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Welcome along! 

Have urine samples been sent by your GP to a Lab to grow any 'bugs'?  It sounds like Vaginal atrophy from where I'm sitting so do read the 'bladder issues' and vaginal atrophy threads on the Forum.  Make notes ;-)

Your GP could have prescribed appropriate treatment so obviously isn't on the ball with regards VA.  Whilst antibiotic treatment will ease initial inflammation the vagina needs oestrogen treatment 2 plump up the tissues etc. 

Let us know how you get on!  Keeping a. mood/food/symptom diary can. help chart symptoms.  What have your periods been up to?

As oestrogen levels drop muscles may become lax = aches and pains including hiatus hernia and reflux. 

“I started to bleed on day 12 of using the progesterone and on day one without progesterone and I already feel an improvement, most notably in terms of mood. I’m still very tired. It’s as though the commencement of bleeding flipped a switch in my brain and I feel much calmer and more like myself. This is exactly how it played out when I was a younger menstruating woman. As soon as I would bleed, the darkness would lift.”

Yes this is exactly how I felt as a menstruating woman. We now know there are several aspects to this – there is the progesterone withdrawal – which can sometimes lead to pms type symptoms, irritability, headache etc that many women got while fertile, and experience when coming off the progesterone phase of the HRT. Then there is the effect of oestrogen. During our natural menstrual cycle oestrogen levels fall just after ovulation, and then rise again falling to a low level for the last few days before the period (coinciding also with progesterone withdrawal). After the bleed starts oestrogen rises rapidly again over the next couple of weeks – but of course with HRT it stays constant.

I used to feel exactly as you did when menstruating – tense and horrible, irritable etc during those last few days and almost a day after the bleed started I could feel all of that melting away – just like the flipping of a switch – I could almost feel the sensation of the oestrogen rising - surging through my blood stream, even though I might have period pain and a bleed, and my mood became light and buoyant again.

Since being post-menopausal it isn’t quite like that because oestrogen does not rise - but I do feel the head fog clearing once the progesterone has gone (which takes a few days) and I feel bright and normal again.

“My question is that my body seems to want to bleed by itself on day 12 of the 200 mg of progesterone. Based on your comment, does that mean that I should not do too long of a cycle? I would like to extend the 16 days to, perhaps 21 days on oestrogen only.”

I can’t remember all the details of your story but if you have been checked out then presumably fibroids, polyps or other abnormalities have been ruled out.

Since the bleed is cyclical then it is likely to do with the hormone regime. You said you used to bleed too much on lower doses of Utrogestan. I presume you had a scan and the thickness was measured? If the endometrium is at all thickened or thicker than it should ideally be, then it still has to shed so sometimes this can be an explanation for an early bleed. In any case even the guidelines if I recall correctly, state that the withdrawal bleed occurs towards the end of the progesterone phase or just after – so you’re within the bounds of normality.

As to the question of lengthening the cycle – well that does depend what thickness your womb lining is, so if it is thickened – it could take several months longer to thin down so in the meantime extending the cycle probably wouldn’t be advisable, if you want to avoid bleeding problems or more thickening maybe.

Another factor to think about is how long and heavy the bleed is – if long and heavy – then there is clearly more lining to shed, but if it is short and light despite starting at the end of the progesterone phase – then that might just be how your body works and extending the cycle may mean the bleeds still start early.  Ideally it would be good to have a scan just as the bleed is finishing when the lining is at its thinnest but if not, see what happens over the next couple of months – depending on the bleed.

In short – if the bleed is long and heavy then probably not a good idea to extend the cycle yet. If short and light then why not give it a go and try 21 days of oestrogen followed by 12 days of Utrogestan giving you just under a 5 week cycle?

Any concerns about anything including your bleeds, of course consult your doctor and ideally discuss with or at least inform your GP or specialist about what you’re doing.

Hope this helps and all the best

Hurdity x

Pick an outfit

I've not kept a food diary but I know what usually triggered my reflux. I've not actually had reflux for several months now, but the stomach discomfort is still there, hence the gastroscopy to rule out ulcers.

I pretty much don't drink alcohol now 😔, caffeine has never agreed with me so I drink green or peppermint tea, dairy is rare, white bread too. I got a shock last week when I got really painful indigestion after eating chocolate 🤯

I've never suffered from uti's before, so when a very understanding GP suggested multiple uti's might be menopause related it was an eye opener. This has now progressed to a urology referral so I'm not sure whether to pursue the menopause angle with the GP now or wait to see what happens with the referral.

Hi and welcome to the forum.
UTIs go hand in hand with menopause as do a few dozen other symptoms,gerd also.We seem to become less tolerant to certain foods as we age,I find taking ginger capsules & camomile tablets help hugely with my reflux. Have you ever done a food diary,it can help to pick out the foods that cause the issue x

Helps him to

I was sent the link to this site by my GP and, so far, I'm finding the information useful.

I've been treated for GERD for 16 months. Had a gastroscopy 2 weeks ago, which was clear. I'm currently on uti number 3 in 4 months so, today, have been referred to a urologist 🙄

Having read the forums, I'm now of the opinion both these problems may be connected to the menopause 🤷‍♀️

Watch this space ...

Been on HRT for some years and it has done great things for my arthritis. I am a slow jogger and seemed to develop inability to breath and jog, which is a bit of a handicap so asked to start T last October and hoped it would help with AFib I had developed.

It has been going fine and can breath again but started after about 3 months of T feeling very tired. Thought it might be throid affected by T and upped dose a bit but still tired and very easily become overwhelmed at work.

Just tested cortisol, as that can be a source of tiredness and can be affected by other hormones. Confusingly blood cortisol showed low total cortisol. But saliva cortisol off top of the range,  high free cortisol.

Not sure how to interpret this, but wondered if cortisol was affected by the T or just a coincidence and has developed over time without me noticing? Any experiences or advice?

Yes, mine was 0.5 so specialist said worth trying T as that is low.

Yes, despite it seeming a no brainer, the g.p. "menopause specialists" seem to be unhelpful and very hasty to pass the buck off onto anyone else they can find, including the patient, if their standard treatment does not suit. Not prepared to engage own brains for fear of being criticised/ sanctioned. Which is especially annoying when it should be free (medical exemption cert), but because they wont prescribe, i have to do all the research,  arranging and paying.

As you say, if things are licensed for other uses abroad, it should be possible for the uk to fast track approval here too. As usual, we don't trust Johnny Foreigner to know what they are doing, to our detriment