Aching joints after stopping HRT

[jardy]

I am 55 years old.For 12 months,(starting February 2009) I took Elleste Duet 1mg-this was a Lifestyle choice,no menopausal symptoms except for occasional night sweats which were not too bad,I could cope with them.I have never stopped having regular and very painful periods.I was checked for underlying cause of the pain but nothing was found.While on HRT I developed blinding headaches,and severe PMT,however I found getting up in the mornings easier.I got so fed up of the dreadful painful periods that I went back to my GP and she prescibed Elleste Duet Conti Tablets to knock my periods on the head.I stopped Elleste Duet 1mg-BINGO!my periods stopped and so did the blinding headaches.
That was three months ago.I havent started the Elleste Duet because I felt so much better without the anticipation of the awful painful period and PMT.I became a bit evangelical about NOT been on HRT because I had NO headaches,and did not notice any noticable loss of energy.Also I kept worring about the increased risk of stroke/breast cancer althought my bp is fine and there is no history of cancer in my family,although my cousin developed a breast cyst while on HRT.However for the last week two weeks I have had vaginal dryness,loss of libido,but worse of all ACHING JOINTS in the morning.I feel like a 90 year old woman getting out of bed each morning.They ache up until at least lunch time.Its really debilitating.I have an appointment next week to see the Doctor about taking oestrogen cream to help the dry vagina and sex Life.My friend said she was like me but she had had a hysterectomy and her ovaries removed,she took HRT to keep going in her job from 55 to 60.She has just stopped and has had no problems with vaginal dryness or reduction in energy.She thinks it would be a good idea to start the Elleste Duet Conti to see if I feel better,then I can make a decision based on both experiences.What do you think?I thought I was doing well without the HRT until these awful aching joints kicked in.I do need my energy because I have a busy physical job and I have to get up my severely physically and mentally disabled son of 22,and it feels a real chore because I am so stiff!Please give me your experiences and/or opinion.Thank you.

[chelseamorning]

I feel for you, Jardy.

I've found sea buckthorn oil capsules really work for my vaginal dryness. They're supposed to help with your skin and dry mouth etc. I started on the recommended dose and now only take 2 per day and could possibly go down to 1. They started working after about a week.

Can't help with the loss of libido or the aching joints as I'm still working on those.

Generally, I found woman essence good at boosting my natural hormone levels so that my symptoms were greatly reduced. However recently my hot flushes have come back and so I'm increased my dose a little which seems to be helping. Might be worth a go? Some people I know take She Oak or Agnus Castus but I've no experience of these.

[purplepeony]

jardy- does it help to know that there are dozens of different kinds of HRT? My gynae who I see privately says it's like finding the right pair of shoes- you sometimes need to try several pairs to find the right fit.

Given that you have only tried one kind.

However, there seem to be two issues running through your post here- PMT/periods and menopausal symptoms such as aching joints.
I am unclear about why you took HRT to be honest- you said to was lifestyle reasons, but do you mean it was for heavy and painful periods?

You are quite old to be still having painful periods. Period pain usually only comes after ovualtion and it is not usual for women of 55 to be ovulating. Having said that, the menopause can be as late as 56 in some women.

Have you had blood tests for your hormone levels? Have you had your thyroid checked?

I am not a dr, but I have been on HRT for 2 years under the care of a very emninent gynae who has also written a good book on the menopause.

If I were you I would ask for a referral either to a gynae with expertise in menopause(GPs often don't know much) or take yourself off to a menpoasue clinic.

IMO you need to separate out all the issues:
heavy periods
painful joints
finding the right HRT to help.

HRT might not be what you need- your joints might not e remotely connected to your hormones.

BTW I have had NO side effects with my HRT. I use oestrogen gel daily and then progesterone pills for 10 days every 3 months, which gives me a withdrawal bleed once every 3 months. I am same age as you.

[jardy]

Thank you very much for the helpful and thoughtful replies.Yes I felt it was unusual to have regular and painful periods upto the age of 55 and the GP gave me the Elleste Duet CONTI because she said that it would stop my periods.However as soon as I stopped the Elleste Duet 1mg they stopped.I haven`t started the Elleste Duet Conti because I thought I would give myself a trial,HRT free.That was 3 months ago and it is bliss not to have the awful PMT.
Purple,my daughter had half her thyroid removed due to a cyst last year,other people have mentioned I might be having trouble with my thyroid.I started HRT because I thought it might make my periods lighter and less painful,instead it made them much worse and gave me splitting headaches.
The last couple of days I have rested more and got more sleep.My joints are feeling better and I feel more centred.Today I think I might try a more holistic approach.Chelsea you have encouraged me to think along those lines now.
I am seeing the Doctor next tuesday and let you know how I get on.I am feeling better for knowing I got two very different but very caring replies,thank you!

[purplepeony]

Jardy- hope you get on oaky. I googled Elleste Duet Conti for you and it says it is only for women who have not had a period for 1 year.

HRT will not make your periods lighter. The progesterone part is what i s giving you PMT.
You can take a 3-monthly HRT which means you only take progesterone for 10 days every 3 months, and have 1 period every 3 months.

Seriously consider going to a meno clinic or ask to be referred to a gynae. I have chatted to ther women who have had HRT prescribed by their GPs and honestly, some of them don't know what they are doing. They don't know all the ins and outs of the different types and how they effect people differently.

[purplepeony]

oh I just thought of something- when you said you had heavy periods on HRT was that bleeding not a monthly withdrawal bleed rather than a real period? You do get "periods" with HRT unless you take a no-bleed sort- the CONTI is short for continuous, which means that the hormones are balanced in each pill so that you don't have any bleeding. This is why they are only given to women whose periods have stopped for good. ( 1 year post meno)

Was this not explained to you?

I doubt very much if the bleeding you had on Elleste Duet was a real period.

You can easily sort out the vaginal probs with either Vagifem or Ovestin creams.

[chelseamorning]

Jardy, have you looked at menopause matters website? The founder is a menopause specialist. The site gives you info about both medical and alternative remedies to help with the menopause. There is also a forum and an interesting magazine.

[jardy]

Hello purple and Chelsea,thank you for your replies.Purple I had a hunch that it was only the HRT that was giving me the heavy and painful periods.It was never explained to me,when I went back to say I couldnt stand it any longer she gave me the Elleste Duet Conti and told me to take them straight away,when I said wouldnt it be better to wait until my periods stopped altogether she said it was as broad as long,as 99% of women has stopped their periods by 55.I saw a gynae 6 months ago because I had a particularly bad flooding episode and she found nothing wrong and told me to continue to take elleste duet 1mg until my periods stopped.Do you think they would ever have stopped on elleste duet 1mg?She never went into why I was taking hrt etc Now the Good News,my stiffness has improved.I went to a Zumba class this morning,I was more like a clumsy elephant but I couldnt help but feel that I would never have attempted it last week.Overall I am feeling better than expected not been on HRT,not a single headache,NO PERIODS OR PMT (wow thats such a wonderful feeling)the only problem is the dryness thing,and the aching joints and stiffness in the morning,even that seems a bit better.Wonder if there is some other cause like a virus other than not been on HRT.Thanks again,I am really so interested in your knowledge and experiences.

[jardy]

Menopause Matters,thank you Chelsea,really helpful.BTW,just rushed out to grab the washing in as it`s pouring down,and OUCH!Joints again!

[jardy]

Purple,very kind of you to let me know about vagifem or ovestin.I didn`t know that there are risks involved and also I might get headaches coming back,so might have to rethink that one.
I am interested in Oil of Primrose,a friend swears by them.She is post menopause and really active and positive.Also I went to a highly regarded herbalist who at first gave me all sorts of pills to buy and then said try more oily fish in your diet first,like sardines (yuk) but might try that.

[chelseamorning]

The sea buckthorn oil capsules have omegas 3, 6, 7 and 9. I'm veggie so I've found them useful in my diet anyway but they have certainly cleared up my vaginal dryness. I wouldn't be without them!

I also have the joint problems. My hands and feet ache. Recently my knee is twinging too. Feel like a very old woman but I'm only 43. Early meno unfortunately runs in my family.

My DS was born 3 years ago and I've pretty much had aches and pains since then. My GP and a private rheumatoid consultant were very dismissive and told me it was probably because I was breast feeding. Anyway, 3 years later I still have the stiffness and soreness but realise it's because of the menopause.

I'm determined to sort out my problems with alternative remedies but appreciate that the vast majority are untested. However I'm also going to be realistic and give myself a year to find a suitable combination of treatments. My mum has breast cancer and her sister has osteoporosis so I'm going to tread carefully with my approach.

My current thought is to find a good menopause clinic - hopefully my GP can refer me. Once my DS starts back at preschool in September I'll have a bit of time to focus on my health issues!

[chelseamorning]

Oh, forgot to say, with joints it's certainly a case of 'use them or lose them' so I'm endeavouring to take up the recommended types of exercise to ward off osteoporosis. We're buying our DS a 10/12ft trampoline for Christmas which we're going to use when he's in bed or at preschool.

Check out the National Osteoporosis Society's website which has some fab tips on nutrition and exercise for our problems.

And another website which might be useful is the National Women's Health Concern's site.

[purplepeony]

Jardy- which risks are you referring to with Ovestin and Vagifem? Not everyone gets headaches using it- I don't!

I have used Ovestin and my gynae says any risk in minute- very little is absorbed into the blood stream, so I wouldn't worry if they help. They give it to 70 yr olds to use.

The other thing is- are you missing the point a little with your HRT and periods? HRT doesn't restore your fertility or give you periods back Is that what you mean by would your periods have continued on Elleste Duet?

The answer is yes, but as i said they are not true "periods" they are withdrawal bleeds to stop the lining of the womb growing too much. The bleed is brought about when you stop the progestin part of the pack which you take inthe 2nd half of the month.

The CONTI brand gives you progestin every day which means that you never ever have any bleeding.

I really do think that if you have bad symptoms you should go to a meno clinic and talk to some experts.

[jardy]

Thanks again girls.I googled ovestin and vagifem and there are some increased risks,so they say,to do with womb cancer and headaches.
I am inspired by it helping 70 year olds!
Thanks Chelsea,for your websites.I will get some sea buckthorn to trial if they are so good.
Really appreciate the support.Didnt want to continue having periods or ovulation.Its just that when I stopped the Elleste Duet so did my periods.I would have stopped taking it if I knew that they would stop.I wish the GP had said just stop taking it,and your periods would stop.It was me pushing it really and it has been a pleasant surprise that I am not as bad as I thought I would be on it,apart from those two symptoms of stiff joints and dryness.

[purplepeony]

Jardy what you have to remember is that all drugs and even alternative medicines can/do have side effects. Even some of the herbs for menopause have been linked to breast cancer- such as black cohosh.

The risks with Ovestin etc are minute. The hormone levels are very low and a tiny amount is absorbed into your system. Far, far less than with taking oral HRT. My gynae suggests that if anyone uses it long term then they should have a pelvic scan to check the womb lining after say 2 years.

He is a fellow the Royal College of Gynaes and also treats the royal family so I assume he knows what he is talking about.

A friend who saw her GP was told she could only use Ovestin for 3 months due to risks which is simply not the case.


www.amazon.co.uk/Your-Change-Choice-Integrated-Menopause/dp/0340828862/ref=sr_1_2?ie=UTF8&s=books&qid=1282938392&sr=8-2&tag=mumsnet&ascsubtag=mnforum-21

I really recommend you read this book which gives all the treatments available, conventional and complementary.

[chelseamorning]

I've just bought that book, purple! Just waiting for my DS to go back to preschool to have time to read it! Incidentally, do you have any experiences with meno clinics?

[purplepeony]

Hi Chelsea- no, but my dr is the one who wrote the book

[chelseamorning]

Fab book, purple. "jardy*, the book contains some useful tips for the old aches and pains!!!

Sad person that I am and completely obsessed with the menopause now, I started to read it last night - with a cup of horlicks made with soya milk. (A few weeks ago, it would have been a few glasses of red wine but I've realised that alcohol disturbs my sleep and increases the risk of hot flushes during the night. )

[jardy]

Update:I visited the Doctor this morning.She was very young and different to the one I had been seeing.She feels that it is best not to go back on HRT if my main symptom,vaginal dryness can be treated locally.She has given me Gynest Cream to try for 3 months.She thinks this should be used with a lubricant but NOT ky jelly as this dries up during sex.She thinks the new lubricants especially meant for sex is better.I will go in Boots to investigate the types.Also regarding the aching joints - I am actually better for the last couple of days which I put down to NOT going to the Gym but she said continue going to the Gym as this will actually help my joints.Also to try paracetomal for the pain.She is reluctant to put me on more medicines for this due to possible other side effects.I asked about the pelvic scan and she said it will not be necessary.The cream is localised and will not have the side effects of HRT.Overall I am happy with the service I got this morning although we covered a lot of ground in less than 15 minutes!I will get the book on the menopause.Thanks for the all the support purple and Chelsea,much appreciated!

[purplepeony]

Phew- one sorted lady! Good luck and do read the book- I'm not on commission but it's a great book and he's a great dr.

[jardy]

Thanks so much purple and chelsea,you really clarified things for me and were such a support

[jardy]

I used Gynest Cream for 3 nights but didnt take it for two nights as I was going away.I filled the applicator right upto the top,when I used it.<br /> Monday-didnt feel myself,felt quite PMT.At 7:30pm I started a period.This was 3 months after taking the last HRT tablet and have had no period since.I am going to the GP on Friday but I feel back to square one really,and disappointed.Lots of women tell me that they have never suffered vaginal dryness after menopause ,and and that their sex department is just as it was before.On Gynest,do you gradually decrease the amount of cream,and also can anyone give me any advice.I dont feel concerned it could be serious because I had a thorough scan and biopsy 12 months ago (clear)and also I have only had sex with my dh,so my GP thinks that if my last smear was clear I dont ever need another one,which I must admit would be fantastic!

[jardy]

I forgot to mention that my aching joints are much better.Not sure what actually helped.I have been exercising more,rested more,and taken cod liver oil and primrose oil,but can`t help but think they have just got better.It started to improve before I started using Gynol Cream.

[jardy]

Gynest Cream!

[purplepeony]

why are you disappointed? I have had what appear to be 2 periods some time after what I thought was my last. My gynae did a biopsy and will do more tests if any more bleeding, but I do think that periods can dribble on for some time even after a big gap.

[jardy]

Thanks purple,that is reassuring.I am disappointed that I have had a set back,as I did notice a good difference down there after only using the cream for two days.I am going to the Gynae department next friday for investigations.Meanwhile this has scared me so she has given me replens on perscription,to try,rather than go back on the cream.She said 50% of women do not experience vaginal dryness after menopause.I find this a bit surprising,but talking to friends of my age it seems to be evenly split between those that did and those that didn`t.
Most however said it sounds like I need more lubrication,relaxation,couple of glasses of wine,more in the mood etc etc.One friend who is into natural remedies in a big way said it could be a phase,just been a bit run down or something.I definatly need to read that book purple!