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[Mousekewitz]

Hi,

This is my first post in the MM forum, I hope I’m doing this right (not experienced with posting in forums and still finding where what how in this one).

I’m 56, postmenopausal, on my 3rd HRT treatment in as many years, trying to find the one - if any - that suits me.

Started getting worried due to cognitive decline 3 years ago(family history of dementia, so first thought this was early onset), apart from hot flushes seem to have passed through menopause lightly so far…

GP put me in Evorel Conti & Vagirux & asked me to come back for review in 6 months. Saw practice nurse then, but had to report I felt no difference. Attempted smear test had to be stopped as was too painful (had vaginsl dryness issues for years before that, only realise now what it was!).
Was put on FemSeven patches - felt slightly better, but the patches came off very easily to the point where I had to stick them in with band aids to take a shower…
Then the bleeds started, so back to (always a different) GP, who recommended to stop HRT (but also said it could be the Covid vaccine) & referred me for emergency scan.

Took more than the usual 15 weeks, got more bleeds in the meantime, so went for a private clinic appointment instead. Tummy scan & internal scans didn’t show any thickening of the womb lining, consultant recommended I re-start HRT, but this time 2 gel pumps, 100mg Utrogestan and a oestrogen cream to be used for my vaginal atrophy.

Back after 3 month for a cervix check & smear test after using the estriol cream & new HRT regime - and had my first pain free gynaecological examination in years!

So been on Oestrogel, 100 mg oral Utrogestan & Estriol cream since start of December ‘24 (so over 6 months now).

Then had a bleeds in January, 2 in March, and 2 in much closer succession in May. Tight lower tummy, but no cramps - however, in the last couple of weeks I had proper PMS & my mood swings are like roller coasters…

Seen (yet another) GP in March, who seemed very clued up about menopause & he put out an urgent USOC (Urgent Suspicion Of Cancer) referral. He promised I’d get a hysteroscopy appointment in 2 weeks… turned out he was a locum and had no idea how long referrals take, as I was told on request after 3 weeks had passed that normal waiting time is 15 weeks…

Had my hospital appointment this Sunday, but only got the cervix and internal scan, as they said everything is normal, they didn’t see a reason for a hysteroscopy.

The consultant recommended to up my Utrogestan to 200mg. She also said my mood swings would be due to my residual hormones in my body, as they don’t just dissapear…

From experience, it’ll now take me another month before my GP practice gets me the higher dose of Utrogestan and I wonder if I can start taking double my 100mg dose in the meantime?

)PS I also have Addison’s, so already on steroids lifelong for this autoimmune condition)

Sorry for the long post!!

[bombsh3ll]

I'm sorry you've had such a rough time.

It sounds as if you haven't been treated by anyone with the appropriate skill level around menopause, particularly when there are complicating factors such as Addison's, plus the mood and cognitive symptoms.

If it were me, particularly in view of the future dementia risk concerns (I also have a strong family history of Alzheimer's and lifestyle-independent raised LDL which suggests ApoE 4 positivity), I would pay to see someone privately who would support a therapeutic rather than palliative dose of estrogen, plus testosterone replacement.

[Mousekewitz]

Thanks for your answer @bombsh3ll, I feel I am slowly making progress toward the light at the end of a tunnel now…

I’m afraid I don’t know what LDL or ApoE 4 are… I only heard that there’s a gene which can pre-dispose you to get dementia (but only a certain variety of it) and so far no GP (our practice has about 4) has told me how to go about that…


What do you mean by palliative/therapeutic estrogen? As for testosterone - I thought this is only prescribed under certain special circumstances…


I’m not great at doing lots of research due to the intermittent brain fog, less focus & struggle to concentrate for more than a few hours here & there per day… hence my limited knowledge and why I got here to find some answers and support.

Thank you.

[bombsh3ll]

LDL = the "bad" cholesterol in our blood

Apoe4 allele - genetic variant predisposing to Alzheimer's disease. NHS doesn't test for this but private testing is available.

Testosterone - also a female hormone, incredibly neuroprotective and helpful for mood and cognitive function. Only available on the NHS for low libido, as this potentially affects a male partner, however I would argue that everyone's circumstances are special enough to justify a trial of treatment that may substantially improve their quality of life.

Palliative estrogen dosing - very low doses that are only intended to stop women complaining of hot flushes and keep them economically productive.

Therapeutic estrogen levels - resolution of all hypoestrogenic symptoms and preservation of bone mineral density and cardiometabolic health etc

Regarding the progesterone, yes you could double what you have straight away, and get on the phone to your GP surgery to change your prescription before you run out.