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[merrygoround]

Hi, I have always had tummy pains and it was diagnosed as IBS 37 years ago in my teens.

It resolved to being much more manageable and I was able to eat more when I got to menopause. That's when I wondered had it been a gynae problem all along. My agonising pains after eating didn't happen for a long time while my periods stopped and I began to hot flush all over the place.

Then I began on the HRT train. My GP has me on tibolone because it doesn't cause "women" the problems that other hrts do, so as "a woman" that must include me, I don't believe it's going to give me cancer anyway, but my GP is very cautious re HRT.

My periods came back with HRT, but so did all the pain regarding eating. Why is this? Do the hormones feed bad bacteria in the gut or something? What is going on?

[CLKD]

Morning.  Where exactly at the 'pains' and what have you taken to ease them over the years?

R these cyclical?  I would become 'constipated' in the week approaching a period.  I would also in later years have 'the runs' 10 mins B4 a bleed began, even if a period wasn't due. 

Sadly IBS is a 'diagnosis' when GPs don't know what else to suggest  .   How are your bowel movements?  We have a thread on "POO" somewhere.  I have had gut issues since a small child, usually associated with anxiety.

However: my bowel is slow very often in that it feels like it needs to expel something but takes hours.  Thank goodness 4 crossword books ;-).  Since cutting out most processed foods from our diet in recent years I go every day even if I don't feel empty.  I have to tick the calendar  .

The Gut is the 2nd brain.  Mine is very sensitive to anxiety. 

How long have you been using 'tibolone'?  Does it help at all?

So many questions, sorry 

MayB review what you eat/drink over 3 days.  Make a diary of ins and outs.  Be honest ;-). U may find that there is a pattern to the cramps.

 

[merrygoround]

Morning.  Where exactly at the 'pains' and what have you taken to ease them over the years?

R these cyclical?  I would become 'constipated' in the week approaching a period.  I would also in later years have 'the runs' 10 mins B4 a bleed began, even if a period wasn't due. 

Sadly IBS is a 'diagnosis' when GPs don't know what else to suggest  .   How are your bowel movements?  We have a thread on "POO" somewhere.  I have had gut issues since a small child, usually associated with anxiety.

However: my bowel is slow very often in that it feels like it needs to expel something but takes hours.  Thank goodness 4 crossword books ;-).  Since cutting out most processed foods from our diet in recent years I go every day even if I don't feel empty.  I have to tick the calendar  .

The Gut is the 2nd brain.  Mine is very sensitive to anxiety. 

How long have you been using 'tibolone'?  Does it help at all?

So many questions, sorry 

MayB review what you eat/drink over 3 days.  Make a diary of ins and outs.  Be honest ;-). U may find that there is a pattern to the cramps.

 

The pains aren't cyclical AFAIK and I've had all sorts of tests that come back negative.
Yeah, I like tibolone a lot, I wasn't keen at first but it is simple to take and is energising in a good way (not in a utrogestan keep you awake all night way), takes away the musculoskeletal aches and pains and lets me fall asleep.

I'm three years post meno and only bleed due to HRT on a monthly basis.

I've been to a dietician and done a four month elimination diet which told me I react with pain to food, pretty much all food.

I was like you with being slightly constipated before my period then would have the runs on day one of my period. Other than that I'm not prone to constipation, but lately been getting such a lot of heartburn.

The only processed food I eat is bread occasionally, both wheat and milk seem to cause problems but I tested negative for any known disorders regarding either.

I'm wondering is tibolone causing the problem to get worse again? I use a little oestrogel as well when I get hot flushes, progestins aren't needed alongside tibolone, I still have a womb. Do these cause inflammation internally? I felt inflamed on ostrogel when that was my HRT.

The only relief I'm currently getting is from loperamide, it just kinda stops everything moving internally for a while, so the pain stops, but I heard it's bad for the heart.

The GP threw everything from buscopan and colofac to amitriptyline at it without any success.

[CLKD]

Was the dietician in the NHS?   Food insensitivity can certainly increase as we age.  Not many people are 'allergic' to foods or they would end up in A&E. 

Onions: I love 'em but have to be very very careful or they cause intense evacuation of bowels: it's the nearest that I have ever been to a 'trip'  .  Now I can tolerate them if they are cooked for hours ....... ginger was a regular addition to our meals but it has caused me a cough, either grated or in syrup.  Shame because it has helped my digestion over the years.  I've begun cutting out other foods that cause the 'cough' clearing of throat nuisance reflex.  'coke' in the bottle does the same. 

Is your body hungry?  If U are eliminating food groups then you may not be getting enough nourishment.  From the age of 3 I mis-interpreted hunger pains as nausea - it wasn't until I was prescribed BetaBLockas that I recognised that as hunger pangs. [long story short].

Reflux can be problematic as we age.  Muscles may become lax = aches and pains.  This can increase the hiatus hernia/indigestion/reflux.  Sometimes I have intense pain between my rib cage which radiates into the chin - a few sips of bottled, fizzy water seems to settle it.  My GP has prescribed 'omeprazolol' which works.

How long did you stop eating bread for, it may be a gluten sensitivity: another problem that may occur in peri-menaopuse etc.. 

MayB put 'tibolone' into the search box and read the appropriate threads.  Make notes ;-).  Trial and Error can be wearying.

[merrygoround]

Was the dietician in the NHS?   Food insensitivity can certainly increase as we age.  Not many people are 'allergic' to foods or they would end up in A&E. 

Onions: I love 'em but have to be very very careful or they cause intense evacuation of bowels: it's the nearest that I have ever been to a 'trip'  .  Now I can tolerate them if they are cooked for hours ....... ginger was a regular addition to our meals but it has caused me a cough, either grated or in syrup.  Shame because it has helped my digestion over the years.  I've begun cutting out other foods that cause the 'cough' clearing of throat nuisance reflex.  'coke' in the bottle does the same. 

Is your body hungry?  If U are eliminating food groups then you may not be getting enough nourishment.  From the age of 3 I mis-interpreted hunger pains as nausea - it wasn't until I was prescribed BetaBLockas that I recognised that as hunger pangs. [long story short].

Reflux can be problematic as we age.  Muscles may become lax = aches and pains.  This can increase the hiatus hernia/indigestion/reflux.  Sometimes I have intense pain between my rib cage which radiates into the chin - a few sips of bottled, fizzy water seems to settle it.  My GP has prescribed 'omeprazolol' which works.

How long did you stop eating bread for, it may be a gluten sensitivity: another problem that may occur in peri-menaopuse etc.. 

MayB put 'tibolone' into the search box and read the appropriate threads.  Make notes ;-).  Trial and Error can be wearying.

I often think I don't recognise hunger properly either, I get cold if I'm hungry then I reach for a warm drink, herbal teas mostly, then leave the kitchen with my tea without eating, all day sometimes. The tea will soothe my tummy, warm me up and get me back to work and I forget to eat. Yesterday I made a ham sandwich and left it sitting in the kitchen for an hour thinking I'd eaten it when I only made it. I was shocked when I found it again!
I don't eliminate whole food groups, I can tolerate most food in small doses, but this morning I turned on my computer and as the light hit my eyes in the mostly dark room, I was overcome with nausea. So now I'm wondering is this hormonal migraines again?
I love being female and I love the fact I grew my own children, but there is quite a cost attached!

[joziel]

I would suggest you think about having endometriosis. A very frequent symptom of it is IBS and bowel type stuff, because it is often on the bowels or adhesions form involving the bowels. 10% of women have it, and that's just those we know about - when most don't get diagnosed because it takes a laparoscopy to diagnose it.

Endo is stirred up by estrogen which is why the most common treatment in pre-meno women is to give them the progestin only pill/POP.

I have endo (diagnosed by lap) and I was told categorically 'you will NOT control endo with utrogestan, you will need the Mirena coil' blah blah, by one of the first GPs I saw. I did my own research, found out that many women are fine with utrogestan and endo, but often need higher doses of it - and found myself a private meno dr via Newson Health.

I am totally fine on a high dose of utrogestan, which is body identical and much better for me than synthetic progestin I've been on for the last 10 years to suppress the endo. I'm even on a very high dose of estrogen at the moment (8 pumps, although serum levels around 400pmol) and the utrogestan is holding up. I take 200mg day 7-16 and 300mg 16-26. Then stop to allow a bleed. I kind of made that up but it's working fine.

ANYWAY, what I'm saying is: It is hard to diagnose endo without a lap and you don't really want to go through that. But what you can try, is a higher than usual dose of utrogestan - and see if that helps and suppresses the pains. I have no idea about tibolone and how that works, but I'd insist you get body identical hormones back - E, P and T and see a different doctor if necessary. You can tell them you have suspected endo and ask if you can try a higher dose of utrogestan.... If you're on a lower dose of estrogen, it will probably be 200mg continuous.

[merrygoround]

I would suggest you think about having endometriosis. A very frequent symptom of it is IBS and bowel type stuff, because it is often on the bowels or adhesions form involving the bowels. 10% of women have it, and that's just those we know about - when most don't get diagnosed because it takes a laparoscopy to diagnose it.

Endo is stirred up by estrogen which is why the most common treatment in pre-meno women is to give them the progestin only pill/POP.

I have endo (diagnosed by lap) and I was told categorically 'you will NOT control endo with utrogestan, you will need the Mirena coil' blah blah, by one of the first GPs I saw. I did my own research, found out that many women are fine with utrogestan and endo, but often need higher doses of it - and found myself a private meno dr via Newson Health.

I am totally fine on a high dose of utrogestan, which is body identical and much better for me than synthetic progestin I've been on for the last 10 years to suppress the endo. I'm even on a very high dose of estrogen at the moment (8 pumps, although serum levels around 400pmol) and the utrogestan is holding up. I take 200mg day 7-16 and 300mg 16-26. Then stop to allow a bleed. I kind of made that up but it's working fine.

ANYWAY, what I'm saying is: It is hard to diagnose endo without a lap and you don't really want to go through that. But what you can try, is a higher than usual dose of utrogestan - and see if that helps and suppresses the pains. I have no idea about tibolone and how that works, but I'd insist you get body identical hormones back - E, P and T and see a different doctor if necessary. You can tell them you have suspected endo and ask if you can try a higher dose of utrogestan.... If you're on a lower dose of estrogen, it will probably be 200mg continuous.

Sorry I didn't see your post Joziel, thank you for your detailed reply, it's made me think.
I assumed that endo was ruled out when I had a transvaginal scan last year because the lining was as thin as it ought to be for my age, but if that scan isn't even the test for endo...
I remember now, Endometriosis is uterine lining in the wrong places, like adhered to the bowel.
I've long believed that my bowel somehow got stuck together in places and I vaguely thought it was to do with a condition I have long term that can throw up many varied symptoms. When I was inflated for a colonoscopy, they could only pump 2 litres of gas into me instead of the usual three because I was almost screaming at the pain by then. A couple of days after the procedure it felt great, like all the scar tissue had been pulled apart and everything was now free to move about.
But maybe it's not scar tissue from the other condition. What if it's endo overgrowth instead? Then it can be helped or made worse by hormones of course. Thank you Joziel for that idea, I'd honestly never thought it could be, but I'll read up on it.

[joziel]

I think you're confusing adenomyosis with endometriosis. Adeno is when there's a proliferation of tissue in the uterus, often causing heavy bleeds. Endo is when it is outside the uterus - it can be anywhere. (Mine was on the outside/top of my bladder and bottom of my uterus and on my right pelvic wall.) Some people have both adeno and endo but you can equally just have one or the other. And endo often causes heavy periods as well.

There is no way to diagnose endo without a lap. It doesn't show up on imaging reliably, although they are always working on this. Latest efforts involved trying to test period blood for markers of it, but not sure how that ended up. Anyway, without a lap you can't know for sure if you have it so people go by symptoms...

[merrygoround]

Sorry I've not been here in a few weeks Joziel, thank you for your detailed reply, it's very interesting and makes me realise I certainly could have endo.

I'd worse pain again last week, so I got on to the phone with my GP again and she went frosty on me again as I asked for pain relief again and told me to buy cocodamol from the pharmacy at the OTC strength if I wanted, but paracetamol was her choice for me.

I stressed to her that it was way beyond that level of pain so she agreed to tests for me.

The kidney and poo tests both came back abnormal so I've been referred "to surgery" but I think the surgery is a colonoscopy, not an actual surgery of any kind, I was in the car when she phoned.

So in due course a letter from the hospital will arrive to investigate my pain plus abnormal results, but she has no idea when that will be and red flag breast cancer is at 12 weeks wait now for first appointment, so it's anyone's guess.

[joziel]

Fingers crossed. I’m sorry your GP isn’t nicer, especially with referrals  I’ve had a colonoscopy and the experience was fine. Hopefully you’ll be out of there in no time. Endo can cause blood in poo by the way, too. I don’t think it’s diagnosed by colonoscopy though🤷‍♀️