Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Peacegirl on October 26, 2016, 05:47:25 PM
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Hi, I feel like such a failure when I hear women my age and oLder saying they didn't even notice menopause. :-\ I'm a bit desperate tbh and though my ideal situation would be to be hrt-free or at least using bioidenticals, I've just hit a tough year when, after 5 (lucky) years on prempak c, I developed muscoskeletal pain, chronic multiple mouth ulcers and infections and a return to hot flushes. My gp put me on evorel sequi and conti patches and my hair fell out big time. He then put me back on prempak c with a daily top up of Premarin and I hit the worst insomnia possible-some nights having 1 or 2 hours sleep and a couple of nights of no sleep. This went on for 3 weeks and I was hallucinating and feeling on the brink of desperation, fearing for my mental health actually. A GP then prescribed femoston conti but I'm scared to take it because I've managed to get some sleep by going back to using some evorel patches I had left. I have my first hrt clinic appointment next week by I'm really anxious as at my last gp appointment, he was dismissive (different gp) and lectured me on the ills of hrt- I had fully broken down in tears probably due to lack of sleep. Any advice of where to go from here or how to put things over at the clinic would be much appreciated. Sorry to be such a moaner, I just want a bit if quality-of-life back but have got a bit lost. Thanks
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Hi and welcome
I've very limited knowledge on hrt as I had a hysterectomy years ago and got put on elleste solo pills which worked a treat until I then went in natural menopause so I'm now on patches
But I hear you when some women say they sailed through it
I work with a lady 4 years older than me who went through menopause in her 30s, she has hrt for 5 years and the dr said that's her limit so been off since and doesn't understand when I say I'll stay on it for life
My boss has just been informed she's menopausal and has said she doesn't need any help
I didn't want to be interrogated so just said I'm staying on to protect things
Personally I'd rather quality of life over quantity but to be fair I've had little quality since this meno thing reared its head a 2nd time, but starting to feel a little better
X
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Welcome to MM.
Your GP doesn't sound very helpful and should not be scaring you off HRT. There are many short and long term health problems that are caused by oestrogen deprivation and it is important to know about them. I wonder how he would cope with the debilitating symptoms you have described?
I would say that bioidentical HRT is the way to go and I can recommend Oestrogel (you rub it on your skin) and Utrogestan which is a micronised progesterone which is best used vaginally but there are other forms of progesterone that you can use with Oestrogel. I have found it to be the most effective HRT regime by far and like the flexibility of the gel because you can easily adjust the dose to suit your needs.
I hope that helps but I'm sure others will be along with their recommendations too.
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:welcomemm: at a time when you need support you are low, weepy and not able to put your point over.
If HRT didn't work for you, those 5 years would have been awful too!
Has your GP done any blood tests etc., as multiple mouth ulcers can be caused by various conditions. Thyroid function tests, VitD, anemia???
You are certainly not a failure but are being 'failed' by your GP practice! Browse round here, make notes. Some ladies find that keeping a mood/food/symptom diary useful. Then pick out the symptom you want sorted first and work through them. Take a list to the Clinic appt., tell them how you were for 5 years and that now your hormones are all over the place!!!
If you don't get a good response then maybe ring Professor Studd's secretary for advice. Let us know how you get on. This is The Change, something many medics don't 'get'!
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Such lovely support. Thank you. :'( :)I had 5 hours sleep last night and this is good, not great but ok. I've had a lot of blood tests as my mum had a thyroid problem which went undiagnosed and possibly contributed to the cancer she got. Bloods have been good except for low white cell count sometimes, borderline under-active thyroid and too much of one hormone (didn't hear what he said as was weeping) which probably caused the hair loss. I will try and be solution-focused at appointment. I.e as suggested mention good years on prempak and patches were OK except for hair loss. Insomnia is definitely not an OK symptom for me, but I can live with occasional ulcers. I totally agree with quality over quantity - I have been thinking I'm not sure if I want to live like this for too long. Thanks for the advice, hopefully I get someone who is understanding at the clinic and I will ask about the bioidenticals, I really like the idea of dose-control as I have learned to recognise oestrogen highs. I will investigate professor studd too.
Annie0710, I hope you also get what you need too X.
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Hi peacegirl
:welcomemm: from me too.
Just to say I agree with you and others that bio-identical hormones (as in those that are the same as our body makes - not compounded bio-identical hormone replacement therapy) are the way to go and especially re the hair shedding.
As Stellajane says they are all listed under Treatments/HRT preparations. I have (almost) always used Estradot patches which are way smaller than Evorel and do the job really well - together with micronised progesterone (Utrogestan) on a long cycle.
You haven't said how old you are and presumably you are now post-menopausal so your hormones surges have dampened?
Do not feel a failure! None of us on here who take HRT do - in fact we fell the opposite as we have made the choice to take our life into our own hands, have read about the pros and cons and have decided that it is better for our health and well-being to take HRT. What's not to like?
Great that you have a menopause clinic appointment. Do all the research you can about what you want to try and be prepared to argue your case. You should not need to investigate private treatment especially if you already have a specialist referral - as long as you know what you want to try!
Btw re the thyroid - if you are borderline - was it TSH that was higher than ideal or did you have T3 and T4 measured too? This could also partly explain some of your symptoms as you say - is this being treated? It is often difficult to disentangle what's due to what at menopause. Transdermal HRT is also better if you have thyroid problems so I've read - at least if you are taking thyroid medication as it affects availability of one of the thyroid hormones (sorry can't remember which!).
Hurdity x
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Hi Peacegirl - its the progesterone in Evorel (Norethisterone) that can cause hair shedding. I had to come off it for that reason.
If you take a look at the list of HRT treatments at the top of the page under the green header you'll be able to see the ones to avoid.
Don't despair - there is a solution out there!
Hi, yes I see that it's a tesosterone derived progesterone and that this is the problem. I will look at the treatment list, thanks. My appointment is Tuesday so I will spend some time this weekend exploring possibilities.
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Hi peacegirl
:welcomemm: from me too.
Just to say I agree with you and others that bio-identical hormones (as in those that are the same as our body makes - not compounded bio-identical hormone replacement therapy) are the way to go and especially re the hair shedding.
As Stellajane says they are all listed under Treatments/HRT preparations. I have (almost) always used Estradot patches which are way smaller than Evorel and do the job really well - together with micronised progesterone (Utrogestan) on a long cycle.
You haven't said how old you are and presumably you are now post-menopausal so your hormones surges have dampened?
Do not feel a failure! None of us on here who take HRT do - in fact we fell the opposite as we have made the choice to take our life into our own hands, have read about the pros and cons and have decided that it is better for our health and well-being to take HRT. What's not to like?
Great that you have a menopause clinic appointment. Do all the research you can about what you want to try and be prepared to argue your case. You should not need to investigate private treatment especially if you already have a specialist referral - as long as you know what you want to try!
Btw re the thyroid - if you are borderline - was it TSH that was higher than ideal or did you have T3 and T4 measured too? This could also partly explain some of your symptoms as you say - is this being treated? It is often difficult to disentangle what's due to what at menopause. Transdermal HRT is also better if you have thyroid problems so I've read - at least if you are taking thyroid medication as it affects availability of one of the thyroid hormones (sorry can't remember which!).
Hurdity x
Thanks for the welcome. No treatment for the thyroid as only just under-active and I'm not sure what the levels were although t3 and t4 were measured but I had to push to get that tested. Admittedly, even though I'm assertive elsewhere, at the docs I feel like a hypochondriac and didn't ask for the detail of my results. I guess they'll keep an eye on it if I ask.
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Hi
"Hi, I feel like such a failure when I hear women my age and oLder saying they didn't even notice menopause."
This is myth 1.
No woman is going to get thru menopause untouched.
I thought that about my own mother until recently and realised very late that she had womans problems for years.
But if I'd asked she'd have said all was great.
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"I'm a bit desperate tbh and though my ideal situation would be to be hrt-free or at least using bioidenticals"
Myth 2
All other HRT in the uk - other than prempak - uses bioidentical estrogen.
There are a variety of choices for the prog part of your hrt - and all have varied benefits and differences.
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"A GP then prescribed femoston conti but I'm scared to take it because I've managed to get some sleep by going back to using some evorel patches I had left"
Myth 3
Both options have the same estrogen component - different delivery though. Some people take better to tablet form of HRT and there are benefits to both tablet and patch.
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"Sorry to be such a moaner, I just want a bit if quality-of-life back but have got a bit lost"
Myth 4
No one is a moaner here. It is just a place to come to and say whats good or bad - question or agree/disagree. I hope you get the quality back soon. Say as much or as little as you like.
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On the Femoston Conti - it uses a Prog part that is supposed to be easy on most ladies. Give it at least 3 months - best to wait 6 months to get used to this new HRT.
Hope you get back to normal asap.
:-*
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peegeetip - your point about being a moaner rang true. I got to the GP today and when she said 'how are you?', I automatically said 'great!' Obviously I wasn't - I was at the doctors! I have found most women of my age have some meno issues, but its only when I've asked that they've admitted it. It isn't [yet] something to talk about. My mum had HRT withdrawn suddenly when it became 'dangerous' and suffered really badly -she just didn't tell me at the time.
So moan away!
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I never thought to ask
- she never thought to say
(was it due to being embarrassed, uninformed, resolute to plough on, thought it would go away, didnt know what to say, sex didn't happen anymore, scared to take HRT etc etc etc).
It pains me to think I didn't see it sooner,
but when people say how are you - and we / they say "oh fine"
then we can't blame ourselves too much?!
I just wish she could have talked to me and I to her, sooner.
:-*
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Hello ladies.
I just wanted to chime in and say that my 75 year old neighbour told me that he didn't think his wife actually went through the menopause! Odd as she's 70 now so is she still menstruating? They had 3 children so it's not as if she didn't make it through puberty! Incidentally they both started drinking in their forties and she told me that if she'd been less grumpy things may've been different in their family.
My mother never mentioned her menopause to me but she may have confided in her friends and sisters.
One thing is for certain, I never expected to feel the horrible things that meno has thrown at me and I have nothing but sympathy for other sufferers.
Take care ladies.
K.
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I think a lot of women suffer from denial syndrome. When someone is faced with a problem they 'think' they cannot resolve, they often pretend it doesn't exist.
What worries me the most on MM is amount of women who are still being scared off HRT and suffering unnecessarily. Why is it OK to use birth control but not HRT? I see it as a natural progression and if I wasn't using HRT I would still be struggling with contraception which, in my case, is far more challenging.
If only all medics had the same attitude to HRT as Professor Studd.
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totally agree Mary G.
the pill we take until docs propose it somehow becomes dangerous overnight.....
however studies show the pill protects us.
the pill would stop a lot of problems on the way thru peri.
the transition to HRT should be a simple thing.
in studies the damage is mainly in ladies with a "gap" in beginning meno and taking HRT.
if we sustain a similar level for a long period of time - then how does it suddenly become this bad/dangerous thing to do.
hypocrisy , uninformed and down right wrong seems to rule the way often.
???
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I agree that it's a bit of a myth that there are so many women without symptoms. They just don't realise that what they are experiencing is meno related, or they don't want to admit it because it would mean admitting they are getting older.
I have a number of friends in their 60s and 70s and there isn't one who doesn't complain about not sleeping well, while I just smile and say I sleep like a baby.
Also all of them complain of various things like aches and pains, poor memories, hair thinning, hot flushes (even those in their 70s), loss of energy etc. All these things can be attributed to the loss of estrogen.
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Thanks all! I had sleep last night- 6 lovely hours. Peegeetip, Thank you for the support and all the info. I'm realising now that I misunderstood the term 'bio identical' and didn't know that most hrt uses bio identical estrogen . Even after much googling and reading on here, I've been struggling to understand what doses of estrogen v progesterone I've been taking and this has now become quite become important to me. I have been taking the prescribed femoston conti the past few days but am concerned that it's only 1mg estrogen to 5 mg progesterone as low estrogen has caused bone ache and horrific mouth ulcers in the past. I'm not sure that ive taken this much progesterone before. Hope that will be ok but I guess I can ask about this this at the clinic on Tuesday. If I tell them I felt great on the evorel conti/sequi patches but can i ditch the hair loss factor, will that be a sensible question?
I totally relate to the mum stuff, wish mine was here too 😭 so I could be more supportive and learn.
Kathleen, your comments about your neighbour made me laugh a lot!
While we're on this too, I've made huge lifestyle changes to accommodate menopause. I went from being superwoman, doing a full time manager job and managing a home too to working part-time and having to rest a lot and consider what invitations I accept. My partner of 6 years is younger than me so this is tricky. I've taken a big hit in the appearance department too as my skin literally hangs and my muscle-tone is poor too. But actually I've grown into my new life. I guess what I'm saying is that some gps dont recognise how hard we've worked to cope and adjust. We accept aging but I sometimes feel like I was 97 and I'm 57.
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Peacegirl, that sounds like a lot of progesterone! I imagine Femoston was prescribed for you because it is one of the better tolerated forms of progesterone so you might find it's OK but if you find the oestrogen dose is too low and you don't feel as good as you either could or should, then you might need to change to something stronger.
You obviously had problems with the evorel conti/sequi so have you thought about going for something with more inbuilt flexibility like Oestrogel and Utrogestan? The beauty of the oestrogen gel is you can very quickly and easily adjust the dose to suit your needs and I have found it to be the best form of oestrogen I have used by a very long way. The Utrogestan (micronised and NOT synthetic progesterone) can be used vaginally too which means fewer side effects and if necessary, you can get away with using a bit less because it is localised and hits the spot as opposed to getting lost in your digestive system.
It might be an option worth looking at.
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Peacegirl, that sounds like a lot of progesterone! I imagine Femoston was prescribed for you because it is one of the better tolerated forms of progesterone so you might find it's OK but if you find the oestrogen dose is too low and you don't feel as good as you either could or should, then you might need to change to something stronger.
You obviously had problems with the evorel conti/sequi so have you thought about going for something with more inbuilt flexibility like Oestrogel and Utrogestan? The beauty of the oestrogen gel is you can very quickly and easily adjust the dose to suit your needs and I have found it to be the best form of oestrogen I have used by a very long way. The Utrogestan (micronised and NOT synthetic progesterone) can be used vaginally too which means fewer side effects and if necessary, you can get away with using a bit less because it is localised and hits the spot as opposed to getting lost in your digestive system.
It might be an option worth looking at.
Thanks, will give this some thought. The patches were OK except for the hair loss. Can i get utrogestan and oestrogen prescribed easily? I really do like the idea of more localised and faster adjustment particularly as my body normally responds quite quickly. I can feel the progesterone from the femoston already I think as feel a bit dopey and slept a fair bit last night. My breasts are pretty sore but different from the oestrogen sore, though that's a symptom I can handle ok.
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Peacegirl, yes, I believe you can get Oestrogel/Utrogestan easily on the NHS but if I were you, I would tell them that this is what you want and don't give them a choice!
The great thing about this regime is the flexibility of both products which, in my opinion, is the key to success.
This is Professor John Studd's preferred regime so it might be worth having a look at his website. He prescribes 7 days of 100mg Utrogestan each month which a lot less than the NHS recommend but this dose is bearable for most women and has fewer side effects when used vaginally. He doesn't make it a condition of using this regime but it is worth having a scan from time to time to make sure everything is OK and you are getting proper clearance/thinning.
Definitely worth a go!
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Hi
just bare in mind the following:
1 mg estradiol & 5mg dydrogesterone daily
Yes thats a low dose - but so is the 5mg of prog in real terms.
For those who used to be prescribed dydrogesterone as a separate tablet - it used to come in 10mg tablets.
So if your finding 1 in 24hrs is not enough - then trying two in 24hrs (giving you a medium dose) might help show if thats the way to go.
Unfortunately dydrogesterone is only available in the UK as part of the Femoston products.
The 10mg option was discontinued a few years ago.
This was only for commercial reasons (ie no doctors were prescribing here) unlike other countries where its still available.
Its up to you if you want to try this or goto a medium strength HRT like Elleste Conti (2mg estrogen instead of 1mg in the femoston).
Hope that helps you see what works.
:-* :-*
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Hi peacegirl
That is not a lot of progesterone in Femoston 1/5! You cannot compare the amount of oestrogen to progesterone by looking at the doses because they are metabolised differently and work in different ways. if you were taking oral oestrogen at the same dose and micronised progesterone (Utrogestan) you would be taking 1 mg of oestrogen and 100 mg progesterone daily for the same purpose!!!!! The reason the progestogen dose in Femoston is so low is because it is dydrogesterone and more stable than progesterone itself so can be taken in tiny doses by comparison. You need to take even less of the other synthetics.
I am puzzled though as to why you are on a continuous combined HRT when you were on a cyclical one. Have I missed somewhere that you are post-menopausal and your age? It would be far better to be on a cyclical one to give a withdrawal bleed and then you wouldn't have to take continuous progestogen and maybe would feel less dopey? However for many women the initial side effects like you are experiencing tend to settle with time ( but for others they continue hence the advice to go on a cyclical HRT). That particular HRT type - Femoston - seems to be the best tolerated of all the tablet HRT types. The cyclical one ( Femoston sequi) comes as a 2 mg tablet as well so available in higher doses.
If you do decide to go down the oestrogel/utrogestan route - you do not need to seek the expensive services of a private gynae - Prof Studd does not have a monopoly on this treatment - these are simply products that are available on NHS so you should be able to get them from your own doc if you do your homework first and go to a GP in your practice whom you know is understanding about menopause and sympathetic towards prescribing HRT. All the product are listed under treatments/HRT preparations ( top tabs light green banner).
Hope this helps :)
Hurdity x
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Doses of progestins are very individualised. I use provera and there are no clear cut guidelines on what amount you should use. It varies from 5mg to 10mg if on a cycle.
When I first started using it my doctor prescribed 5mg for about 12 days and that worked fine, but then I started scaring myself by reading things about it being 10mg, so I asked both my doctor and pharmacist and both said it was variable and basically "if it ain't broke don't fix it".
My doctor also said if I wanted to try it continuously I could see how well 2.5mg worked, but I haven't done that experiment yet.
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Hi peacegirl
That is not a lot of progesterone in Femoston 1/5! You cannot compare the amount of oestrogen to progesterone by looking at the doses because they are metabolised differently and work in different ways. if you were taking oral oestrogen at the same dose and micronised progesterone (Utrogestan) you would be taking 1 mg of oestrogen and 100 mg progesterone daily for the same purpose!!!!! The reason the progestogen dose in Femoston is so low is because it is dydrogesterone and more stable than progesterone itself so can be taken in tiny doses by comparison. You need to take even less of the other synthetics.
I am puzzled though as to why you are on a continuous combined HRT when you were on a cyclical one. Have I missed somewhere that you are post-menopausal and your age? It would be far better to be on a cyclical one to give a withdrawal bleed and then you wouldn't have to take continuous progestogen and maybe would feel less dopey? However for many women the initial side effects like you are experiencing tend to settle with time ( but for others they continue hence the advice to go on a cyclical HRT). That particular HRT type - Femoston - seems to be the best tolerated of all the tablet HRT types. The cyclical one ( Femoston sequi) comes as a 2 mg tablet as well so available in higher doses.
If you do decide to go down the oestrogel/utrogestan route - you do not need to seek the expensive services of a private gynae - Prof Studd does not have a monopoly on this treatment - these are simply products that are available on NHS so you should be able to get them from your own doc if you do your homework first and go to a GP in your practice whom you know is understanding about menopause and sympathetic towards prescribing HRT. All the product are listed under treatments/HRT preparations ( top tabs light green banner).
Hope this helps :)
Hurdity x
Hi, thanks for the info, l'm realising that the doses can't be taken at face value. Believe it or not, I google my hrt every time but find the dosing very confusing. I'm also confused as to why I'm on a continuous combined femoston, but this was prescribed in my absence when what was originally prescribed (by a grumpy locum who had to ask my own GP what to prescribe and then couldn't explain it to me) wasn't available at the chemist. I did question this by phone and the gp said it can also be given to women over 50. I will discuss this and a zillion other things at the clinic! Is it better to go the cyclical route then? I'm not sure if I'm post-meno or not tbh and I haven't been on the ball the past few weeks. Having now had a bit of sleep and feeling less awful, I'm coming to and trying to learn a bit more. Tbh I've learned more on here the past few days than in the last year! Thanks again.
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Doses of progestins are very individualised. I use provera and there are no clear cut guidelines on what amount you should use. It varies from 5mg to 10mg if on a cycle.
When I first started using it my doctor prescribed 5mg for about 12 days and that worked fine, but then I started scaring myself by reading things about it being 10mg, so I asked both my doctor and pharmacist and both said it was variable and basically "if it ain't broke don't fix it".
My doctor also said if I wanted to try it continuously I could see how well 2.5mg worked, but I haven't done that experiment yet.
That's really useful info Dana, thanks for taking the time to post!