Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: gilaray on June 05, 2013, 08:13:12 AM
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Just when I thought the flushes were easing back they came with a vengeance
Yesterday I had the most intense flush. I was dripping with sweat from head to toe and I felt so nauseous that I had to lie down until it passed
I was at home so it was fine but if I had been out or at work it would have been a very difficult situation
Ladies do your flushes vary in intensity?
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I'm in the process of reducing my HRT. I'm halving my estradot 25 patches. However, flushing has started again. Not often, but there are some which are really intense. One in particular nearly floored me. I was passenger in car with hubby driving. I felt quite faint. Opened my window, switched fan to my side of car and still felt awful.
Not sure why it happens though, but it's not pleasant.
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Mine do too - which is why I have been unsuccessful in coming off HRT - not that I want to but the meno clinic would like me off by 60 which is next year. I have tried cold turkey and coming off slowly but both ways are ok for around three months before the symptoms begin again eventually reaching the same level to where they were when I started HRT five years ago.
Taz x
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I've been on HRT for 10 years, now aged 63. Got dose down to VERY low, only using it Mon, Wed, Fri and all has been fine for the last 4/5 years, no symptoms at all............suddenly about 3 months ago back came the night sweats and the occasional day flush........so what's all that about??? Really don't want to increase the HRT as felt comfortable with the low dose I was taking, but the night sweats are really getting me down...........does it never end???
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Not sure there is an answer to that skkb! I have friends who never experienced any flushes and others who are still merrily flushing away in their seventies. Merrily is probably the wrong word. A close friend has recently begun flushes again at the age of 60 after five years without. She never took HRT and really thought she was through it. I suppose her levels must have dropped further now.
Did you drop your dose on medical advice or is it something that you wanted to do? By the way night sweats can often be caused by an undiagnosed low-grade infection of some kind so it might be worth mentioning it to the GP?
Taz x
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I am same as Taz, tried to come off HRT cold turkey and slowly cutting down, but only managed 3wks, sweats came back so intense i felt i could not breathe got them every 20mins :'( Really feel for you Gilray.xx
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I also get very intense hot flushes which last a long time, most unpleasant. Why does the menopause have to be so horrible. >:(
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I'm upping to full patch again, after truly awful flush yesterday. I'm not prepared to put myself through all that again.
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Cuba its such an overwhelming feeling and so hard to explain to anyone 'what its like', really hope back on full HRT hepls..xx i did get the warning signs and even though i tried to stay calm the feeling of intense body heat and not being able to breathe was horrible, i am 64 in August no mention yet of my GP stopping HRT, just hope the break through bleeds March/April do not make him feel he will stop it..it was mentioned to me by the Gyno that maybe it was just due to a hormone blip...both bleeds occurred on holiday, just as the previous one did 3yrs ago..strange really as i am so relaxed for 2mths in the sun, so don't know how the hormone blip happens :-\ x
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I've got gynae appointment end of next week. She told me a year ago that she was happy for me to stay on HRT until I'm 60, so got 3 more years yet.
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I've got 8 months :(
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Girls will you have no say at all? x
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I went back to my doc (well a different one at the same practice) 6 days after reaching 60 (last month) and told her I didn't want to stop (the previous one having said I should due to spotting) and she has agreed but has changed my prescription to 37.5 mcg patches instead of 50 mcg - because I told her I was snipping a bit off to see how I could manage on the slightly lower dose.
So far so good but only 1 month since I started snipping.
If all OK after the investigation then I will continue indefinitely.
I went along armed with print-out of Dr Currie's e-mail where she said I didn't need to stop - but Dr C did recommend I went onto conti.
For anyone who has had hysterectomy I would have thought no need to stop at all because as far as I remember even the risks with the WHI study showed that oestrogen only was fine?? (Bit late so haven;t looked this up recently).
I think we should have a say but of course always taking into account our own medical history - but all GPs should be told about the latest recommendations from British Meno Soc if they are not up to date themselves.
Hurdity x
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I've been discussing HRT with my doc today. I am swapping back to Evorel (even though it has the nasty norethisterone in it) as I can't be bothered with Femseven, and its failure to stick, a moment longer. She talked about the fact that I will be reaching 60 next year and that it may be better to come off it. It is the breast cancer risk for over sixties which she (and the meno clinic) are bothered about. She felt that although it is making my life much better with relief from the flushes etc. she would have failed in her duty of care if she hadn't reminded me about the increased breast cancer risk.
Taz x
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Just to say if your GP insists that you come off HRT you could try one of the SSRI anti depressant group - Prozac, Citalopram etc. I have been on these for decades and it was only when I started cutting down my dosage a while back that I experienced my first hot flushes at the age of 54. I'm back on my normal dose now and hardly ever get them. 10mg is the optimum dosage for preventing flushes apparently.
My new GP told me yesterday that Vagifem carried all the risks of oral HRT. She also said that 25mcg is still available ::) cos it was in her drug book. She WAS very young and I didnt want to upset her so I just mentioned the tiny USA survey and left it at that. She gave me my prescription for 10mcg anyway.
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Glad they worked for you Milliemoo. However personally I would never touch any of those ADs for symptom relief - I wouldn't want to take medication - and of course they don't replace oestrogen lack of which causes the more worrying symptoms and potential health conditions as you get older.
How appalling about your ignorant GP. If a young newly qualified GP goes round telling women that then there is not much hope for the future... :(
Taz - I understand re the duty of care - when I said I wanted to continue it was quite like a formal statement ie she said you are aware of the risks but it is your right to decide to continue knowing these risks. I explained I minimised all other risk factors ie re weight, diet, exercise, smoking, alcohol. It has probably been put on my records as such too ie that they explained the risks.
Thefact is we really don't know because that study used equine oestrogens and synthetic progestogen taken orally and the design of the study was flawed anyway - unfortunately it's the only major study there is so until there's another big one we are stuck with it. The small increase in breast cancer risk was with combined HRT (oestrogen and progestogen) so my view is to keep the prog to a minimum and stay on a cycle - but this has increased risk of endometrial cancer!
So I suppose none of it is without risk and we have to weigh it all up and decide for ourselves.
Hurdity x
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I had a full bloods check and all came back 'normal' so I'M guessing the flushes are due to my estrogen levels dropping again!! Think I will slightly increase the hrt to eliminate the flushes as day to day life is miserable. So far my GP hadn't mentioned stopping hrt (thank goodness). Feel bad moaning about it when others have so much worse to cope with!!
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May be its me but I find appalling that GP's want to take women off HRT. So long we understand the risks the decision should surely be ours to make?
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It is important to understand the risks and then make our own decision. My doc was very fair in that I must admit. She said that she didn't want to be sat opposite me sometime in the future, with me facing terminal breast cancer, and not feel that she had spelled it out plain and clear the risks to women taking HRT when over 60. We also discussed the risk from drinking wine - she is of the opinion that any woman on HRT should give up alcohol - as she has - just to lower the risk. We then talked about the stroke risk for women over 60 - it wasn't a cheery conversation obviously! She is a good GP but sometimes a bit forthright in her manner!
Taz x
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But Taz we could scare ourselves to death with something we "shouldn't" be doing/eating/drinking etc every day.........some women who have never been on hrt will develope breast cancer, some people who have never smoked a cigarette will get lung cancer, someone who has always had plenty of fibre & a healthy diet with regular bowels will get bowel cancer.....it's endless, you cant live like that, you have to have a life. One day something will end your life, for some it's far to soon but instead of worrying about the next glass of wine just enjoy it and look forward to the next one and so on. You die of old age, illness or accident and thankfully we don't know which or when and wouldn't want to know.......but who wants to live to be 100 if the last 20 or 30 years of that life have been utterly miserable because we didn't accept medical or other help as we were always worrying "but what if" before we popped a pill!! Just my thoughts
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You might find this interesting
http://www.medscape.com/viewarticle/727863
I think its important also to know that there are two types of strokes Ischaemic and Haemorrhagic, estrogen is supposed to make blood vessels more elastic so for one kind of stroke (Haemorrhagic) it could be protective.
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That's great silverlady publicising that BMJ study from 2010 with evidence demonstrating that lower dose transdermal oestrogen is associated with lower risk than oral oestrogen. Have you got any more info about the different types of stroke and oestrogen - that sounds interesting - or did I miss that in the paper as I only glanced at the summary?!
This is a summary about the research to date re stroke in the recent paper giving recommendations on HRT by the British Menopause Society and Women's Health Concern:
http://min.sagepub.com/content/19/2/59
Stroke
Observational studies on the use of HRT and stroke have yielded conflicting results.
The WHI study revealed an overall increased incidence of stoke in women using estrogen and progestogen therapy or estrogen alone. Re-analysis of the combined data from the estrogen and progesterone study and that of the estrogen alone study revealed a smaller increase in incidence of stroke in women who commenced HRT between the ages of 50 and 59.
The HERS study (the Heart and Estrogen progestogen Replacement Study) found no increased incidence of stroke with HRT.
On current evidence, HRT cannot be recommended for the primary or secondary prevention of stroke.
Caution should be exercised when prescribing HRT in women over the age of 60 particularly when they
have a risk factor for stroke or thromboembolism. In these groups, current evidence would suggest that the transdermal route may be advantageous.
The effects of HRT may be dose related and the lowest effective dose should be prescribed in women
with significant risk factors.
Interestingly at the end of the article you linked to silverlady it says this:
These are intriguing findings. Keep in mind, though, that this is an observational study -- it's not a randomized clinical trial. It is possible that there were other factors explaining the differences. It could be that there are confounding factors contributing to the better results of transdermal vs oral estrogen. But I think these findings should encourage and stimulate additional research on the benefits and risks of transdermal estrogen. In the meantime, they inform clinical decision making by suggesting that transdermal estrogen may be a very good alternative for many women.
So as well as reducing other risk factors eg alcohol when we reach 60 :( women should think of changing to patches or gel if we haven't already done so.
I agree Taz - it is their duty to tell us the risks as they understand them and then we can make an informed choice.
Hurdity x
PS I meant to say as long as they (the docs) are up to date with the latest evidence and recommendations!
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SKKB, I agree.
What we develop or not is mostly within our genetic make up.
Lifestyle is important but not to a draconian degree
My mum was slim, ate healthily, loved walking, didnt drink or smoke but she still died at 66 from cancer
My husband who is also slim and stress free had a heart attack at the age of 53
Its all in the luck of the draw
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ABSOLUTELY - don't live life fearing what you might get
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Hurdity I don't know if this applies to our own endogenous balanced hormones or man made added hormones.
Estrogen is known to be an antioxidant http://www.sciencedaily.com/releases/2005/08/050827120540.htm
No matter what I read I have found conflicting findings where hormones are concerned whether it is scientific papers and findings, or mainstream.
I think you can drive yourself mad searching for evidence that you are doing the right thing for your health and wellbeing including taking hormones.
In the end you can only do what feels right for you and cross your fingers. I try to do this but I have the research gene and have to know the ins and outs ::) It drives me nuts sometimes.
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.... but I have the research gene and have to know the ins and outs ::) It drives me nuts sometimes.
Haha - so do I!!!
Thanks for that link - very interesting - really going into the cellular mechanism for how it works - it's one thing to have all the studies showing an association (between treatment and effect) - or possible cause in terms of conditions/side effects/illness etc, but how this is caused is quite another.
What we develop or not is mostly within our genetic make up.
Lifestyle is important but not to a draconian degree
Its all in the luck of the draw
Hi gilaray - sorry to hear about your mum, but I do disagree with your statement above - yes we have a predisposition to certain things in our genetic make-up but whether or not this is expressed or not in many cases can be affected by external factors ie diet, exercise, lifestyle. I know there is evidence for this but haven't got anything to hand. If we took a fatalistic view of ourselves and our health there would be little point in doing anything - I meanwe could loll about eating fatty foods, no fruit and veg, smoke, drink, never take exercise etc!!! No thanks - I want to maximise my chances of good health despite my genetic make-up.
Also cancer is a complicated disease and we can never know whether for example if some environmental factor earlier in our lives could lead to our developing it later. Even if you have a genetic pre-disposition to a cancer eg breast cancer, then living a healthy lifestyle could make a huge difference to survival or life-span even if you are unfortunate enough to develop the disease. I am sure there will be information on this.
Hurdity x