Doctors appointment - what do I need to know

[googlepoodle]

Hi all
52 here and periods stopped in January. Minimal hot flashes but terrible insomnia, low energy and brain fog, irritability. Very healthy lifestyle - runner and fairly good diet.
But researching HRT and want to try it to see if it makes me feel better mentally and energy wise and for the protective factors re heart disease and bone density.
What would you all advise me to go armed with to the GP and what has worked for you? Looking at advice on here I'm thinking gels are the way for me to go?

[PollyPerky]

Hi there
I think it depends on what you want to use. You might tell your dr that transdermal is safer re blood clots over pills. Your GP may be a bit reluctant to prescribe HRT for heart disease / bones unless they consider you at risk- in other words just for prevention. Depends how 'pro' HRT they are! many GPs are not very pro HRT.
So you might be better saying more about how you feel rather than this.
If you use gel, then you have to use a separate progestogen / progesterone each month and again, some GPs freak out a bit at prescribing /or how to prescribe this because it doesn't come in a neat pack like pills or patches. Do you research and be prepared to say what you'd like and why!

[googlepoodle]

Thanks Polly - I've been reading you previous posts and they are so helpful. Wouldn't it be a good idea for GPs to have menopause clinics like they have for diabetes etc. I'll certainly keep researching until Wednesday. I've read the NICE guidelines and they are definitely not anti HRT and perhaps I need to emphasise in the appointment how it is affecting me now.
How do you feel on the HRT you use - ha it taken away all symptoms?

[PollyPerky]

maybe as a back up you could take along the relevant bits of the NICE guidelines? In case you need to refer to them. I think you could mention how your symptoms are affecting your daily life.
I felt I was doing all I could before using HRT; diet, exercise, various lifestyle changes, so HRT was the icing on the cake so to speak. My main issue was insomnia - which it helped a lot though not 100%- I never sleep right through the night without waking a few times even now- and hot flushes, which were embarrassing in a work, client-facing situation. These have gone and I feel fine overall.

[googlepoodle]

Any impact on weight issues/metabolism?

[PollyPerky]

My weight is unchanged- BMI of 19.2

[madmother1]

If your GP offers you pills. Ask for the 3 month packet. It saves having to remind yourself to keep reordering each month. Good luck.

[googlepoodle]

Hi
Thought I would update as everyone so helpful on this forum. Appointment straightforward and Gp said as I have no family history of breast cancer or clots and I'm young (haha!) as in 52 then she would be happy to give HRT. I went armed with names of want I want and she was happy for that.
So I have gel (estrogel) for 2 pumps daily and utrogestan capsules for progesterone.
Anyone tried this combo and can give experience etc. hot flushes are not too bad but really brain fog and tiredness is main problem at moment. Feel like I'm coming down with flu.
Having wobbles reading the leaflet but suppose they have to lay down risks.

[PollyPerky]

I'd avoid reading the side effects! Most companies are still using the old stats from the WHI and MW studies from 12 years ago and are now discredited.
I've used that combo for ages. You might like to try breaking the gel into morning and evening applications - 1 pump each- which lessens the drying time and also gives a more steady dose. Take the Utro at bedtime as dizziness is a possible side effect (not that it would last long.)

[googlepoodle]

Thanks Polly. Yes read on another thread about splitting the gel to morning and evening. How long before you noticed the difference?
Also the GP said take the progesterone for 14 days but the instructions in box say 12 days and then a withdrawal bleed for 2. The latter makes more sense so assume that's the right way?

[KindDogsTail]

Its sounds good GooglePoodle as the estragel is bioidentical, plant sourced and utrogestan is natural progesterone.

Not so long ago GPs wouldn't give these good ones.

[googlepoodle]

I know KindDogs - was relieved the appointment was so smooth.

[PollyPerky]

I saw an improvement in about 4 days.
BUT not everyone does- dr says you have to give it 3 months.
The usual dose is I think 12 days- day 15 to 26. You may find this is quite contentious! Prof Studd allows women to use it for only 7 days if they have bad side effects. Some of us are on long cycle ( 2 months or more) so use it only once every 8th week BUT I need to stress this is under the guidance of a private consultant who is there to offer scans etc who can, if there are problems, quickly arrange a scan of the lining , so it's not something you ought to do yourself unless your GP agrees and they prob won't as that regime is 'off label.' I use it for 10-11 days every 8th week.

[googlepoodle]

Thanks Polly.
Will stick to 12 days per month for now but can see the sense of what you are doing. A lot of the risks are with the progesterone element of it so what you are doing makes sense.

[googlepoodle]

So 5 days in and noticing changes already.
On the positive side:

• mood lifted almost right away. Before I had a low level continous irritable crankiness which I just put down to 3 kids and a busy almost full time job. But that has lifted and I feel really happy and content. Pretty amazing really.
  
• definitely more energy and feel I'm even walking faster and want to get on and do things. I had a lethargy before that I had to push through to get things done. Also a bit of all over stiffness which I put down to being an older distance runner but that has lifted as well and I just feel more mobile and energetic.
  

On the downside/

• sleep not improved and if anything when I wake up I'm more wide awake and difficult to drop off again.
  
• feel quite bloated in the lower half of my body but haven't weighed myself
  
• some dizziness and swimming head on occasions.
  

Overall positive so far. The mood lift is worth it in itself.