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Author Topic: Confused on HRT  (Read 1354 times)

Lilylight

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Confused on HRT
« on: April 19, 2018, 04:47:01 PM »

Hello! So glad to find this site.
My GP seems to know less than I do  ???

I'm 48, peri menopausal with still fairly regular periods. I opted to go on hrt a couple of months ago due to fatigue, no zing, night sweats and (a big reason) awful brain fog.

I haven't had a great start on hrt and am considering stopping completely. Initially my GP prescribed conti (in error as I am still regular) and I had no period and felt awful. The last 3 weeks I have been on sequil and although was ok in the oestrogen stage am really suffering with pmt now I have switched to conti - and no period (day 35, when I'm usually 24). What's worse I've put on 6 pounds argh!!

I feel fat, irritable, emotional and wondering why I'm doing this. On the other hand cognitive symptoms have improved and night sweats are now nil.

Does anyone have experience or advice?

Thank you
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Dancinggirl

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Re: Confused on HRT
« Reply #1 on: April 19, 2018, 06:22:49 PM »

Hi and welcome to MM Lilylight
What HRT have you been given and at what strength? GPs are notoriously clueless about HRT!!!!

Having had a bad start, I would actually stop everything at the end of your current box and give your body time to recover over 4 weeks or so - then start again.  If you are using Elleste HRT then the progesterone in that one is quite tough to tolerate (hence the PMT symptoms) - so ask to try Femoston 1/10 instead.  There are plenty of options to try - do look under TREATMENTS to see the options.
Weight gain can happen at first - but the menopause does tend to make us put on weight whether on HRT or not!!!  I'm afraid we simply have to eat less and keep moving!!!
Keep us posted.  DG x
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Lilylight

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Re: Confused on HRT
« Reply #2 on: April 19, 2018, 06:36:20 PM »

Thanks dancing girl for replying. I think the brand is evorel patches. I'll have a look at femosten.
Im worried about stopping completely as I feel I'm mucking about so much with my hormones.
I'm sure the weight gain is hrt related - it's so sudden and extreme. I hope it's temporary. Anyone else gained weight with it?
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Dancinggirl

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Re: Confused on HRT
« Reply #3 on: April 19, 2018, 07:20:34 PM »

Ahh!!! You have been given the combined patches and these are medium dose - look under TREATMENTS-  probably too high a dose if you are in early peri meno. This could also explain the sudden weight gain!! HRT can give some fluid retention that will settle.
Stopping would not be mucking things about at all - it would take you back to where you were and starting fresh - I would give things at least a one week break. DG x
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Lilylight

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Re: Confused on HRT
« Reply #4 on: April 20, 2018, 05:26:00 PM »

Thanks again dancing girl. I've taken your advice and stopped completely. I can't get another GP appointment for a couple of weeks, so that should give me a chance to see how things pan out.
Can I ask you whether you recommend patches or pills? Also I've looked at treatment and still confused - have you a suggestion for early peri menopause. I would like to take something as in addition to other symptoms I also have sore bits and no libido.
Thanks dancing girl x
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Dancinggirl

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Re: Confused on HRT
« Reply #5 on: April 20, 2018, 05:45:05 PM »

Lilylight - If in peri meno then, in my experience, a low dose of HRT is best to start with.
Oestrogel (just one pump per day) or a low dose oestrogen patch with separate progesterone (Utrogestan or Provera in pill form for 12 days each month) is a very good regime in peri. I would personally opt for Provera but many love Utrogestan (micronised progesterone).   Using transdermal hormone treatment is often best for improving libido as well. You might want to consider a Mirena as this will usually mean no bleeding at all after the first few weeks and you can use as little or as much oestrogen as you need as patch or gel alongside -  a real no hassle HRT regime!!!
Here is the link for all the info you need, so print this off to show then GP:
https://www.menopausematters.co.uk/perimeno.php

AS for your sore intimate area - well this is probably the start of urogenital atrophy and needs local oestrogen  e.g. Vagifem pessaries and some vaginal moisturiser alongside ( although not at the same time of day).  The Vagifem is on prescription and the moisturisers you can buy online and the best are SYLK or the YES products.
https://www.menopausematters.co.uk/local.php
https://www.menopausematters.co.uk/dryness.php

Here is the section from the NICE guidelines on treating urogenital atrophy which you may want to print off to show your GP - many GPs are not familiar with these guidelines !!!! Local oestrogen should probably be standard treatment for all women once menopause hits - it would prevent many long term problems.

Urogenital atrophy
1.4.9
Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.
1.4.10
Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.
1.4.11
If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.
1.4.12
Explain to women with urogenital atrophy that:
symptoms often come back when treatment is stopped
adverse effects from vaginal oestrogen are very rare
they should report unscheduled vaginal bleeding to their GP.
1.4.13
Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.
1.4.14
Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.


When having sex, then lots of lubricants is the best idea and Durex do a fab one called ‘Perfect Glide' - again, it's best to buy online.   DG x
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Lilylight

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Re: Confused on HRT
« Reply #6 on: April 20, 2018, 06:33:41 PM »

Superb advice dancing girl . I'm tjinking mirena and separate oestrogen as that seems to be best tolerated. I wish I'd come in here before Gp ...
I have tried Vaginal lubricants specific for menopause symptoms but they gave me thrush. Think systemic may suit me better and possibly the lubricant for intercourse.
Thank you again - that's more helpful than I could have hoped for x
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Dancinggirl

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Re: Confused on HRT
« Reply #7 on: April 20, 2018, 06:40:12 PM »

SYLK or the YES products won't give you thrush - they should actually help to prevent thrush or BV taking hold. Thrush is usually occurs because bacteria from the bowel has taken hold in the vagina. If the vaginal flora is out of balance then this bacteria is not destroyed - local oestrigen and moisturiser will help to maintain the vagina flora. DG x
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