Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Clovie on April 13, 2023, 09:29:38 AM
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So cross!!
Had an appt with gynae consultant today.
Backstory - I'm 59 and i truly believe I am still having periods.
My periods have never stopped. I get regular 6ish day bleeds, (on a 21 to 26 day cycle) all the usual PMT symptoms beforehand and bleeds take the pattern of a period.
Been on HRT for 10 years now due to hot flushes, never been able to sync HRT due to short menstrual cycle. So was having my own periods and withdrawal bleeds.
I was found to be anaemic - hence lots of appts....
In the meantime advised to start continuous HRT instead of sequential.
I had a scan.
The sonographer told me lining was thin (good)
Womb of a still menstruating woman (good)
No fibroids/irregularities etc (good)
Follow up with consultant today.
He thinks they could not be periods??????
talked about me coming off HRT soon as I've been on it a long time and it could be causing 'irregular bleeding'
I've been on continuous utrogestan for 3 months and 'periods' still regular.
Scared he was threating to stop my HRT?????????????
So cross and scared!!
Please, any opinions?
.
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So sorry to hear you are going through this Clovie. Others will know more then me but one thing I do know is, HRT can be taken for life and research has shown it can help protect bones as well as help the brain.
Your scan sounds great so I cannot think why they would suggest you stopping HRT. Women can have periods at 59 and it seems really odd for a gynae not to know that. I never really trust them when it comes to HRT as they do not know as much as a menopause clinic.
You are entitled to carry on with the HRT. It is shocking for a professional not to know women can have periods at 59!
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Clovie, this consultant should know that some women bleed at different intervals on continuous combined HRT.
I was told the following by a gynaecologist.
Progesterone works like a kind of regulator on the womb lining so if you are taking a high dose of progesterone and a lowish dose of oestrogen you will never bleed,. If you take a high dose of oestrogen and a fairly low dose of progesterone and the womb lining starts the build up, you will bleed. Both scenarios are based on using oestrogen and progesterone on a continuous combined basis.
Obviously it you use oestrogen but never take any progesterone, your womb lining will either build up to a dangerous level or you will have erratic bleeding.
Your scan was normal so there is no reason why you should stop using HRT. If this consultant refuses to prescribe it I would find somebody else who can or alternatively I would buy it from an online pharmacy.
What type/dose of HRT are you using?
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The up to date guidance is that you can stay on HRT for as long as you need it. There is no age when you have to stop it .
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Hello ladies.
The Consultant I saw last week said that he believed HRT, especially high amounts of Oestrogen were causing many problems. He then said something about sending out a message to medics about over prescribing.
We didn't dwell on the subject but I wonder if some hospitals and doctors are trying to reduce the number of women on HRT?
The Consultant also said that the private clinics were adding to the problem by prescribing very high doses of Oestrogen.
I wonder if change is in the air and if so women need to be alert to it and prepared to argue their case.
I don't want to alarm anyone but forewarned is forearmed.
Take care ladies.
K.
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Hello ladies.
The Consultant I saw last week said that he believed HRT, especially high amounts of Oestrogen were causing many problems. He then said something about sending out a message to medics about over prescribing.
We didn't dwell on the subject but I wonder if some hospitals and doctors are trying to reduce the number of women on HRT?
The Consultant also said that the private clinics were adding to the problem by prescribing very high doses of Oestrogen.
I wonder if change is in the air and if so women need to be alert to it and prepared to argue their case.
I don't want to alarm anyone but forewarned is forearmed.
Take care ladies.
K.
Thanks for this Kathleen, interesting.
I only use x2 pumps of gel per day. i told him this. Would this be considered a high dose?
Thanks x
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2 pumps is a medium dose and is within prescribing limits.
The latest articles relate to doctors who are prescribing outside licensed doses.
Licensed doses are up to 4 pumps of gel; 100 patch; 2mg oral and 3 sprays of Lenzetto. x
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2 pumps is a medium dose and is within prescribing limits.
The latest articles relate to doctors who are prescribing outside licensed doses.
Licensed doses are up to 4 pumps of gel; 100 patch; 2mg oral and 3 sprays of Lenzetto. x
Thanks, Dotty :thankyou:
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There are many stories like yours and it makes me so cross. You don't need to 'truly believe', you know your own body better than anyone else and you know when it's a period. There seems to be textbook that says everyone is post meno by 54 and sadly many doctors seem to believe it. I was told by a specialist that at 57 (pre hrt) I couldn't possibly still have my own periods. Then aged 60 discussed lack of hrt induced bleeds with gp and mentioned the 2 recent periods I'd had. Panic and urgent referral for 'unexplained bleeding' which of course showed nothing. Search for late menopause on here for a thread where there are many of us with late menopause. Some women aren't meno until their early 60s.
As above, there is now no age limit for hrt though it used to be 60 so perhaps your gp is out of date (NICE guidelines) . I was on gel/utro so varied the cycle according to my own hormones (some can tell when they ovulate but I get sore boobs on prog so start it then), perhaps this is an option for you if you find conti doesn't suit you. IMO conti should be prescribed when the meno timeline is right not because of age.
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There are many stories like yours and it makes me so cross. You don't need to 'truly believe', you know your own body better than anyone else and you know when it's a period. There seems to be textbook that says everyone is post meno by 54 and sadly many doctors seem to believe it. I was told by a specialist that at 57 (pre hrt) I couldn't possibly still have my own periods. Then aged 60 discussed lack of hrt induced bleeds with gp and mentioned the 2 recent periods I'd had. Panic and urgent referral for 'unexplained bleeding' which of course showed nothing. Search for late menopause on here for a thread where there are many of us with late menopause. Some women aren't meno until their early 60s.
As above, there is now no age limit for hrt though it used to be 60 so perhaps your gp is out of date (NICE guidelines) . I was on gel/utro so varied the cycle according to my own hormones (some can tell when they ovulate but I get sore boobs on prog so start it then), perhaps this is an option for you if you find conti doesn't suit you. IMO conti should be prescribed when the meno timeline is right not because of age.
Thanks Sheila.
It's like some Drs WANT to find something wrong no matter what results show :(
I have no pain
I have no spotting
I have no dryness down below
No bleeding after sex
I've been left feeling like a total and utter freak. :(
He has taken more blood to see if my blood count has gone up.
Now I have another week of stress waiting for THAT result although I feel much better (less faint) than I did :(
I feel like a trapped animal :-\ ...
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Just to comment on the question about age and HRT, I recently looked at the BMS guidelines and they say there should be no arbitrary limit placed on the age of someone being prescribed HRT it might be worth looking at their info, also it is worth looking at the NICE shared decision making guidelines. I have had experience of this lately with menopause clinic/gp surgery so I understand how it feels (not the same just struggles over HRT, not listening). This is your medical care and you have a say in it, particularly as there are no concerns regarding the lining of the womb. How has the bleeding been since going continuous? You can also point out to him that intermittant bleeding is common on a continuous regime for 6-9 months anyway. I hope you are on a good iron supplement and I'm sorry you are dealing with this. It's so important for medical people to listen to women and respect that it is their body xx
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I've been left feeling like a total and utter freak. :(
Unique possibly :), freak definitely not. The problem is his ignorance, it isn't you. I look on it as a positive, we've had our own protection for heart and bones longer than most.
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Hi clovie
So sorry to hear about your difficult experiences with medics over HRT and your situation.
Before commenting further just to say regarding periods - whether they are or they are not, without certain types of investigation which are not usually carried out, once you are on HRT it is impossible to say definitively whether your periods are natural or not. The only way to find out whether a woman is truly menopausal is to be off HRT for at least 12 months and see if a period occurs. The other way I gather is to take a scan of the ovaries and look at the eggs etc - I'm not familiar with the details. However that is not to say that you are not having natural periods ie you could well be - though this is very much on the minority end of the scale...but someone has to be!! Also some docs are wrong if they think everyone is post-meno at 54, I think the stats (which probably will be based on studies of Western women not on HRT) say approx 80%? That is a big number who won't be!!!
However, that being said - the consultant was doing the right thing in investigating whether or not the bleeding was abnormal or normal but having looked into it and the health of your womb, and pronounced it healthy - then that should be an indication that all is well and no reason to stop!! As others have said - it is your body and your decision, provided everything has been looked into and there is no arbitrary age limit on HRT.
Have you thought of taking the utrogestan cyclically again - maybe a higher dose (sorry don't know what dose of oestrogen and prog you are using) but if the lining is being shed, and there are no abnormalities - then there should be no worries. The only thing is they should keep an eye on it, because it is more worrying the older one gets, just in case.....and your body's response to HRT may change as mine has ( ie lining thickened when it didn't do so in the past...).
I hope you manage to resolve this soon so that you can continue taking the HRT you need without hassle
Hurdity x
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Gynaecologists often have little idea about menopause etc.. Could you see a specific menopause specliast ?
If everything is 'within normal limits' for you, then there isn't any reason to stop a regime that is working.
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There is such a thing as late onset menopause. This can happen in your 60s. It's a common and simple phenomenon. Your doctor needs to read a book or two. There are, however, significant supply chain problems relating to HRT, and there is a growing reluctance to prescribe where another explanation or drug route is possible. I can't prove that the two are linked but it is coincidental.
Menopause is under researched and women's problems are often low down the priority.
Many doctors are behind the researchers too. I know that the health crisis that is dementia has led to research and proposals to give women HRT for life due to the protective benefits.
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Just to comment on the question about age and HRT, I recently looked at the BMS guidelines and they say there should be no arbitrary limit placed on the age of someone being prescribed HRT it might be worth looking at their info, also it is worth looking at the NICE shared decision making guidelines. I have had experience of this lately with menopause clinic/gp surgery so I understand how it feels (not the same just struggles over HRT, not listening). This is your medical care and you have a say in it, particularly as there are no concerns regarding the lining of the womb. How has the bleeding been since going continuous? You can also point out to him that intermittant bleeding is common on a continuous regime for 6-9 months anyway. I hope you are on a good iron supplement and I'm sorry you are dealing with this. It's so important for medical people to listen to women and respect that it is their body xx
Hi Claire
Thank you for your reply x
My bleeding has continued since I've been on continuous. By that I mean, continued at a reasonably predictable timeframe and for a set length, starting gradually getting heavier then tailing off. As a period would do.
I feel they are def still my own periods. I have all the symptoms beforehand, physical and emotional.
I do feel it is getting a little lighter though.
I read that continuous utrogestan can take 6 months to slow any build up?
And my lining is thin, anyway.
I'm still upset today. :(
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I've been left feeling like a total and utter freak. :(
Unique possibly :), freak definitely not. The problem is his ignorance, it isn't you. I look on it as a positive, we've had our own protection for heart and bones longer than most.
Thank you Sheila. xx
That is how I myself was seeing it after the good news at the scan - well, until I saw the consultant yesterday anyway... :(
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Hi clovie
So sorry to hear about your difficult experiences with medics over HRT and your situation.
Before commenting further just to say regarding periods - whether they are or they are not, without certain types of investigation which are not usually carried out, once you are on HRT it is impossible to say definitively whether your periods are natural or not. The only way to find out whether a woman is truly menopausal is to be off HRT for at least 12 months and see if a period occurs. The other way I gather is to take a scan of the ovaries and look at the eggs etc - I'm not familiar with the details. However that is not to say that you are not having natural periods ie you could well be - though this is very much on the minority end of the scale...but someone has to be!! Also some docs are wrong if they think everyone is post-meno at 54, I think the stats (which probably will be based on studies of Western women not on HRT) say approx 80%? That is a big number who won't be!!!
However, that being said - the consultant was doing the right thing in investigating whether or not the bleeding was abnormal or normal but having looked into it and the health of your womb, and pronounced it healthy - then that should be an indication that all is well and no reason to stop!! As others have said - it is your body and your decision, provided everything has been looked into and there is no arbitrary age limit on HRT.
Have you thought of taking the utrogestan cyclically again - maybe a higher dose (sorry don't know what dose of oestrogen and prog you are using) but if the lining is being shed, and there are no abnormalities - then there should be no worries. The only thing is they should keep an eye on it, because it is more worrying the older one gets, just in case.....and your body's response to HRT may change as mine has ( ie lining thickened when it didn't do so in the past...).
I hope you manage to resolve this soon so that you can continue taking the HRT you need without hassle
Hurdity x
Hi there Hurdity! :)
Thanks for your reply!
I had my ovaries checked and all was OK, not counted eggs or anything though.
My womb is "that of a menstruating woman" the sonographer told me. She could tell by the size and shape, she said it was clearly obvious.
The consultant still seems to think it might be 'irregular bleeding'.
Do you know anything about sinister irregular bleeding? Only mine is reasonably predicatable (between 21 and say, 26 days between bleeds) and for a predictable length of time (around 5/6 days) Starts light gets heavier and tails off.
With 'irregular bleeding' would you get all the PMT symptoms beforehand?
He has me worried sick.
He told me towards the end of the appt that he thinks I'm 'peri-menopausal' !!!! Like it was news to me!!
No sh*t Sherlock!
I know!
I have been on HRT for nearly 10 years due to hot flushes mood swings etc!!!
Thanks for any further insight, and hope you are doing Ok! :)
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Gynaecologists often have little idea about menopause etc.. Could you see a specific menopause specliast ?
If everything is 'within normal limits' for you, then there isn't any reason to stop a regime that is working.
Thanks, CKLD. Yes, I'm going to see what his follow up letter says and the results of my blood test, then I will prob go private to see someone.
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There is such a thing as late onset menopause. This can happen in your 60s. It's a common and simple phenomenon. Your doctor needs to read a book or two. There are, however, significant supply chain problems relating to HRT, and there is a growing reluctance to prescribe where another explanation or drug route is possible. I can't prove that the two are linked but it is coincidental.
Menopause is under researched and women's problems are often low down the priority.
Many doctors are behind the researchers too. I know that the health crisis that is dementia has led to research and proposals to give women HRT for life due to the protective benefits.
Thanks for reply! :)
I know, I was like, how much do you actually know about menopause :( :( :(
I totally agree about the benefits of HRT - I said to him when he was talking about me coming off it that I would just go get it privately, that I WANTED to carry on taking it for ALL the benefits it provides.
Yes, I've heard of the link with dementia, very encouraging! :)
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Still confused a little...
Following my consultant appt I finally got his letter through which he promised me.
I'd had another blood test whilst at that appointment to see if the intensive iron therapy I was having was working. (Was anaemic following having my own periods and the withdrawal bleeds from sequential HRT as well)
The letter said my blood count was now fine, and to just follow up as necessary with my GP.
No mention of what he thought my bleeds could be - or any agreement that they were indeed periods (regular period-long bleeds at predictable intervals with all the associated PMS symptoms preceding them, which haven't changed DESpite changing to taking continuous HRT for several months now)
Still concerned he had spoken about being taken off HRT as I'd been on it a long time :(
HRT surely is for women coming up to and following menopause?
Despite my age I clearly still have not even got there yet, so to talk about stopping it just causes excess anxiety, something I've suffered with immensely throughout this whole peri period :(
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No wonder you are confused. U don't have to stop unless there is continual heavy bleeding when a hysterectomy may be suggested. After which a lady may require oestrogen replacement.
If there is no mention of stopping HRT I wouldn't be too worried. Your GP can contact the consultant if he/she thinks it's necessary.
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Hi Clovie, Sorry I didn't see your response until now, yes it can definately take time for bleeding to settle on continuous progesterone. I'm glad he didn't mention taking you off HRT in his letter. I had my bloods taken by a nurse at the surgery once and she said she had been on HRT for many years and they tried to take her off it but she refused as she felt much better on it, she seemed very well and older than yourself. Glad the iron has come up I would supplement if I were you to keep your energy etc up, take good care xx
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How can bleeding be 'irregular' if it's cyclical ::) ..... we know our bodies. If the bleeding is 'within normal limits' for your body .......
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Hi Clovie, Sorry I didn't see your response until now, yes it can definately take time for bleeding to settle on continuous progesterone. I'm glad he didn't mention taking you off HRT in his letter. I had my bloods taken by a nurse at the surgery once and she said she had been on HRT for many years and they tried to take her off it but she refused as she felt much better on it, she seemed very well and older than yourself. Glad the iron has come up I would supplement if I were you to keep your energy etc up, take good care xx
Thanks for reply :) And that's interesting about your blood nurse, thank you . :)
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How can bleeding be 'irregular' if it's cyclical ::) ..... we know our bodies. If the bleeding is 'within normal limits' for your body .......
Exactly CKLD, this is what I said to him at the appointment.
He said to me "I understand you've been sent to see me because you've had a bit of bleeding?"
(What my GP had written to him I have NO idea but she definitely did not believe my periods are my periods and something MUST be amiss at my age)
I said to him
Yes, but my periods have never stopped, it's not post-menstrual bleeding
I told him my bleeds were predictive in length
Lasted as long as a 'period'
Started gradually got heavier and tailed off, like a period does
I get all the PMS symptoms before hand.
My scan was one of a still menstruating woman
no abnormalities at all to note
And since changing from sequential to continuous HRT my bleeds have carried on as normal.
He would STILL not commit to these being periods.
Nor would he say what ELSE they could be!?! :(
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He's a man, out of his depth ?
What's your GP's take on him?
Let us know how you get on.
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Clovie, I have no words of wisdom but I am 100% certain you know your own body.
As you have said before some of us do not fit into the happy age bracket of menopause that some in the medical profession would like.
I am truly furious and pis*ed off on your behalf. I really feel for you and the lack of belief you have been shown, I am certain you know you are having natural periods.
Xx
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We didn't dwell on the subject but I wonder if some hospitals and doctors are trying to reduce the number of women on HRT?
The Consultant also said that the private clinics were adding to the problem by prescribing very high doses of Oestrogen.
I wonder if change is in the air and if so women need to be alert to it and prepared to argue their case.
This is exactly what I have picked up from a few different sources. I have an endocrinologist who has looked after me through thyroid, coeliac and osteoporosis issues and in not so many words said that doctors were starting to restrict the prescription of HRT. This is probably in response to proposals (correct me if I'm wrong here) to make it much cheaper for women to get HRT as in one prescription charge for the whole year.
I am getting BHRT privately so I think he was more inclined to tell me - but he basically said that it would be advisable for me to have 'other symptoms' in addition to the osteoporosis or they would force me onto bone drugs.
I have also heard from a senior medical research source that there is a proposal to put all women on HRT for life (low dose) to protect against dementia as that is a public health crisis and HRT can prevent it by up to 50%.
Either way there are policy/product/cost changes afoot which will be driving decisions.
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I have also heard from a senior medical research source that there is a proposal to put all women on HRT for life (low dose) to protect against dementia as that is a public health crisis and HRT can prevent it by up to 50%.
Has the link been proven now? I thought it was still open to debate.
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I wondered that too Sheila. I have an interest in this as both my mum and my brother developed dementia. This is the latest info on the Alzheimer's site https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/hormones-and-dementia#:~:text=Until%20there%20is%20better%20evidence,treat%20or%20prevent%20dementia%20though.
Taz x
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I am hearing it from the research community which is way ahead of mainstream. When I was researching the cancer I had I looked at the biochemist research rather than talked to GPs. The 'official' published advice from NICE/charities etc. will be at the very end of the process.
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Do you have links to the research? I'd be interested to see it.
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Hi Clovie, I didn't see the responses until now, this place is like a maze!
I hope that gynae realises he's out of his depth with menopause and learns something more than text book theory before scaring his next patient. I just wanted to say something to help you not worry.
Male doctors can be very insensitive in my experience, like the one who said to me, seven months into my first pregnancy, "You know, it doesn't necessarily mean there's anything wrong with your baby just because it's very small."
It hadn't even occurred to me that my neat bump meant anything bad for the baby. I was frantic for the next ten weeks, then my 8lb son was born, sod all wrong with him and he's now a doctor himself!
That particular GP actually thought he was being helpfully reassuring and he said as much at the next appointment. In hindsight I should have set him straight, but I felt so vulnerable during pregnancy I wanted everyone on my side, no conflict please.
Clovie, I have been disbelieved about my periods too. I had over a year with no periods then asked for HRT. I'd been told HRT is only licensed for post menopause, which I think is still true, so I didn't think there was any point in asking before then. I'd not had hormonal treatments/contraceptives in over ten years at that point.
My GP gave me Evorel Conti.
Within six weeks my periods were back. I was told no, it's irregular bleeding brought on by HRT, I believed it then.
I was told the progesterone in Evorel Conti was not the thing made me go loopy same way progesterone always kicks me in the teeth, but my GP had no idea what caused it instead of the progesterone that I was "incorrectly" saying was the cause.
I was given tibolone as it's for difficult cases where a woman like me believes she is reacting to progesterone when the doctors know that is not possible. (yet everyone here seems to get it)
On tibolone I continued to have a period every month, no spotting in between, PMS and sometimes even middlemonth pains which was how I predicted my irregular periods in my 20s because back then that pain came 14-15 days before every period, now it's only occassionally.
Back then, I was laughed at by a male GP when I told him I know when I ovulate because I feel it each month, he assured me that wasn't the case at all.
I was told it was impossible for me to know I was pregnant before I missed a period. They refused to test for it or put me on the hospital list until a week after my period had been due, that was reasonable of them, but the disbelief that I could know what being pregnant felt like, with two toddlers in tow, that was fairly unbelievable on it's own!
What I'm saying in my ever rambling way is that I know you know they are periods, just like I know my body and probably all women know their bodies in a way I believe most men simply don't.
This is my theory on it.
Men don't need to think about their inner workings much, they don't deal with cycles and periods and pregnancies and natural chemically induced mood swings, so I don't think there is the same need or interest there.
Besides a woman's sense of touch in her fingertips is 20 times more than a man's on average. In tests they found the most sensitive men were still only a sixth as sensitive as the least sensitive women, on fingertip sensitivity. Sense of touch is thought to be the most clear cut difference between the non reproductive abilities of men and women. Even strength has some overlap with some very athletic women being stronger or faster than some men.
I think men have trouble believing we can know our bodies as well as we do and we probably feel a lot more of what is going on in there than they do. The fact we are all different confuses them too, obviously women couldn't understand something better than men do?
THANK you, Poppy.
I totally agree with all you say! :thankyou:
Interesting about your son tool, I have a son currently half way through Medical School! I often joke to him that I hope HE goes on to have a better understanding of menopause issues later in his career for the sake of 50% of his future patients! :)