What should I ask tomorrow?

[mazarineblue]

Hi all,
I've been lurking on a few threads and can see there is a lot of knowledge here- so any advice would be lovely as I've finally got a GP appointment tomorrow.
I'm 47, no periods as I'm on the Mirena (so I don't know what my cycle is as I've had Mirenas for 12 years), but I have brain fog, particularly can't remember /need to search for the right words,irritability, bladder sensitivity, no energy, anxiety,itchy skin etc etc.
My main issue is I'm boiling hot at times! Especially at work and bed, I'm literally drenched in sweat at work when other people may be warm but not boiling type of thing. It's as if my thermostat has been re-set recently, it's just embarrassing at work. I also have hypothyroidism but I've been on thyroxine for a few years so I'm pretty sure it's not that (and I really don't want the GP to tinker with my thyroxine!).
I'd be happy to have HRT but ideally I don't want my Mirena taken out either as its great not having periods. In my shoes,what would you ask? My main concern is I'll be fobbed off or told to take anti-d's , or told to come back in a few years / when my Mirena has been taken out. Thanks all!

[PollyPerky]

Hi The good news is you are lucky having the Mirena and liking it. I've had issues with coils before and although my dr offered me the Mirena as part of HRT, I didn't want it. Some drs think the Mirena plus a separate oestrogen is the 'gold standard' HRT regime. No periods , progestogen localised in the uterus and only oestrogen to use alongside.
Soooo.. depends on what you want. if you feel your symptoms are making you tired and miserable then yes HRT will stop all of that. If you haven't already tried lifestyle measures- exercising, healthy diet, cutting back / out things like sugar, booze, caffeine etc, which may help alongside a supplement like menopace, you could give that a whirl. On the other hand you could waste 6 months on that and still be no further forward. Although between 45-55 is the age for meno, the average age is 52, 47 is quite young and as you say you won't know if your periods have now stopped or not. If you want to try HRT then all you need is oestrogen- the coil will stop your uterine lining building up- so you could ask for a patch or gel. Both are bio identical and safer than pills re. blood clots. Hope your dr is accommodating!

[mazarineblue]

Thanks PollyPerky, I'll ask the dr about that gel, I suspect she'll pack me off for 6 months or fiddle around with my thyroxine dose as without much info on my periods the symptoms all sound a bit vague / thyroidy/ pressures of life etc etc don't they? My mum has quite severe osteoporosis though and if at all possible I don't want that, she's very frail with it ( she had to come off HRT herself after being on it 48-54) and she's only 70

[PollyPerky]

You should definitely talk about your family history of osteo- this is really important. It's hereditary (though you can do things to prevent it if you start soon enough.) If you have had an early-ish meno (you won't know when it happened as you have the Mirena) you should ask for a bone density scan now. I'm sorry about your mum; this is another example of women being taken off HRT when in fact they ought not be be. HRT is licensed for treatment of osteopenia and osteoporosis in younger women (under 60) .
A friend of mine had a bone scan at 45 and was found to have quite advanced osteopenia, yet she went on to have periods right up to 54. her mum has bad osteoporosis. Friend takes a type of HRT for her bones.

[mazarineblue]

Just a thank you for your help PollyPerky- my GP has prescribed me an oestrogen patch straight off with a low dose for 3 months then a phone appointment to see if it needs tweaking. She may add something for osteoporosis later should I need it also. I was expecting to be fobbed off for a few months so pleasantly surprised! Hopefully I'll see an improvement soon , thanks!

[PollyPerky]

Great news and hope it helps! Might be worth pushing for a DEXA scan sometime in the next couple of years to get a baseline, bearing in mind your mum's problems.

[NK346f2849X127d8bca260]

Just to add, that if you are using the Mirena for the progesterone part of HRT it needs renewing every four years not five as when used for birth control.

[mazarineblue]

Thanks NK, yes the Dr picked up on that too, its bern almost 4 years so at the 3 month check up fir the HRT we'll discuss whether I have another mirena . Its been so great not having periods for over 10 years I don't really want to change to something else-unless it'd help me magically lose weight