Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Katty on September 20, 2016, 10:47:19 AM
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I was just wondering what proportion of women actually manage to go through this and remain healthy without HRT. Is it possible to go into old age still enjoying penetrative sex for instance without topical HRT? Do women get their energy back post menopause or is it just a complete wind down? I had a GP appointment today but cancelled due to my symptoms improving. I hear they don't like to prescribe HRT after 60 and you should be on it for no more than 5 years so I thought I'd delay a bit and see what happens. I'm persevering with Hyalofeme for now.
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If you would like to carry on having a sex life I would start topical oestrogen treatment asap...there is no way I could have sex if I didn't use topical HRT. The Hyalofeme will not keep the VA away, so if your symptoms get worse I would get some Vagifem/Ovestin prescribed.
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That mind set should alter following Guide lines to GPs. It is hard to get information so that one can make informed decisions. Many consultants are prepared to prescribe HRT for ladies for longer than 65 but it's finding one that remains consistent.
Maybe make a list of symptoms and prioritise. Vaginal atrophy symptoms can be eased by localised HRT, it's been a Life Saver for me. It was like razor blades up there :o.
My sex Life :bed: has improved in recent years, being retired means we don't have to set the alarm so I'm not as tired. I pace myself otherwise, i.e. gardening, walking, resting ………
Anxiety has been a problem since aged 3 so it can floor me, otherwise we get out and about.
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Like cal oestrogen ASAP at the very least , vaginal atrophy is truly awful .
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To respond to the original question: I believe it is estimated that between 30-40% of women get moderate to severe meno symptoms for 7 or more years so I think the other 60% probably either have no real meno symptoms or have some meno symptoms that subside over a short time, so it doesn't really impact their lives that badly.
I think energy will naturally drop as we age, I honestly don't think we can expect to have the energy of a 40 year old at the age of 60 but lack of sleep because of meno symptoms has a terrible impact on energy.
I do think there are quite a few women who simply opt out of life to a certain degree because they feel they should ‘weather the storm' without HRT or any treatment and this is terrible. HRT is a choice, well worth trying and if it helps with symptoms then it can and does improve quality of life. As for the 5 year rule - that is nonsense. If you suffer with bad meno symptoms and need to work till 66 then you may need it till that age to be able to work. After 60 the risks do slightly increase but often the benefits outweigh the risks.
As for having a sex life, again this will probably vary greatly. Libido does tend to drop at the time of menopause - the need to procreate has gone so inevitably the need to have sex declines - however, I am finding that with the right attitude (having a lovely man in your life really helps) and careful management of my ‘lady bits' I'm still enjoying a ‘tumble'. Those that manage to keep having sex on a regular basis, probably using lubrication, may do OK for many years beyond meno. If, however, a women gets bladder problems or pain with vaginal atrophy, then this will reduce the chance of having sex so it's very difficult to maintain that side of our lives. Local oestrogen should be dished out by GPs far more to prevent VA and bladder problems in the longer term - I know from experience vaginal pain and particularly urethral pain is truly horrid. I can do without systemic HRT but I will probably use local oestrogen for the rest of my life. DG x
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Thank you so much for all your replies. I think probably topical oestrogen may be the way for me to go soon. It didn't help that I learned only yesterday my GP practice has been placed in special measures. I need a re think on where to go for help on this and other health issues.
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Does your Surgery have a Practice Nurse? Or ring up and ask for the product to ease symptoms.
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I finally managed to register with a new GP today. I had a new patient interview and smear. The smear was uncomfortable and the nurse said my sample may come back as inadequate as she was struggling to locate the opening of my cervix. Apparently this is not uncommon as we age. I noticed as she was completing the smear form she wrote post menopausal on it. Blimey, I have an appointment next week with a GP to finally sort out hormonal support. ATM I am so uncomfortable, People talk about hot flushes in the body. I am generally warm but the heat in my genital areal and going down my thighs is awful and almost constant but worse at night. The itching and sensitivity has spread over the whole perenium and even around the anus. I wondered how common this is. I definitely need topical HRT ( has anyone got any recommendations? Cream, vaginal tablets or estring?) I don't know whether systemic HRT will also be prescribed. I lack energy, feel depressed, achy, poor sleep, can't concentrate and my joints feel awful. Thus far I have tried Sylk, Replens, Hyalofeme, Sass, Hydromol, Yes, Betnovate. All of these no longer keep the problem at bay. I had to lay off anything for a few days for the smear and it has been awful. I have been awake a lot in the night with the heat downstairs. God I feel like one of those kids in the old Ready Brek ads only it's my nether regions that have the red glow :)
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I need local and systemic HRT all for the bladder / vaginal area.
I use vagifem and ovestin on the outer bits and multi-gym act gel on the outer bits also.
If like me you need the whole " nine yards " to be able to function okish, regards my nether regions.
My Sil had to use vagifem every night for four weeks , before they could even get a speculum in to do a smear.
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Hi Buzzy
Like MaryJane I too need the whole lot- Hrt / Vagifem/Ovestin I know exactly what it would feel like if I stopped 😡
VA is a life style, unfortunately one that has been thrust upon us poor unfortunate ladies ! But properly managed there is light at the end of the tunnel !
💚💚💚💚Ss x
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SIL had to use vagifem every night for four months not weeks before they could do smear with the virgin speculum.
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I have needed systemic HRT for the VA, started that six months ago. I also still need vagifem every night and use Ovestin for the outside bits a few times a week, even with that lot I get a blip every few weeks. But the horrendous burning is now a memory, even during a blip it has never got as bad as it was before treatment started.
Get your topical treatment started asap.
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Luckily we have so many products now to try and ease all of this but how the hell did women cope in the past? No wonder women looked old at 50 in my mother's day. They were carrying all of this with no one to share it with and very little medical help. How sad.
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I have severe urogenital atrophy and will need estrogen for life but I've often thought back to my poor auntie. When I was much younger she used to annoy me because whenever we went anywhere we would spend all day looking for toilets. Also some days she couldn't leave the house as she was so comfortable. It's only now I realise she must have been suffering from VA, poor woman.
If left untreated it gets worse and worse so god knows how she coped. So sad.
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Going back to the original question of this thread: this also got me thinking about the study that is supposedly monitoring HRT and the risks involved. The recent announcement again threw up the risk of breast cancer, thrombosis etc when using HRT and of course we on MM are very sceptical about this study as it is deeply flawed on so many levels.
I haven't actually looked at this study in depth - you need to have a scientific background (I certainly don't have a science background) to fully understand what it's doing but it is a long term study. Many feel it is fundamentally flawed as early HRTs are different from what are currently available and from the outset included women who had started HRT in their 60s (I think). Anyway, I doubt whether this study can be truly representative as we all experience the menopause differently so many women do not need HRT treatment.
The questions I would like to ask of the professionals following this study:
Does the study simply look at a random selection of women regardless of menopause symptoms? Perhaps women who get bad meno symptoms are generally more likely to get BC?
When assessing the risk factors of BC did they take into account life style choices e.g. were the women who did develop BC over weight, drink too much alcohol or smoke?
Is there a base line for this study e.g. did all the women being monitored suffer from moderate to severe menopause symptoms from the normal age of peri menopause (late 40s early 50s)? After all 30%- 40% of women have few if any meno symptoms.
I assume they have monitored 50% of women who didn't get HRT and 50% who did?
Drop out rates have been high as many women do suffer side effects from HRT - however were the ladies who gave up HRT given advice and help to find an HRT that did suit them?
Of the women who have not been on HRT:
How many have had to stop work due to meno symptoms?
How many had a breakdown in their, otherwise happy, marriage?
How many are permanently on ADs/SRRIs to help them cope with meno symptoms?
How many have developed early osteoporosis, heart disease, vaginal atrophy and bladder problems?
I think the findings so far from this study throw up far more questions than conclusions:
Do women who get life inhibiting meno symptoms have a greater risk of BC etc?
Why is it the combined HRTs that encourage the development of BC ? If oestrogen is the hormone that encourages BC then why do the women who have had a hyster (so don't use progesterone) not have an increased risk.
Is it really progesterone that is the bad boy? If so why?
Considering the undoubtable benefits of keeping a certain amount of hormones (oestrogen) circulating in us for longer that is normal, why aren't they researching how the benefits can be delivered with fewer risks? Surely healthier women can be working, contributing more to society and definitely costing the NHS less. DG x
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So many interesting points thrown up by the last post. Of course another thing now is financial implications. We seem to have gone back to quite restrictive prescribing. You have to wonder if GP's are ticking boxes to meet financial targets and not treating women in a way that's best.
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The laughable thing is that I have always read up on things and I thought I knew what was going on in my life but yesterday I realised that I am just as ignorant as the women in my mother's day. Over 10 years ago in my early 40's I was having terrible bleeding problems. I even tried taking the pill back to back but it did not work. Eventually I was having around 1 week off bleeding and 3 weeks on in a month. I was put on the Mirena coil and that helped for a few years and then the problem was back. So around 6 years ago I had an endometrial ablation. Last resort before hysterectomy. Thankfully it sorted the bleeding out and I never had a period again. During all that time I had a few panic attacks at work. Often felt hot and dizzy and developed gastric problems. I was on proton pump inhibitors for 18 months. I eroded part of my esophagus with acid reflux and pain was as bad as a heart attack. I had to sleep on a foam wedge. I had a lot of work stress and family problems at the time and put it all down to stress. In the last 6 years post ablation I have developed the vaginal dryness problems. I tried all the products mentioned above and went to the doctors about 4 times about it. She insisted I must have excema and prescribed Betnovate. She did blood tests and said I was OK and didn't need HRT etc. I just assumed that the menopause was yet to come as she seemed to think the tests showed I was not there yet. My last blood test was a year ago. So yesterday having moved GP surgery I had a new patient appointment with the nurse and a follow up smear as I had first abnormal one a year ago and now have to be followed up yearly. The nurse recorded me as post menopausal on the form and when asked about this we had a short chat. She said that blood tests can not be relied upon to judge a woman's menopausal status. You have to take symptoms and other evidence into account. Just this last 2 years I can see a visible difference in how I've aged. My skin and my eyes etc. I really do look the older woman now. Looking back I feel that I must have been actually going through the menopause during all that time I had all those health problems and I just didn't know it. I was seeing all the issues as separate health issues and my GP never indicated. I thought this dryness was the start and the other issues were all unconnected. Now I just feel washed out and finished. I've no energy for anything. I've been like this a while. I probably should have had hormonal support earlier. It's really amazed me how stupid I've been. All this information and reading and I still didn't put it together. I'm 54 now and relied on what my GP said about the blood tests. How could I have been so stupid? I came on here thinking here it was all starting due to the vaginal problems and tentatively wondering if I should consider HRT or leave it a while. In reality and given my examination yesterday I am probably nearer the end than the beginning of all of this and in desperate need of HRT. I can only hope that when I get to see the actual GP next week they are in concurrence.
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I seem to be surrounded by women who've not had meno problems. My mum doesn't even remember going through it and never had hot flushes and a good friend recently had a hysterectomy due to fibroids and feels great without any HRT - it was never even offered to her. Apart from one friend, who's suffered for years with bad PMT, hormones seem to not have been much of an issue and they've assumed my situation has been very irregular. My older sister did have to have IVF for both her pregnancies and had heavy periods and has since had an endometrial ablation but is doing really well now and has never considered HRT. She said a lot of her friends in their 50s said they struggled in their 40s with anxiety and other perimenopausal symptoms but felt great post memo.
I'd also never heard of VA until I saw it talked about here and I don't know anyone (close enough who'd discuss it) who suffers from it.
It's been the same with work colleagues as most are in their 50s and when I've briefly mentioned I'd had meno problems they said they'd fortunately been ok with it.
I'd, therefore, assumed our cases were rare and am hoping peri is worse than post but who knows?!!!
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My three real life friends have VA , it's only because I don't care who knows I have it that they said yes they also do.
All who no me , no I have it . Took my lifestyle away from me owning/riding horses. 😥
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Maybe the reason that some women appear not to have menopause problems is that, like me, they don't associate individual health issues with it. Who would have thought, for instance, that reflux is so common at that time? Who associates acid reflux with their nether regions? A lot of things are related to hormonal changes but most women don't associate health issues in their 40's with menopause. I think a lot of us are just getting to the teenage years with kids then and we don't think we are as close to the end of our fertile time as we actually are. Looking back I am 54 now but I know I had issues at 40 and between 40 and 45 things were awful. Women may tell each other they are having no issues with the menopause because they don't think the heartburn they keep suffering etc is anything to do with it.
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Heartburn and GERD, dizziness and insomnia is how I started. As you say, I had no idea what it was.
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Buzzy, it's difficult to say how many women get through the menopause without HRT but from my experience of family and friends, I would say not many come through unscathed. Hot flushes and night sweats are the most common menopause symptoms but they are the thin end of a very big wedge and just because someone does not have them does not mean they have got away with it because there are so many long term health issues that are caused by oestrogen deprivation.
My mother just kidded herself that she didn't need HRT but her health deteriorated rapidly post menopause. To name a few of her ailments, high blood pressure, constant indigestion, chronic fatigue, insomnia (she hasn't had a full night's sleep for well over 30 years) womb prolapse, bladder problems, knee problems, 2 hip replacements and curvature of the spine. A friend I used to work with went through a complete personality change and had practically everything wrong - she now has osteoporosis. She went from being a vibrant young woman who enjoyed sex to a depressed individual with endless health issues who completely went off sex and lost all her vitality overnight. My aunt also developed high blood pressure post menopause and died of a stroke aged 57 leaving us devastated - I still miss her even after all these years.
So whether or not to take HRT is a personal thing but I would not want to risk being without it. Oestrogen acts like a control centre for so many vital bodily functions and without it, all sorts of things can go wrong. I am probably one of the few people on here who does not only take it for symptom control (migraines and dodgy thermostat) but as a preventative measure because I am not interested in suffering from any menopausal symptoms be it short term or long term. I decided a long time ago that I will be taking HRT for life.
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Yes the effects are huge. I lost my job then and never had the confidence to go back to work after around 45. I just felt overwhelmed. I can't wait for this appointment and I hope there won't be a reluctance to prescribe. I do think I need both systemic and topical HRT. Sat here tonight and my whole lower half is just on fire. Another night awake until the early hours
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I found this online out of interest.
http://www.pcwhf.co.uk/documents/pcwhf_menopause_guidelines_2016.pdf
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It absolutely amazes me that some women say they have no symptoms of menopause. I would love to know why this is, are they very good at producing oestrogen from other sources than their ovaries or do their ovaries function better than others or are they taking SSRI's which may inhibit some symptoms or make them feel as if things dont bother them. Why would they fib on this issue. I wish research would come up with the answers. I am one of those who have been hit badly for some reason I also dont understand. Lack of support from uncaring or ignorant GP's is quite common. I believe that many women are struggling on not knowing what to do for the best. Dryness and shrinkage of genitalia is a feature of female menopause, tragic! Sorry to sound so negative but symptoms can just go on and on unfortunately. I look at younger women and think, make the most of it while you can, I had no idea what was in store! Given the reluctance of many in the medical profession to even prescribe HRT which of them is going to give it to a woman for life and what happens when you have to stop?
Meg
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I had one friend who said she suffered terribly with heavy periods, palpitations etc. in perimenopause. She never tried HRT but eventually found a recipe book (by a famous menopause writer but can't remember name now) and she said it made everything a lot more bearable and now she is post meno by about 4 years she feels better than ever. I spent a recent holiday with her and she has tonnes of energy and is in really good health.
As our hormone production continues from the adrenals, fat cells etc., maybe some women produce enough or have the correct ratios which I've heard is the key to hormonal balance.
I met another hypnotherapist at a seminar in the summer who treats hormone imbalance by redirecting the pituitary gland. She said it's really effective so I'm also thinking of getting back in touch with her to learn more. I've used similar techniques to lower blood pressure in clients and Dr David Hamilton's work on the extension of the placebo effect suggests it could work.
For the opposite reasons, let's not expect the worst, and we should remember the positive posts we've had on this forum about the relief of coming through the other side.
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It absolutely amazes me that some women say they have no symptoms of menopause. I would love to know why this is, are they very good at producing oestrogen from other sources than their ovaries or do their ovaries function better than others or are they taking SSRI's which may inhibit some symptoms or make them feel as if things dont bother them. Why would they fib on this issue. I wish research would come up with the answers. I am one of those who have been hit badly for some reason I also dont understand. Lack of support from uncaring or ignorant GP's is quite common. I believe that many women are struggling on not knowing what to do for the best. Dryness and shrinkage of genitalia is a feature of female menopause, tragic! Sorry to sound so negative but symptoms can just go on and on unfortunately. I look at younger women and think, make the most of it while you can, I had no idea what was in store! Given the reluctance of many in the medical profession to even prescribe HRT which of them is going to give it to a woman for life and what happens when you have to stop?
Meg
Women who are fat or fatter will produce more oestrogen and therefore this may mitigate some menopausal symptoms for some of them. Estrone is made (and stored?) in fat cells and provides a reservoir for estradiol in the body. Not a reason to be or stay fat though as this condition (having excess fat leading to being overweight) is associated with all sorts of health problems!
Hurdity x
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I think a bit like the whole natural birth or breastfeeding situation it seems that women can be a bit hard on each other. I had the experience of all sides. One ceasarean birth, one vaginal with pethidine, one "natural" without medication as it happened too fast. 2 babies I couldn't breastfeed due to prematurity. The third I breastfed for 18 months. I appear to have had a number of separate ailments in the last 15 years and have had medications and an operation to put them right. I've had 2 bouts of private physiotherapy to deal with pain. In reality I probably should have been on HRT. I think it's a mistake to be too purist about things. We all have to do what works for us. On telling a friend yesterday that I was going to the Dr next week to ask for HRT I was asked "why do you think you need it?" Another friend had a sister who died from cancer so she won't go anywhere near HRT. It's almost as if they view me as weak and giving in for even considering it. Quite frankly I've had enough and I can't understand the way something like this becomes yet another stick to beat women with. We are lucky enough to have choices these days so we should feel able to use them without feeling a failure. This is how life is now. If everything has to be natural then taking that view we shouldn't even be on this forum communicating using this new fangled technology thing. No sisters get outside and shout over the garden hedge instead it's far more "natural." :) :)
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We are all different and we all make our own choices. What is right for one may be a disaster for another.
It's the same in all aspects of life. Each to his/her own :)
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Buzzy, I don't get this natural thing or the failure stuff, what are these women on about? I wonder how they will feel about being natural if they end up like my mother? I assume they refuse all other forms of medication too?
If you can't take HRT for medical reasons then OK, you have to look at other options but if you can take then why suffer, I mean what is the point?
If you take the right type of HRT at the right dose that suits you, there is no reason why you should not be able to feel the same as you did pre menopause. I do.
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Just to say regarding the GP I moved from. Having failed 3 inspections and been judged inadequate in many areas the surgery is now in special measures and has a year to improve or be closed down. I only found this out due to press reports. Now that I have gone more into depth regarding prescribing guidelines etc I can see that my doctor was obviously not in favour of HRT and treated me accordingly keeping me in ignorance. I was prescribed essentially an excema cream for my vaginal issues. Betnovate. I was once prescribed Clonidine for flushes but didn't take it because I read up on it. I have no blood pressure issues and did not feel it was appropriate. The Dr insisted that I was fine hormonally based on blood tests. The nurse at the new practice said that you cannot rely on blood tests alone. There have been many wrong turns in my treatment in the last 5 years. What with friends saying anti HRT stuff and the GP stonewalling I feel very frustrated. I just hope I get somewhere next week.