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[Robin]

Hi,
I'm in my early 50s and have been in perimenopause for several years now. I use evorel sequi patches and estring along with something to alter the ph when things flare u that I read about whilst lurking on the sidelines of this forum (thank you dancing girl it has made a huge difference so far although I'm not out of the woods yet. I'm crying writing that because it was so bad and I wasn't getting any help with it). I'm definitely better with hrt than without but I think I have some way to go to find a better fit. I'm struggling hugely with anxiety and depression. I don't get full on flushes but my internal thermostat seems out of kilter. I get really hot but for long periods of time whereas I think the flushes are shorter lived. I'm not sure that's just me guessing. I won't put it all down in one go and bore you all that probably enough for anybody to wade through.
Thanks for listening

[CLKD]

You probably need to browse round.  Read the treatment section above.  Look for the various threads about vaginal atrophy, i.e. 'my bladder etc.'.  Localised HRT 'down there' can work wonders!

 

[Hurdity]

Hi Robin

 

Glad you've found the forum useful - yes there is a wealth of really helpful practical info from Dancinggirl, Maryjane and others on VA and suitable creams, treatments etc.

When you say you've been peri-menopausal for a few years - how long have your periods been irregular before starting HRT and have you been having long gaps between them? Also how long have you been using the Evorel sequi?

Sorry to hear you are still suffering from anxiety even while taking HRT - maybe there is a pattern to this related to the HRT cycle or the different patches? Why not keep a diary on how you feel and see if you can work out if it is hormonal? Maybe you feel better on one type of patch or worse just after changing to a different type?

If you continue to feel low then it may be that a different preparation would suit you better or perhaps a higher dose of oestrogen maybe? Ideally HRT should be at a dose which eliminates hormonally induced hot flushes.

I hope things continue to improve but please just ask if you need help or support - there is always someone here to give you advice or a "there there"  for  when you need it .

Hurdity x

[Robin]

Hello CKLD, thanks I will do that. I've been reading threads for quite some time just wasn't feeling up to posting myself till now 😬.

Hello Hurdity, I always had a long menstual cycle around 32-36 days with long heavy periods lasting 7-10 days from the age of 10. Around 12 years ago they suddenly started arriving every 20-21days and were shorter at around 5 days but still heavy. Around 6 years ago my peri menopausal symptoms really ramped up but my periods still arrived quite close together with just the occasional missed or late one.

Around 3 years ago I had an ablation and around 2 years ago started hrt so unfortunately I now can't be entirely sure what stage I'm at. Although I don't bleed each month now because of the ablation I do get a little period pain though nothing like I used to get and that has been monthly since using HRT so hopefully that means it has regulated my cycle as I've never had a 28 day cycle before.

 The VA became much worse 6 years ago and I'm finally now using estring, yes and something to alter the ph and things are improving in that department but the anxiety and depression have stuck around. It's definitely worse on the progesterone part of the evorel sequi but having reacted really badly to utrogestan and dydrogesterone im stumped as to what to try next. I definitely don't want to try the mirena. I've wondered about increasing the estrogen but as I'm unsure where I am in this journey I'm not sure if that's appropriate. I'm considering trying antidepressants again but I really struggle badly with side effects so I'm quite reluctant.

I do have an appointment with a private doctor next month but will have to travel 150 miles so I won't be able to easily have many follow up appointments especially as things have got so bad I rarely leave the house anymore. I'm so desperate to feel better than this that I'm going to do my utmost to get there but would appreciate any input beforehand. If anybody has any ideas that I can be looking into now so that I go at least a little prepared. I have been wondering about testosterone and whether that helps mood/ energy levels?

That all seems rather long and rambling but hopefully somebody makes some sense of it.
Thanks for your reply Hurdity and anybody else who has taken the time to wade through this

[Robin]

I should probably have mentioned that the anxiety and depression arrived when I was perimenopausal although I always struggled with pmt and had postnatal depression

[Robin]

Also have had occasional months without the period pain but because of the ablation can't be sure that's a missed period. It's all so confusing

[Hurdity]

Hi Robin

It does sound as if your sympotoms are hormonal and in which case ADs are not really indicated - but I understand your problem with progesterone and synthetic progestogens - there are quite a few women on here who are either intolerant or prefer to take them as little as possible!

If you started missing periods 6 years ago then it is very likely you are past or very near menopause by now - it doesn't usually last that long from the start of missed periods. The periods getting close together is a classic indication of the late reproductive stage just before peri-menopause and that sounds like some time ago.

As you have had an ablation - are you able to take less progesterone or perhaps have a longer cycle than the rest of us with intact wombs? That would be ideal for you if possible and something to explore with your specialist when you see him/her.

It does sound like your depression/anxiety were/are hormonal if you suffered from reproductive depression ( ie PMS and PND). Have you seen the work of John Studd who has researched and treated this using high doses of oestrogen? There is a lot of info here: http://www.studd.co.uk/reproductivedepression.php. The main pages on different types of depression are on the left but lots of pages in each section on the right. His regime consists of usually 3-4 pumps of oestrogen gel, a blob or so of testosterone gel daily and for progesterone intolerant women 7-10 days of vaginal progesterone per calendar month - but such a low dose of progesterone would need medical supervision because of the risks of endometrial thickening and potentially cancer - but not sure how having an ablation is affected by this? You would be advised to have regular scans on this regime - so this is something to mention also to your specialist.

Yes testosterone improves mood and energy levels and helps with muscle aches and pains as well as libido - but not for everyone as it depends on the reason for your symptoms. Also it is best to make sure your oestrogen levels are good before or at least at the same time as introducing testosterone.

Hope this helps

Hurdity x

[Robin]

Hi Hurdity,

Sorry for the late reply Ive been struggling a bit.

Thank you so much for the information on professor Studd. I can really relate to a lot of that. A longer cycle would be preferable so I will definitely ask about that and about a shorter period of progesterone. I have wondered about the ablation and whether hrt  might affect my lining less or whether I would be just less likely to have warning signs to show there's a problem i.e bleeding. As the menopause specialist is so far away from where I live I'm hoping that I might be able to access scans closer to home if needed.

All the symptoms that you mentioned in relation to testosterone are problems I have. The aches and pains are relieved a bit with the estrogen but not completely gone and I struggle after exercise. When I experimented with lowering my estrogen the aches came back with avengence and lessened when I increased it again. I chose this particular doctor as she is the closest at 150 miles that I know does prescribe testosterone. It's really good to know it sometimes helps mood and hope she is willing to let me try it.

Thank you so much for your reply Hurdity it was very informative and I feel more prepared for my appointment. I just need to hold my nerve enough to get through it now.🙄

[Kwebst]

Hiya
I had an ablation about 7/8 years ago and am now 51 and def in the throes of menopause! I've tried a few diff hrt and my dr is quite happy for me to have a longer than usual oestrogen cycle because I had an ablation . I tried tridestra (3 months oestrogen then a bleed) but tablets aren't as effective for me as patches and so I changed. I think you could have a longer cycle too.
Hugs

[Robin]

Oh that's good news Kwebst.

Was it a menopause specialist who suggested that or your gp? I'm sure I would manage better on a longer cycle if a doctor will agree to it. Did you have to have scans to check your womb lining?

Thanks for your reply