Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Annie0710 on August 31, 2018, 12:36:27 PM
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I think this lovely Specialist covers lots on menopause x
https://youtu.be/JMF4EwODch8
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She does indeed, Annie! Thank you for posting.
The only issue I have is that on her website, she states that when a woman stops HRT and if her menopause is 'over', then any withdrawal symptoms should only last a 'couple of weeks at the very most' (!) https://menopausedoctor.co.uk/what-is-the-menopause/myths-about-hrt/
I'm pretty sure from the many experiences I've read from women and the fact that HRT takes up to 3 months to work, that it would be rather longer than that for things to settle once stopping. I've only ever heard this as being her opinion - most authorities say that staying off for 3 to 6 months to see if symptoms settle is the norm. Surely it takes a while longer for the estrogen receptors to downregulate than a couple of weeks?
Does she know something that other specialists don't? It would be extremely interesting and helpful to know! xxxx
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Ive no idea Tempest, I once forgot my elleste solo tablets whilst going on holiday and that's been the biggest break I've ever had, 11 long days hrt-free and I didn't notice an iota of a difference BUT saying that, apart from testosterone (which took a couple of weeks for the energy to kick in) I've always felt the benefits of oestrogen replacement within a few days x
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I remember you saying, Annie! :)
I therefore wonder if in fact most changes can be felt after a few days and that waiting (as many women are asked to do) for up to 3 months for things to 'settle' whilst coming on or off HRT is in fact a bit cruel if a woman is clearly struggling. Many GP's insist on this as it's more or less the accepted 'guidelines' and so many women here struggle on for months after being made to wait. It all adds to the stress! :'( xxxx
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Hello ladies.
I haven't had time to listen to the interview but I'm reminded of a male GP who confidently told me that the menopause is all over after three years! I understand that several cycles need to be completed when beginning any HRT so surely the same must apply in the reverse?
Perhaps now that Louise Newson is running her own menopause clinic she can start collecting some research data which hopefully will take the guesswork out of this whole business in the future.
Tempest - I would be interested to know more about the workings of oestrogen receptors, for example do they remain on the cells and become dormant with declining oestrogen or do they stay active until that cell dies and is replaced by another cell minus a receptor? . They say every cell in our body is replaced over seven years so could this be why the transition can take so long? Puberty takes five years apparently and perhaps that is for similar reasons? I think I read a comment of yours stating that menopause is akin to oestrogen withdrawal and when my innards are quivering for no obvious reason, a chemical withdrawal is what it feels like lol. Incidentally I heard an endocrinologist say that puberty for boys feels like testosterone poisoning and that explains their behavior until things settle down!
Take care ladies.
K.
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Thanks for posting this link Annie. It makes very interesting listening and it has actually made me feel more positive about what I'm going through. I just wish she was my GP !
Rosie x
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I've just seen your post Tempest and I totally agree with what you say. I was taking Prempak for years and whenever I took a break I would notice the difference within 3 or 4 days and again, when I started taking it again I would start to feel better within a couple of days. I'm quite lucky that my GP only expects me to give it 1 to 2 months but even that length of time can seem like an eternity when I'm feeling rubbish.
Rosie x
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Kathleen, I get that blessed quivering too! It is so, so unnerving! You raise some good questions and points here - I will try my hardest to fish out any research I can on the receptor/cell question! ;)
It most certainly is withdrawal - and although I probably didn't frame it well in my previous thread, I was trying to illustrate the point that estrogen withdrawal shares so many characteristics of withdrawal from any substance on which the human body becomes chronically dependant.
I'm going to use - just for example - opiate dependency. Withdrawal includes sweating, nausea, shakes, restless legs, disturbed sleep, emotional instability, anxiety - these are acute withdrawal symptoms. And then symptoms progress into something called Post Acute Withdrawal Syndrome, which is what I also believe happens when periods stop and women are still symptomatic in post menopause. I also believe the faster and steeper (or more erratic) the withdrawal, the more severe the symptoms - just as in a 'cold turkey' withdrawal (for surgical meno) or in peri, like an 'addict' constantly abstaining and relapsing from any other substance.
The receptors then have to down regulate, and this is not a linear process. The receptors are active but not 'occupied', and this is what causes drug cravings or in our case, the horrible symptoms we still get post menopause.
I'm still not sure I've explained what im getting at too well - but hopefully you get the gist!
I've heard the theory that boys become 'drunk on testosterone' at puberty before - it certainly explains a lot! Puberty for me was pretty horrid as well - so I'm pretty sure that's why I'm hating this whole experience too! :o xxxx
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Hello ladies,
This is a very good article on the subject. Don't be put off by the techy speech at the very beginning, just go on reading and it will make sense 😁
http://jci.me/27987-pdf (http://jci.me/27987-pdf)
I'll post some more later on today 💕
Conolly X
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Brilliant, Conolly - thank you! This just goes to prove that this is a very complex issue indeed - and that there is a 'critical window' for HRT too.
I think this is why we need dedicated menopause clinics - especially for helping women who have early risk reducing surgery for BRCA mutation, surgical menopause for any reason prior to age of natural menopause and POF.
This is much too big of a responsibility to place in the hands of GP's! xxxx
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This one's a recent review on androgens in postmenopause
https://www.sciencedirect.com/science/article/pii/S2050052118300465#bib115 (https://www.sciencedirect.com/science/article/pii/S2050052118300465#bib115)
Conolly X
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Whenever I read on the forum that it's recommended for a woman to wait 3 months for hrt to settle my heart bleeds for them. 24/7 for 12 weeks is hell when you're feeling total crap. Personally I'd not be wait that long apart from testosterone x
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Hello Annie,
That's exactly what has happened to me, 3 months in hell and I just collapsed and ditched the patches and the Utrogestan capsules, but not the testosterone sachets... I wonder why! ::)
Conolly X
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Hello again ladies.
Tempest - Yep the quivering is so unsettling, it certainly contributes to my anxiety and I always feel so much better and calmer when it stops. I read a report on alcohol withdrawal and the sensations described are very similar to our experiences.
Conolly - excellent finds, thank you.. Obviously the development of targeted HRT is what's required for symptom relief and it seems Tamoxifen has some of these qualities. Ideally we would have oestrogen delivered to the brain, heart and joints etc but avoid the breasts and uterus. Such treatment would alleviate so much misery and reduce incidence of disease.
Take care ladies.
.
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Thanks for sharing Annie! 💐
I find Dr. Louise Newson so sympathetic and kind! She makes me feel more secure about taking hrt!
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I was off of HRT in the 2000's because of the research results they came out with that had everyone scared. I was off of HRT for 3 years and it was the most horrid 3 years of my life. The doctor said at the time that the symptoms should disappear in a year ;D. I went back on HRT after the 3 years as I felt my menopause symptoms were getting worse and not better.
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Great article Annie, thanks for sharing. I really like Dr Louise Newson, would love to go see her, wonder how much it would be. Also, I don't agree with trying a regime for 3 months if it isn't working either. In fact when I've switched hrt's and it hasn't worked I've been physically unable to do so, and I always feel sorry for the women who are advised this x
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Definitely, I've tried a few different ones and I know within a week of it's going to help or not, apart from testosterone as I know that takes more time
X
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Annie!!! Guess what? Just discovered there is a private menopause clinic in Newmarket! Dr. Hannah Short is lovely - take a look!!
https://www.drhannahshort.co.uk/about
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Great article Annie, thanks for sharing. I really like Dr Louise Newson, would love to go see her, wonder how much it would be. Also, I don't agree with trying a regime for 3 months if it isn't working either. In fact when I've switched hrt's and it hasn't worked I've been physically unable to do so, and I always feel sorry for the women who are advised this x
But it does take time. I don't think you should stick with it if it's making you feel absolutely crazy. But you should stick with the ones that make you just feel a bit miserable and uncomfortable because it takes 12 weeks for physiologic changes to have an effect. Perhaps I'm more patient because I am also hypothyroid and still titrating dose for that. With hypothyroidism you change dose and have to wait 6 - 8 weeks before you can test again. During that time almost everyone will feel worse for a period of time. But your body catches on and makes adjustments and things settle just in time to repeat the dratted process.
I had a Mirena for peri symptoms. I felt miserable, bloated, tired and disinterested in life and at my 3 month check up I said it wasn't working for me and I should probably have it removed. The doctor talked me into giving it longer. She said it can take up to 6 months to settle. I never went back because long before 6 months I was fine and never gave it another thought until it was time to have it removed as it had expired. I wish I'd had another put straight in, would have made all this easier.
I'm not feeling a bit out of sorts and miserable with Utrogestan at the 6 week mark, but I'm not giving in. 3 months and I'll have a blood test to see what's happening to my levels and take it from there. People might miss good fits of HRT by giving up too soon because of side effects. Forget the "couple of weeks" mantra the doctors give us. I don't think they ever mean that. But if they said it might be 6 months before you feel well none of us would go for it.
Again, I don't mean stick with it if you feel absolutely awful or crazy or anything like that.
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I do understand what you're saying and personally, I think that different meds do require a settling-in period. ADs for example take time, as does testosterone and by the sounds of it, progesterone and thyroid meds. I just feel for me whenever I have tried oestrogen, the effects (good or bad) are felt within days and I couldn't ever contemplate waiting 12 weeks on one that made me feel worse. I don't need progesterone, thyroid meds and haven't taken ADs for depression so can't mskr any comment on that. But I do take amitriptyline at 10mg for my nerve pain in my back and that worked within the first week
I'm not saying I'm right of course with oestrogen, I'm just saying my heart goes out to the poor women sticking with it for 3 months and not gaining any benefits because they've been told to do so x
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Annie!!! Guess what? Just discovered there is a private menopause clinic in Newmarket! Dr. Hannah Short is lovely - take a look!!
https://www.drhannahshort.co.uk/about
That's really interesting Tempest, thank you !
I have to make a gp appt for asthma review so will take that opportunity to properly go through my gynaes request of putting me back fully on what I'm on/been on. Failing that I have no choice but to go private but can't afford it right now xx
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I like what I have read about Dr Newson, she is a credit to her profession. No wonder it's so difficult to get an appointment with her.
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As I am new to this forum (but not to menopause :P) it is so sad to read what people have to go through. I thought my struggle for the last 20 years was hard but in reading this forum I feel so sorry for all these women who struggle everyday. Daisydot I hope things will settle for you and you will get relief eventually.
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Is she not a colleague of dr Newson tempest I'm sure I've come across her before.😘
I've read all her web site and there is no mention of anyone of that name. She was a GP until very recently, like early summer, with a menopause clinic in Solihull, at the hospital there. I think that is ongoing. Now she's opening a new clinic for women's health (private) in Stratford upon Avon and she has a couple of other doctors joining her there, both women. No mention again of that name.
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I have been off tibolone for nearly a month now after a biopsy and waiting for results. I am 60 and was on it for 18 months. Now I am having bad hot flushes and don't feel good. Don't know what the future holds regarding HRT but I don't like feeling like this.