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[CLM07]

Good morning, newbie here.
I'm 50 on Sunday and still having a pretty regular period. I have been doing lots of research and reading up on peri men to be prepared over the years.

I have been off work for two weeks with extreme fatigue. I've had pins and needles sensation in my arms which then moved to feet and ankles. On occasion maybe soles of my feet burn like I've walked on hot coal. When the p & n settle I have joint pain in wrists and ankles. It's been two weeks of continuous cycle of joint pain and this p & n sensation and burning. For the last two days I haven't slept in the day which shows my energy is perhaps improving. But the joint thing is driving me crazy.
All my bloods have come back satisfactory- I was convinced it was b12 def or even Lymes disease (had a tick on holiday from Scotland at the start of summer) . Rh.Arthritis clear.
My GP said - it's probably hormones. Over the years I have been reading up on HRT so agreed it's likely . I started patch on Sunday and replaced on Wednesday - Evorel 50 sequi.
I don't have many of the typical peri men symptoms on the 'list' but know we are all different.
I have read that if I have a cycle
Then I don't need estrogen? I need progesterone - but the progesterone in Evorel is Projestin - which is different ?!
Am I getting to hung up on this?
I read that fluctuating estrogen and progesterone can cause pins n needle sensation and joint pain.
Every morning I wake and suffer and it sets of anxiety - I have never suffered with anxiety or stress and very calm person. I'm worried sick it's a nerve condition.  I'm going back to GP this morning and don't even want to say it out loud.
I'm in a whole new world of anxiety and worry.
Has anyone else suffered from these symptoms ?  I have read a few threads that say HRT helped and the symptoms went away- how long did that take 🤪
Thank you

[Taz2]

Hi CLM07. The tingling and burning symptoms you mention together with the aching wrists and ankles and the extreme fatigue are typical of fibromyalgia which I've had for thirty years. Has this been mentioned to you? It's worth reading up on it https://www.nhs.uk/conditions/fibromyalgia/symptoms/

Sorry to be brief but that part of your post leapt out at me. I'll try to pop back on here later.

Taz x 

[joziel]

Don't worry, pins and needles are an extremely common menopause symptom: https://www.positivepause.co.uk/physical-symptoms-menopause/numbness-tingling

You do need estrogen, I don't know where you've read that if you have a cycle you don't need it. Your estrogen levels will be fluctuating massively so you need a stable amount from HRT to overcome the fluctuations. It is very old-school (and usually US) advice which says not to start if you still have a cycle and that has been discredited now.

I wouldn't recommend Evorel Sequi because the progestin in it is (as you say) a synthetic progestin. This is not ideal because it is not a natural hormone which your body needs. Ideally, you would take utrogestan - which is body identical progesterone.

The other downside to Evorel Sequi is that it is a fixed amount of estrogen - only 50mcg - which is the starting dose. This is unlikely to be enough for you. Ideally you need to be taking estrogen and progesterone separately so you can adjust them, separately.

I would go back to your doctor and ask for the Evorel (estrogen only) patch and utrogestan (body identical progesterone).

[CLM07]

Thank you so much for taking the time to respond.
I have the Hormone Repair Manual by Lara Briden and I quote from her book " Because you are still cycling, your doctor may offer the pill, or less likely estrogen patch, but in either case, you're being offered more estrogen when you already have too much estrogen" she goes on to say that a better approach is progesterone alone....
I will go back to GP regarding the dose and the utogestran .

[CLM07]

Thank you also Taz, Fibromyalgia was not mentioned !

[Taz2]

It's sometimes easy to think that symptoms must be meno related but it's always good to look for other possible causes too. I was forty two when I first developed fibro and began HRT at 53 due to unrelenting hot sweats. I found it interesting that as I went further into peri menopause the fibro symptoms didn't worsen and once on HRT they still stayed the same. I was still having periods when I started HRT which was, funnily enough, Evorel Sequi. It did help with the menopause symptoms.

 I did have an MRI eventually to rule out any other causes for the tingling and burning feet. I still get that and also the feeling like I'm standing with my leg pressed up against a hot radiator or the sensation of hot liquid being poured down my outer thigh.

Sorry for a muddled post but I'm travelling in a car on a very pot-holed road 

Taz x

[joziel]

As I write this, my feet are tingling. It tends to be worse or more obvious at night for some reason. And yes this is all peri for me.

Re Lara Briden, I would forget that. There is a group of old school functional medicine doctors based in the US who conventionally were all about no estrogen and progesterone only, but it's really outdated as an approach. Even when she talks about using estrogen, she is saying to use the smallest dose for the shortest time - which is just old fear-mongering around estrogen. I'd forget all that...