Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: KayemBee on October 27, 2019, 06:43:41 PM
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Could anyone offer any advice on whether HRT is recommended, particularly for someone who is not suffering from any symptoms of Meno (a few warm episodes now and again) Peri-menopause/Menopause exacerbated my ADHD of which I didn't even know I had until mother nature turned the dial up, so Meno symptoms such as brain fog, anxiety, insomnia, mood swings, concentration issues and bouts of depression have always been part of my life that I am used to the issues they bring. Also, taking HRT can minimise the effectiveness of ADHD medication and as I am struggling with my ADHD and not Meno symptoms, I would prefer to take ADHD medication but am concerned about health issues in the future if I don't take HRT. I am 45 and my last period was 18 months ago. As a binge eater I'm overweight by 4 stone although constantly active and I'm vegetarian (12 years)Don't smoke, don't drink. There is no family history of breast cancer or heart disease. Bit confused, can anyone help please! Thank you!
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Maybe decide how bad the warm episodes are? Do they keep you awake, are you embarrassed if it happens in public ........
Browse round. Make notes. In case symptoms become bothersome. Do read the threads on vaginal atrophy as this can be eased with appropriate HRT which is delivered differently to patches/pills for other symptoms.
If you are OK then don't worry. Although HRT can guard against heart and bone problems, other ways can help too. Brisk regular walking for bone health, a good over-all diet and keeping hydrated is important. I don't take HRT other than 'ovestin' for vaginal atrophy and am fine. Bone scan 3 years ago showed nowt untoward. I have any health investigations that the NHS offers: i.e. poo samples, blood pressure checks .......
I don't binge eat but do have fads ::) - I will enjoy for example cheese for weeks then go off it >:( ::). Weight can be lost gradually by upping exercise and cutting portions. Maybe go to your Practice Nurse for a well-woman check?
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From what I've read about ADHD in adults it is the reduction in oestrogen which causes symptoms to increase. Often the ADHD medication dose is raised to combat the increase but nothing is done about the low oestrogen levels so problems continue. Advice seems to be to begin HRT. Also at your age HRT will help protect your heart and bones as you are merely replacing the oestrogen which should have been made naturally by your body at least until the age of 51/52 which is considered the typical age of menopause. Obviously you have researched this much more than me but it sounds as if HRT will help not hinder and can be taken in tandem with ADHD medication?
Taz x
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Maybe decide how bad the warm episodes are? Do they keep you awake, are you embarrassed if it happens in public ........
Browse round. Make notes. In case symptoms become bothersome. Do read the threads on vaginal atrophy as this can be eased with appropriate HRT which is delivered differently to patches/pills for other symptoms.
If you are OK then don't worry. Although HRT can guard against heart and bone problems, other ways can help too. Brisk regular walking for bone health, a good over-all diet and keeping hydrated is important. I don't take HRT other than 'ovestin' for vaginal atrophy and am fine. Bone scan 3 years ago showed nowt untoward. I have any health investigations that the NHS offers: i.e. poo samples, blood pressure checks .......
I don't binge eat but do have fads ::) - I will enjoy for example cheese for weeks then go off it >:( ::). Weight can be lost gradually by upping exercise and cutting portions. Maybe go to your Practice Nurse for a well-woman check?
Thanks CLKD, I have found that I get warm spells in summer and the shivers in winter, in between those times I haven't had any problems. I've always had problems getting to sleep at night and it is in the winter when I get the shivers in bed, the warm spells aren't too much of a problem as I work from home and have a little USB fan to cool my face when they appear. I forgot to mention that I also have Tinnitus, I did go to the doctors but they don't seem to connect it to the Menopause - it's always there and has been for a year so now I've adapted to the noise. No problems with vaginal atrophy or any dryness yet.
Over my life I have avoided taking tablets and the Menopause is no exception, my partners Mum said she never took anything and said "Women managed before HRT was invented" made me think, and I am a big worrier about the dangers of taking it. There was a recent story that was on the main news saying HRT carries higher risks of breast cancer than previously thought, but then next year another study could come out saying actually it lowers the risk.
Thank you so much for your advice, it is good to know I can come here and get help and advice instead of trying to learn it all myself and constantly worry about making the wrong decisions.
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From what I've read about ADHD in adults it is the reduction in oestrogen which causes symptoms to increase. Often the ADHD medication dose is raised to combat the increase but nothing is done about the low oestrogen levels so problems continue. Advice seems to be to begin HRT. Also at your age HRT will help protect your heart and bones as you are merely replacing the oestrogen which should have been made naturally by your body at least until the age of 51/52 which is considered the typical age of menopause. Obviously you have researched this much more than me but it sounds as if HRT will help not hinder and can be taken in tandem with ADHD medication?
Taz x
Hi Taz,
Thanks for your information regarding low Oestrogen exacerbating ADHD conditions, I didn't know that and you mentioned that I probably know more than you having researched but the truth is I had only read a couple of articles that HRT can minimise the effectiveness of ADHD medications, I hadn't had it confirmed by an expert or really looked into it too much so your advice is very helpful! It is something that I will discuss at the doctors when I have weighed up my options and made my mind up whether to go on HRT. The nurse had suggested I have patches as I don't like taking tablets and it might be easier to control the dose by the patch size, so I'll see. Thank you for your reply too, Karen x
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The risks of hrt differ by type, trans dermal is safer than oral. There's a thread on it, I can't recall the facts but the risk is much less than smoking, drinking or being overweight. You say menopause is natural - so is child birth without pain killers, osteoporosis, untreated cancer etc, it doesn't mean you want it. My mum was bedridden for 2 years from a botched op for repeated cystitis which was almost certainly VA. Medical intervention moves on and hopefully improves our lives. Quality of life is important.
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Hi Kayembee,
Its nice to meet another neurodivergent person on here! I'm Autistic so can speak to my experience of having a differently wired brain and the menopause.
Like you I didn't have a solid notion that i was Autistic until my Perimeno was well advanced and my Oestrogen levels were on the floor! It definitely made me display more clear signs of my autism & I'm considerably more prone to meltdowns, complete with yelling, throwing things, sobbing etc. It also made my concurrent Depression & anxiety considerably worse as well as land me with a new dx of OCD (intrusive thoughts). Not nice to say the least!
The HRT has most definitely helped me. I'll have a meltdown maybe twice a month instead of daily! Like you I'm overweight so after I'd humoured the GP and trialed entry level dose tablets (which helped a bit), I sought out a local meno specialist and had her switch me to the gel. It comes with considerably less risk than oral route HRT & I don't metabolise it so quick so it works well for me.
It hasn't affected my psych med doses though as I'm not ADHD I can't speak to its effects on Adderall or Vyvanse etc. It might be a good idea to google for interactions (Rx list is a good site, though it full of medical language that can be a touch intimidating!).
PP x
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The risks of hrt differ by type, trans dermal is safer than oral. There's a thread on it, I can't recall the facts but the risk is much less than smoking, drinking or being overweight. You say menopause is natural - so is child birth without pain killers, osteoporosis, untreated cancer etc, it doesn't mean you want it. My mum was bedridden for 2 years from a botched op for repeated cystitis which was almost certainly VA. Medical intervention moves on and hopefully improves our lives. Quality of life is important.
Hi Sheila,
Thanks for your reply and so sorry to hear how much your Mum suffered with VA. I am fully with you on the quality of life being important and thank you too for sharing the info on the trans dermal HRT being safer than oral, I am definitely going to look into it and then make an appointment with the nurse next week! :)
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Hi Kayembee,
Its nice to meet another neurodivergent person on here! I'm Autistic so can speak to my experience of having a differently wired brain and the menopause.
Like you I didn't have a solid notion that i was Autistic until my Perimeno was well advanced and my Oestrogen levels were on the floor! It definitely made me display more clear signs of my autism & I'm considerably more prone to meltdowns, complete with yelling, throwing things, sobbing etc. It also made my concurrent Depression & anxiety considerably worse as well as land me with a new dx of OCD (intrusive thoughts). Not nice to say the least!
The HRT has most definitely helped me. I'll have a meltdown maybe twice a month instead of daily! Like you I'm overweight so after I'd humoured the GP and trialed entry level dose tablets (which helped a bit), I sought out a local meno specialist and had her switch me to the gel. It comes with considerably less risk than oral route HRT & I don't metabolise it so quick so it works well for me.
It hasn't affected my psych med doses though as I'm not ADHD I can't speak to its effects on Adderall or Vyvanse etc. It might be a good idea to google for interactions (Rx list is a good site, though it full of medical language that can be a touch intimidating!).
PP x
Hey PP, thanks for your help and reply and hello to a fellow ND!
I haven't heard of the gel before, the nurse at our doctors suggested I go on patches which can be sized to ensure I get the right dose. I can't tell you how much I want my severe symptoms of ADHD to calm down, I'm not even able to work properly and I work for myself as my attention span is non existent and I cannot stay in my seat for more than a few minutes (I should use this to shift some weight!) Sounds like you have finally found a good balance with both medication and HRT, just hope I can too but it will take some time to get there. Thank you so much for replying, it's really good to know there are so many women on here that can give great advice from experience and I don't feel so alone x
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Kayembee,
Patches can work and you're more than entitled to give them a trail (though be aware there are serious supply issues with several brands at the moment- Femseven and Evorel are a horror to get hold of!) If you search on here for 'HRT supply issues' you should find links to the British Menopause Societies latest updates on UK stock.
A lot of us are on the Gel as it's considered the 'Gold standard' by the menopause specialists, but it doesn't mean you have to try it or that its right for you! I use it as I now have 3 skin conditions that mean its very likely that I'd have a bad reaction to the glue.
For a lot of us who have neurodivergences or mental health problems this can take on a seriously nasty edge or become more problematic. For me I've lived with GAD my entire life but low oestrogen anxiety is a new level of hell. Its totally endogenous and for a lot of us all the meds and CBT in the world doesn't do much!
They'll start you off on a low dose anyway and you'll try it for 3 months. For me 2 months was enough to know that HRT was the solution and that the low dose was nowhere near enough! I'm a mid to late stage peri with reactive depression/anxiety so the standard strategy for people like me is high doses of oestrogen and as much stability of levels as possible! And for me its working; slowly, but its working!
Anyway, Have a look round here, there's lots of good advice to be found, even if its a new symptom that appears and freaks you out! chances are very high someones had it on here!
take care, PP. ;)
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Hi PP,
Apologies for late reply!
Thank you for your advice and the heads up on the supply issues for the patches, I will double check on the BMS site before I go in case the nurse recommends a patch that I may struggle to get hold of. I will also ask about the gel as well and see what she suggests.
Your comment about the skin reactions to the glue on the patches raised my interest as I can suffer from allergies and dermatitis with a tendency to allergic reactions to certain things (I always got itchy, red rashes beneath plastic watches that I wore as a child) so thank you for alerting me to that, I will be cautious and also mention this to the nurse.
I'll come back to this thread in a few weeks with an update which may help others too
Thank you so much for your help and take care too x