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Author Topic: Can’t cope with Peri. Would like to see a specialist.  (Read 2716 times)

Cally

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Can’t cope with Peri. Would like to see a specialist.
« on: February 18, 2018, 07:23:54 PM »

Hi there

I have been going through a particularly hard time this last week. I am on day 31 with no sign of period coming. Last month was 37 days before it came. Very slight bleeding. I have felt depressed and lethargic with this weekend having the worst of it. I have been experiencing internal shakes and jitters and have spent most of the time in bed. I feel so panicky. I also have hard painful breasts. Now I am getting my migraine aura symptoms. I think this is down to low estrogen? Is this correct?

I have been thinking about going to see Dr Panay as I feel that things are getting worse and I seem to not be coping too well with them.  I did see my GP about vaginal dryness and she gave me an estriol cream [0.01%] but I have not used it yet due to worrying if I am doing the right thing!

I have never suffered migraines in my life before a few years ago where I started to get stroke like symptoms but not the headpain. I was diagnosed with Hemiplegic Migraines but still don't get the headpain. I asked my mother if she had ever suffered migraine and she said that she remembered getting really bad headaches in Peri but once her periods stopped they went away.  She unfortunately had a stroke at aged 65 but she was a life long smoker, not overweight and had just come back from a long flight to New York. She only suffered slight damage to her peripheral vision. I do remember her being on Prempo.

I do tend to get a lot of these stroke like auras- multiple episodes. My only trigger I can see is the drops in estrogen throughout my cycle. At certain times during my cycle like after ovulation I will get three days of aura with between 3 and 6 auras. They call it looping I believe. Never had them when I was younger. I have had all relevant testing etc done.

I also came back low on my serum testing of estrogen, progesterone and testosterone. I haven't supplemented anything yet not even the vaginal cream as I guess I'm worried about the stroke risk.

I think I should get some advise from a doctor who is more knowledgeable than my GP and Dr Panay seems a good choice. 

I would be grateful for any advice on how to see Dr Panay and also any thoughts on my symptoms.  Thankyou. 
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CLKD

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #1 on: February 18, 2018, 07:42:44 PM »

What makes you think that the auras are related to stroke? Have you been referred to a specialist at your local Hospital, or maybe look at the UK Stroke Association web-site.  A friend of mine suffered a stroke last week so I've been on the site a lot recently.

  What particular symptoms did you see your GP with?  Vaginal atrophy requires different HRT to what may be prescribed for other menopausal symptoms.  It is for Life.  VA mimics urine infection-type symptoms and treatment can certainly ease those symptoms.  For me it was like razor blades up there  :o.  Treatment eased symptoms, job done.  Used every night for 2 weeks and then every 4th and every 5/6th night, or if necessary, every night: each lady needs different amounts of medication and some use Sylc or similar to keep the whole area supple.  This can stop itching.

Maybe keeping a mood/food/symptom diary would be useful to you?  Keeping a chart helps when we have better or worse days to see if there's a pattern.  Also, taking a list of symptoms to the GP appt. can help, making a double appt. so that you don't feel rushed.  If your GP isn't sympathetic, see if there is one in your Practice who is interested in female health, or see the Practice Nurse.  We should not have to see anyone privately though for quickness and peace of mind, with menopause it may be necessary.

Browse round.  Make notes.   Symptoms won't alter over-night as the body doesn't get where it is suddenly.  Some don't have many symptoms where as others have lots, but not necessarily all at the same time  ::) - it ain't called The Change for nowt.

Ask away.
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dangermouse

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #2 on: February 18, 2018, 09:54:50 PM »

You sound very similar to me. Now getting cycle’s in the mid 30s for last 3 months (anovulatory also) and have also had the silent migraines since peri got bad a couple of years ago.

It sounds like it could be from oestrogen surges rather than low oestrogen and the highs can cause all the symptoms you describe. It’s hard to see in a blood test and oestrogen can surge and fall many times even in one day.

Many women who get this ovarian over stimulation say it all calms down when periods finally stop but it’s just hard to know if that will be next month or a few more years away!

I’ve put up with the overwhelming feelings/migraines/dizziness/bloating/swollen breasts/high blood sugar etc. heightening since November (when it was already tough before then!) and am going back on the pill as I just want my cycle suppressed for a while just to have a break from it all.

If you do go to see a menopause clinic they can possibly do the same for you with HRT if you prefer that, although they’ll probably start you on low dose in case your lows are more of the problem.
« Last Edit: February 18, 2018, 09:57:22 PM by dangermouse »
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Hurdity

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #3 on: February 19, 2018, 05:29:29 PM »

Hi Cally

Depending on your age I wonder if you can be prescribed one of the gentler CCP types that are suitable for peri-menopause - such as QLAIRA  or ZOELY? Qlaira has only 2 tablet free dys although the oestrogen dose is variable and may be less sutiable for you with your symptoms. ZOELY is lower dose and the same dose throughout the cycle apart from a few tablet free days? Otherwise I would definitely go and see Nick Panay if he is in your area as I know he runs an NHS Menppause clinic. Not sure how long the waiting list is but others on here have seen him on NHS.

The shakes and jitters are most likely due to the extreme fluctuations in either hormones eg extreme sudden fall in progesterone (which would only happen if you had ovulated) or the same - extreme sudden drop in oestrogen. I started to get migraines for the first time during peri-menopause (although I didn't realise this is what they were), just before my period and I assumed it was progesterone withdrawal but could just as easily have been the oestrogn fall too. I also got low blood sugar symptoms (sweating and shakes, sugar cravings) at this point too and I know this was due to the changes in hormone levels ( drop in prog and oestrogen).

Do use the oestrogen cream - there is very little systemic absorption and no stroke risk!

Let us know if you get a referral and how you get on - and hope your migraine auras subside.

Hurdity x
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Mary G

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #4 on: February 19, 2018, 07:13:04 PM »

Cally, I also started getting silent migraines (aura without headache) like you when I hit the menopause.  I had never had them before and only started getting them when my oestrogen levels dropped - this was back in 2004 and I had a Mirena coil for contraception at the time.  It's a tricky one because everyone has a different migraine trigger and it can be low oestrogen, oestrogen surges, progesterone surges or in my case, the combination of low oestrogen and synthetic progesterone/Utrogestan in high doses.  It took me a long time to work out the trigger but I got there by a process of elimination.  My silent migraines consist of a sudden blind spot (although I sometimes skips that phase) followed by zig zaggy, shimmering lines (scintillating scotoma) for about 25 minutes which gradually disappear to the upper sight field.  It's pretty nasty stuff and there are a whole load of jobs I would not be able to do because of it.  I have now managed to greatly reduce them by sticking to a superlow progesterone dose but ultimately I need to do something more permanent like an ablation or better still, a hysterectomy because I'm in the difficult situation of needing shed loads of oestrogen but no progesterone. 

I consulted a migraine specialist who said that the probable reason for my getting migraines in menopause was because I no longer had enough of my own oestrogen to protect me against the effects of synthetic progesterone in the coil and that would explain why I didn't have migraines during my reproductive years when taking the contraceptive pill or having a Mirena coil. 

It is very likely that your migraines are caused by low oestrogen.  A tell tale sign is if you start getting them just before a period while you are still menstruating.  A former member called Elizabethrose (you might want to read some of her posts) suffers from very severe migraines and gets them with all hormone fluctuations which means hers are very difficult to treat. 

Don't worry about the stroke risk, migraine with aura does not necessarily lead to strokes and it does not preclude you from taking HRT.  If you can get onto the right HRT regime, the migraines should greatly reduce. 

I would definitely see Dr. Panay if you can and get his opinion.  The contraceptive pill could be a good option for you and give you some hormonal stability which should help the migraines. 

Are you taking any form of progesterone for birth control at the moment?  If so, what type?   
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dangermouse

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #5 on: February 19, 2018, 07:36:46 PM »

Mary G - my sister (who was 48) had an ablation (due to endometriosis) and all her hormones calmed down after that. This may be an extra benefit to also not needing so much progesterone for you.

Doctors say that it shouldn't affect your own hormones but she found it did (e.g. bad PMT etc that she had all stopped) and she read an hypothesis that by ablating the womb, the brain registers zero chance of pregnancy and everything calms down.
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Jinja

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #6 on: February 19, 2018, 07:47:46 PM »

I wanted to go back on the pill when I started my peri journey but they won't prescribe it if you have migraines with aura. I often have weeks when it feels like I'm about to have a silent migraine i get very light sensitive and everything seems very bright and shiny, luckily the feeling seems to go after a few days, but I know it's hormone related still feel I haven't got quite the right her dose yet
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Mary G

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #7 on: February 19, 2018, 08:02:24 PM »

Thanks dangermouse, that sounds encouraging.  I am 10 years post menopause so I don't know if that makes a difference.  My thinking is that for someone like me who is severely progesterone intolerant and can't really take progesterone at all, an ablation is a reasonable compromise and not as drastic as a hysterectomy which has a long recovery time - work makes that difficult at the moment. 

Obviously you still have to take progesterone after an ablation but at least you can do a long 3 month cycle without getting breakthrough bleeding which does make the whole thing more palatable and also there should not be much of a bleed at the end of it. 

Jinja, I'm sorry to hear that.  So you are yet another silent migraine sufferer?  There seem to be quite a few of us.  Are you currently using HRT? 
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CLKD

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Re: Can’t cope with Peri. Would like to see a specialist.
« Reply #8 on: February 20, 2018, 12:36:51 PM »

How R U this morning?
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