Perimenopause and constant vs cyclical symptoms?

[rosemaryc]

A bit of a general question at this point as I have my follow up appt to get test results on Friday.

I have a massive list of symptoms and have no ideas if any are hormonal. I went to see a specialist as, whilst I am never well, I get worse at certain times of month, or rather I have about a week a month when I feel maybe 50%well. So my question to those who have taken Hrt of any form at this point in your life is;
Did it just help with cyclical symptoms or did it help with others that were more constant?
Thanks

[PeterSpots]

What are your symptoms. Mine are twitching face/spasms, bladder, pelvic pressure & aches? Wishing you good luck Friday. I was shocked my bloods actually said I was in menopause. Hoping HRT will make a difference

[rosemaryc]

Hi Peterspots
I have a chronic headache with more cynical migraines, and a lot of fibromyalgia type problems with feeling generally unwell, muscle and joint aches, vertigo, occ heart palps, fatigue ...
Hope you get some relief soon.

[PeterSpots]

You too. I know we can look & find our symptoms match so many things but it seems some people can have a horrid menopause. Let's hope that's us & we can celebrate a new chapter soon

[rosemaryc]

Yes I know. I assumed initially mine were hypothyroid as my results aren't great, but I don't seem to get any better on them (and it actually made my joint pain worse for some reason). I am feeling completely desperate now as feeling so ill all the time :-(

[rosemaryc]

can anyone else advise re this? Are symptoms of perimenopause always cyclical or can you feel constantly crap?

[ovenchips]

OP All those symptoms sound rough and very draining - I feel for you.

2 things spring to mind - are you on thyroid meds? If so some people do not have symptoms alleviated by artificial thyroxine, but do on natural desiccated thyroid (NDT). If you do have thyoid problems have you also looked at 'adrenal fatigue' as a possible issue for you? That can also cause a lot of your symptoms.

What particularly made me think of it was you having hypothyroidism and taking meds for that. I know that when you start on thyroid meds some people feel worse because they also need suplements for adrenals (their functions affect each other).

There is apparently a marvellous thyroid forum for UK users with all this NDT info and adrenal stuff if you wanted info.

I don't have thyroid issues but I do have adrenal ones. I take adrenal cortex extract and it makes an unbelievable difference to my symptoms so I know that first hand. I am also perimenopausal and use natural progesterone cream which I also find v effective.

Best of luck with figuring out what will help you.

[pinkfrocks]

I'm not sure what the answer is for your question!
PMS is supposed to increase in peri. This means in theory that many women will feel worse for 2 weeks a month. If your cycles are erratic then you might get more symptoms. I only (usually) get migraine when progesterone is withdrawn, prior to a natural period(used to) or HRT induced bleed.

HRT is supposed to give you a constant and steady level of hormones, so you should avoid the ups and downs of a natural cycle. But depending on the type of progestogen used in it, you might still get PMS symptoms in your cycle. some women get round this by having long-cycle HRT- ask your dr about this when you have your appt.

Are you doing any self-help things - like regular exercise- like 30-45 mins a day of brisk walking? Are you taking care of your diet and avoiding sugar that gives highs the lows? Same for refined carbs. Is your diet generally healthy with lots of veg/ fruit etc? It's just that this is a time when all of these things become really significant to help us feel better.

[rosemaryc]

thanks both.
Pinkfrocks - I suppose I mean that, do people who have symptoms in the perimenopause have them all the time eg tiredness, aches and pains etc or are they always only at certain times of the month? I have been working on diet, sugars etc for a year or so but no improvement. I am seeing the consultant NP on Friday to get blood results (ultrasound was clear) - he sent a letter to my GP talking mentioning bioidentical HRT but also possibly GNRH analogues which seems rather major. He remarked that I was virtually symptom free days 12-18 - what I had said is that I am better that week, but I am far from well at any point in the month. My cycles are pretty stable.
Ovenchips - thank you. Yes it all smacks of a thyroid issue and I had a year on first thryoxine, then T3 then 3 different types of NDT with no success (raising dose increased joint pain). I stopped about 9 months ago and remain borderline hypo. I have been trying to tackle adrenals - tried licorice but it raised my bp, recently been taking Nutri Adrenal but no improvement. What brand of cortex are you taking ? I had been avoiding this route (and the NDT) for a while as i'm vegetarian but I'm past caring now. Natural progesterone cream didn't work for me (and made my periods v heavy and more pmt).
thanks again, tearing my hair out and feeling absolutely dreadful, especially in this heat.

[pinkfrocks]

Sorry you are suffering so much
I don't know really. If you are short of oestrogen then it figures that on days 12-18 (depending on your cycle length) this could be when your oestrogen peaks so you feel better.
Sounds like your diet is going okay- what about exercise?
Someone in my immediate family was diagnosed with post viral fatigue/ mild ME and exercised their way out of it over 2 years instead of accepting ADs (this was under a consultant.)

I know friends who have had aches and pains - joint pains- which have and haven't improved with HRT but in the main went away.

Personally, I had no peri symptoms except hot flushes once my periods stopped. I do believe as does my consultant that exercise helps(ed) and some studies show it is very effective compared to HRT.

[rosemaryc]

Thank you Pinkfrocks. Just hoping something actually comes up in the test results Friday as at the end of my tether now.
Not too much happening on the exercise front since I got ill, as I am trying to hold down a 4 day a week job and have 2 children, so that is taking everything I have. Not ideal I know.

[ovenchips]

Rosemaryc You are 2 steps ahead of me in what you have tried I think!

All I can think of to add is that the forum I referred to in previous post is the Thyroid Patient Advocacy UK website. I understand the woman who runs it is v knowledgable and spends a lot of time on forum helping advise people on their specific circumstances. Bearing in mind there prob is still some sort of thyroid issue, it worth asking on there for advice? Even if it only to feel assured that your symptoms are prob not thyroid related (of course, they may say opposite too).

Sorry, I don't know what a consultant NP is but is it worth consulting a good naturopath or functional medicine practitioner? But as I say this post is prob not useful as you seem more knowledgable than me!

The ACE I use is Thorne. I have also used the one you tried but think the Thorne one much more effective. They do a couple of very similarly titled products but I only use the pure ACE not one with any glandular or vitamins added to mix.

Best of luck for Friday, and if you can, let us know how you get on.

[rosemaryc]

Hi Ovenchips,
Thanks yes I am familiar with the TPAUK website, been on there a lot over the last couple of years. The joint pain I get from NDT doesn't seem to be something that is common.
NP is just the consultant I went to see about hormones - a gynaecologist with PMT specialism,
Thanks for the tip re Thorne - I will take a look.

[rosemaryc]

Well I had my appointment yesterday and it doesn't look like I'm in perimenopause yet in that my oestrogen, lh, fish etc fine. For some reason progesterone not on blood test is it because day 2? As last year my testosterone is undetectable and so NP wanted me to try testim gel off prescription. It appears it can help wit migraines, joint pain, fatigue etc but not holding out much hope. Anyone else used it?
As expected my thyroid is still not good and at this lab I was out of range again with TSH 4.69 (range to 4.2) and ft4 as usual at bottom end. This is t the board for a discussion about thyroid of course - he prescribed a low dose thyroxine but of course been there and got the tShirt.
I am going to try the testim gel before the thyroxine , but feeling so rough atm ????.
Anyone else taken testosterone here (esp when still having periods)?

[Bellaciao]

Hi rosemaryc
From what you say I would definitely persist with some form of thyroid meds. I have a friend who has suffered for years and she constantly has to tinker with her medication. She has a problem with T3 - and levoT doesn't work so she uses NDT. If my TSH was as high as yours I would be working at reducing this as a reason for my symptoms. My TSH has been rising over the last 3 years - not by much - but at the last reading was 2.98 and I have been feeling progresivley more tired and especially after exercise and in the morning - more than normal tiredness. Muscles aches and fatigue etc. of course doc won't do anything. I also went to see a private meno consultant (Dr Annie Evans), as I have no libido either and she has prescribed testogel. also in the hope that it alleviates the tiredness & muscle aches etc. She would be happy also to prescribe thryoid medication ( v mild) but thought better to try one thing at a time. I gather from reading about hypo thyroidism that the aim is to get TSH between 1 and 2 I think but that some people don't feel well until they are below 1! This contrsats with the upper reference range of "normality" being up to 4.5 - thus implying that there must be a whole section of people with TSH values of 2 - 4.5 who are not feeling well but nothing is being done about it!!!

I'm not familiar with tesosterone being prescribed without oestrogen - since it is generally prescribed ( off-licence) to women who are peri or post-menopause and are also having replacement oestrogen - in fact it isn't recommended without oestrogen. As your oestrogen is normal then presumably doc thinks it's OK just to take this?

There is so little research into T and its effects and the correct dosage - it's appalling! I am sure many cases of ME fibrolmyalgia and CFS in women could be cured or alleviated with proper enocrinological assessement and treatment - with either testosterone, oestrogen or some form of thyroid replacement - or a combination of these. So much work needs to be done so women are not fobbed off and labelled with a chronic condition and left to languish for the rest of their life!

In my case it's too early to say whether I have noticed a difference as I need to monitor how I feel after my (fairly) intensive exercise classes.

This probably isn't much help - but I would persist with the thyroid treatment until yuor TSH at least is consistently reduced. What TSH levels did you get to? Maybe you need this and something else ie T or oestrogen? How are your periods? (Btw I know very little about thryoid and treatements!).

[rosemaryc]

Hi Bellacio,
Thanks for your reply. I am going to start back on thyroxine initially once I've had a few days to see what the testosterone gel does to me (in terms of side effects). I tried 3 different types of NDT over the course of a year (same result each time - joint pain as I raised dose, and generally more out of it), so going to start back at the beginning in case I am actually one of the few who is better without active T3. Previously my TSH went as high as 5.25 and as low as 0.5 when on NDT (but I felt exactly the same!).
As usual I forgot to ask some key questions at the consultation but I saw a top consultant who is meant to know his stuff so I assume he thinks its ok to do testosterone alone (bloods retested in 3 months). I will probe re this but assume it's not a short term problem - I will worry about it IF it does any good at all (nothing has to date!).

So are you taking the testosterone from Annie Evans? If so for how long and are you noticing a difference?

thanks

[ovenchips]

Hi RosemaryC Thanks for update. I don't have any useful info to add but just wanted to say I hope you see some results from the testosterone.

I feel for you, you have tried so many things for your symptoms and imagine how fed up you must be. Really hope things improve with this cream.

[rosemaryc]

Thank you Ovenchips x

[Bellaciao]

Hi Rosemary C - interesting that you felt the same with very different TSH levels!
Re the T being prescribed on its own - as I said I was referring mainly to those whose oestrogen level is low ie perhaps near or post-menopause. I think it's because some testosterone is converted to oestrogen in the body ( not completely sure about this), so those on HRT will also be taking a progestogen ( if they still have a womb) and therefore be protected. Also I think maybe the balance of oestrogen and testosterone needs to be optimal. If you are early peri then you will probably still have plenty of oestrogen. Anyway the consultant will know what they are doing!!! Who did you see? Oh I can see from the initials - I would defo trust him - he's the man!!!

Yes I'm taking the T from Dr Annie - have been taking it for two months. Don't want to speak too soon and hope I'm not imagining it but I'm sure I feel less tired/muscle aches/after exercise and fewer headaches - but I will reserve judgement on that. She said try it for 4-5 months as the T receptors take a while to fully re-activate and for the benefits to show. I am using a "petit-pois" sized amount on my thigh daily. So far no spots/hairy chin - but again I reserve judgement as these may become more apparent as time goes on if the full benefits aren't appreciated until 4-5 months - then so might the side effects come on later!!

[rosemaryc]

Hi Ballaciao :-) great to talk to someone who is taking the T too! Sounds like you are taking the same amount - there is 50mg in a 5ml tube (daily male dose) and I have been told to take a pea sized amount on thigh 0.5-1ml per day. Now been 5 days so I suppose I shouldn't be expecting a result yet. Did you only recently start to think maybe you were improving?

I think I will have to start the thyroxine without waiting long enough to see what the Testosterone is doing, but I just wanted to check it didn't make my aches and pains and head worse first (as I think the thyroxine may do). Only thing was I noticed I was totally exhausted and out of it the day after my first dose? I am very up and down anyway though and haven't been able to exercise for 2 yrs, so I do have days when I feel like I've been hit by a truck. NP did say it could take 3 months.

What were your levels on the blood test?

My oestrogen was apparently ok and he thinks I am 5yrs off the menopause (give or take). He said if this doesn't help we could consider taking oestrogen (and prog) to stabilize (or kill) my cycle but not there yet.

[Bellaciao]

Re thinking I'm improving - yes recently. I started keeping a diary because I was getting so many headaches and feeling exhausted after exercise and I haven't written anything for ages! eg Today I went to Zumba class as usual and then did an hour's gardening this afternoon. Don't feel tired at all and I am on the progesterone phase of HRT ( long cycle) which usually has me feeling foggy headed by now.

It might just be that I've been out in the sun a lot, it's summer, and I finish work this week for the summer until mid Sept - so less stress - but then again it could be the T..... I am well post-meno though and 62! I never felt a thing re side effects (I think I imagined I did but not really).

I haven't had oestrogen levels done for ages as I'm post-meno and never had T done - Dr E didn't think it necessary and just went on my symptoms (tiredness, muscle aches, lack of libido, headaches).

Do hope it works for you!

[rosemaryc]

Well it sounds like it's working for you :-) Were you on the HRT before adding in the T, so you can tell that it's likely the T that's helping?
Was Dr E talking specifically re the T for tiredness, muscle aches, libido and headaches? If so that bodes well for me....

[Bellaciao]

I've been on HRT for 8 years more or less the same dose - since I was in late peri. The libido was the clincher. She couldn't say re the other symptoms eg whether I was one of these sub-clinical slightly hypo thyroid which was affecting me but thought because of the libido that it was worth trying this first.

[rosemaryc]

Thanks Bellacaio, hope it does the trick. I'm a week in now, and will probar leave it another week or 2 before I go back on thyroxine. Wondering if its going to affect my cycle or not!

[Bellaciao]

Unfortunately have developed a migraine so bang goes my theory - well so far anyway, and still on the final day (tonight) of the Utrogestan. It's so difficult to sort out what's doing what and to get the right balance.... also have bled early this month and wondering if the T had anything to do with it as this is the only thing that's changed?

[rosemaryc]

Aargh sorry to hear that, is it still less headaches than before though? Surprised it would cause a bleed?