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[BeadyAlice]

Hello there 

I'm feeling a bit lost and confused.

I am now 45 (in June), and have suffered with various symptoms since my early 20s (at least). Some of these symptoms have increased in their severity over the years and then some new symptoms have slowly incorporated themselves into my life too.

These symptoms include, but are not limited to: bouts of physical fatigue, non restorative sleep, constant sore throat, random sudden onset pains in my body (anytime and anywhere!), back pain, brain fog and issues with concentration or finding the right word (honestly, I feel utterly stupid sometimes!)

I've seen various GPs about these issues on and off through the years, and have been told that they're just due to my anxiety issues, or my depression, or that they're just fitness issues... etc.

Last year, my GP saw a correlation with my age and these symptoms and concluded that I was probably peri-menopausal. A blood test came back with an elevated FSH level, and she was convinced that her diagnosis was correct...

I asked if my Progestogen pill (Desogestrel) may have had an affect on the FSH level recorded in the blood test. The GP advised that I should come off it and then we'd test again. So I did, and the level was still a little elevated, but not at a conclusive level ("Not as high as I would have liked," said my GP). However, my GP wanted me to try HRT and I agreed - it was worth a try if it could see my symptoms eased.

When I first started taking HRT (Utrogestan and Oestragel), while I was off the pill, I started having bleeds that lasted 3 weeks, then I'd have 1 week off, before another 3 weeks of awfulness. Before that, my periods had been fine and normal. I told the GP and she advised I went back on the pill because it had previously stopped me from having periods. I did, and they did mostly stop but I had spotting when I'd not had any before on the pill. I knew I needed to stay on it for at least 3-4 months to see if I noticed any difference with any of my symptoms...

I didn't notice any difference with my symptoms and so I went back to the GP, and she said, "Well, HRT won't help you with any of the long term symptoms you've been having." Me: 

So, I said that I would like come off HRT as I had actually seen a slight increase in some of my symptoms. I had continual leg pain for the whole 3 months I was on it too (new symptom! Yay), which was the first time any of my aches had lasted that long. When I came off it, the leg pain started to subside, but that could have just been coincidental.

I've recently revisited the issue of my symptoms again with my GP, because I am just fed up and want to know what's happening with my body, and she did another blood test. My Vit D levels were a bit low, so I'm taking supplements for that (still waiting to see if it makes any difference). She also took another FSH level read, which I didn't know she was doing, and that has come back high again... so she's mentioned HRT to me again and wants me to think about it... However, after my chat with her, I realised that the test had been done while I was taking Desogestrel again... so I am not sure how reliable it is anyway??

I'm due another blood test in 6 weeks, and so I need to ask my GP if I should come off the pill in preparation for it.

I don't know what to do, though. I do know that I am now in the right age-range to be peri-menopausal, and I certainly could be... but I am not suffering with hot flushes or nights sweats or any 'new' symptoms that could be caused by the lead up to the menopause. I don't know what the point in taking HRT is if there are no symptoms that it can help me with, and I am worried about my current symptoms becoming worse again because of it.

I am also feeling completely unheard by my GP. She's so hot on diagnosing menopausal symptoms (which is great in so many ways!), that she is ignoring the fact that these symptoms may have another root cause. My symptoms may have increased in the last few years (from Sept 2017), but I have had two reasonably traumatic experiences in that time, and feel that the increase in my symptoms would be more likely to be connected with those (especially as HRT had zero effect on them).

Has anyone else had anything like this happen with them? Or, does anyone have any insight/advice to offer me?

Thank you so much for your time if you read all of this - it was a LOT, sorry! 

[JS79]

So many conditions have crossovers with peri, including vit d and vit b12, then fibro etc. It could be that you have had one of these since your early 20s but now peri making symptoms worse.
I think I'm peri, and HRT has helped with certain symptoms but I also think my vit d being very low has caused issues and I'm away to get b12 tested.
I think maybe you should ask for specialist menopause referral, this may take up to a Yr for an appt so ask now.
Good luck

[bombsh3ll]

Given the length of time you have had these symptoms, and the fact HRT didn't seem to help much, it is likely that they are not all related to perimenopause, but kudos to your GP for thinking along these lines.

Desogestrel would not have caused a raised FSH, if anything birth control suppresses FSH, but not typically the progestin only pill.

Your FSH will be genuine, and realistically who at 45 ISN'T perimenopausal?

If it were me, I would take the HRT for long term health benefits including bone protection, and I would also consider testosterone, as that can help with some if the symptoms you describe (although you may have to say it is for low libido to get it on the NHS)

However being on HRT should not deter you from pursuing other potential contributing factors if you still have symptoms.

There are also multiple bleed free options if cyclical isn't acceptable to you.

[CLKD]

   good advice thus far.

MayB get your GP to run VitD and VitB12 blood tests to get a handle on levels.  Also thyroid function .   Some find that keeping a mood/food/symptom diary of use to chart progress.

For me periods waxed and waned then disappeared.  I had cold flushes after my evening bath for a while, the continuing problem has been itching ....... in no specific areas.  Probably due to low oestrogen. 

Do read the bladder issues and vaginal atrophy threads on the Forum: 4warned is 4armed!  U may/not require appropriate VA treatment but be warned repeated 'urine' infection-type symptoms mimic VA really, really well!

As mentioned HRT protects bones and heart.  However, good exercise also protects both.  Some need to review their overall diet as we age, an intolerance to alcohol being the main 1 apparently.  I've had to change what I eat/drink, cutting out ultra processed foods over a few years.  Food items such as croissants, scones, hot cross buns now make my really ill.

Let us know how you get on!

[joziel]

A few thoughts...

I was on desogestrel when I had my first FSH bloods done and the result was normal (not high). I was still peri-menopausal. So - forget that. There's not a way to diagnose peri, forget about bloods and just go by how you feel.

Second, at 45 you should really consider HRT for health protection long-term. (Bone density, dementia reduction, cardiovascular and lipid profile benefits etc). This is a separate thing to your symptoms.

Third, have you had a full thyroid panel done - including T3 and free T4 and thyroid antibodies? You won't get this on the NHS, only privately. But it can cause all the symptoms you list there and can potentially have affected you much earlier. You can ask your GP to include free T4 along with the TSH she has probably already tested - but she won't be able to include T3, which arguably is the most important....

[Kathleen]

Hello BeadyAlice and welcome to the forum.


I wonder if your blood tests have included C Reactive Protein ( CRP )? This is a marker for inflammation and may indicate an autoimmune disease. This has probably been done by your GP but it may be worth checking.

I hope you get all this sorted soon and wishing you well.

K.

[CLKD]

joziel - we are a mine of info on here  .  Is there any scientific Research suggesting that HRT protects from dementia? 

[Ayesha]

There is research that suggests HRT increases the risk of developing dementia and there is no definite proof that HRT protects you from it, as yet!

[CLKD]

Wondering out loud who sponsored that Research? 

[SundayGirl]

CLKD - some studies have shown positive effects of HRT on dementia, yet other studies have shown the exact opposite.

It's not as simple as yes it does or no it doesn't. Lots of other things need to be taken into consideration alongside, such as socio-economic factors, age etc

Unfortunately, there's no magic bullet that you can use to protect yourself from everything. 

An extract from Alzheimers.org

Research on HRT and dementia risk
Studies into hormone replacement therapy and dementia are conflicting. With some suggesting a benefit on memory and thinking abilities, or dementia risk, and others finding the opposite.

In 2021 a study of nearly 400,000 women, found both new and old HRT drugs reduced the risk of diseases that cause dementia. The study found that the effects differed based on many things: dose, type of medication, length of treatment, age, and time from menopause. Another study in Denmark, following dementia rates of over 55,000 women showed the opposite, that HRT increases dementia risk.

Part of the reason of the uncertainty is that many studies only show a connection between dementia and HRT, but they can’t tell us if HRT leads to dementia. Brain fog is a common symptom of menopause, but may also be an early symptom of dementia. If early dementia symptoms are confused for menopause symptoms and HRT is prescribed, it may also skew the numbers.

Other complications are around the type of HRT used. Older types of HRT were known to have higher risks related to them than the newer types. Also the timing of the HRT and the age it is taken may be important.

Researchers are currently working to understand the link better, to clarify whether HRT really does reduce dementia risk.

[SundayGirl]

BeadyAlice - if you're unsure about what your symptoms are pointing to, and due to the fact that you've had them so long (probably not peri then), it may be worth asking for a full health MOT to cover all bases.

Please don't be railroaded into taking anything you don't want to until you know what you're dealing with.
Only then can you make an informed choice.

Good luck.

[CLKD]

Interesting Sunday Girl - who is sponsoring the Research ;-) ?

[SundayGirl]

Many are funded by philanthropic organisations. 

[CLKD]

Such as? 

[SundayGirl]

Sorry I don't have time to do a Google search at the moment but would be interested to know what you find.