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[marras]

 
Have suffered for 12 years with menopause symptoms and didn't want to go on HRT as worried it would make my migraines worse. However, at the age of 62 I could stand no more and consulted a private Gynae last November who put me on 25mcg Estradot and 1mg Climaval. I initially felt much better and the migraines weren't any better but weren't worse either. However, eight months on and I've had four migraine attacks, three with aura, in the last month and I feel dreadful. I've hardly recovered from one when I get another. I've had a phone consult with the Gynae who says it's not the oestrogen causing the migraines and is convinced it's insulin resistance for which she had put me on Metformin.
The Migraine Association recommends that migraine sufferers should have the patch only and The Gynae has agreed that I wean myself off the tablet and just use the patch. I don't want to come off HRT altogether as it does control the hot flushes and I sleep better but if it is causing the increase in migraines then I shall have to. I have cut out a lot of sweet stuff and have a good diet and do a lot of walking and swimming and I not convinced that insulin resistance is my problem. I feel very frightened by these migraines and not sure what to do. I don't have much faith in GPs. I'm fortunate that I can afford the private route but I'm not sure my GP practice does private appointments and I have to wait weeks for an NHS one. Oh dear!

[dazned]

Hi not sure if this might help but if you can afford private route try looking for a private endocrinologist,even better if you can find one with an interest in meno,but that be pushing it 
Just Google endocrinologist for your area then look them up to see their interested fields. Wishing you well.

[Kathleen]

Hello marras and sorry to hear that you are suffering.

Forgive me if this sounds stupid but could you be reacting to the Metformin? I ask because my MIL is a type 2 diabetic and her GP recently commented that some of her problems may be due to this drug rather than the diabetes. Worth thinking about possibly.

I hope you can find a solution soon and wishing you well.

Take care.

K.

[marras]

Thank you both for your replies. I did come off the Metformin for a while as wondered if it was causing my indigestion but I still got the migraines. However the Gynae has now suggested I try Glucobay.
Thanks Dazned for your suggestion of seeing an endocrinologist, brilliant idea. Shall do some research for one in this area. I can tolerate most things but migraine doesn't make life worth living.

[CLKD]

 

[marras]

Thanks for hug CLKD, really need it.
I think I shall have to come off the HRT as on my fourth day of yet another migraine with aura. I feel absolutely awful and quite ill. I have lost confidence and don't want to go out and can only assume that the tiny bit of oestrogen that I'm taking is exacerbating my migraine. I have already reduced the Climaval tablet to every other day and now I'm wondering if I should cut my patch in half as well although it's only 25mcg. Suppose I'd better see my GP for some advice but don't have confidence in GPs.

[Dancinggirl]

marras - why are you on a pill and patch form of oestrogen??  At your age I would have thought using just transdermal oestrogen would be the best option and less likely to give you migraine. I assume you have had a hysterectomy?
I just wonder if you would be better using Oestrogel which allows you to control the amount you use and I also wonder if you could do with a lower dose??!!! I am 59 and I find one pump per day of oestrogen ( a low dose) keeps my flushes at bay and I do get fewer headaches.  2 pumps per day gives me headaches and no oestrogen at all also gives me more headaches - so maybe it's about finding the right amount for you???  DG x

[marras]

Thanks for your reply DG. I have no idea why I am on pill and patch but not for much longer as phasing out the tablet now and really not sure which way to go with regards to the patch. No, I haven't had a hysterectomy. My Gynae has given me Cyclogest to use three times a year but I'm petrified and haven't used it yet. Just don't know which way to turn and feel really quite ill today. I thought I was doing the right thing getting private treatment but have lost a bit of faith now as she says my problems are metabolic and it's not the oestrogen causing my headaches. However, I spoke to my daughter today who reminded me that when she first went on the pill many years ago she had her first ever migraine with aura and they told her she was allergic to the oestrogen part of the pill and put her on the progesterone only pill and she's never had another migraine since. That tells me something!

[Taz2]

Sorry to hear you are feeling so unwell marras. Do you mean that you are using oestrogen but no progesterone at the moment? I agree with Dancinggirl that at your age (I'm 61 myself) it's usually advised that you should only be on a patch type HRT due to increased risk from stroke from pill HRT once over 60. You also do need a progesterone to keep your womb lining thin.  What is it that worries you about using the cyclogest?

My mum was on Metformin for her diabetes but it gave her uncomfy side effects - mainly nausea and stomach pain but also depression and tearfulness.

Taz x 

[dazned]

Marras if you have been using the oestrogen since November you really do need to use the progesterone this is what will ensure that the lining stays thin and that you don't get a build up as Taz2 says. Ask any questions you have but you can't use one without the other if you still have your womb.

[marras]

Yes, I do realise about the womb lining but everything I've been feeling since going on HRT has been so erratic that I can't cope with anymore and I'm scared that the Cyclogest might give me even more migraine. I've already made the decision to come off the Climaval and will probably come off the patch as well but at the moment not sure which way to turn and don't know who to ask. I've recently moved and my doctor doesn't know me from Adam.

[Taz2]

I think that even though you have decided to come off the pill you need to use some form of progesterone as soon as possible or, failing that, ask for a scan to check the thickness of your womb lining. Just stopping using HRT won't give you a bleed as it's the withdrawal of progesterone which triggers it. I know it's scary but far better to know where you are in this respect - one less worry.

Have you been referred to a migraine clinic or someone who can help you re the migraines and what medicine do you take to help with them?

Taz x

[dazned]

I know how it feels believe me   

But you only need use it for 12 days the any excess will come away.progesterone usually helps make things calmer ,alot of people say they feel tired ,but everyone is different. 8 months could be quite a build up can't emphasize enough how important it is to pluck up the courage to use it . As you say you have alot going on and you need proper medical guidance and support,we can help you too. Either see a different gynecologist to discuss your options with or a meno clinic. Wishing you well.

[Dancinggirl]

marras - Climagest is another form of HRT that combines oestrogen with progesterone so would be adding some more oestrogen to your mix - all very odd!!!!  All you need at the moment is some progesterone to shed your womb lining.  It's very strange that this gynae has prescribed so much oestrogen without some proper progesterone.
I really wonder if your migraines will be better when you are just using the patches? I would get back in touch with your doctor and ask for something like Utrogestan or Provera to induce a withdrawal bleed as you may feel better once you have shed the lining and are more in balance.  The headaches one gets with 'The Pill' I think are because the oestrogen in The Pill is not bio identical but the oestrogen you are using is bio identical so very different and less likely to cause problems.  I still think you probably need just a low dose of oestrogen for a while.   DG x

[marras]

Thanks for your replies, I really appreciate your input. I had a baseline scan in April and the endometrial thickness was 5mm and the consultant said that I didn't need to take the Cyclogest until August.
Goodness knows why I said I was 62 when in fact I'm 65! Maybe wishful thinking but more like brain fog!!
With regard to the migraines I have suffered with the since I was 8 years old and both my sisters do too. I have tried various medications over the years including prophylactics but nothing stops them. Looking at the info leaflets which accompany the Climaval and the patches both mention migraine as contraindicative. I did know this but felt it worth a try as it could have gone the other way. Thanks for you opinion regarding trying the patch only DG. When you say 'The Pill' do you mean the Climaval I've been on?