Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Cori on July 14, 2018, 03:59:25 PM
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Has anyone taken HRT for osteopenia or to prevent heart disease after going through an early menopause?
I started in peri menopause at 38/39 (could have been slightly earlier, but that's when my symptoms started... although I was very moody since 36) and had my first FSH test at 39, which indicated my FSH levels were high. I had my last period in March 2017 at almost 42, so I am now post menopausal.
I had a Dexa scan in May and I am osteopenic. My doctor said I could either take HRT for 5 years, which I was reluctant to do, as I'm worried about side effects such as blood clots, risk of breast cancer, headaches and bleeding.
The other option is to ensure I'm getting enough calcium and vitamin D through my diet. I'm having a blood test in a week and if I'm not getting enough calcium and vitamin D, my doctor will prescribe a supplement or I can take HRT. I'm also reluctant to take calcium as calcium supplement give me an upset stomach.
My doctor said HRT is reccomended for women who go through an early menopause and it's only putting into your body what it's missing.
I've had hot flushes since 39, which were quite bad during the first year, I've gained over a stone and I have belly fat for the first time in my life, which I hate, loss of muscle tone, dry skin, thinner hair, dizziness, sore joints, especially my hips (had sore hips for 5 years, but only just realised this was connected to the menopause), moodiness, lack of motivation.
So after researching, I am beginning to wonder whether the benefits of HRT would outweigh the risks. If I could have no hip pain for 5 years, that would be great. But would it be worse when I stopped taking it after 5 years along with all my other symptoms? Also, I was worried that HRT might make me gain even more weight, but then I read online that it could get rid of the belly fat.
I just don't know what to do. I just wanted everyone's opinions. Thanks!
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I diagnosed with early menopause at 42 and my gyn gave me almost immediately hrt. It is vital for our overall health. Actually I don't think that your doc is right about the 5 years limit. I intend to stay on it at least until 50.
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My menopause started in my mid 30s and I strongly recommend you have HRT until at least 50 or you will really suffer in the long term, especially if you already have osteopenia. No amount of exercise, Vitamin D and calcium etc. will give the same help as HRT. The risks of HRT only start if you are still using it after the age of 60 and for your the benefits will be very good.
I am 62 now and really pleased I had the HRT for nearly 25 years. You still need to have a good diet rich in all the right nutrients, keep weight under control, exercise regularly and practise some relaxation techniques regularly - HRt can't fix everything. I would say you need at least 10 years of HRT and maybe more if your bone density is already suffering. Osteoporosis is truly dreadful and you need to do everything you can to prevent this. HRT will protect your heart, prevent early onset of urogenital atrophy and there is a small protective factor against bowel cancer as well!!!!
So lots of benefits with HRT and very few risks. It can be trial and error till you find a HRT that suits you but I would try Femoston 1/10 sequential first. This does give a monthly bleed but its best to start with sequential first to see if the progesterone suits you or not.
You might choose to have a Mirena fitted as you can then use as much oestrogen as you need, as gel or patch, and most women don't get a bleed with this combination - also fewer progesterone side effects.
The answer to your question - definitely use HRT for at least 10 years - you'll probably find you get a much better quality of life as well. DG x
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I would seriously consider HRT, my mother in law had awful debilitating/crippling osteoporosis, it was suggested she took HRT but she refused and went down the calcium route.
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Thanks everyone... I'm really tempted to try it after reading your replies.
My mum is wary of me taking it, as she is convinced HRT caused her breast calcifications. She was taking it for 20 years though until she was about 25. She took Prempak-C to start with, which gives you a bleed. But she was bleeding a bit heavy. Then she took Kliovance, which is a continous combined HRT with no bleed.
She has been off HRT for 10 years. She's 75 and still has hot flushes!
I'm not sure whether to try one that gives you a bleed or not. I've got used to having no periods now but does HRT with no bleed have more side effects? And would I bleed inbetween aswell when I'm not supposed to (with either)?
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It is suggested that HRT is taken until the age of natural menopause , think that is 51, if you have a premature menopause as the benefits outweigh the risks until that age.
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Some say the natural age of menopause is 49, some say 51. When they say the normal age of menopause, do they mean the age you are actually in the menopause for those 12 months without a period, or the age which you start perimenopause? I started perimenopause at 39 as far as I know, but I was in the menopasue at almost 42 as that's when I had my last period.
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Cori - you are focusing too much in the negatives.
Menopause is defined as having been without a natural period for 12 months and the average age to be post meno is between 51-54, I believe. Many women need to work till they are 66 - so to be able to continue working they may need to stay in hrt.
If you already have bone density loss then hrt is you best option at this stage.
Progesterone can be problematic for some women and this why we suggest trying a sequential hrt first and this will give a monthly bleed. If after 3-6 months you find the progesterone suits you, then you can switch to a continuous hrt.
There are many HRT regimes on offer and most have bio identical oestrogen which is considered safer than the HRT your mother took to start with. Look under TREATMENTS on this site to see your options.
Do you want a life without flushes and night sweats? Do you want more energy so you can exercise and loose a bit of weight? Do you want to help your bones and heart?
Try HRT - you can stop whenever you want but I bet you'll enjoy getting your life back - quality of life is very important. DG x
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Cori
I agree with the girls above, I started hot flushes aged 44, periods stopped completely aged 45, started HRT aged 46. It gave me my life back! hot flushes went in 3 days, anxiety soon after, took a few month to sort my sleep, and I've lost a stone in weight.
Do your research and verify everything the gP suggests, they do make mistakes sometimes but at least for a few years hrt is great and benefits outweigh the risks. I think up to 5 years it's considered short term use, and if you had early menopause, then the 5 year count starts at the age of ‘normal' menopause, I.e. 50/51 or so.
Sequential is a good start, keep and eye on endometrial thickness by having an ultrasound scan if offered sometime down the line. There are different types of progestin to try, and estrogen can be taken as systemic (tablets), patches or gel (less risk for example of stroke with long term use) so read up on it, but the choice is really either to suffer the debilitating symptoms and possible osteoporosis, or take it, and get your life back. I can't begin to tell you how my body just went back to normal on hrt, everything just works. Remember you can always stop, but once find the right fit and feel great, you will not want to...
Xx
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I agree with DG, quality of life is what is important, HRT was life changing to me, i was plagued with awful VA and awake all night with palpitations. You are young and you need to protect your bones, honestly you don't want to end up like my mother in law did, try the HRT, you can stop it at any point you want to.
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Thanks guys. Do you have to have a mirena fitted to use patches?? Are patches as effective as tablets?
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Oestrogen Patches or Oestrogel are usually better than pills - these can be used with the Mirena OR you can take progesterone as Utrogestan or Provera, sequentially or continuously.
You can get combined HRT patches which have both oestrogen and progesterone.
Here are the links on this site that give all your treatment options.
https://www.menopausematters.co.uk/treatment.php
https://www.menopausematters.co.uk/treatafter.php
https://www.menopausematters.co.uk/to_progestogens.php
https://www.menopausematters.co.uk/perimeno.php
https://www.menopausematters.co.uk/postmeno.php
DG x
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I had a strong argument with a gyn yesterday! I said to him that I am on hrt due to my early menopause and he said that it is the worst thing I can ever do.
I asked him why and said that if I were his wife, he would never give hrt to me.
He said that it is poison and it gives cancer. When I said that I am only 43, he said that it doesn't matter and I will be better without it.
I said that I am going to take it longterm, maybe for life and he said that there is no scientific data that hrt is safe.
When I said that it is like replacing the hormones I don't produce anymore, he said that it is not natural and artificial hormones are far riskier than our natural hormones. Of course I will not visit him again...I feel so sad sometimes and I want just to share it...:)
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Emerald - how awful. He should be struck off for being so dogmatic, misinformed and being unethical.
If I had been you I would have asked him to put his recommendations in writing and I would then forward this to Dr Currie, the Menopause society, the Royal College of surgeons and the health authority.
He is basically being negligent because if a women follows his advice and then develops osteoporosis or heart disease due to early menopause and no hrt treatment he should be sued for negligence.
It is staggering that a gynae can be so out of date. DG x
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So true Dancinggirl! My gyn and my endo suggested me hrt for longterm use but I wanted and asked for a second opinion.
And maybe that was a bad idea cause it made me anxious and depressed. He was absolutely unkind and arrogant!
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Hi Emerald
I strongly agree with Dancinggirl, please write to Dr Currie via the email service and it will be the best spent £30, I had to do it a few times, for similar reasons, early menopause and doctors told me to Stop HRT .
Dr Currie's involvement led to letters to Gp and the gynaecologist dept at the hospital and finally the doctor has written a very nice letter back to dr Currie asking if she could consult her on future hrt cases and she will share the knowledge with her dept. Took a few weeks but it was all worth it
Fingers crossed! Xx
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I went through early meno @ 39 have been on the rub on gel and utrogestan used 12 days a month and am well into my 50s my gynae said that I can stay on it until 70 if I want. You need to replace your hormones, get some gel or the patches they are really the best and safest in my opinion.
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Thank you ladies! I will write to Dr Currie for sure. I am not in UK and at my country I don't need a prescription for taking hrt fortunately! :)
At my country the gel isn't available anymore and I don't like the idea of patches. I started Femoston 2/10 a year ago and feel great but when I ask a gyn or share it with my friends, they look at me with despair.
I feel like a heroine addicted sometimes and everyone says to me to stop taking hrt for my good. Forum helps me so much not to feel alone! :)
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Thank you Stella, it is relieving to know that there is a supportive context for me!
It is really upsetting for me all the negativity I receive regarding hrt and my decision to take it.
I feel sometimes that I would have more sympathy if I was a cocain or heroine addicted!!! I feel that everyone is against hrt and it affects my mood and my confidence. It creates fear and doubt to me!
Nice to find all of you!!! :)
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When I told a friend that I had decided I would stop HRT a couple of years ago, she immediately said “I'm so glad you have stopped that poison†!!!! She had only heard the horror stories - I didn't try to convince her otherwise, sometimes people just believe what they want to believe. DG x
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The gyn with whom I had the argument told me that one of his professors believe that all meds are actually poisons!!! I said to him that he chose wrong occupation if he believes such things. Of course I will not visit him again but his attitude made me anxious about hrt.
My endo and my gyn are adamant that I absolutely need hrt for longterm use and with regular checkups.
Thank you dancinggirl! :)
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Sadly, many of us started out thinking hrt was all bad, I certainly did. I've read so many posts on this forum about women who had struggled with symptoms for 2 years (average!!!) before trying hrt. So much bad publicity out there, but when you read the reasearch properly, the picture becomes clearer - in younger women benefits can certainly outweigh the risks, hrt gives back why would normally be in the body at that age.
I also found this forum makes me feel I'm not alone, it's such a great support xx
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So true Andie!
I try to be well informed and control my fear. I think that taking hrt is an individual decision. We need support and encouragement from our gyns.
The forum is really godsend!!! 💐
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Hi guys... I have just received my blood test results for my vitamin D and calcium levels. My vitamin D levels are ok and my calcium levels are only slightly low. I told my doctor I had decided to take HRT and my reasons why. She said she was glad I had done some research and decided for myself to take it as she never wants to force anyone to take it. She has prescribed the combined patch... FemSeven, I think (I haven't picked up the prescription yet, it was a telephone appointment). She has prescribed 2 months supply and then I need to see her to check my blood pressure etc.
I'm quite nervous about starting it, but I just need to remember why I'm doing it.
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Emerald2017 just catching up with this post and I agree with Dancing Girl the gynae's attitude is shocking, and I think it wants challenging. These decisions affect quality of life and it's really not funny x
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Thanks for replying Perin, the forum gives me such a support and knowledge! Many thanks! 💐
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I told myself I wasn't going to read the side effects on the leaflet, but Im confused about something it says on there... There is no evidence that HRT will prevent heart disease/heart attack. Women over the age of 60 on HRT are slightly more likely to develop heart disease.
I know it says over 60 but it's a bit worrying as that's one of the reasons I'm taking it.
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Also... if I'm on HRT, do I not have to worry as much about getting enough calcium and vitamin D? Should the HRT increase my bone density?
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The leaflets are not up to date - they are simply standard information based on old research and are put into every type of hormone related preparation. The leaflet is also the same for local oestrogen and the risks simply DO NOT apply for Vagifem and oestrogen creams as so little is absorbed systemically. The drug companies are also covering their backs - just in case. When oestrogen drops, the arteries are more likely to fur up and become clogged, thereby increasing the chance of heart problems - this is one of the reasons why the cholesterol tends to go up past menopause.
The trials done with HRT and indeed most medication is often so flawed but any findings do have to be presented.
Once past 60, the risk of heart disease and cancer go up significantly whether on HRT or not, however, the trials so far have shown that if a woman in her 50s has 5 years of HRT it can extend life by a year or more. The protection for the bones is not disputed - HRT is one of the best preventives against osteoporosis.
Using HRT does not mean you should relax about ensuring you get enough calcium and vitamin D either, as these are vital nutrients throughout our lives. I believe HRt does restore some bone density - here is the quote I found “By restoring estrogen levels, HRT helps to slow the rate of bone loss, as well as relieving the symptoms of menopause. Studies have shown that HRT, even at low doses, can significantly increase bone density (1) and reduce the rate of fracture â€.
We must still consume enough calcium and supplement with Vitamin D and magnesium if you don't get enough sunshine.
Try to focus on the benefits and not the side effects and risks. If you drink a lot of alcohol, smoke, are overweight or lead a sedentary life, these are the BIGGEST risks for heart disease, stroke and cancer - so for example, being overweight is a bigger risk than being on HRT. Sadly, what is in our genes is not preventable. DG x
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Thank you so much for that, DG. After reading that, I definitely feel like I'm doing the right thing in taking it.
When they say it can extend your life in your 50s, could it do the same for me if I'm in my 40s?
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You would need to use hrt till at least 55 to really gain the benefits and protrction for your bones.
I can't remember where I found the research that showed the statistics regarding using HRT in your 50s - I wish I had saved it.
There are many factors at play when looking at pros and cons with so many treatments but the press love to highlight risks.
I have recently stopped taking parectomol having down some research - it's considered relatively safe but paracetamol can still cause internal bleeding, damage kidneys and liver and gives very few benefits in terms of pain n relief!!!
Pain killers, PPIs and ADs are dished out so readily by GPs with no information about the many long term risks. DG x
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So that would mean I would be on HRT for 12 years. I'm not sure if it will be safe to do that? Would I be best waiting until I'm 50 to start taking it??
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If you wait the bone loss will be worse and harder to treat. I was on hrt from the age of 37 and took it for nearly 25 years. The old idea that a women should only use HRT for 5 years is now defunct.
Natural menopause is between 51-55 so technically, until 51, if you are hrt, it is only replacing the hormones you would have naturally. The very small risks kick in if you are still on hrt after 60 and even then the benefits can outweigh risks if you have osteoporosis.
There have been so many scare stories based on flawed research regarding hrt it is appalling. If it was something that helped men I doubt there would have been so much negative press. I have a friend who was diagnosed with advanced osteoporosis 5 years ago and she can't have hrt because of having had aggressive breast cancer. She had sailed through her meno at 53 so never used hrt. She is slim and fit, always ate what was would be deemed a healthy diet but sadly never liked dairy - there is also osteoporosis is her family. She is having to have treatment for her bones that can give some very nasty long term side effects - she really wishes she could have hrt.
Just be thankful you have hrt as an option for you and stay with it as long as possible. The back problems I am getting at 62 would probably be far worse if I hadn't been on hrt.
I think you have been given the combined patches and this is medium dose. Do expect your body to react a bit at first as it can take 3-6 months for things to settle and you may have to try different hrts till you find the right one for you.
Do try not to overthink things. If you had heart disease you wouldn't question any drugs you were given so just accept that hrt is the best treatment for you now. DG x
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I have been on it since 40 and intend to stay on it until well into my 70s with the blessing of my gynae. The best and safest is transdermal, I use the gel its amazing along with Utrogestan for 12 days per month, its essential at your age, that GP needs his head read! ::)
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Thanks.. I will ask my doctor how she feels about me staying on it until I'm 55... it makes sense to do that.
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Unless your doctor is up to date on the latest menopause treatment, he/she might still quite the old 5 year guidance. I wouldn't muddy the water at this stage, just get yourself going on hrt and then when you get to 52-55 review the situation and discuss your options then.
Do remember you will have an annual assessment while on HRT so you will be monitored.
I can tell you are very anxious about all this but it's no good worrying about any future problems - just focus on the benefits you will gain.
DG x
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Thanks DG. I am very anxious about it all. I'm planning on starting wearing the patches tomorrow evening.
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I expect your oestrogen levels are very low so when you start these patches you must expect to get some side effects that you may find worrying e.g. sore breasts, a bit of bloating and you may find your intimate area will tingle - these are all signs of your body waking up and and welcoming the hormones.
All these things should settle over the first 3-6 months.
I can't remebrr whether you have men given a sequential or continuous hrt patch?
If it is continuous (non bleed version) then sometimes there can be more side effects due to the progesterone. We can help you choose a different hrt if the side effects are too troublesome - it can be trial and error till you find an HRT that suits you.
Having said this, many women do great on combined patches so you may find you feel really good in 3-4 weeks time.
You must try to keep busy and not focus on the HRT - just get on with life knowing you are doing the right thing for your health and well-being.
DG x
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Thanks DG. It's a continous patch.
I used to be on the contraceptive pill for 17 years, so I'm guessing the side effects will be similar to that? I did get a lot of bloating with one particular contracetive pill I tried, but the other two were fine. Whenever I tried coming off it and then went back on it, I got a bit of a buzz and always felt better on the pill. So I'm kind of hoping I feel like that on HRT rather than feeling worse with lots of side effects. But like you say, I wil just have to try different ones until I find the right one for me.
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Well guys, I've applied a patch! I've been nervous all day! I applied it onto my butt cheek at the back in the middle, tying to avoid the edges of my underwear. Is it normal for it to go on a bit wrinkly around the edges? I knew it said to apply it to non irritated skin, but I've just realised I have a tiny pimple at the edge of it! I'm worried that if I bend over, it will spring off as obviously your butt stretches when you walk and bend over.
I'm suprised at how discreet they are. I was expecting a big square flesh coloured thing like a band aid haha.
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I only tried patches once and found they weren't good for me but many women love them. I think they do crinkle a bit. Try not to worry, Good luck. Dg x
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Thanks. It's still stuck but I haven't been sweating and I didn't spend too long in the shower. I find it amazing how the hormones can pass through the skin and into the bloodstream. How will I know if they are actually working? If I don't feel any different, I won't really know, will I? I only get hot flushes/over heat when it's really warm anyway and as for the joint pain, I'm not expecting that to disappear overnight. So how will I know if they are having an effect?
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Hi Cori
My specialist put me on HRT following a DEXA scan which showed I have severe osteopenia with a T score of -2. I am 53 but haven't gone through the menopause yet (so most bone loss would be expected over next 5 years or so). My mother and grandmother had severe osteoporosis and they both died following serious fractures (hip and pelvis). My mother's fracture spiralled down her femur and was untreatable. My grandmother had an embolism resulting from the pelvic fracture. Osteoporosis is an awful condition.
I have always eaten dairy, my vitamin D levels are fine and I have always done loads of exercise. My specialist thinks it is genetic: we just turn over bone too quickly. HRT is my only treatment option at this point - they will not prescribe bisphosphonates yet.
I won't know whether HRT has helped until my next DEXA scan in 5 years but I have trust in my doctor that she knows what she's doing. I hope it works out well for you :)
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Thank you Sid.
I've had a bit of a scare... So, 27 hours after I applied the patch and just about to go to bed, I get this intense pain across the bottom of my stomach, on my pubic bone and in my ovaries. That area looked slightly swollen too. It went on for about 20 minutes and I was worried, as towards the end of my cycles, I used to get intense ovary pain when I ovulated and this felt similar. One time when I ovulated, I collapsed and ended up going to hospital in an ambulance. It was worse when I sat down. I wasn't sure what to do, so I removed the patch.
Is it normal to have pain like that after first applying the patch? Should I have left it on? I intend on trying again once this pain has gone. Should I speak to my doctor? I just don't know what to do.
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Cori - the sudden cramps are exactly the type of thing that will happen when first starting HRT - your body is reacting and waking up having been dormant for some time. Unfortunately starting with a continuous HRT can give more reactions at first. The patches you have been given are also medium dose, so you body is getting a biggish dose straight off. Don't worry it should settle.
You could try cutting the patches in half for the first 2-4 weeks to allow a slower adjustment but check with you doctor first. Personally, I think you might have been better with a low dose pill HRT e.g. Low dose or Ultra low dose Femoston and then move to a higher standard dose after 3-6 months when the body has adjusted. One gynaecologist I saw actually suggested starting on half a dose for 2 weeks before increasing to the standard dose to allow the body to adjust. Don't forget, you may well get some spotting or bleeding in the first few months as well.
I think it should be fine to simply cut the patches in half as many women do this. Do try to persevere as you are far too young to be oestrogen deficient and as Sid has said, osteoporosis is truly awful and I can't begin to tell you the horror of urogenital atrophy (due to oestrogen deficiency) that brings so many problems - it will be worth it and you may find your feel great in a couple of months and wish you had started sooner. You may need to consider a sequential HRT which unfortunately means putting up with a monthly bleed as many of us prefer to stick with this instead of a conti HRT. It will probably be trial and error I'm afraid but we are here to help. DG x
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Thanks DG. I think I will try cutting them in half. Which way is best to cut them? Along the 'S'?
The cramps stopped after I renoved the patch. Not sure whether it was coincidence and they would have stopped anyway. I have a bit of a stomach ache now so not sure whether to try again today or tomorrow. Will see how I feel this evening.
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I've never cut a patch in half so don't know what to recommend - perhaps start a thread asking advice from others specifically about this as I know lots of women do this. ?
You are so anxious, I really think a more gentle start would be best. It can take some weeks for the body to adjust to the hormones especially if you are starting with very low hormone levels which I suspect you are. DGx
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Thank you DG, I will do that.
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I cut one in half and applied it this evening. A couple of hours later, I have slight cramps, but I'm riding it out. I'm determined to make this work.
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By the way, how many days/weeks do the cramps last? I still have 3 weeks and 2 days left on holiday from work. I'm planning on using half a patch for 2 weeks and then going onto a full patch. So I will have been using a full patch for just over a week before I go back to work.
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Nobody can tell you how long it will take for your body to adjust. It might be some weeks and that's assuming this type of HRT is right for you.
Only increase to the full size patch if things have settled.
If you had started on a sequential hrt at a lower dose it might have been a bit easier but you would then have had a monthly withdrawal bleed which i assume you don't want.
As you successfully use BCPs in the past I'm hoping this hrt patch will be ok for you in time. DGx
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Thank you DG. Yes, I would rather have a non bleed HRT if it works for me.
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If I don't get any stomach cramps this week using half a patch, do you think it would be ok for me to move onto a full patch next week? Or am I still best waiting until the week after?
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Cori - don't rush things - your body needs time to adjust. If the cramps settle, I'd give it another week or two before increasing. Dg x
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Thank you. I will give it another week, but I want to try and avoid starting a full patch just as I'm going back to work if possible.
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Is it normal to feel a bit spaced out when first starting HRT? Also, I've had a bad headache this evening. I'm praying it's nothing to do with the patch. I wouldn't want these headaches too often 😧 I know it's getting into my system as my boobs are a bit sore. Will that wear off or will they always be sore? Maybe I will carry on with half a patch for 4 weeks altogether.
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Your body will react and what you are experiencing could be initial side effects. I'm afraid you are more likely to get side effects because you are starting with a conti HRT and the progesterone may cause things like headaches. Sore boobs usually wears off after a few weeks but again is worse with conti hrt. Hopefully things will settle. DG x
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Thanks DG 👍
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I think I am going ro have problems with these patches staying put. I applied half a patch on Tuesday. I had a shower today, went to the bathroom an hour later, noticed I was spotting (which is fine as I know that it likely) and saw my patch in the bath! I'm constantly checking to see if it's still on so don't know how I didn't realise it had come off.
I'm hoping the full patches will stay on longer than the half patches. If not, I'm not sure whether to try the Evorel patches, which apparently stick better or a pill. From what I've read online, the different progesterone in Evorel patches can have worse side effects, but I'm wondering how it compares with a pill? Also, if it's more sticky, will it cause more skin irritation? These patches leave my skin red and spotty. It doesn't bother me too much as it's not sore or itchy.
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I personally think you would do better with Femoston 1/10 pills at this stage. It's less hassle popping a pill each day and starting with a sequential hrt is usually better anyway.
I didn't get on with the patches when I tried them but many women love them.
You are very anxious about the hrt anyway so keeping it simple might be you best option and many women do really well with the pills DG x
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Thanks DG. My patch came unstuck at the corner today so I took it off and applied another half a patch in a different place. But that is coming unstuck too. It's always at the corner where I've cut it in half so I'm hoping the full patches will stick better.
Also, I've been bleeding for two full days now. Started off brown, now red. How many days in a row is it normal to bleed for?
You may be right about trying a pill. I really wanted the patches to work as they say there are less side effects eg less chance of stroke etc. But if the patches aren't going to stay on I may have to try a pill. I wanted to avoid having periods if I can but if there are less side effects with a sequential pill then maybe that's the way to go.
Could I be bleeding for so long because I'm using half a patch? Should I start using a full patch? The doctor would probably prescribe a pill for the same dose as a full patch anyway. Maybe I should see how long a full patch stays put before trying a pill. But if carry on bleeding like this I'm not sure what to do.
I'm thinking maybe a sequential pill may be best but not sure which pill to try. My mum took Prempak C before Kliovance. Maybe I will suggest that. How does that conpare to the one you suggested, DG?
A sequential one is the one where you have a bleed, right?
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I'm afraid bleeding in conti HRT can go on for some time when starting conti hrt even if you are deep into post menopause. If you are still peri meno then the bleeding may not stop!! I think I am right in thinking that before the age of normal meno ( so between 51-54) you have to have gone 2 years without a natural period before you are considered truly post menopause.
Femoston 1/10 would be a lower dose than the patches.
The risk of stroke is extremely small unless you have previously had a stroke, have a strong family history of stroke or you are overweight, drink alcohol heavily or smoke.
Prempacvis the old fashioned hrt that had equine oestrogen in itv and these have been phased out because the newer bioidentical hrts are considered safer.
Th half patch may not have sufficient progesterone to control bleeding and if they are not sticking this will effect absorption. Many find the full size ones don't stick so well either.
If you try Femoston 1/10 then this lower dose hrt ( this is lower than the patches you are using) might well be a better start and popping a pill is less hassle.
Maybe try going to the full patch for a week to see what happens so you can tell the GP you have given this a good go? BUT you may find you bleed more. I can't remember whether you have gone 2 years without a period? DG x
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Thank you. I just want to take it off now until I go back to the doctors. I'm due back in 5 weeks and don't even know if I can get to see my doctor before then. Can I stop using them until I go back?
I have only gone 17 months without a period and I'm 43 but the doctor said I was post menopausal. I didn't mention the two year thing to her. Am I best waiting until I've gone two years before starting HRT?
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Cori - it's fine to simply stop the patches. You do not need to wait to start HRT till you are truly post menopause - in fact as soon they realised you were peri menopause the doctors should have discussed HRT straight away - I started HRT when I was peri meno in my mid 30s, I was post menopause when I was about 42. However, starting with conti HRT is not always the best idea because the progesterone can bring more side effects which women find challenging, so by using a sequi HRT, where there is only half the month with progesterone, this will often be easier to tolerate. A sequi HRt will mean a monthly bleed but this will more predictable, whereas, with a conti HRt you often have to put up with erratic bleeding for up to 6 months and if this doesn't settle then investigations are done and a different HRT regime would be tried.
You shouldn't have to mention the 2 year thing to your doctor - they should know this already!!!!!!!
Starting on a medium dose is also tougher for many women as it can be a shock for the body to suddenly get this big hit of hormones - it's often best to introduce things gradually.
If you really want a non bleed easy HRT regime, then having a Mirena fitted would be good and then simply have oestrogen as gel or patch alongside. There are oestrogen only patches that are very small and come in various strengths so much easier to start low and then build till you feel good.
Do remember that HRT is about getting the benefits with minimal side effects and it can be trial and error finding the right regime for you - you have more risk factors if you don't use HRT, so you really need to let go of the anxiety over using HRT.
Phone your doctor and ask for a telephone appointment - explain you have had bleeding (which you know is normal at first on any conti HRt), so you want to try a sequential HRT to see if it's better and also ask of Femoston 1/10 because it has the kinder progesterone. Give yourself one to two weeks without hormones to allow the bleeding to subside and then start the pills and see how it goes. If Femoston doesn't suit you then we can suggest something else to try.
Please, please remember that osteoporosis is a nasty problem and you really don't want this to happen too soon - it's a very distressing, painful and disabling condition and at this stage HRT is your best treatment option. DG x
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Thank you DG... don't know where I be without your help and support.
From what you say about there only being half the month with progesterone and a predictable bleed, I definitely want to try a sequential pill. I will ask about Femoston. Although I am in the Uk and not sure if we have that one?
Would it harm me to wait until the third week in October to start taking it? I was thinking I would prefer to wait until I am off work again so that will give me a week to deal with any initial side effects. Although I understand I may not get any during the first week. If I am going to wait until then, I might just make a proper appointment with my doctor for around the time I should have and she can check my blood pressure etc at the same time.
Another doctor I saw did give me the option of HRT when I was perimenopausal, but I didn't want it. This was before we knew I had osteopenia though, so they didn't mention osteoperosis.
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Cori - here is the link to all the peri menopause HRT types available in the UK and you will see there is Femoston 1/10 and it has a star by it that indicates it is a good one for bone health.
https://www.menopausematters.co.uk/perimeno.php
You can start this any time you want but the sooner you get going on HRT the sooner your bones will benefit - I expect you will be fine with Femoston (it suits many women very well) and by delaying things, your anxiety will simply get worse - if you are working, then you are getting on with life and not focussing on the HRT. It is very, very rare to get side effects that prevent you from working - you are far more likely to start feeling really good after 3-4 weeks.
So why not phone the GP now, get the right prescription, get the HRT pills and start in a couple of weeks - take a pill in the morning with breakfast and forget about it. I bet in 3 months you'll feel much better and relieved you are doing something positive for your health and wellbeing.
What a shame that doctor who offered you HRT when you were peri meno wasn't a bit more insistent - maybe you wouldn't have osteopenia now??!!
You shouldn't need to have your blood pressure checked for some time unless you have blood pressure issues.
Go for it girl. DG x
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Thanks DG. I might phone the surgery tomorrow and see if I can get a telephone appointment.
Do you only take a pill for 2 weeks out of 4, not 3 weeks like the contraceptive pill?
Does it matter what time of day you take it? If it has to be taken at the same time everyday, evening might be best for me as I get up later at weekends and when I'm not working.
Not sure if this is related to the patch but I woke up today with really sore legs (thighs) and they've been sore all day. Should I be concerned?
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Sequi hrt is nit the same as a BcP.
Hrt pills are taken everyday and will be 14-16 days of just oestrogen and then the remainding pills of a full cycle will be a pill with both progesterone and oestrogen.
This is a 28 day cycle and once you finish the progesterone + oestrogen pills, having started the next pack with oestrogen only, the bleed usually arrives within 2-3 days. It can take a few months for the cycle to settle but Femoston 1:10 is a good dosage.
You can take the pills at any time of day but I would take them with a meal and at the same time of the day, each day, to give consistency. It's also easy to get into a good routine with Hrt pills - perhaps set a reminder on your phone.
The sore legs may be due to your uterus (womb) reacting to the hormones and this should settle as everything wakes up and improves.
So many parts of our bodies become dormant and atrophied with oestrogen deficiency. DG x
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Thanks DG.
I am still bleeding now quite heavily after removing my patch and have had a headache since this afternoon.
Will the bleed always arrive after the progesterone and oestrogen pills have finished or could it arrive before?
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It can sometimes arrive a bit early but the bleed usually arrives one to two days after finishing the progesterone phase while you are taking the oestrogen pills. The leaflet with the pills should explain everything. The headache and heavy bleeding you are getting now needs to happen to shed the womb lining that has built up. It should settle within a week or so. DG x
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Thanks DG.
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The soonest I could get a telephone appointment with my doctor was Sep 18th and the soonest real appointment was the 25th, so I thought I may aswell wait the extra week for that.
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Go well prepared for the appointment with stuff written down and print off the info from this site about the hrt you want to try. It's going to be trial and error but you do need to get some hrt up and running soon.
DG x
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Yes I will, thanks DG.
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The day has almost arrived for me to go to the doctors and ask for Femoston 1/10. I was wondering, if I start taking them on Wednesday 26th September, what date would my first period be? How many days after starting them do you get your period? I'm planning on taking them around 6pm. Does it have to be bang on 6pm everyday? Will it affect anything if it varies 2 or 3 hours?
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Thanks. How many days is that after the first tablet? Do you take the progesterone tablets for 3 weeks and the other ones for a week?
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I went to the doctor's today, told her what happened with the patch and said I would like to try Femoston 1/10. She said yes that's fine, we prescribe that one. Then she said she couldn't understand why I wanted a sequential pill and that she thinks a conti pill would be best for me. I said because I want a more predictable bleed and less side effects. She said I will only get random bleeds in the first 3 months and there are no more side effects on a conti HRT. She was quite insistent and part of me doesn't really want to start having periods again, so I agreed to trying Femoston-Conti 1/5. I really hope I'm doing the right thing. I said what if I bleed? She said we can give you some more tablets to counteract that??
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Your GP is wrong!!! Using progesterone all the time will often bring more side effects and taking extra progesterone together with the conti HRT really will give more progesterone side effects. Do try the Femoston conti and see how it goes. DG x
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Thanks DG. I'm going to give it a go. Do you think I should try and stick it out for 3 months, providing my side effects aren't extreme?
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Hi Cori
Yes. Stick it out for the full three months. You might get a bit headachey, have sore boobs and some erratic bleeding, but persevere. There is no magic, overnight bullet with these things and you need to give it some time until it all settles. Trying not to overthink it all will help too - keep a mood diary, then you can compare as you go along. Good luck with it all xx
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Thank you NorthArm.
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The main thing is with a conti HRT you may well get random bleeding for the first 6 months which is quite normal!
Also Femoston 1/5 is a low dose oestrogen and as you are young you may well benefit from a higher dose, but Femoston does not come any higher in a conti preparation - but see how you get on anyway....
I hope it works for you!
Hurdity x
PS haven't read all the thread so apols if I've repeated something that's already been said!
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Thanks Hurdity. I just hope it's strong enough to make a difference to my bone density as that's the reason why I'm taking it.
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Oestrogen Patches or Oestrogel are usually better than pills - these can be used with the Mirena OR you can take progesterone as Utrogestan or Provera, sequentially or continuously.
You can get combined HRT patches which have both oestrogen and progesterone.
Here are the links on this site that give all your treatment options.
https://www.menopausematters.co.uk/treatment.php
https://www.menopausematters.co.uk/treatafter.php
https://www.menopausematters.co.uk/to_progestogens.php
https://www.menopausematters.co.uk/perimeno.php
https://www.menopausematters.co.uk/postmeno.php
DG x
Hi, I've just joined this site, so apologies if I don't get it straight away. Dancing girl u sound like a medical professional and I think your posts are super and very informative... I had awful problems getting pregnant, hormones all over the place, started ivf, had beautiful twin girls and was put in hrt immediately at 40. There's just so much cancer in my parents families that I'm afraid femoston might contribute even more. I'd also love some ideas on natural, trusted forms to ease this as I've started getting slight hot flushes again but I've also missed a few pills. Thanks
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Hi and welcome to MM clairep
I am not a medical professional (though I have quite a few medical professionals in our family)but I had a premature menopause, so have had around 25 years of dealing with all the menopause problems.
Delighted to hear you had your daughters but I'm sure coping with them and the menopause is challenging at times.
You haven't told us how old you are now? Which Femoston are you on? When you say there is a lot of cancer in your family, what cancers are these?
If your mother or sister have had oestrogen receptive breast cancer then there could be some concern but with proper monitoring the risks of cancer generally are very small.
The important thing to remember is that the normal age for menopause is between 52-54, so using HRT till at least 54 is simply replacing what your body would produce naturally. I believe trials have shown that 5 years of HRT in our mid 50s (so beyond menopause) will lengthen our lives and protect the bones and heart for the long term.
Femoston has bio identical oestrogen(as do most HRTs now) so is a good hormonal supplement. There are no alternatives to HRT that will protect your bones, heart, skin, muscles, bladder etc. in the way HRT will, so please be reassured that you are definitely doing the right thing by using the Femoston. You need to take your pills properly and regularly but if the flushes are emerging again you may be needing a higher dose - maybe try the Femoston 2/10?. Often a higher dose is needed because your own hormones have bottomed out and the body is craving more oestrogen. If you find the progesterone in Femoston suits you Ok, then I wouldn't change HRT type. However if you would like to stop having bleeds and want to increase your oestrogen level more, then having a Mirena fitted can be a good alternative and use oestrogen in patch or gel form alongside.
There are many that use Utrogestan (bio identical progesterone) as the progesterone part of HRT alongside oestrogen only patches, however it can have a sedating effect and doesn't suit everyone.
I can understand your concerns regarding cancer but the scares in the press have been greatly overplayed and the very small breast cancer risk only applies if still on HRT beyond 60.
Quality of life is terribly important and being on good form for you family is also vital. There are so many HRT options but there are no true ‘alternatives' that will control flushes and protect you bones the way HRT does.
Keep posting. DG x