Lightbulb moment - thinking of HRT - any advice?

[JennyTaylior]

I've been suffering with some odd symptoms for months, getting worse this year. Was getting worried, but then had a lightbulb moment that they might be menopausal in nature.

I'm 52 (almost) have a very old mirena in situ, must have run out a ages ago. Doc told me I was POST meno a couple of years ago with a blood test when he diagnosed my hyperthyroidism. Shocked would be an understatement. No symptoms then at all. Or so I thought.

But now, I've kinda realised all my niggles may be related. Does this sound like menopause to you? I've looked at Menopause Matters and it seems so.

Now, my symptoms are mainly psychological: absolutely no get up and go, apathy, lethargy, can't find joy or passion in anything but not depressed. This is, to me, the most disturbing aspect of it all. But OMG I have discovered an irritability with all people everywhere that takes me by surprise. I feel I should keep away from the human race to avoid indulging this feeling.

Also, I've also got aches and pains alllllll over. Morning is worst. It takes me nearly four hours to find even a smidgen of get up and go. Neck, shoulders, elbows, hands, knees. I also get a lot more cramps in odd places, like when I yawn, ffs.

I feel my tendons are disintegrating and in fact one actually has. Headaches that painkillers won't touch.

Occasional palpitations, anxiety (but that may be due to the teens)

Need to wee a lot sometimes. Almost seems cyclical, but due to the mirena i haven't had a period in years.

But, no hot flushes, no vaginal dryness, but also no libido. Could my mood be helped by HRT?

Sorry for all that. I'm hoping to get to the doc on Monday to see what he says.

What's likely to happen? I presume my Mirena will have to come out as it's well past its sell by date now anyway? (Yikes!) Should I get another? Or go with the combined treatment? Will I have blood tests? (Awkward veins, it's a trauma).

Any advice, recommendations gratefully received.

Apologies for the length, and late night ramblings - thanks for making it through. If I don't reply immediately, it's because i feel sleepy for once, so am going to try to sleep. Hah!

[PollyPerky]

In a word 'yes' it's likely to be menopause.
In another word, 'yes' HRT may help.
I've had friends who have had all those symptoms.
I had no anxiety or mood swings (other than wanting to murder all the family , daily) but bad flushes, insomnia and bladder stuff.

Here are your options:

Have another Mirena for the progestogen part of HRT plus a separate oestrogen (gel or patch is best).

Get rid of Mirena and use other forms of HRT.

TBH Patches and gel are safer than pills and generally more effective.

GPs tend to dish out pills as they don't know all the options.
My consultant said he wanted me to use gel from day 1 as 'it's brilliant stuff'.

This might sound complicated so bear with it....

You need to take 2 hormones - oestrogen and progestogens.
If you have been period-free for a year or more you can use a no-bleed HRT. This means using 2 hormones daily (as a patch, tablets, or gel plus a progestogen daily).
The downside of this is that it's the combined hormones (the progestogens are the issue) that can cause side effects like PMS.)

The other option is to mimic a natural cycle with oestrogen daily and a progestogen for half a month, giving a 'period' every 4 weeks.

If you don't want this then the Mirena + oestrogen is the best option.

Some women get side effects from the Mirena but if you have used it and are happy it might work well for you.

You don't need blood tests - no point.

You DO need to bear in mind that the first blood test you had that showed you were post meno may have been inaccurate- they often are especially as you use hormonal contraception.

So there is a risk you may get some odd bleeding now and then once you get rid of the Mirena if you own hormones are not as low as the dr thinks.

This would show up as spotting or light breakthrough bleeding for a while once on HRT but would settle down which type you choose.

Your GP might start you on a low dose of 1mg oestrogen but the idea is to see how you feel and increase if necessary. The beauty of the gel is you can increase it yourself from 1 pump a day up to max of 4, to get improvement.

[JennyTaylior]

Thank you so much Polly. That's really comprehensive and useful.

I slept in for the first time in months and I think it's because I'm no longer worrying quite so much about what's going on. And I agree the first blood tests may have been wrong, but who knows.

I'll see if I can get to see my doc tomorrow. I feel the need to be fully armed before seeing him because he's quite gung ho. Great, but bonkers. He gave me a cortisone injection in my elbow once before I'd even had time to realise what he was doing!