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[Daisy1]

I know from what I've researched and read that I'm not too young for perimenopause symptoms to be affecting me, but does anyone else second guess themselves when others say they're very young to be experiencing symptoms? I started noticing changes age 37, shorter cycles, heavier bleeding and mood symptoms which got increasingly worse (which I'd never had before).

I went to the GP yesterday to change from combined pill to HRT, he was really helpful and very understanding. I knew what I wanted and he was happy for me to try it. But he did say can I get some background, because you are very young to be experiencing symptoms and starting HRT. I explained my symptoms and he agreed HRT worth trying to get oestrogen at the right level.

But does anyone else then spiral into a panic, I worry that I'll need to be on HRT for too long, I should just be able to deal with the symptoms like so many others do, maybe I'm imagining it, perhaps I need to do more lifestyle changes to help (I already stopped drinking alcohol, go to bed early, try to eat ok, exercise (when I feel I can manage it! etc). But I really gaslight myself and think maybe I just need to crack on and manage things until I'm closer to mid 40s and having hot flushes and insomnia type symptoms. None of my friends are on HRT yet or seem to experiencing symptoms that are impacting their life to the level mine were.

I think there's probably a lot more people who would experience symptoms, but are on the combined pill which masks things for many years until they reach closer to menopause. I'm sure I can't be in the minority experiencing symptoms at this age.

[sheila99]

Everybody's journey is different. I'm on the other end of the scale as I had no symptoms til 56. You're lucky you have a good doctor, many are dismissed as being too young when of course you aren't. Lifestyle is important for a healthy life but if you have symptoms of low oestrogen no amount of healthy living is going to replace the missing oestrogen. You may never get flushes or insomnia, the set or symptoms is different for each of us. There is no upper limit for hrt as transdermal is so much safer than the old horse urine type. I'm 65 now and intend to stay on it for life, every time I try to reduce my anxiety and insomnia return (and I'm not too keen on osteoporosis either).

[bombsh3ll]

I'm someone aiming to mask (bypass) perimenopause on the combined pill taken continuously. I've been on it for 16 years and plan to just switch directly to HRT around 55, when hopefully my periods won't come back.

It is perfectly possible and quite common to be perimenopausal in your late 30s. Symptomatic perimenopause can last 10 or more years without treatment, and menopause is considered "normal" between 45 and 55.

Personally I think a combined pill taken continuously can be a better option for younger perimenopausal women because it gets rid of your own hormonal fluctuations, eliminates menstruation and guarantees a bone protective estrogen dose, as well as a duration-dependent reduction in risk of ovarian, endometrial and colorectal cancers.

The danger with going onto menopause hormone therapy at a young age if your ovaries are starting to fail, is undertreatment, which unfortunately is common particularly on the NHS.

Many prescribers are afraid of HRT and unaware of the higher physiological doses required by younger women, and end up prescribing too low a dose to prevent the negative health consequences of early estrogen loss.

The combined pills with ethinylestradiol are slightly less body similar (although Zoely and Qlaira both have 17 beta estradiol), however they contain a set dose of estrogen that is more generous than MHT, not prescriber dependent, and is known to provide bone protection.

[CLKD]

No one is 'too young' to go into peri menopause!

[bombsh3ll]

Absolutely perimenopause and menopause can occur at any age from puberty (in rare cases a girl goes straight into menopause without even having a period) but you can be experiencing perimenopause in your late 30s and still be on track for menopause at the "normal" age, ie without it being considered pathological at all.

This is a bit of a blind spot in clinical guidelines, which are quite clear when actual menopause ie cessation of menstruation occurs prematurely, but not when young women are experiencing hypoestrogenic symptoms but still menstruating, this group can really fall through the cracks in terms of unmet need.