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[KBIOW]

Hello all,

I’m new to this forum and am in quite a predicament about what to do as I’m sure many of you have been.
My Mum is no longer with me and would have been the one I would have spoken to about this, my sister is younger and I’m sure I’ll be able to help her when the time comes, but she’s busy with her own things, I don’t have any friends to talk to and was advised by my GP to check this forum out so here I am!

My periods stopped a year ago, I had been on the pill from the age of 14 until I was 47, I’m 51 in August. I haven’t had children.

In between I’ve had various eye health issues that started in 2022 these are managed now. Narrow angles, laser iridotomy twice and now have treated narrow angles with my eye pressure being managed by drops… although I have been recently diagnosed with meibomian gland disease. (not sure if this is associated with the menopause!).

My symptoms are a few hot flushes, occasional aches, lack of energy, my eyes are very sore and baggy, eye sight getting worse..dry skin, arms and knees looking a bit saggy and my face especially(wow I’m painting a great picture of myself!)

After my blood tests the female GP has recommended that I start HRT the combined patch, I hate taking medication, the eye drops I have to take daily I hate but I have to otherwise my eye pressures will rise and this could ultimately effect my vision. I feel lucky that I have a GP that is offering me this but I just don’t know what to do.
I’ve read lots of pros and cons.
I’ve read Liz Earle’s book very pro HRT.
I’ve seen posts on Instagram from Lisa Snowden, Davina, Menopause Doctor etc but I just don’t know what to do. I used to be ok at making decisions but realise I’m no good anymore!

I would appreciate any of your thoughts and if I have posted this on the wrong part of the forum just let me know.

Thanks in advance!

[CLKD]

Morning.     peri-menopause are the years where we notice different health issues.  How au fait is your optometrist with menopause? I've been educating mine ;-)

As oestrogen levels drop muscles may become lax = aches and pains. Over the counter pain relief can help.  The body may also become dry: inside and out, do read the threads about vaginal atrophy which requires appropriate treatment if 1 should be diagnosed.

Have U had your thyroid function and VitD levels checked with a blood test?  The former can become affected by other hormone upheavals.

Why do U 'Hate' taking medication  which can be a life saver for some.  Menopause is natural as are other health issues, would U baulk at essential diabetic or heart medication prescriptions?  When I was diagnosed with depression that required treatment, I wanted to know why I was depressed organically but no1 was interested in finding out! So tablets it had to be which have enabled me.

Not being able to made decisions is also a menopause symptom for many of us 

[Ayesha]

The first thing you have to accept, there is no getting away from symptoms of the ageing process, menopause is just one of them and you will find as time goes on you will accept any medications you are offered to help relieve chronic conditions, I was like you in never wanting to take medications but all that changes with the passing of time.

My best advice is to do your research by reading the posts on this website because this is the real world and not of celebrities you might read about.
 

[joziel]

KBIOW, in my mind there are almost zero risks to taking HRT and massive gains, so it's a no brainer. I'm not sure what you have been told about it, because that doesn't seem to be your starting point - or you wouldn't be hesitating..?

Personally, I had dry eye going back to about age 38. Paradoxically, it would water and run a lot - which I think was the eye trying to create moisture to compensate (same thing happens with the cervix and vaginal lubrication). It made life really embarrassing because I was constantly dabbing at my eye, couldn't wear any eye make up and would end up with tear streaks. No one ever mentioned low estrogen or peri menopause to me as a possible cause, even my optician, who just diagnosed dry eye and cautioned me about not wearing contact lenses too much.

Then at 42 I got all the other unbearable symptoms and started HRT. Amazingly, the dry eye just went away and I never get it now.

Which is all to say - a lot of eye stuff is caused by loss of natural hormones.

[chopsuey]

KBIOW - I am not keen on taking medication either but had no qualms about taking HRT. It has been a life saver, after experiencing a huge range of debilitating physical and mental symptoms, leading to me having to go part-time at work.

The symptoms you describe could all be explained by low oestrogen. Oestrogen has so many functions in the body and to me, HRT is just putting back the hormones that have a clear purpose in the body and which it is clearly missing.

Not everyone gets on with HRT of course and for some it is difficult to find the combination that works for them. My own journey was not straightforward, but I got there in the end with specialist help and also advice and info from this forum.

It sounds like you have a fairly supportive GP, so I would encourage you to at least give HRT a try and see how you feel.   

[Ayesha]

I want to just add that at your age I went on HRT to relieve debilitating hot flushes and it was great. After five years side affects started to appear and I decided to come off HRT and by then the hot flushes had gone.

Whatever you decide its important to live a healthy lifestyle with supplements, exercise included if you can't or don't want to take HRT.
Also be aware of GSM (Vaginal Atrophy) as systemic HRT doesn't always help with this and know that topical oestrogen is very safe to take without all the dire warnings you tend to get with systemic HRT which to this day is still demonised for one reason or another.

[sheila99]

Perhaps it would help to think of hrt as replacing the hormones you should produce but don't (major design flaw  ) rather than medication. When you research how risky it is make sure it's research on transdermal hrt, the older oral type made from horse urine was far riskier. For me the deision was easy because like without hrt was't worth living, if you have few smptoms perhaps it's diferent. You could trial it for 3 months and make a deision then whether to continue or not, you might be suprised how diferent you feel.

[bombsh3ll]

I also wouldn't really consider menopause hormone therapy as medication because you are simply putting back what you had originally, and what our bodies are designed to function optimally with.

I would think about both the short and long term consequences of not having estrogen, and think about whether those are things you would rather avoid given the choice.

It sounds like your eye condition is a lot more than the dry eyes that many experience with hypoestrogenism, and I wouldn't necessarily expect hormone therapy to improve that, but it will benefit your health in many other ways.

Also you have taken the birth control pill for decades, I don't know whether that was for health reasons but it makes little sense to be OK with that and then deny yourself hormone therapy in menopause.

[KBIOW]

Thank you all for taking the time to read my post and comment.
I’ll have more of a read on here before making my decision, as far as I’m aware I’m being offered the lowest dose of the combined patch…. The GP mentioned tablets, gel, spray, coil but I think the patch seems the most straight forward option.

[joziel]

I wouldn't recommend the combined patch, because the progestin in it is synthetic. If that's the only thing you can use or tolerate, then fair enough... But as a first-line choice I would avoid synthetic progestins due to their increased risk of breast cancer, adverse effects on lipid profile and inflammation - and much more - especially when choosing something you could be taking for the rest of your life.

[KBIOW]

I wouldn't recommend the combined patch, because the progestin in it is synthetic. If that's the only thing you can use or tolerate, then fair enough... But as a first-line choice I would avoid synthetic progestins due to their increased risk of breast cancer, adverse effects on lipid profile and inflammation - and much more - especially when choosing something you could be taking for the rest of your life.

Thank you, as I’m new to all of this, I don’t quite understand what you mean as apparently I need both the oestrogen and progesterone what are you suggesting as an option I don’t like the idea of the synthetic part so would welcome your feedback….

Katy

[joziel]

There is only body identical progesterone, called utrogestan (or gepretix, which is another brand of the same thing). It comes as little capsules which you either take orally usually at night or insert vaginally if you want better absorption or have side effects you don't like (as you can reduce those if you take it vaginally).

Body identical progesterone cannot be absorbed through the skin, so it won't be in any patch.

Body identical estrogen can be absorbed through the skin...

See the Balance Menopause website for more info.

[KBIOW]

Hello, well the GP has recommended the following… Evorel Conti Patches combined.
I don’t know anything about these, anyone that has any feedback would be great or point me in the right direction if this has previously been on the forum.

I am now concerned since reading up that coming off the pill was a bad decision, but I didn’t have any discussions feedback from the doctors as perhaps I’ve been in Peri Menopause without even knowing….

Many thanks a confused 50:year old….😞!

[bombsh3ll]

I have not personally used evorel conti patches, I still am on the combined pill taken continuously, but when I switch to menopause hormone therapy in my early to mid 50's once menopause can be reasonably assumed, my own first choice would be oral estradiol plus vaginal micronised progesterone taken cyclically.

However the combined patch isn't a bad place to start and is the most convenient out of the non-oral options.

Personally I am not anti synthetic progestins, my only issue with the combined patch would be the fixed low dose of estradiol, and then what do you do if this isn't enough, you would likely have to switch products.

As to coming off the pill at 47, whilst this may have resulted in avoidable discomfort and some degree of bone loss, this should not persist once you start hormone therapy, and you have still banked 3 decades on the combined pill which will have MASSIVELY reduced your risk of ovarian, endometrial and colorectal cancers!

(My own ambition is to complete 20-25 years for reduction of familial OVCA risk).

[joziel]

Already said what I have to say about synthetic progestins. Plenty info available online. There's a good article here as well: https://www.larabriden.com/guide-to-using-progesterone-for-womens-health/