Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Dancinggirl on November 27, 2014, 12:21:51 PM
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Hi everyone
Menopause symptoms can be quite wide ranging and, as we know, will vary from woman to woman.
There is no doubt that the treatment of menopause symptoms needs to handled better by GPs and I'm hoping that the new guidelines will go some way to addressing the wide variations in help and advice we women get.
I also think we women need to be educated better about what the menopause involves. We are given information about birth control as teenagers, advised to examine our breasts etc. but when it comes to this part of lives that we will all have to face we are left to muddle through with precious little information unless we are fortunate enough to discover this site.
I am starting back on HRT after a one year break - for me HRT has always been a compromise. I do get side effects with HRT but being without it is also tough.
I often read posts on MM where women seem to have really high expectations of how HRT will help - do you feel we expect too much?
DG x
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For me ,ithink its a matter of trade off..i never expect to feel wonderful anyway meno or no meno..if hrt can help with my mood but i end up with some other minor physical symptom for example ..i will happily joyfully even lol trade that..totally agree with you about lack of support and info ..as you know i was in a complete state of shock and fear about being told i was in perri..and how horrible i was feeling because of it ..wish ide been better informed x
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Yes, I think we expect far too much from HRT. It isn't a magic bullet, nor does it suit everyone. Sometimes life sucks and there is no rhythm nor reason as to how we feel so we just need to get on with it. I have been a member of MM for many years (joined on the old forum) and I remember how I first felt when I found it - I thought great - someone here will tell me what recipe to use to make me better. Nooooo! It did make me feel better to know other women were out there and I was not the only one feeling absolute c***. But every menopause journey is one you travel alone. There is no magic cure-all, not even HRT, and I have tried everything from Peruvian Maca picked in the Andes, to Reiki and all things inbetween. And to be honest, I think it was time that was the healer.
Bramble
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For me, no, I didn't expect much from HRT, and was amazed that a small amount of oestrogen would make so much difference. I wish I had tried a few years ago, but thought I couldn't. It's not magic, though, as I still have health issues, but I can do more and live a quality life.
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I think people expect a sudden improvement on most medications. When I was suffering severely from depression I didn't seek help for months, so when I did eventually own up I wanted a cure and I needed it yesterday …… but it took several years to get to where I am now, as some ADs gave me side effects that I was unable to tolerate [i.e. nausea].
I think it's the same when people go on a diet, they want instant results. But we don't get 'here' all at once, either with weight increase or other health problems, putting aside emergencies like appendectomy or heart problems.
I need to keep in mind that on a daily basis I am better than in the 1990s. But I have to keep in mind that unless I eat correctly and get good quality sleep I soon go down-hill. My anxiety is background partly due to the time of year ……. knowing that doesn't help the physicality of the anxiety :'(
Any chronic condition can take a while to find a status quo. It's a learning curve that our Grandmothers didn't have the opportunity to consider.
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I agree with Ju Ju and CLKD.
I too wish I'd started earlier than I did, and annoyed that Doc did not point out options sooner.
Some of my personal symptoms were directly related to peri and doc made me go through unnecessary tests when all my body was shouting for was hormones :o
That is where I think a lot go wrong.
Its not expecting too much, more taking it too late.
We put off going on HRT for various reasons, often silly ones or just down to being refused it.
We get higher stress, wear and tear due to our reducing hormones without HRT.
Then unfortunately take HRT to try and make us all better when things get unbearable.
In some cases things have maybe gone to far to get back fully to where we used to be.
Even the way our bodies react to the hormones may differ after time making the whole process even more difficult.
It scares me what would have happened if I'd been another year or 2 down the line before taking HRT.
For me it took 6 months plus to help some of my more personal issues.
Had I started earlier I reckon I would have bypassed the issues and not had such a horrible time.
Just part of my view on my journey so far.
:-*
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I suppose that GPs have a route to go down ……… so doing blood tests is a starting point. Also patients are notorious for not explaining their symptoms ::) , what is known as the 'door effect'. the patient tells the GP what is wrong as they are about to leave the surgery therefore elliciting another appointment …….
Fortunately my GP realised I was headed towards VA before I did - after 3 urine tests came back 'normal' and by the time I was sitting on razor blades >:(, he guided me towards treatment ……….
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I wish my doc had be so astute CLKD.
Had my doc been willing to consider HRT earlier they would have:
1) saved me from some horrible symptoms
2) kept appointments at local doc and hospital for others that really needed them
3) not wasted a lot of money in the process
4) made me well sooner
5) stopped me worrying during the tests
6) stopped me getting worse
Given that they keep telling us how much our health services are under strain surely this would save suffering, money and time if this even applied to a small percentage of us in peri/meno.
I'm sure I'm not the only one thats gone through the mill on this.
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Agree wholeheartedly peegeetip - I went from hardly seeing a doctor year on year to visiting nearly every department at the hospital with all sorts gong on. My doctor at the time refused hrt and said that I needed to get through it as I would only get the symptoms back when finishing hrt. That is all well and good but was trying to juggle a job, elderly parents, children, grandchildren, etc. etc. and felt that i was going mad.
If there was more info out there about menopause it may help hospital waiting lists.
Lesley x
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Should there be a menopause dept at each Hospital?
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There is a lot of information about menopause and there has been for decades, my mother gave me a book in the seventies called "Women and the Crisis in Sex Hormones" by Barbara Seaman" and since then I must have read dozens and dozens of books about woman's health, menopause( and HRT) most found in the library before Amazon and online information.
I worked at a Well Woman's Centre and gave advice and counselling on health, hormones and menopause. and there were stacks of books in our library to read and borrow for anyone who came to the centre, this was in the nineties.
Today there is so much information about women's health, menopause, hormones and HRT its over whelming.
Its all out there, it just takes the will to research and find out for yourself.
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There should be well-women centres today at every surgery to educate women about menopause and the changes expected and to give them a health MOT if necessary as they reach 50 for example, and have a general health and life-style review.
I agree there is a lot of info out there especially nowadays with access to the latest scientific papers (as well as a lot of dross though!) but as Dancginggirl says, whereas at school girls are taught about puberty - the true picture about menopause comes as a surprise to most of us. It did me.
Re the original question - we have to ask the question why are we taking HRT? In most cases the over-riding reason we turn to it in the first place it is to prevent debilitating hot flushes, and night sweats which prevents us getting on with our lives. All the other reasons for most women, I suggest - are extra to this - anxiety, palpitations, low mood, vaginal dryness etc.
Therefore what we should expect initially, is that the HRT will more or less eliminate these, so that we can function - and perhaps this should be promoted more - that overall women should hope to feel better than they did without HRT and better able to function. No-one should be under any illusions that you will get the old "you" back because in most cases you won't but you will be better than before. There may well be side effects. There will almost certainly be some form of pms/pmt as with periods, but hopefully not worse!
Many of us as we read more about it then realise it has so many health benefits beyond just symptom control, and opt to stay on it for longer.
Hurdity x
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:thankyou: certainly once I began to feel better: from depression and anxiety : I could go to my GP with more informed questions and actually listen to suggestions ………. without feeling that I was a nuisance; without feeling that they might be nothing more the GP could do; without feeling that there was only 1 option and if that didn't work …..
Not everyone has access to the internet even now. Particulaly in the 3rd World. So talking, sharing, advising, listening ………. 'it helps to talk' ;)
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Hello ladies.
All I wanted from HRT was to feel a bit more normal.
Oh well, that's the way the cookie crumbles I suppose.
Take care everyone.
K.
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Totally agree with you about the well woman clinic idea Hurdity.
And Lesley ,i also relate ,maybe this meno stuff would be alot easier to deal with if we didnt have such intense pressure on us ,if we wernt having to keep so many balls in the air..i truly believe intense and prolonged stress is a massive problem which in itself causes so many debilitating issues mental and physical including more than likely a much rockier hormonal transition if not even possibly an early meno Its kind of a catch 22 really that we end up having to resort to taking all sorts of pills and potions to keep functioning at those levels.
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Thank you for your thoughts ladies - all very interesting.
Well Women Clinics in every region would be so sensible - or at least extend the Family Planning Clinics to include the management of the Menopause.
Peegeetip - I really liked your comment about saving the NHS money. How much money is wasted simply because GPs go around the houses trying to treat symptoms that could be sorted with some HRT. Of course some tests have to be done to rule out anything ominous but there must be so many unnecessary procedures and tests done because of meno symptoms.
silverlady - How I wish your Well Women Clinic had been near me back in the 90s. I know there are books and magazine articles out there about the menopause but most of the ones I have read seem to stress the 'natural way' i.e. telling us to get more exercise, change our diet, try phytoestrogen and herbs etc. which are great if you have the time, money and energy to put these into practise but the reality is often very different. Unfortunately the use of hormones is still seen by many as a 'cop out' or something that is the last resort. It reminds me of the baby books I read when I had my babies. I read the Penelope Leach books that advocated 'demand feeding' and 'never letting your baby cry' - it basically made one feel sooo guilty and inadequate. I think my mother hit the nail of the head when she commented "The problem with that book is that the baby hasn't read it"!!!! I later discovered that when Penelope Leach finally had her own baby she had a 24hour nurse for the early weeks!!!!
A really good book would be a compilation of menopause experiences from ladies who post on this site. The amount of us who comment that it is a relief to discover we are not alone with our meno challenges when we discover the MM site. If there is an author out there who wants to put this together I would be happy to contribute my experiences if it would help others?
Interestingly, when I had my private consultation with a gynae last week, he was very surprised that I hadn't been treated with local oestrogen earlier. I have attended various meno clinics both private and NHS in London in the past, due to my premature meno and the need for HRT, and though I have mentioned to all of them about my problems with burning and discomfort in my vaginal area none of them suggested local oestrogen alongside the systemic HRT. I do wonder if things might not be so bad now if I had been given the right treatment earlier??!!
DG xxx
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I think we've had the suggestion of adding views to a book here before :-\ …….
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Just one more thing back in the eighties and nineties HRT was mainstream and natural ways of dealing with menopause not so popular.
HRT is not new at all. It was only after the million women's study back in about 2002 that it went into decline and women started to abandon their HRT.
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Yes Stellajane - As silverlady rightly pointed out the really negative view of HRT emerged due to the findings of the 2002 trial which may have left many women with unnecessary long term problems. I have to say that even in the 90s, when I first went on HRT, I still felt I shouldn't mention that I was using HRT as I encountered many negative opinions about it.
My comment about local oestrogen really relates to the still widely held opinion that if you are on systemic HRT you don't need local oestrogen. The gynae I have just seen knew the doctors and clinics I had been attending over the last 20 years or so and was surprised they hadn't recommended some extra local oestrogen as he felt they should have known systemic HRT doesn't always help with VA. Up until my late 40s I was on only one pump of Oestrogel per day which is a very low dose so it is no wonder I developed vaginal problems.
Of course this boils down to doctors getting the right training to be able to tailor menopause treatment to each woman's needs.
I could be wrong about this but my understanding from the recent evidence is that if a women uses HRT for 5 years through her 50s then there is some benefit over the long term in terms of bone health and possibly VA/bladder issues. So basically there could be a preventative element to HRT - maybe if the right balance of hormones were found for each women this protective side could be extended which would ultimately save the NHS a lot of money??? I think this point was put forward by peegeetips regarding earlier treatment in the peri stage?
Going back to my original question, the down side of HRT is that it does bring side effects which many women find unacceptable - mostly because of the progesterone. Before I went on the Pill I had awful trouble with PMT and painful periods so wasn't surprised that I got some of these symptoms with HRT. I supposed many women go through their productive years with few problems with their periods, the meno symptoms come as a shock and the side effects of the HRT seem intolerable. Again, because doctors are unwilling or don't have the time or knowledge to help women find the appropriate HRT preparation how many women are draining the NHS funds with menopausal symptoms that could and should be treated with hormones? SSRIs do have their place but they will certainly not help VA and libido!
That's another point - how many marriages/relationships suffer because women are given SSRIs instead of HRT because GPs won't prescribe hormones?
Sorry for all the ramblings - I just long for us women to get a better deal all round. So much is expected of us at this time in our lives - caring for elderly relatives, working for longer etc. and then we have the 'Change' to deal with.
'Oh Boy' the menopause certainly brings some 'Changes'!!! :'(
DG x
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DG, this post is thought provoking. I was very ignorant. I was offered HRT a few years ago, but refused on account of my sister having beast cancer. I assumed that I couldn't and this was not challenged. Both doctors and us women need to do our homework. Maybe the last few years would have been easier and I would have been able to work. Being forced to reduce then give up work had financial implications then and now with my pension. I see friends struggling with responsibilities both for children and elderly parents, and worry about coping when my parents need more help from me. It's enough to look after myself at times, not a lack of willingness.
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Looking after elderly parents is challenging to say the least especially if you are not feeling great.
It's,a problem faced by so many.
I never had to fight for HRT. I had terrible flushes and insomnia. I turned up at the doctors and asked for patches and was prescribed them immediately with no question.
My anxiety did not start until I had been on HRT for two years so in that respect it has done nothing d for me. Perhaps my dose is too low.
I think I would have developed anxiety whether I was going through the menopause or not so it's unrealistic to expect it to sort every thing.
My life should not be stressful really as I have a good husband and two great kids but with life's challenges it would seem I am just not up to the job of coping very well.
Being feeble worries me as I don't know where I would find the strength to cope with anymore. I guess you find it from somewhere though.
Bit of a ramble really :-\
HRT does help with a lot but not every thing unfortunately.
Honeyb
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You are not feeble, HB! Just under great stress! You do the best you can and that is good enough. Stop beating yourself up!
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Who told you that you are 'feeble'? You work hard to keep your family fed and watered, plus an almost full-time job with your elderly, sometimes awkward, mother!
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The last few posts I think have really highlighted how the menopause effects us and whilst HRT can improve some things, I believe we can't expect HRT to solve everything.
I've now had a whole year without HRT and I think I started a thread some months ago titled "My warranty has run out" which basically sums up how I have been feeling. Now I am starting with HRT again it will be interesting to see whether I feel as if the engine has had a good service and running more smoothly. DG x
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I think its more the fear of becoming feeble (HB?) :)
No one is rambling btw ;D Its great to get our thoughts out there.
Here's to DG feeling great soon.
:-*
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I think many of us end up feeling feeble - I certainly do - constantly complaining and generally feeling under par. The meno can really knock ones confidence.
Many thanks for your good wishes - I will post about my progress. DG xxx
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I wish as suggested there had been some sort of MOT at the surgery when i was 50 - some information given out or reading material suggested.
I bought a booklet in Boots about HRT combinations read through it and thought not for me i'll weather through it - i've never liked taking pills unless i had really to - also at the time i think Teresa Gorman MP put me off it rather than for it when she publicly spoke about HRT.
Realise now from posts on this forum that stress around mid fifties didn't do me any good like it hasn't many others on here.
Hattie X
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Hattie - do you think you would have given HRT a go if there had been better information?
HRT doesn't suit everyone so if you get bad side effects from the HRT, that can be an added stress.
I think our 50s can be the most stressful time of our lives - our kids often struggling to find accommodation so possibly still living at home, older relations needing more support, we also have to work into our late 60s - add in sleepless nights, sweats and generally feeling low this must have an awful effect on our mental wellbeing and general health.
If there were MOTs at 50 with specialist doctors or nurses who could advice and guide us through the best options, maybe the NHS could save a lot of time, money and distress. To be able to sit down with someone who was trained to understand all these pressures and possibly come up with some treatment options, would mean the world to many women. Most GPs don't have the time or the expertise.
DG x
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That's the hub - GPs don't generally have the knowledge regarding menopause and unless there is a good Consultant close by it can be hit and miss. I have over the years tried to engage with my GP about various treatments that I think will help, we recently discussed how hard it was to find an AD which stabilised me. It took years ………. partly because of my reluctance to take ADs regularly. My own worst enemy sometimes :-\
Also when I was poorly for what ever reason/s I found it difficult to be clear in how I felt and what I might consider taking.
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Hattie - do you think you would have given HRT a go if there had been better information?
HRT doesn't suit everyone so if you get bad side effects from the HRT, that can be an added stress.
I think our 50s can be the most stressful time of our lives - our kids often struggling to find accommodation so possibly still living at home, older relations needing more support, we also have to work into our late 60s - add in sleepless nights, sweats and generally feeling low this must have an awful effect on our mental wellbeing and general health.
If there were MOTs at 50 with specialist doctors or nurses who could advice and guide us through the best options, maybe the NHS could save a lot of time, money and distress. To be able to sit down with someone who was trained to understand all these pressures and possibly come up with some treatment options, would mean the world to many women. Most GPs don't have the time or the expertise.
DG x
yes i think if you saw a gp or specialist nurse at 50 and went through your own medical and family history a few options could be pointed out to you at this time in your life. What you might expect to happen during menopause might be better coming from 'someone' rather than a book as well - as you say it might all be a bit preventative in the long run.
If HRT had been suggested as a personal best option for me i might have considered it.
Hattie X
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I think we should expect reasonable quality of life, because what is life worth, if it is spent in discomfort, in a low mood, too anxious to remember that life is magical, unable to appreciate the things that cost no money etc...
I was getting sweats and flushes and low mood/excess anxiety, for 4.5yrs, not realising it was perimeno, as I was only 42 and put these symptoms down to medication I was weaning off at the time.
I only realised last year, got the blood test and started the hrt testing merry go round.
The million woman study has a lot to answer for, even GP's believed it.
I had a seemingly pointless struggle at my surgery before getting on my current hrt and wasted a year on one that had no effect on me, as I was scared off, due to one doctor being 'snappy' with me about hrt.
All that needless suffering and multiplied knock on effects.
Annie Evans put the risks into real perspective.
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Am in the position that my GP refuses to prescribe HRT and goes through a list about various cancer risks. I have spoken to other women who are in the same position with their doctors. Personally I have been prescribed three different antidepressants which I have not taken up as yet as I am worried about side-effects and GP has not discussed these. Have also been offered clonidine. I think this approach is very common. GP's may well not have the time or the knowledge, maybe worried about litigation these days. Really dont know what the answer is as many women suffer from the flushes, insomnia etc etc for who knows how long and its no use doctors trying to kid women about this. It seems pot luck if you get a GP who really understands. Many women are losing out financially because they simply cannot cope with paid employment when they would really like to, especially at a time of great pressure on women regarding changes to pensions,( which they did not expect to happen when they were younger! ) Of course a lot of women find that they cannot tolerate the progestogen bit of HRT because of side-effects, they dont want a bleed and the continuous regimen doesn't suit either! If you go on anything and then want to come off, that too has its own issues. Sorry I do sound very negative but just wanted to vent on this theme which has been raised.
Meg
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I think I was lucky to have a really understanding GP of. By the time I went to see her I had been taking various herbal remedies for about 3 years which had helped up to a point.
The main thing that made me want to take HRT was that I was just starting a degree and couldn't sleep because the hot flushes were increasing also I felt like I couldn't think straight!
Coping with being a student again nearly sent me over the edge....It felt really strange and soooo noisy!!
The HRT definately helped to get me through. I had done a bit of research before and my GP gave me some websites to look at before giving me a prescription.
As you know I recently came off for a couple of months but now am back on it and feeling 100% better.
I don't think we expect too much just to be able to have some sense of normality... Whatever that is..... And just to cope with life
It good to be able to talk about these things!
Have a good day everyone x
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There should be well-women centres today at every surgery to educate women about menopause and the changes expected and to give them a health MOT if necessary as they reach 50 for example, and have a general health and life-style review.
Hurdity x
I was just picking up on Hurdity's suggestion further back - credit where credit is due !
Hattie X
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Meg - you vent away - knowing what to do for the best when encountering the challenges of the menopause is a minefield and sadly many GPs really don't help - as Hurdity says, Well Women Centres are the answer.
When posing this question on this thread I wanted to get contributors on MM views and thoughts and I've found it all very interesting.
DG x
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Thanks Dancing Girl. It seems from the Forum that many women are close to the edge with menopausal symptoms and can only turn to sites like this one for some support. There is still so much secrecy and even lack of understanding surrounding meno with women not really being able to discuss it even in this day and age. There is still an attitude that you should be able to cope with this often dramatic chemical change in the body. I do hope that things will alter for the better so that women will not feel as if they have no support.
Meg
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Hi Meg
just like its not the doctors decision if you wanted to go on the pill when you were younger, its not your doctors choice to use HRT.
HRT helps protect you from heart disease, from chronic conditions and other cancers, womb and large bowel for a start - both of which we don't get screening on so those can be missed.
If Doc tries to confuse things again, just tell them that things like eating certain foods, alcohol and smoking are far higher risks for cancer than HRT has ever been :)
Hope you get a more understanding doctor soon.
:-*
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It's not so much what i expect from HRT that's an issue with me but the lack of knowledge in a GP surgery about menopause and all its symptoms.
HRT is a lick it and see for me but i agree with peegeetip that too many unnecessary tests are often undertaken before there's a recognition of something that is after all a natural part of a women's life. I'm certain my anxiety would have been more manageable if i hadn't gone through months of worry and feeling neurotic when all along I was telling the GP I suspected my hormones.
I hope HRT will improve my quality of life for my sake and my family.