Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: CrispyChick on December 16, 2020, 03:15:12 PM
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Hi
I have a lovely GP. I have had an NHS meno clinic phone appointment (it was an hour long, which was great).
All told me to try the pill... And keep trying them. I've practically tried them all. They all seemed to make me feel ill.
Next step was HRT. I only got to day 15 as the estradiol alone made me feel vile, like I was poisoned... Even half the dose.
So I'm wondering where next. I've just spotted there is a gynaecologist with specialism in meno and registered with BMS at our private hosp - or actually in the next health board across, perhaps my gp can refer to another health board??? Although Im desperate, so I'll pay!
But I'm wondering if this will help?! BMS only deal with standard HRT, if I cant take extra estrogen, maybe I'm more complex, or not at that stage. Age 44. Would I be better seeing someone who deals in bioidentical???
I feel like I am off balance rather than requiring strong regular dose estradiol and off the peg high dose prog. Does this make sense???
2 days off HRT and back to feeling yucky... But no longer poisoned!
Thanks all. X :)
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I’ve found The Menopause Consultancy very good. They’re based in Surrey I think but I’m not. I had a virtual consultancy in November. Might be worth a look at their website? They’re a women’s health clinic too.
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Thanks. I'm in scotland. I guess I'm wondering if BMS makes a difference, as my local NHS meno clinic is not listed.
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Oh sweetie, at this age your hormones are all over the place, the pill would be more effective but if you say you have tried them all maybe ask for implants? I believe this is offered on the NHS when all other options have failed? On the other hand, that may not be a good idea if they make you feel ill too! I don't think bioidenticals will make any difference, the gels and Utrogestan are bioidientical, the only difference is the available doses. If you think extra hormones are poisoning you, and that oestrogen is the culprit, you could try just progesterone and see how you feel? You could take it vaginally for 12 days and then decide if you take it on a sequential or continuous basis. Sorry if you have already tried that! :-*
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That’s interesting sage, this was suggested to me too. Does this work for anyone? I’m in a similar position Crispy Chick x
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I don't know anyone on this regimen, but someone has posted a link somewhere (sorry, can't find it now, but will keep looking) to a Canadian centre for women's health that advocates this regimen for women in perimenopause and they have published studies about it.
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Thanks ladies.
Oh. No I haven't tried progesterone only as when I did 2 days of it with the low dose estradiol I was away with the fairies. Lol.
Also I was on cerazette, prog only mini pill for years fine. I went back on it when all this started, but my mood was really off on it now...
I just feel so unbalanced. That's a very helpful comment about bioidentical Sage. Thank you. It puts it in perspective.
I guess I've always wondered whether I've got some sort of imbalance rather than meno... So perhaps I should pay to see the specialist as, although she specialises in meno, also period problems avd is a gyny.... I might be able to get nhs referral to her if I push.
My next treatment step will prob be contraceptive patch... But I'm scared 😬
Scampidoodle, what did your clinic suggest you should do???
:)
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The website is called Cemcor, I don't know if a link is allowed, just google it. :-*
Oh yes, there's the contraceptive patch! Is it norethisterone?
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CrispyChick, how did you take progesterone, oral or vaginal route?
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The clinic I went to diagnosed histamine intolerance so I’m being treated for that now as I had an unsuccessful attempt with oestrogel where, as you mentioned, I felt like I was being poisoned!
I think that’s stabilised now so I need to go back to them as I have issues from the day before my period starts to day 6ish (it used to be when oestrogen was high pre having the histamine sorted) the main symptom I have is a deep depression and anxiety before I feel very well again about day 8-10.
Weirdly I feel better when I have progesterone in the week and a half before my period so they did suggest I try utrogestan 100mg daily. But I haven’t done so yet. But after a horrific few days I need to try something. X
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Thank you Sage. I'll go and look at that.
I've only taken progesterone orally. It was in femoston 1/10 last week. Well, at half a tablet dose.
Prior to that I was on cerazette last year. Again oral.
I think I'll find it hard to get utrogestan on prescription to use alone. I've been promised I could have it for hrt... But it was a fight. They don't prescribe routinely in Scotland.
Contraceptive patch is not norethisterone, but I cant recall what it is... Yet a different one I think. I'm scared because I believe it is higher dose than pill format. I tried the ring. Which claims lower doses and my mood went very low.
Interesting Scampi doodle. How did they discover the histamine issue? Blood tests???
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It was through symptoms really and medical history. So much stuff I’d never really known was linked. Eventually came to light after trying oestrogel and it causing me to have many menopausal symptoms I’d never had before like hair falling out, hot flushes, skin reactivity, anxiety and jittery feelings and heart palpitations. Apparently oestrogen increases your histamine levels!
Feel much better than I did as the histamine being treated but still cyclical depression symptoms during period. I feel good for week and a half prior to my period arriving!
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Thanks for the heads up Sage - I've looked into the Canadian way.
I've looked into the 'canadian' way. I'm not sure it will be right for me... My periods are sooo light, that I assumed my estrogen was low. Plus the recent mood changes I experienced on the mini pill, cerazette, suggested I had become more prog dominant on it 🤷♀️
But... Nothing else works. Lol. So I am open to it. I think it highly unlikely my gp will let me try this (esp as I pointed out above, utrogestan rarely approved for prescription up here!!) so I'm still thinking I need to see a specialist.
So, does anyone think BMS accreditation will give me a better 'expert'??? As I've previously spoken to meno clinic, been told to try pill then hrt... Signed off straight back to gp. Problem not solved.😬
I dont want to pay £170 to be told I've got pms... I'm 3 years in this hell that has stolen my life every single day ???
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Just reading an article which I think helps make sense of this peri mess.
So basically, your estrogen fluctuates wildly. Some days too high, some days too low. It might no longer be high enough to cause the surge in LH and ovulation - if this doesn't happen then prog won't be produced. Hence prog deficiency. Then as you move towards meno estrogen drops and drops to a low and you also be one estrogen deficient.
This still doesn't t help me, but helps me realise that I am fluctuating sooo much that that's prob why hrt poisoned me 🤷♀️
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Just to chime in, I read the article (or similar articles) about the fluctuations too - that's when I realised HRT probably wasn't the right route for me and I'm decided to try Zoely.
If you've tried every contraceptive pill there is, maybe it is time to try something another contraception method - anything else (anything!!) with enough hormones that will override your own natural hormones that are fluctuating (mine too). Rather than HRT which I think is more about topping up dwindling levels. I'm not sure what there is and how different they will be - patch, implant, etc - but definitely worth trying them all! I do think with all of them we have to be patient though - I'm still having my original symptoms and new ones (my boobs have gone up four - yes four - bra sizes and are SUPER swollen and painful) but I know it takes time for your own hormones to be suppressed and everything to settle down xx
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:o Omg... 4 sizes :o. That's crazy. Jeez, mine are not much there to start with and I'm lucky if they go up half a cup ;D. I understand your pain though. I had immense pain with the first pill I tried last year. None of the others did that... So I guess they are all very different.
Thanks for the message. Particularly the point about trying anything. You are right. I can't give up. I'm so much better today than I was on the hrt the past few weeks. But today, my good day, I have had crashing fatigue, narkiness and am now about to take a triptan for a migraine I can feel coming on. This is a good day!!! I need to try something.
It will be the patch I think.
I hope zoley works for you. Have you tried alternative pills or is this your first attempt???
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Hey, just to reiterate what I'd said in the other thread, it's very hard to control these extreme fluctuations. The combined pill or high dose oestrogen gel would be best bet but, as hard as it is, I would also consider riding it out.
If you can find a way to cope, knowing it will calm down, might be less stressful than trying endless things that can irritate and make things worse. I'm saying this from my own experience!
What are your worst symptoms and could you bear them if you knew they would end of you were given a date (even though of course you can't know the date!)?
Sometimes the fear of thinking it will never go can be the worst part about it.
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I am currently reducing my HRT in the hope that I can come off it! I too suffer from extreme fluctuations and have been changing and upping doses for over 18months now! I do wonder if I can now ride it out and see how i go! Not an easy decision but one I feel I must try
Good luck everyone
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Thank you ladies for the alternative views.
I guess I was planning on trying to ride it out after my full year of pill trials, 2 of which I managed the full 3 months on. The last one I did 3 months but was feeling really ill on it. ::). My GP suggested I go with the best of a bad bunch... That was the one that gave me severe migraines... So that wasn't an option.
So after 3 months of nothing I felt desperate again and tried the hrt. The estradiol alone seemed to poison me. It's all so hard.
I'm feeling dreadful today. Dizzy, nauseous. Low and teary (that's not a particular problem). The dizziness is awful. Yesterday it was fatigue and migraine. As every day is different, I guess it is surges and dips.
I'm not sure I can ride it out....
I don't have bad flushes though... Is that what should come next once I stabalise on lower levels?? Funnily evough I got bad night sweats on the last pill I tried...
Im not going to take anything over Xmas.. See where I am at in the new year again. I'm hoping today is he still coming down from the hrt which I stopped on Tues after 15 days.
Danger mouse did things just eventually start to calm down and stabalise for you?
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Flan.. Are you still peri?
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Hi Crispychick!
Yes I am peri had regular periods up until I had the mirena coil fitted
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CrispyChick, finding the right balance is very difficult.
You have a few choices, the pill works well for many women in peri menopause because it overrides the cycle but if you can't find one that you can tolerate, it's not a goer.
Another option is to go very high with the oestrogen component of HRT which also overrides the cycle and counters fluctuating hormones but you either need a progesterone coil (synthetic progesterone) oral synthetic progesterone or Utrogestan which is body identical progesterone. The problem with oral synthetic progesterone and oral/vaginal Utrogestan is you either have to take them every day (which often causes problems) or suffer the instability of using them cyclically.
The other option is to go the bio identical (aka compounded, bespoke) route as I have done. I had no choice because I had tried every conventional progesterone available and I could not tolerate any of them. I use conventional oestrogen and testosterone and just use the bespoke progesterone at a low 50mg continuous dose and it works extremely well. If you feel unbalanced but don't need or want a high dose of oestrogen then this regime might be worth considering. Have a look at my thread on compounded hormones in the Alternative Therapies section on here.
What type of migraines do you have ie are they with or without aura? I starting having silent migraines (migraine aura without headache) in the lead up to the menopause and they were caused by extreme hormone fluctuations, oestrogen spikes and low progesterone. I have since realised that my own produced progesterone acted like a protectorate and stopped my oestrogen spikes which is why I didn't have migraines during my reproductive years. In my case and possibly yours too, it's all about hormone balance and synthetic progesterone will not balance your hormones, it is just to protect the womb, you can only achieve balance with body identical progesterone. The idea is to mimic your own hormones as closely as possible and to avoid the upheaval of a cycle.
I wonder if you need a steady, low dose HRT?
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I started to feel halfway better when hot flushes kicked in properly which coincided with big gaps between periods. I assume this is because oestrogen is reducing.
I still have some some oestrogen spikes where I get very shivery and legs go like jelly but it's nothing like it was, which was a constant surging feeling.
Mary G's regime is the one I didn't try with the very high oestrogen (apart from via my combined pill) and the lower dose progesterone that you take every day so that you don't have to keep going through prog withdrawal. Stability is key when you already have so much volatility.
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Thank you ladies. I really do appreciate you taking the time to respond.
Dangermouse - you have given me hope. I'm not really having many flushes. Roll on the flushes and some stability then. I should prob be careful with what I wish 🤔.
Mary G - thank you so much. I have looked at your other posts and was considering finding a clinic and looking at bioidentical.... Bug then I had an awful experience on the low dose estradiol that taking a much higher dose if that, just feels wrong ::). Maybe it's just prog I need, I really don't know.
So, from what you say, synthetic prog won't help balance. I wonder if that's why I started to feel so bad on the mini pill because, if my estrogen was spiking, I expected it to kerp it low. It was really bad moods I was getting with it though. So I assume too much prog and low estrogen. If I tolerated cerazette mini pill for years, I'm guessing I'm not prog intolerant.
My migraines are just classic head pain. No aura. They are now a lot more frequent when on nothing. Low estrogen? But then one of the pills gave me regular migraines, high estrogen??
It's all such a mind field. I think I'll ask to see a specialist again. The meno clinic had one phone call with me then signed me back to gp... But I'm still in hell, so surely they have to help me 🤷♀️
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Hi sweetie, how are you doing? Hope you had a lovely Christmas, without migraines! :-*
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Awww thank you Sage. So kind of you to ask.
I had a migraine on 23rd... But survived 24th, Xmas day avd today without. Woo hoo. I've been soooo fatigued, but hey ho. Had a decent Christmas with the kiddies. Hope you have too.
I now have my contraceptive patches ready to try...
Hope you having a lovely holidays. Xx
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I'm sorry about the migraines but glad you have been spared during Christmas! I had a lovely time, thank you! Everyone is healthy and that's what matters.
Which brand is the contraceptive patch? My fingers are crossed for you :-*