Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: hoping4best on December 08, 2016, 02:12:24 PM
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Long-time lurker here, but this is my first post!
I am 41. I went through sudden, early menopause at 38 (Premature ovarian failure, and yes, I love https://www.daisynetwork.org.uk ! I'm from the states, and we have nothing like the Daisy Network there. I am grateful they exist!). I've been on proper HRT, estradiol patch + oral micronized progesterone, for about 2.5 years.
I've been losing hair for the last 2 years. Just shedding like crazy. I had a ton of hair to begin with, so it was hard to tell at first, but now my family and friends can see it, too. I've gone to a specialist, and she said that I have female pattern hair loss, kicked into high gear early by my sudden menopause. She put me on 5% topical minoxidil, 1x per day. I'm 4.5 months into minoxidil treatment and I'm still shedding buckets of hair daily, and can't say I see much, if any, improvement in my widening part. My overall volume is much decreased. I can still hide it, but it goes on and on and I won't be able to hide it forever.
I wonder about changing up my HRT in some way. I'm on a 0.75mg estradiol patch and 200mg oral progesterone, continuous. My brief addition of testosterone a couple years ago may have made my hair loss worse, but it's hard to say. I've always been very sensitive to hormones mood-wise and in other physical ways, so am hesitant to make any of the changes that my reproductive endocrinologist has suggested: take a birth control pill, or switch to an androgen-derived progestin (like the Mirena IUD or the agestin mini-pill). I've heard they can make hair loss worse. I've heard that some people regrow hair on Marvelon and Yaz, but again... I am afraid of the mood effects, and I can't stay on birth control forever.
I've had all the thyroid and ferritin blood tests and all the many doctors I have seen shrug and say: you're losing hair b/c hormones. My androgens are low to begin with, so my docs have advised against taking an androgen-lowering pill.
Anyone else been through this, and have advice, or words of wisdom? Many thanks in advance. Happy holidays.
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Hi hoping4best
:welcomemm:
I am sorry I can't really help with your problems. I do know there are several women on here who have hair-shedding problems and hopefully they will be able to share their treatments.
Although you are on "natural" ie bio-identical progesterone (Utrogestan), and is the least androgenic, that is a high dose to be taking continuously. I can see that you need a decent dose for quite a high dose of oestrogen ( to protect your uterus) so my only suggestion would be to revert to cyclical progesterone if you can and perhaps think about taking it vaginally which means you might be able to stretch your cycle to a bit longer than 4 weeks. Obviously you would have to put up with a withdrawal bleed - but that it only what you should have been having at your age anyway. I have no idea whether that might help but maybe worth a try?
In the absence of anything wrong with your thyroid/iron etc it is baffling.... Have you actually had your oestrogen levels tested - although normally this is not required, in your position it might be worth finding out how much you are actually absorbing from the patch? Do you feel well otherwise - as this would also be an indication of whether the dose is OK?
Hurdity x
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Hi. I'm a hair shedder and I hate it. We have a few ladies on here suffering
I was referred to a dermatologist who was quite frankly, no help
She said it didn't look bad (I wasn't asking how she thought I looked!)
She said I had a mix of female pattern hair loss and seborrheic dermititis . My scalp looks nothing like google images of SD so I reckon the overall loss is more TE
I've worried myself silly over this and got nowhere. I tried minoxidil and gave up as it's monotonous and I couldn't see any improvement after about 3 months
I use hair fibres to hide the thinness on top and wear my hair up most days. If I'm going out I wear clip in extensions for volume at the bottom , but I'm now investigating hair enhancers and to just accept this is happening
It probably would be a good idea to get full bloods done, you've probably researched but the list is endless what can cause hair loss thyroid/iron/b12,low oestrogen etc I think vit D too
Hope this is of some help x
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Thank you both for your thoughts!
I have had lots of blood work done, including thyroid, adrenals, zinc, B12, D, testosterone in its various forms, estrogen, etc. Everything is normal, except that my androgen levels are on the low side, and my estrogen level tends to bounce around a lot. Even on this patch dose, I had one estrogen test that was 44 in late July, and then it was 150 in September. I suspect my bad sheds triggered by the particularly low dips in my estrogen level.
I have one ovary, and it seems that it's no longer functioning, except when I add some HRT, it kicks into gear and makes some estrogen. That's one theory my specialists have suggested, anyway.
I am going to my old reproductive endocrinologist tomorrow, and I'm trying a new person next week, and I was going to ask them both about vaginal progesterone use. I had one endocrinologist that I trusted a great deal tell me to "take as much progesterone as you can handle", to protect myself against cancers. But of course, nobody I've seen so far really knows how to handle Premature Ovarian Failure patients. So perhaps I am taking too much progesterone.
This has been such a confusing journey! I feel tired sometimes. I just want my body to feel like it's more balanced. I have weird bleeding episodes every few months, and intermittent breast pain. Things feel off. I eat really well and exercise daily. But this last 3 years of hormone confusion has been a real bummer. I know I don't have to explain that to others here! :)
Annie, I'm sorry you've had so much stress over your hair loss, too. I know that acceptance can be key to peace with hair loss. I was advised by a scalp pathologist to give minoxidil at least a year, so I'm attempting to do that. But it is not for everyone, and it really may not be working for me. In which case, I'll have to look at other ways to deal with hair loss.
X-posted with Stellajane, edited to add:
I've heard of frontal fibrosing alopecia. It's not what I have, I don't think, but it sounds challenging. I'm sorry you've got it! Do you still have your uterus? There's a lot of fear among my various doctors of ever giving patients estrogen alone if they still have a uterus. I feel like the doctors in the UK have more tools in their toolbox for menopause. I never even had one doc (of many) propose cyclical HRT to me--only continuous. I don't know why, but I'm going to ask.
My eyebrows and eyelashes have thinned a little, but my other worst-hit area is another body hair area... which seems like it'd be helpful since women spend time trying to remove some of that hair? But it feels quite strange.
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I was given testosterone mid oct and I took the chance it could help the hair loss or make it worse. I decided to try it. My pubic hair is growing quick again and my eyelashes have increased in quantity and length!
I can't work out the hair. Some days it feels a little thicker and easier to style but I think the fphl is still happening
Ps you need a good level of oestrogen to have testosterone therapy
X
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HI there hoping for the best.. I feel your pain
I've been losing hair for 6 years.. slowly gradually and then after a radical hysterectomy and ovary removal in June this year drastically.. which leads me to believe it is hormone related. What remains on my head is not hair, its dry, brittle strands of candy floss that looks awful and I cant' style.. I'm considering a wig right now as my self esteem and sense of femininity is in the toilet
No doctor has given me any advice or help or even referred me to a dermatologist since it started. I've now ruled out ferritin as my levels are good once more (70s) and my thyroid seems to be ok although I have mild antibodies
I'm on 75mg patch. and waiting to maybe add testosterone in a few months if my levels raise
but to be honest I've lost the will. I've lost my job, my relationship, my love of life and some friends from being so depressed about it
hair is a very important thing and yet it's brushed (hahha see what I did there?) under the carpet and we are told 'its just your age'
bollocks is what I say
I wish I was brave enough to shave it all off start again and wear a wig for a few years, maybe I will.. Maybe tis better to be a bald lady in a scarf like our brave cancer sisters rather than be a thin wispy sad balding menopausal shadow as I feel I am now
Primrose oil, biotin etc all good but I have taken bucket loads of both and not really seen an improvement
I hope you get some answers
Abby xx
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Abby, this is for you
:bighug:
I had no idea about your relationship or your job bless your heart
Xxxxxxxxxxxx
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Abby, I am so sorry. I struggle with anxiety and depression, and the hair loss has definitely made those things worse.
I do suspect I may be a scarf wearer as opposed to a wig person, if I lose much more hair. I have a colleague who has alopecia areata and just goes out totally bald, and I admire her greatly. She's gorgeous.
Annie, that's excellent that you've gotten some hair back from the testosterone. I thought I had an uptick in shedding when I was on testosterone (tiny transdermal dose) for a couple months, so I got scared off. But my androgens levels are the bottom of normal, so I sometimes wonder if I should explore testosterone again. I certainly felt good on it. I have read that for some women with hair loss, testosterone is awful, and for others, it's a huge help. Sigh.
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I can't work out if testosterone is helping or not. But I guessed no point feeling CRAPPY with hair shedding so took the chance to maybe feel BETTER with hair shedding or just maybe feel BETTER WITH hair growth.
maybe genetically it was meant to be (I'm starting to think this way now as I've explored all avenues - )
Either way my heart goes out to any woman for whatever reason who suffers this - yes I feel sorry for myself too
X
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Bollocks to hair loss and hugs to all!
;D :D :P :P
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:cuss:
To hair loss !
Xx
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Can I just say that I really empathise with the hair loss. My fp loss was caused by the progesterone in my evorel patches. The trouble is, I had very fine hair to begin with, hardly any very fine eyelashes plus my eyebrows have fallen out and gone haywire too. Believe me, mine shows, people have noticed! After wanting to weep on many occasions I gave myself a stiff talking to and actually it's not the worst Meno symptom I've had by far. Now my hrt had been changed, I've returned to normal hair loss so fingers X' dill keep what's left. I have decided to get a 'going out' wig ( not that I go out much) and I'm going to take advantage of the fact that curly hair suits me even though my real hair is super-straight. Where to get one in the uk is proving tricky though as most sites have the more old-fashioned styles. Anyway scarves look super cool too and there are so many to choose from theses days. Where I work in the university, lost of the students wear them with pride from very African looking styles to bohemian or quite chic. I say go for it! I'm also thinking of trying testosterone but obviously am a little worried and my hrt isn't settled yet (currently sporting a heavy rash and quite grumpy-progesterone?). Enough rambling on, good luck with the wigs/scarves, let us know how that goes. 😊
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Bless you Peacegirl, it really is a confidence knocker is nt it ? And I wasn't exactly brimming with the stuff pre meno either
Like you I had fine hair all my life, hairdressers used to say "fine but lots of it" now it's fine and not a lot of it
To be fair I think mines still early stages but 17 months of panic in front of the mirror feels like forever. My daughter says I camouflage mine so well she wouldn't know had I not told her and so I think now is the time for me to move to an enhancer ready for if things go further downhill
X
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Hi all, I also suffer from hair loss, started about 9 months ago. Im 50 and have been postmeno for 5 yrs. I do not get on with HRT at all but the hair loss has remained the same whether ive been on HRT or off it! I have often thought that I could just try testosterone but im not sure if they will prescribe it without any other hormone and I was also worried that it would just aggravate the hair loss!!
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Clare it really isn't wise to use testosterone without good oestrogen levels. There will be an imbalance in the wrong direction which would probably increase your hair problem
X
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Ok, I have a potentially stupid question, but my current reproductive endocrinologist is not the most helpful. So I'll ask.
At age 41, my RE wants me to have a blood estradiol level of around 100. I just got my blood level back from last week. On my current regimen of 0.075mg patch + 200mg/day oral progesterone (prometrium/utrogestan) continuous, my estradiol is at 50. And I am bleeding intermittently, with cramps. Like, I bleed for 3-5 days, every other week. It sucks!
If I raise my patch *and* lower my progesterone dose, that should make more estrogen available, right? Like, the high continuous progesterone is part of what is keeping my estradiol level that low probably, right?
I'm so frustrated with my doctors right now. My RE *prescribed* continuous 200mg/day oral progesterone, and then last week was like "wow you're on a lot of progesterone!"
GAH.
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Hoping4best
If I were you I would start a new thread in the menopause section where a lot more women will see and be able to give you answers
I have no experience of progesterone and can't say what's best to do
Start your new thread and wait for the knowledgeable ladies to answer
X
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Hello Hoping best! I'm also POF diagnosed at 38 and in the US. I'm not positive, but thinking that yes, that's a lot of progesterone. I think the continuous dose is normally 100 mg. So it could be that between that between the low estrogen and high progesterone, your having some endometrial atrophy causing the breakthrough bleeds. Did they take a look on ultrasound and measure your endometrium? I don't think the progesterone actually cancels out as in lowers the levels of estrogen. I believe it can cancel out some of the positive effects that we feel, but not blood levels. I may be wrong on that. Either way, your solution of raising estrogen and lowering progesterone sounds like a reasonable plan.
As an aside, I have read that we POF ladies are more prone to breakthrough bleeds on continuous doses. Nothing is simple for us. I was also given continuous initially even though I hadn't even been a year without periods. Based on the information on this site, I declined and requested cyclical to start. I have trouble finding any US sourced info directed at early menopause except for women trying to conceive. I can't even get in to see an RE because I'm done having kids. It's a shame.
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Hello Hoping best! I'm also POF diagnosed at 38 and in the US. I'm not positive, but thinking that yes, that's a lot of progesterone. I think the continuous dose is normally 100 mg. So it could be that between that between the low estrogen and high progesterone, your having some endometrial atrophy causing the breakthrough bleeds. Did they take a look on ultrasound and measure your endometrium? I don't think the progesterone actually cancels out as in lowers the levels of estrogen. I believe it can cancel out some of the positive effects that we feel, but not blood levels. I may be wrong on that. Either way, your solution of raising estrogen and lowering progesterone sounds like a reasonable plan.
As an aside, I have read that we POF ladies are more prone to breakthrough bleeds on continuous doses. Nothing is simple for us. I was also given continuous initially even though I hadn't even been a year without periods. Based on the information on this site, I declined and requested cyclical to start. I have trouble finding any US sourced info directed at early menopause except for women trying to conceive. I can't even get in to see an RE because I'm done having kids. It's a shame.
Lizab, wow. Yes! I have a kid, am done. All POF support here is around fertility. It's really frustrating.
My lining, about a year ago maybe, was very thin. And I was bleeding then, too. I'm traveling pretty far Thursday to try a new RE. At least his website says he treats women with early menopause. I will ask him about cyclical HRT. My current RE was all "cyclical HRT is for women who are trying to conceive". Sigh.
Can I ask what kind of progesterone you're on? I was told 200mg prometrium/utrogestan for 10 days per month is what they give for cyclical "bioidentical" HRT, and oral (when I brought up vaginal progesterone she looked at me like I was nuts).
I'm sorry you're dealing with POF, too. It's quite frustrating!
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I'm on 10 days/month 200 mg prometrium orally and .50 Vivelle dot patch. I'm still trying to get settled on it. I started with a lower dose patch end of last year and increased to my current in the spring. Bleeding has not been a problem for me in the last two years. That settled before I started hrt. I'm mostly battling fluctuations in anxiety and energy levels now.
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I'm on 10 days/month 200 mg prometrium orally and .50 Vivelle dot patch. I'm still trying to get settled on it. I started with a lower dose patch end of last year and increased to my current in the spring. Bleeding has not been a problem for me in the last two years. That settled before I started hrt. I'm mostly battling fluctuations in anxiety and energy levels now.
I was diagnosed with POF when I was 38, 3 years ago. My HRT bleeding had stopped initially. But I still have one ovary and they think it's been stimulated to sometimes ovulate. Along with the breakthrough bleeding I get, too. Whatever it is. Right now, I get a week of cramps and bleeding, a week or two off, then cramps and bleeding again.
I started out on a 0.0375 patch 3 years ago and slowly got to 0.1mg. I really hear you on the anxiety in particular. Progesterone seems to help me with that, so we will see how I do with it lower, and possibly cyclical. But I know everyone is different!
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Ok, I have a potentially stupid question, but my current reproductive endocrinologist is not the most helpful. So I'll ask.
At age 41, my RE wants me to have a blood estradiol level of around 100. I just got my blood level back from last week. On my current regimen of 0.075mg patch + 200mg/day oral progesterone (prometrium/utrogestan) continuous, my estradiol is at 50. And I am bleeding intermittently, with cramps. Like, I bleed for 3-5 days, every other week. It sucks!
If I raise my patch *and* lower my progesterone dose, that should make more estrogen available, right? Like, the high continuous progesterone is part of what is keeping my estradiol level that low probably, right?
I'm so frustrated with my doctors right now. My RE *prescribed* continuous 200mg/day oral progesterone, and then last week was like "wow you're on a lot of progesterone!"
GAH.
Hi there - I presume you are in US or Aus and your oestrogen levels are being measured in pg/ml not pmol/l as they are here? if so yes 100 would be a good level although many women are lower than this and happy - like me (don't know what mine are but not that...).
As Lizab says - high prog does not lower oestrogen levels - as when we are pregnant both are extremely high as they should be! However yes 200 mg daily is a high dose, although some women find that 100 mg daily oral dose is not even sufficient for low dose oestrogen. This is because the amount that is absorbed when taken orally is very variable - lost to digestion and metabolism through the liver. Because there are no half size capsules the only way to increase the prog (to protect the lining) is to go from 100 mg to 200 mg - so I presume this is why you have been given that dose?
You may find if you reduce to 100 mg you get breakthrough bleeding or spotting.
The only way to know is to get your womb lining measured through US or TVS (scans). Oh I see you had a thin lining but depends on what you'd been taking and what they mean by thin - is is usually measured in mm. I would be surprised if it was ulcerated with a 75 mcg patch but who knows - if a lot of prog gets through into your system it could be a possibility. :-\ Anyway as I said only a scan will tell you....
Ah if your ovary is working then this could explain all the odd bleeding....
Sorry I kept seeing different bits of your posts so a bit confused !!!
Hurdity x