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[Redladybird74]

Hi, would someone please give me any advice. I'm 50 and had regular periods once a month but after a viral infection I was suffering from vertigo dizziness and balance issues these issues along with migraine ramped up the week before my period and left me debilitated and unable to work. I thought combined HRT would help. I paid to see a midwife/self employed lady £200 and she suggested combined HRT (estradiol and ugestersterone) 2 pumps. I started on the first day of my period on 19th November. I had my withdrawal bleed on 19th December but just after Christmas I decided to stop the estradiol. My dizziness seemed worse and I was getting random neck and shoulder pain which scared me. I went the whole of January without a period which didnt concern me as I knew my periods would be out of wack. I had my period on 3rd February and I am still on it  I have been passing big clots for weeks and changing pads literally every hour some weeks. Other weeks it's just a watery mess  I am so scared. I am still off work with the constant dizziness but now I feel I've messed up things even worse. I messaged the menopause lady and she said I would need to pay again for a follow up. I contacted my GP who was a trainee and he said that I should take tranexamic acid for four days to stop the bleeding. I honestly dont know what to do and if i should take them as even though it's been ten weeks of bleeding I'm scared I will mess my periods up even more. Any advice would be so helpful, thank you

[Taz2]

Hi Redladybird74. It sounds as if you have had a tough time of it lately especially with the vertigo and being unable to work at the moment so you're bound to be feeling worried and vulnerable. Are you having investigations for the vertigo from your GP and have you had recent blood tests as anaemia can cause awful dizziness. You also mention neck and shoulder pain and particularly in the case of neck problems this can cause vertigo. Have you always had migraine? HRT can sometimes make them worse though some women find they improved! I think there is info on the Migraine Trust website about this

As for the bleeding I personally would follow the advice of the trainee and try the tranexamic acid to see if this does stop the bleeding. You say you stopped the estradiol. Did you also stop the utrogestan?  I'm not sure why you consulted a midwife but appreciate that nowadays it is difficult to see a menopause specialist or gynae.

We all understand on here how scary it can be coping with what seems to be never ending bleeding. You'll find support and encouragement on here so please do keep posting.

Taz x 

[CLKD]

Welcome to the World of peri/menopause.

Many find that the tranexamic acid helps ease any bleeding which is what it is designed for.

Some keep a mood/food/symptom diary to chart progress and issues.

R U in the UK?

[bombsh3ll]

I'm sorry you're dealing with this.

I don't know what is causing your dizziness and balance issues - some kind of post viral syndrome would be my guess, however the length of time it has gone on and the fact you are unable to work warrants referral for investigation of this, with either ENT or neurology.

Regarding the bleeding - you have not done anything to cause this, taking hormone therapy for a few weeks doesn't permanently alter your cycle and any effects of this will be long gone and neither here nor there at this point.

Irregular bleeding can be common in perimenopause however 2 months of continuous bleeding in a 50 year old is not normal and your GP should refer you for gynaecological investigation.

You should also have had bloods done, including a full blood count and ferritin as you may well be heading towards anaemia.

In terms of immediate bleed control, I don't love tranexamic acid, either the mechanism of action or that it doesn't address the cause of the problem, however it is worth taking to get out of a hole if that is all you have, pending investigation.

Longer term I would consider either a mirena IUS or double dose daily desogestrel ie 2*75mcg cerazette/cerelle pills for definitive bleed control.

Transdermal estrogen as a patch or gel can be used alongside either of these.