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[catblack]

Hello, I have been on HRT for roughly 15 years (Tibolone). It was a wonder drug, solved all my menopause problems brilliantly. However in April I had a T.I.A.. The consultant said to come off HRT because of the stroke association, although my doctor doesn't really agree about that. I have gradually weened myself off of it over 4 months and now after 2 weeks feel the flushes, tingling, etc coming back. The doctor gave me Venlafaxine anti-depressant, saying it would help with flushes, but I don't really want to start that, scary stories about being both on it and coming off it (it has been discontinued in the US). I have to take Clopidrogel anti-platelet medication for the stroke thing and the consultant suggested statins as well, but my cholesterol is within the normal range, so not taking that either. Basically, is there any other magical potion out there to help? Has any one tried Acupuncture, which I see is one of the alternative therapies recommended? or Reflexology?
The (possible) effects of the stroke and getting the menopause symptoms back again is most disconcerting, feel like I'm going slightly mad. Also should I take vitamin, or calcium supplements, something else I read about bone being weaker after stopping HRT?
Any advice gratefully accepted.

[SadLynda]

Hi Catblack, afraid I cant help either.  But I suspect some of our more 'clued up' ladies might first ask how old you are, if you dont mind to help them compare experiences.

I have not had acupuncture for this (yet) not got around to asking him.  But if you did take that route, I would suggest a well trained private one who has done over 10 years in training in India/China.  My guy who cured my sciatica and a few other ailments is amazing, and I have heard so many who have had no result at all from the nhs acupuncture available which is a very short time of training for.  I have been trying all the alternatives too, but cant say I am that impressed so far.

[catblack]

Thanks for the welcome.
I am 61 (still find it weird to think I am 61!!), have always been healthy, the peri-menopause was a shock, suffered with terrible flushes and sleepless nights for a year before going on HRT. I really do not want to go through it again, didn't realise that's what happens when you stop. There is an Accupuncture school near where I live, they give sessions at half price for the final year students, which is the only way I would be able to afford it, I thought it would be worth a try....

[Taz2]

Hi Catblack - welcome from me too.

It seems a shame that your HRT wasn't changed to either patch or gel as you got  nearer the age of 60. Although Tibolone suited you well it is not advised for women over 60 due to the risk of stroke. Patch or gel HRT is considered safer up to the age of 70 so, although you may not wish to go back down that route, it may be worth bearing in mind if you can't find anything else to help. As for acupuncture I think that it may enable you to cope better with the symptoms of menopause even if it doesn't change them much.

Taz x 

[Hurdity]

Hi catblack

....and from me as well!

Sorry to hear about your TIA and I agree with Taz re the patch. I am 62 and have been on HRT for 8 + years - but have always used transdermal HRT (patch) and vaginal progesterone so have not taken tablets. I don't have plans to stop any time soon and so far I haven't had any health issues although if I do I will have to re-think HRT.

Are you able to perhaps consult a gynaecologist who can specifically advise on the stroke risk and a low dose transdermal HRT? This is what it says on this site about the risks:

"The incidence of stroke increases in women after the menopause and an association between a protective effect of ovarian hormones estrogen and progesterone has been suggested. Similarly, it was thought that the use of HRT reduced the risk of stroke. Although some studies have shown a protective effect, others, including the Women's Health Initiative trial, have shown a small increase in risk of stroke in those women taking HRT. It has been concluded that HRT should not be used for either primary or secondary prevention of stroke. If a woman has had a stroke and is considering treatment for menopausal symptoms, non-hormonal options should be tried first and HRT should only be considered after full discussion with a specialist".
http://www.menopausematters.co.uk/atoz.php#GlossS

Unfortunately there is no magic potion and I fear also being in your position when I eventually decide to stop HRT for whatever reason (health or age) in the future. Taz is right about acupuncture - its value is therapeutic (similar to placebo) rather than some mystical effect of pressure points. Here is an article about the scientific studies:
https://www.sciencebasedmedicine.org/acupuncture-for-menopausal-symptoms/

This is the key conclusion from an analysis of a lot of studies:

"The therapeutic ritual surrounding acupuncture has predictable placebo effects and nothing more". This is because studies have failed to show any significant difference between "sham" acupuncture (just sticking needles into the body) and "true" acupuncture (using specific pressure points - the basis of this alternative therapy). As such of course it has some value - but not like HRT.

Re supplements - of course you need to make sure your diet is excellent - a variety of foods and full of fresh and unprocessed low fat ingredients, not too much carb and low sugar. I'm sure you know all of this - limit alcohol and smoking, maintain weight in healthy BMI, take plenty of exercise/fresh air, get enough sleep, reduce stress etc.

Good luck and hope you don't suffer too much. We are here to advise and support you anyway!

Hurdity x

[catblack]

Wow! Thank you so much! Just going to bed and thought I would check see if any reply and feel a bit blown away actually. I shall read and digest in the  morning.
Thank you

[Sarai]

Hi, I am in the club that is a stroke risk as I have APS a blood clotting disorder. I am on daily fragmin (blood thinners) injections. Previously I spent years on warfarin. I did also have had plavix like you.
My consultant an expert in his field as he discovered aps says if we are fully anticoagulated hrt is ok he recommends low oestrogen. I have just got his permission for my GP, don't know if I will use it though.
I would say being properly anticoagulated is going to be more that just plavix.
Maybe get a referral to a knowledgable doc mine is a rheumatologist based in London, but a good haemotologist should understand the risks and benefits.
Have you been shown to be post menopausal now? Hopefully if you are the rotten symptoms will settle. I have a friend who gave up hrt as she did not want a bleed and eventually everything settled.

[Jenni]

Hello, I have been on HRT for roughly 15 years (Tibolone). It was a wonder drug, solved all my menopause problems brilliantly. However in April I had a T.I.A.. The consultant said to come off HRT because of the stroke association, although my doctor doesn't really agree about that. I have gradually weened myself off of it over 4 months and now after 2 weeks feel the flushes, tingling, etc coming back. The doctor gave me Venlafaxine anti-depressant, saying it would help with flushes, but I don't really want to start that, scary stories about being both on it and coming off it (it has been discontinued in the US). I have to take Clopidrogel anti-platelet medication for the stroke thing and the consultant suggested statins as well, but my cholesterol is within the normal range, so not taking that either. Basically, is there any other magical potion out there to help? Has any one tried Acupuncture, which I see is one of the alternative therapies recommended? or Reflexology?
The (possible) effects of the stroke and getting the menopause symptoms back again is most disconcerting, feel like I'm going slightly mad. Also should I take vitamin, or calcium supplements, something else I read about bone being weaker after stopping HRT?
Any advice gratefully accepted.

Hello I am also a newbie aged 67 and have had hot flushes etc. etc. since I was 47( 20 years now). My periods stopped at 52 but the symptoms went on. I tried several types of HRT but had really bad migraines so Dr. said I would have to come off it and just put up with it. I went back every year asking if there was anything else I could try but was told no. One medic even said "Well hot flushes aren't going to kill you". I tried all the herbal things on the market but nothing helped. About 7 years ago I saw a female nurse practitioner who prescribed Tibolone. Miracle!! the hot flushes and night sweats, mood swings all disappeared. I went for regular check ups and at last I felt I'd got my life back. Last year, a new female Dr. put me on patches instead. She said there was less risk of heart attack and stroke, so it seemed a good idea. However, after 14 years without periods I started to bleed every 2 weeks (for 7 days). I persevered but was sent for 2 internal scans and eventually a hysteroscopy. They found nothing wrong apart from slight thickening. I was advised to wean myself off the patches, the bleeding stopped and after a few weeks went back on Tibolone. I felt good again and carried on with my life. My husband and I eat well and walk as much as possible and ski in the winter. We also still had a very good sex life (yes, after 46 years with the same and only man).
Then 8 weeks ago, and right out of the blue I had a TIA (mini stroke). The Dr. at the hospital told me to come off HRT that night and put me on statins and blood thinning tablets, and said I will have to take them for the rest of my life. They still don't know what caused it because I have normal blood pressure, and cholesterol, don't smoke, don't drink much alcohol and there's no history of strokes in my family. I was OK for 2 weeks but then the flushes started again and have just got worse and worse. I'm hot and sweaty all the time, can't sleep properly, I'm moody and I'm getting very depressed thinking I'm going to be like this forever.
Do'es anyone know of anything that will help and can be used with my meds.

[Butterfly22]

Just wanted to say hello too, you are having a rough time but your in the right place xxx

[CLKD]

Welcome both!

catback:  "The doctor gave me Venlafaxine anti-depressant, saying it would help with flushes, but I don't really want to start that, scary stories about being both on it and coming off it (it has been discontinued in the US)" - you took HRT probably without thinking about it and now that you need to try something else due to health problems and your GP has suggested an AD that does help some ladies and eases their flushes .........
 .  Maybe ignore the info about what happens in the US, that's over there  .  Have a look at what NICE suggest?

Many people, including myself, take ADs successfully.  Some ADs need weaning off B4 starting a different types, others do not.  I have experience of both types.  A few people have un-bearable side effects.   It really can be Trial and Error which is so tiring. 

Brisk walking several times a week can protect bones and heart.  You will need to talk with your GP or Consultant regarding calcium etc..  It may be worthwhile getting your GP to arrange a DEXA bone scan so that you have a base line from which to work.  In general exercise and a diet including dairy should be enough.

Jenni - browse round, make notes.  TIAs can come out of the blue, regardless of whether you are on medication/not.  Are you having regular checks with a Consultant?

[Hurdity]

(CLKD this is a very old thread from 2015 and catblack has not been on the forum for almost 6 months and your reply to her will likely fall on deaf ears!)

Hi  Jenni

Your post got missed as it was an old thread  - if you want to introduce yourself then perhaps start a new thread? Anyway I am really sorry to hear about your TIA and having to come off HRT. In fact patches are thought to be the safest way of getting HRT once over 60 due to risk of stroke so that I am a bit surprised that your doctor put you back onto Tibolone especially knowing this. Also this particular type of hRT carries with it the risk of endometrial thickening so it is likely the bleeding you had when starting the patches was due to the stronger progestogen beginning to shed the lining.

I can't comment on your meds - but I did think statins were for people who had raised cholesterol? Has your specialist ruled out continuing with patch HRT in the long term (once your womb lining has thinned)?

If you want to look at other treatments then there are various papers outlining the scientific basis for alternative treatments - here is one such:
http://journals.sagepub.com/doi/full/10.1177/2053369117711646?hootPostID=6690d93930a10b86869c48433ab506e7

Hope this helps

Hurdity x

[Jenni]

Hi,
Thanks for the reply. As I said I'm new to this and was having trouble finding out how to reply or comment on anything (posts?). I emailed for help but didn't get a reply. I still haven't worked it out. I don't do anything like this normally because I'm not very "techi". How do I do a new thread?

The Dr. took me off the patches because the bleeding went on for about 8 months, and wasn't getting any less. After the hysteroscopy  I asked to go back on Tibolone because I didn't want the bleeding or the hot flushes etc and I wasn't offered anything else (apart from the usual grin and bear it!!). These young female Dr.s don't seem to have much empathy with women of my age, because they think the menopause is something that will pass, and none of them have gone through it themselves. It has blighted 20 years of my life, one way or another.
I had the TIA when we were on holiday, so the stroke specialist I saw was in another part of the country. I haven't seen a GP since it happened as the only appointment I could get was with a nurse practitioner at our surgery. I had a 24 hour ECG last week and it will be 2 or 3 weeks before they get the results. I think this has been done to rule out that the TIA was brought on by a heart problem.
So, I haven't actually discussed my menopausal problems with anyone since the TIA apart from just after it happened to the NP who said "Oh don't worry about it, the problems probably won't come back now, at your age). How wrong she was!!!
I was going to wait until the results are through and then try to get an appointment to discuss the whole thing at once. I just thought I might get some ideas on here that I could put forward to the GP.
Anyway thanks again. Jenni

[CLKD]

Whooooops  .........  my suggestions were as useful as a chocolate fire-guard then 

[Hurdity]

Jenni  - Don't worry now about a new thread now - I just thought you may get more replies - you could still introduce yourself though to say hello and say you've posted on this thread - if you want to that is! You just go the the new members section (where you are now) and top right there should be a little blue tab that says "New topic" - just click on that, give the thread a title (in the subject bit), say something in the main box, scroll down to "post" and away you go!

It does sound to me like the bleed from the patches was from overgrowth of the endometrium on the Tibolone and if your womb lining is now thin (has this been shown from a scan?) then the bleeding should stop. I would press for a specialist appointment following the results of your tests and if you are given the all clear a menopause specialist may well prescribe patches but try to push for seeing a doctor/gynae not NP - and especially at a specialist clinic as they will have the expertise, knowledge and discretion to say yay or nay.

Do have a look at that link which outlines the other possibilities than HRT. If having tried all the options they really say that re-starting HRT even patches are inadvisable due to your TIA then I would go for one of the prescribed alternatives - in your position and at your age. I mean why go on for another 10 years of flushes (if this is how long they go on for)? The link I gave says this: "paroxetine is the SSRI with the best evidence for efficacy effective at 10 mg daily" ie best for hot flushes. I would do the same if I had to stop HRT for medical reasons and flushes came back and refused to abate after a few months.

Haha CLKD! You should read the date!!

Hurdity  x

[Jenni]

Whooooops  .........  my suggestions were as useful as a chocolate fire-guard then 

Sorry, I've only just seen your reply because I thought it was for someone else. All suggestions are helpful in my situation. Thank you.