Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: matildamouse on January 18, 2017, 02:32:51 PM
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:-\ I am 53 and 2 years post menopausal. My regime is Estradot 50mcg patch, vagifem twice a week, prometrium vaginally alternate days and testosterone which I still need to start sometime. Recent scan showed multiple fibroids and a 3mm endometrium. My main reasons for commencing HRT were non-stop hot flushes, night sweats, palpitations and poor sleep. As of current, I still get breakthrough flushes when having a hot drink or feeling very stressed but it is a HUGE improvement overall to my flushes and bnightsweats. Still have palpitations at night every now and then. I can cope with these residual symptoms but my question is :
Ladies on HRT...are you totally symptom free of your main menopausal symptoms or do also still have residual symptoms and sort of just getting on with it?? Saw my GP today and she recommends I should increase my estrogen to 62.5 and then 75mcg and see how I feel. She is very pro-HRT and specialises in women's health and is of opinion Estradot 50mcg at 53 years of age is still low etc. She mentioned she has one patient who is on 200mcg for the last 6 years as " that is what her body needs and she feels good on". My GP herself is on 75mcg at 63 years of age. She is very pro HRT (though careful regards risks) and specialises in woman's health.
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I was totally symptom free until around 18 months ago when I started transdermals. I'm 54 and prob 3 years post meno. I now have palps, terrible joint pain (closed small beauty business as I couldn't manage with joint pain), exhausted, night sweats and 3/4 nights of waking at 2/3am per week, ultra low mood and no happiness in anything, foggy thinking and lack of concentration, avoiding social events. The only thing that seems to be mostly sorted is daytime sweats although I do get some breakthrough with hot drinks etc. I currently have a mirena and think that's exacerbating some of the symptoms. Pretty much half the person I was 18 months ago.
Mx
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Hi Stellajane - whilst I'm very aware that one can't turn the clock back, and nor would I want to, I'm also aware that I've felt better than this previously and having to nap in the afternoon is not conducive to a full life at 54! 18 months ago I was running 3 times a week and attending spinning classes, I can barely manage 2 dog walks now. Whilst typing this I've started flushing after a cup of tea. Not really ideal if you're on a high level of E.
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Hi again, Murph!
So are you saying that you felt BETTER before you started transdermals - were you HRT free before this, or using a different method? Because curiously - I was BETTER on nothing at all despite having ovaries removed and having no HRT for a year afterwards, than I have been using patches or gels and my symptoms have been EXACTLY as you describe. Hence why I'm now trialling Tibolone (nervously, I might add - but I'm on day 5 just now).
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Hi Tempest - yes, from what I can remember I had better symptom control on tabs but prob also had more of my own hormones so hard to draw a true comparison. Oestrogel worked really well for about 6 months and then got less and less effective. I think we've discussed this before and I know you have issues with levels and absorbtion. I've tried almost every transdermal that's suitable for me and get some relief from some but the symptoms eventually come creeping back. I also feel a 'hit' of E a few hours after application and can then feel it wearing off so it's obviously an absorption/circulation issue. I'm almost obsessive in application methods/sites. I think my current mirena is knocking out benefits of E and adding side effects if it's own as I'm at an all time low. Waiting for GP to contact me re. removal this week as she wouldn't remove it yesterday as I hadn't seen her previously to discuss a post mirena plan.
Mx
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:-\ I am 53 and 2 years post menopausal. My regime is Estradot 50mcg patch, vagifem twice a week, prometrium vaginally alternate days and testosterone which I still need to start sometime. Recent scan showed multiple fibroids and a 3mm endometrium. My main reasons for commencing HRT were non-stop hot flushes, night sweats, palpitations and poor sleep. As of current, I still get breakthrough flushes when having a hot drink or feeling very stressed but it is a HUGE improvement overall to my flushes and bnightsweats. Still have palpitations at night every now and then. I can cope with these residual symptoms but my question is :
Ladies on HRT...are you totally symptom free of your main menopausal symptoms or do also still have residual symptoms and sort of just getting on with it?? Saw my GP today and she recommends I should increase my estrogen to 62.5 and then 75mcg and see how I feel. She is very pro-HRT and specialises in women's health and is of opinion Estradot 50mcg at 53 years of age is still low etc. She mentioned she has one patient who is on 200mcg for the last 6 years as " that is what her body needs and she feels good on". My GP herself is on 75mcg at 63 years of age. She is very pro HRT (though careful regards risks) and specialises in woman's health.
Hi matildamouse - yes totally symptom free ever since starting HRT - 50 mcg Estradot patch (after breif dalliance with Evorel sequi for 3 months) from just 54 ( when I was in later peri-menopause). No flushes, no sweats. They have only returned if I have stopped HRT (briefly for 3 months at 58), and later that year when I was on 25 mcg for a few months, and then in 2013 when I was 60 and redcued to 37.5 for a few months, otherwise hunky dory :). The fall in oestrogen two years following menopause ( which must have happened sometime after age 55.5) did not exacerbate my symptoms as it does with some women. No residual symptoms.. Recently I increased to 62.5 mcg ( by patch snipping) not because of any symptoms, but to increase my levels slightly as I take Testosterone and was worried about androgen dominance. My GP didn't think this would make much difference
Maybe the alternate day progesterone is preventing your experiencing the beneficial effects of oestrogen to their full extent and you would benefit from being on a cycle. I can't see at your age that there would be any reason not to increase if your symptoms are not completely controlled - but I agree with Stellajane you might find the progesterone insufficient - so another reason to revert to a cycle.
Hurdity x
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Hello ladies :)
I am totally symptom free when my dose is balanced- hooray!
But I do have weeks where I've got to tweak the dose depending on the symptoms that crop up, either going to low or high, so it's not easy.
It really is a juggling act ::)
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Nope, it stopped the hot flushes and urge to keep peeing all the time, but apart from that I don't think it's had an impact on my low mood/anxiety etc and they were my main concerns. I could have put up with the sweats and palpitations but this dreadful doom and gloom feeling every day is soul destroying.
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Exactly, Murph! I used to get the 'hit' too and then a pretty rapid draining down. Dose never lasted 24 hours, and split doses caused too many peaks and troughs - it was literally a rollercoaster and I would love to know exactly WHY this happens with some of us (definitely circulation issue - but why it varies from individual to individual, who knows)? I'm not getting this so far on the Tibolone, and didn't get it on the very small dose of Premarin I trialled (had to stop the Premarin due to extreme dizziness).
Hope your GP manages to sort out a good plan for you following your Mirena removal - do keep us posted, won't you? xxxx
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Thank you Tempest. The highs and lows are the same with me. I may consider Tibolone so I'm watching you and your friends progress with interest. You keep posting too!
Thanks again.
Mx
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I'm 57 and have been post meno for probably about 4-5 years. I use estradot 50 and I'm symptom free. I use provera for 12 days every 2 months and I might have a few nights of sleep problems then but that's about all.
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I'm on birth control pill, back to back for 3 months and then a 4 day break. I'm not totally symptom free on the pill, but 100 x better than I am without it...if I ever doubt that, I just have to wait for my break to remember how horrible I feel not taking anything! On my break atm, and having almost continuous hot flushes and feel as if I've aged 50 years (which would make me 91!). Aching, tearful, exhausted but can't sleep. Or else sleep non-stop but still feel exhausted when I wake up. Oh, and needing the bathroom all the time. Starting the pills again tonight and CAN'T WAIT!!!!!
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Dorothy - you don't need to take any breaks on the pill, particularly when they allow your cycle to come back to bother you so much, plus you will now need another week or so to build the pill back up again to control your cycle.
There is no health reason to take any breaks (even though some websites suggest it) as the progesterone is high enough to keep the lining from building up, which means much less to shed when you do stop. I was on it for over 6 months without a break and had a tiny withdrawal bleed when stopped.
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Thank you all for your responses. What a roller-coaster ride for many women! Hope you all get sorted in the end...Please keep us updated with all of you regards your progress.
Yes Stellajane and Hurdity, I might need to up the alternate days of progesterone to daily or go on a cycle. Will first do the daily as I have been without a period for so long and would like to be able to maintain the status quo ;) I still need to add the testosterone as well...will do when at the higher dose of estrogen. I am reluctant with the testosterone as I had crazy facial hair growth on Livial which was the reason I had to cease taking it. Can testosterone be the missing link in my case to feel fully balanced...? My GP says my testosterone levels are very low and testosterone is very crucial in protecting against dementia besides assisting with energy levels and libido. She says in her case it was like "the lights went on in my brain again"...
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I think for many women testosterone is the missing link but unfortunately its role is not properly recognised and treated by the medical profession. We urgently need studies, trials, preparations, doses for women - and long term too. It seems we are just left to get on with it...the NICE Guidelines were a step in the right direction (re testosterone) but it's role was only seen as important in relation to libido and not all the fatigue and muscle aches that women suffer at this stage too.
Hurdity x
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Excellent point thanks Hurdity!
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Excellent point thanks Hurdity!
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Dorothy - you don't need to take any breaks on the pill, particularly when they allow your cycle to come back to bother you so much, plus you will now need another week or so to build the pill back up again to control your cycle.
There is no health reason to take any breaks (even though some websites suggest it) as the progesterone is high enough to keep the lining from building up, which means much less to shed when you do stop. I was on it for over 6 months without a break and had a tiny withdrawal bleed when stopped.
My previous GP prescribed it on that basis - they did keep a very close eye on when I came in for a repeat prescription to make sure I was taking the breaks. My new GP (I have moved) says that I shouldn't be running packs together at all, so my chances of getting her to agree to me taking it continuously isn't great! (The new one is one of those 'you can't have menopausal symptoms in your 40s' types >:( )
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Gosh that is really old advice as it's well documented now that pill breaks aren't necessary and I've had several doctors (whilst I was on the pill) ordering me not to take the breaks to keep symptoms at bay - especially as mine were severe (couldn't eat at all). About 10 years ago it was a different story but things have moved on and it is a shame GPs are not up to date with their medical knowledge - as mine are also ignorant in other areas!
You could of course just not tell them you have the breaks but I understand you feel more comfortable following their advice.
Not sure if this is common but once I'd taken the pill for 6 months I started to feel different. I stopped it and I've never returned to those awful extreme symptoms and so I wonder if it interrupts our cycles enough to calm the surges? Just to give you some hope for the not too distant future!
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When so many GPs still refuse to believe women under 50 can be menopausal (lost track of the number of 'early' ladies on this forum who have mentioned this problem with their GP), it's not surprising the GPs are equally fuzzy about current HRT advice! Hopefully the next generation will see an improvement!
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Yes let's hope!
I think for women generally they should have more monitoring of their hormones throughout their menstruating years too - which might then allow a smoother menopause.
I've felt something was 'off' from my 20s and this very gradually got worse and worse until it exploded in my late 40s and I'm not even technically perimenopausal (as FSH levels are normal). I tried every supplement in existence, presuming it was some nutritional imbalance, always hoping I'd found 'the one' but to no avail. Then being aware of feeling normal every now and again inspired me to try to get that feeling back and try another. Didn't have a clue it was hormonal (apparently hormonal gastric migraines) and would have had a very different life if I'd known how to rebalance. Fortunately I'm still young'ish but you do think about all those wasted years!