Post Menopausal at 42 - Treatment Advice for Psychological Symptoms

[BabyCakes7419]

I have recently discovered that I have been through the menopause, I'm 42 and my last period was 13 months ago, recent test shows FSH levels of 50. I had my suspicions that I was peri-menopausal but because of my age my drs ruled it out and also I was still having fairly regular periods up until 2 years ago, when I had an eight month gap (which was put down to stress) and now the 13 month gap since my final period.

Looking back I can see that I had pretty much all the typical menopausal symptoms but because of my age and because my periods hadn't stopped they were explained away with other causes. Also, because I have clinical depression and have been on anti-depressants since my 20s to treat this, I presumed the psychological symptoms were due to me just having a bad day/week/month, something I have got used to over the years and have learned to cope with.

However, I'm pretty certain now some of the psychological symptoms are linked to the menopause and was wondering if anyone has advice on the type of HRT that might be effective for the particular symptoms I'm experiencing, in particular -

*General low mood and a feeling of not caring, you know as in not caring about my appearance, not caring about washing, not caring about how I look etc
*Lack of motivation, struggling to get up, struggling to do anything even simple tasks like having a shower
*No energy, fatigue, there have been days where I have literally spent all day in bed, sleeping for most of it and this has gotten worse in the past 2 or 3 months. On a daily basis I struggle to get through the day without a nap.
*Stiffness (although I am quite flexible) and muscle aches & pains
*Absolutely no sex drive although this isn't really a problem as I am single and so not desiring it is kind of a good thing when I don't have a partner!

These symptoms have been particularly bad in the past year or so but again I just assumed it was done to my depression. However, now that I know I was perimenopausal during this period I'm fairly certain they are related and that HRT will help.

I think I could benefit from testosterone, as well as combined HRT, and think Tibolone may be a good option for me, would love to know what other people think and/or any advice would be greatly appreciated.

Thanks!

[PollyPerky]

All your symptoms should respond to all HRT but not Tibolone. That is a type of HRT for women who cannot use other sorts and it's all synthetic steroids. It's not 'mainstream'. It carries a higher risk of some side effects.

Some drs think that at 43 you would be better off with a sequi type of HRT so you keep cycles with a period but it's your personal choice.

[BabyCakes7419]

Hi Polly, thanks for the reply, it's appreciated. I'm very new to all this and the only reason I thought Tibolone might be good for me is because it contains testosterone and from the little I have read taking testosterone would be helpful for my symptoms, as well as estrogen and progesterone.

I saw my dr this afternoon, who I usually find great, but surprisingly she does not recommend HRT and wasn't going to put me on anything except for the fact that I told her I wanted it. From everything I have read I should take HRT to help prevent risk of osteoporosis and heart disease but she said she can give me something else to help prevent osteo.

My Dr also said HRT does increase your risk of breast cancer but again from what I have read this risk does not apply to someone like me who has had an early menopause. Also, the latest thinking seems to be that HRT doesn't cause breast cancer, rather it can potentially accelerate the growth of already existing breast cancer that is already present.

I think I may print off some info for my Dr as she is lovely and is very open to discussing options, I just feel she is completely out of touch with current guidelines!

She wants to discuss my case with gynae before deciding which HRT to put me on, she said she should hopefully be able to know what bests to prescribe in a couple of weeks.

[PollyPerky]

I'd spend some time reading Menopause Matters website and printing off info. Your GP sounds a bit misinformed.

The risks of HRt- which are tiny anyway- do not apply to women using it up to 52 ( average age of menopause) because it is being used as replacement. You would normally have enough oestrogen to protect your heart and bones to 52 but meno 10 years too soon is going to potentially land you in trouble later on.

And yes, HRT to breast cancer is like a fertiliser on the plant- it isn't the plant seed.

[BabyCakes7419]

Thanks for taking the time to reply again @PollyPerky, you really are a great source of knowledge, have seen you pop up in a number of threads.

I told my GP what you said above that the risks don't apply to someone like me, as HRT will only replace hormones that I should actually be producing at my age but she was very insistent that the risk of BC is still increased.

I have been reading Menopause Matters, thanks for the suggestion, and like you say I think I will print off some reading for my DR as I was very surprised by her attitude towards HRT as she is normally very open minded and well informed. To be fair though she's not refusing to give it to me and said that if my symptoms are affecting my quality of life, and I'm aware of the risks associated, then she's happy to give it to me, she just wants to get advice from gynae as to the best form taking into account full personal history.

[PollyPerky]

Your Gp could benefit from a BMS meno course!
This from Menopause Matters. the info is written by Dr Heather Currie- chair of the British Menopause Society.

menopausematters.co.uk/risks.php

If HRT is commenced at a young age because of premature menopause, then the use of HRT up to the age of 50 does not increase breast cancer risk any more than in women who continue to have periods up to the age of 50. Additional risk from HRT only applies if it is then taken for more than 5 years after 50.

Comparing other known risk factors for breast canc

[BabyCakes7419]

This is brillaint, thanks again @PollyPerky

I'm going to print this off and give to my Dr, I think she will appreciate the info actually x