Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Ajay]

Hello everyone!

Well having floated around this forum like a sweaty, irritable (often tearful) ghost I've finally taken the plunge and am joining in. I have to say the wealth of information and support on here is astonishing and everyone is so polite - not something you often see on web forums!

So, at 52 I find myself on the good ship peri-menopause. I think I've been going through it for a while starting with sleepless sweaty nights, increasingly erratic periods (having been like clockwork all my life) and finally, the straw that broke the proverbial camel's back, the most spectacular mood swings. Who knew you could veer from tearful to elated via anxious and depressed in the space of an hour? Not my (very patient) hubby that's for sure I honestly felt like my brain was short circuiting. So off to the docs I toddled.

My lovely male GP was incredibly supportive and quick to admit he was no expert but put me straight in touch with another female GP in the practice who has a special interest in menopause. I do feel very lucky with our local practice having read some of the stories on here. She suggested a mirena coil and oestrogen gel but wanted an ultrasound first to check for fibroids. I wasn't having particularly heavy periods so felt confident they wouldn't find anything. Ha, guess what - I have a large orange sized fibroid attached to the back of my uterus (probably outside) on a stalk! I think the technical term is 'pedunculated subserosal'. I prefer to call it Fred.

Anyhoo, having spent quite a bit of time reading up various HRT options on here I was pretty sure I wanted to try bio-identical hormones and my GP was more than happy to oblige. As Fred wasn't giving me any trouble she suggested no action was required there, but to report back any troublesome symptoms and that they'd scan again at some point to see if the oestrogen was having any effect on it. And the coil was out because of Fred. So, I left clutching a prescription for Estradiol gel (2 pumps a day) and Utrogestan 200mg to be taken days 11-26 of my cycle.

So I'm now 6 weeks on and found that the Estradiol worked pretty quickly on the sleep, sweats and screaming ab dabs, I certainly felt a bit more level/clear headed. The Utrogestan was fine until day 7 when nausea hit me and then all the Estrodiol goodness seemed to be cancelled out somehow. Then the promised 'withdrawal bleed' didn't come until a week later accompanied by some pretty painful cramps focussed around my back and left leg - I'm thinking Fred might be responsible for those?

I've seen my GP since then and she's suggested extending the cycle so that I have four weeks Utrogestan free. I then asked the other question that I think she was half expecting - what about Testosterone? I have noticed a dip in libido and 'response' and could still do with recovering some of my 'get up and go' and it seems that testosterone does bridge that gap for women? She was still pretty supportive (and I knew she wouldn't be able to prescribe it) so has now handed me over to the big guns at the Menopause Clinic at St James's in Leeds as she thinks they will prescribe testosterone. I'm hoping they'll also do some hormone blood tests - my GP was reluctant to as she didn't think it was worth it as I was already on the HRT. Not sure if that's right or not?

Sorry for the lengthy tome, it's all been bottling up in my head so it's high time I got it off my chest. If anyone has got to this point in my post without nodding off (congratulations), I do have a few questions I'm itching to ask you lovely lot:

1. Does anyone else have a Fred like mine - and how has it been on HRT?
2. Should I be on a lower dose of Utrogestan. And would it be better taken vaginally?
3. Should I be having a blood test now to check hormone levels?
4. Anyone else been to the Leeds menopause clinic at St James's?
5. Testosterone! Yes or no?

Thanks in advance everyone...

Ajay
 

[elsie001]

Hi & welcome to the forum Ajay.

Sorry I can't answer any of your questions I'm afraid as I just have the mirena coil at the moment (peri, aged 50). Hopefully you'll get some more useful & informative replies soon.

Good ship peri-menopause - love it!

Elsie x

[Elizabethrose]

Hi Ajay

I can't help with the HRT queries or 'Fred' I'm afraid but I just wanted to say welcome to the forum. You have a great, positive attitude and it really helps to have a sense of humour, especially when juggling the myriad of goodies that peri thrusts upon us. I really wish you well and feel sure someone will be along soon who can offer advice on the HRT etc. x

[Ajay]

Thanks Elsie. All aboard! ;-)

Did you have the mirena specifically for HRT or for contraceptive reasons too? My GP did suggest revisiting the idea when I told her about the Utrogestan side effects - and as the fibroid is external (we think) it wouldn't necessarily be affected by the coil. I'm not too sure. How do you find it?

Ajay
x

[Hurdity]

Hi Ajay

 

Firstly - great news that you have a sympathetic and up to date doctor who is prepared to listen and prescribe what you would like to try and need!!

Re the fibroid - I am interested in the fact that she scanned you for fibroids in advance of taking HRT without any symptoms as this is not routine and wondered if there was an indication that this was necessary eg some abnormal bleeding or pain?

To answer your questions:

1 I had a small fibroid ( 0.8 cm so very small - found on scan because I had spotting after sex but this was not considered problematic. The next scan I had ( to see if it had grown) - it had actually shrunk! Orange size is quite big though. I can imagine that might be quite uncomfortable and could cause bleeding?

2 You are taking the licensed dose of utrogestan and this is recommended at least initially until you see what sort of bleeds you get, but can be varied under supervision depending on your bleeds, the presence of fibroids etc, your oestrogen dose and resultant systemic levels, and how well you absorb the progesterone as well as how you take it! You will experience fewer side effects if you use it vaginally which is how I've always taken it. More gets into the system this way - and with a fibroid you may well need this. Great though that GP is happy to extend your cycle!!

3 Blood tests are not necessary and especially at your age and once you are on HRT. Don't be persuaded otherwise unless they are done at no cost as part of your consultation. If you are feeling well on that oestrogen dose then you are fine!

4 No - I live in SW

5 I am not sure whether you would necessarily benefit from T (or even notice its effect) for just a slight dip in libido. If you are peri-menopausal then an increase in oestrogen may well make a difference in this respect. It is important to top up oestrogen before adding T. I did notice a drop in libido for quite a few years from late peri-menopause onwards- as well as decreased response. I am well post-meno and in my 60's and started to take it over 18 months ago. It has made a huge difference to response but not to libido ( I don't mind that!) and to my energy levels generally. If your reduced libido etc is problematic then no reason why you should not ask for it, although you might like to wait a couple of years?

A Mirena does sound like it might be a good idea re controlling your fibroid?

Hope this helps and good luck at the menopause clinic - do report back and let us know how you get on

Hurdity x

[Dancinggirl]

Hi and welcome to MM Ajay
I love your dry humour.

I've just noticed Hurdity has done a post and she gives excellent advice.

I am not the best person to ask about Utrogestan as out of all the progesterones I have tried (and I've tried just about everything) Utrogestan gave me to most problems - erratic and heavy bleeding, nasty cramps, feeling sedated etc. Utrogestan is supposed to be the least risky in terms of breast cancer but for me it was far from ideal.  However the risks of BC is very small unless you are over 60.

My only comment would be to suggest having the Mirena, as this is known to shrink fibroids (this local progesterone might still have an effect on your fibroid), is very effective at keeping the womb lining thin  (therefore reducing the risk of womb cancer) and will usually result in no bleeding at all after the first few weeks - which can be great!!! I had a Mirena for 4 years (post meno) and it was good apart from a little sedative effect in the first few months - I slept really well.

If you want to help your libido then it's worth trying Tibolone (Livial).  Apart from this aggravating my acne, I felt really great on this and it certainly helped the meno symptoms and the libido   However I think you need to be post meno to have this.

I'm 60 now, recently stopped systemic HRT and actually I've found my libido is not bad!!!! - I'm taking life a bit more easily these days and not being so tired makes a big difference. I use local oestrogen and vaginal moisturisers to help with vaginal dryness and loads of lubrication for sex

Hope that helps.  Dg x

[Ajay]

Hi Hurdity,

Thank you so much for replying to all my questions (and reading my lengthy post!).

Re the scan - my GP wanted to check for fibroids before fitting a coil. I had no symptoms like heavy bleeding, spotting or pain - at least none that I would have attributed to a fibroid at the time. Apparently, they do these pre-coil fitting scans as a matter of course in our surgery as they have a private ultrasound service that comes to the surgery twice a month. As I said our GP surgery is pretty amazing! Glad I had it now as I don't think I'd have known until it really started to give me some symptoms. Maybe it's because of its position - outside the uterus? Even now I'm not sure if it's contributing to the back/leg type pains I get during my period.

Glad you think blood tests aren't necessary as I was a little worried - does feel a bit like guess work on dosage etc. And your thoughts on testosterone are interesting, it all feels like such a complicated balancing act! It was reading about Prof Studd, Nick Panay and all the stuff that's been in the press lately that got me thinking about the testosterone approach.

I certainly will report back from the meno clinic - my appt is on 29 Dec, just a five week wait which isn't bad.

Ajay
x

[Ajay]

Hi Dancinggirl,

Hello and thanks for replying.

Oh dear, I think I've just discovered yet another work distraction - as if Twitter, FB and Instagram weren't enough

Yes Hurdity is like the hugely knowledgable prefect of the forum.

My GP did suggest thinking about the Mirena again once she's established my large fibroid is on the external wall of my uterus. Apparently not an option if it was inside? So I'm interested that you also think that could be a good option. I never thought about its actual effect on the fibroid either but it does make sense.

I did ask about Tibolone and was told that it could only be given if I was past having periods. I didn't ask why this was - if anyone knows on here I'd be interested! It does sound like a good alternative for libido boosting. I'm not suffering too badly with dryness yet but you've reminded me of a very near miss we experienced a couple of nights ago...

While we were enjoying a romantic and passionate moment downstairs in front of a roaring fire my lovely hubby offered to head upstairs and fetch some lubricant that I told him was in my bedside cabinet. After a rather long wait I went to check what was taking so long (it's the same when he's looking for something in my handbag) only to find him poised, manhood in one hand and my Estradiol in the other. Thankfully contact hadn't been made, lord knows what effect that would have had on him.

Ajay
x

[Dancinggirl]

Oh Ajay - you have got to keep posting - you are going to really liven up this forum.

I believe many gynaes favour the Mirena if fibroids are present - mainly because they stop the oestrogen feeding the fibroid so they often shrink - I could be wrong but I have read this somewhere on several occasions - I think women posting on MM have been given the Mirena for this reason.

Could be worth having a referral with a gynae to check on this.  The problems with the peri meno stage is the fluctuation of hormones.  Sometimes the oestrogen can rise and this will make the womb lining thicken and if no ovulation occurs there won't be the progesterone to shed the lining.  I'm not sure why or how fibroids develop but they are common at the meno - I believe because of these fluctuations.

You have options - give it some thought.  Dg x

[CLKD]

 

[Ajay]

Hi Dancinggirl,

I can't believe I'm getting so much useful info already on here - I had not made the connection between a having a Mirena and shrinking Freddie the Fibroid. I'll certainly be exploring this when I visit the meno clinic in December now.

This whole (peri) menopause business is like training for a new career, so much to learn, so little time...

Thanks again for all the thoughts and advice. And welcomes! 

Ajay
x

[elsie001]

Ajay, your comment about your OH & the Estradiol really made me chuckle - bless him!

I've had my mirena for around 14 months now and love it.  Definitely not needed for contraceptive purposes - OH had the snip soon as he could after surprise child no.3 came along! 

My only regret is not having the coil fitted sooner (I was put off getting it done after reading horror stories online - don't google it!!!).

I had horrendously heavy periods which lasted for an eternity and really bad insomnia - at least 2 nights per week I didn't sleep a wink & the more over-tired I got, the harder sleeping got.  Whoever says if you're tired enough, you will sleep is a big fat liar! Periods now stopped (took a good 6 months for that to happen but they were light), and sleeping much, much better.  In fact, it had quite a soporific effect at first (a bit awks at work - anyone speaking to me after 4pm had to wave their hand in front of me to check I was still listening!), but that soon lessened and now I just have the very odd bad night, which to be honest is probably more down to OH snoring or one of the kids making a noise when they come home in the early hours, than my dreaded hormones.

[Hurdity]

Hi there

The information about Mirena and fibroids is here on this website and this is what I usually quote:

http://www.menopausematters.co.uk/atoz.php#GlossF

Fibroids
Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT

Hurdity x

[Ajay]

Thanks so much Hurdity - some interesting stuff in there re Mirena. It's all very confusing, when I started out I was told a fibroid would mean I couldn't have a Mirena (hence the ultrasound to check) and yet it seems a Mirena could actually help shrink it! So glad to have found you girls on this site :-) It's all going in my bulging HRT file....

Ajay
x

[Hurdity]

Maybe the physical position of your fibroid might affect whether it can actually be insterted properly? That is a different issue than the effect of the progestogen on the uterus lining and fibroids. Your gynae (or maybe GP?) would be able to tell you this by looking at scans I presume?

Hurdity x