice…if you don’t bleed on the mini pill then you can take the Utrogestan every day. It’s possible that it’s the mini pill that is stopping the bleeding.

There’s no reason to stop the mini pill if you’re happy on it. If you stop it you would need another form of contraception so why change what you’re on if you’re ok with it ?

But there’s no reason to stop the sequential regime if you’re happy on it. An increase in Oestrogel should help your symptoms.

[Kai_63]

Thank you, I currently get a withdrawal bleed pretty much like clockwork on the last day of Utrogestan.

Hard to know if the mini pill is also causing that bleed.

The doctor was adamant I’m menopausal rather than peri and that therefore I can come off the mini pill, use a condom for six months and move to a daily Utrogestan regime at the same time. 

She said my bleeds should entirely stop after that and there would be no need for contraception at that point (but we could do further blood tests to double check first).