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Confused about perimeno/hormone blood tests - anyone know what I should be asking for?

(10 Posts)
EllenRipley Tue 24-Oct-17 16:23:37

I read a lot on here about women who’ve had their hormones tested and diagnosed as perimeno/meno. I realise at peri stage that hormones fluctuate so much that it’s difficult to get an accurate reading of what’s going on, and have recently been told as much by both GP and GP nurse (apparently they don’t test after 45 - I’m 46 - for the above reasons).

I’m most definitely peri and in retrospect probably have been since my early forties; had my son at 39 and had a good few years of very heavy (though regular) periods and diagnosed with a small fibroid. Last 18 months and following laparoscopic surgery to remove a cyst and scar tissue adhesions, things much more erratic; period every 2/3 months, phantom periods, and an assortment of other mild symptoms. Been having a lot of ongoing cramping and pelvic discomfort so currently being referred back to gynae to see if cyst and/or fibroid issues have returned.

So (apologies for length)! Regardless of outcome of scan etc, I want to speak to consultant about obvious peri hormone imbalance and treatment options - should I be asking for blood tests? How do they know what hrt combos to put you on without measuring your existing levels? On the one hand my symptoms suggest low estrogen, on the other I’ve had a doc tell me my estrogen levels could actually be too high and causing absent periods/pain etc. I’d like to be armed with a bit of knowledge so any insight much appreciated, Thankyou x

PollyPerky Tue 24-Oct-17 17:20:49

NICE Menopause Guidelines

1.2 Diagnosis of perimenopause and menopause

1.2.1 Diagnose the following without laboratory tests in otherwise healthy women aged over 45 years with menopausal symptoms:

perimenopause based on vasomotor symptoms and irregular periods

menopause in women who have not had a period for at least 12 months and are not using hormonal contraception

menopause based on symptoms in women without a uterus.

1.2.2 Take into account that it can be difficult to diagnose menopause in women who are taking hormonal treatments, for example for the treatment of heavy periods.

1.2.3 Do not use the following laboratory and imaging tests to diagnose perimenopause or menopause in women aged over 45 years:

anti-Müllerian hormone

inhibin A

inhibin B

oestradiol

antral follicle count

ovarian volume.

1.2.4 Do not use a serum follicle-stimulating hormone (FSH) test to diagnose menopause in women using combined oestrogen and progestogen contraception or high-dose progestogen.

1.2.5 Consider using a FSH test to diagnose menopause only:

in women aged 40 to 45 years with menopausal symptoms, including a change in their menstrual cycle

in women aged under 40 years in whom menopause is suspected (see also section 1.6).

PollyPerky Tue 24-Oct-17 17:23:38

The treatment for peri is HRT if you want it. There is no point doing blood tests- your hormones in peri are all over the place day to day so the test shows nothing except hormones on that day. This is not diagnostic.

If you use HRT you start with a low dose and increase until you get relief of symptoms. If you use Oestrogel you can alter the dose yourself to get an improvement- start with 1 pump and go up to 4 daily.

It's trial and error!

EllenRipley Tue 24-Oct-17 18:21:58

@PollyPerky great, thankyou. Do your periods tend to return if you’re on hrt?

PollyPerky Tue 24-Oct-17 19:16:07

No.

You get withdrawal bleeds like being on the Pill but HRT doesn't give you more eggs.

HellonHeels Tue 24-Oct-17 19:19:57

Sorry to jump on your thread Ellen but can I ask, would the HRT relieve the hideous overheating and sweating I'm getting? And is it like being on the pill which never agreed with me?

EllenRipley Tue 24-Oct-17 22:56:36

Ah, right - I realise it doesn’t replenish your egg supply and reactivate your cycle, I meant more the regular bleeding side of things.

Hi @HellonHeels as far as I know the sweating/hot flushes is related to diminishing estrogen so I think that’s one of the main things hrt addresses. I’m cautious too, I’ve reacted very badly to hormonal contraception in the past - I’m by no means sold on the prospect of hrt but I’m getting to the stage where it might be better to try it rather than put up with the symptoms!

IvorHughJarrs Tue 24-Oct-17 23:05:18

For some people dietary changes can make a huge difference to symptoms.

I didn't want to do HRT, unless it was unavoidable, as I have had bad experiences with hormonal contraceptives. Discovered when dieting (I'm a massive fatty) that my hot flushes eased dramatically when I cut back on carbs and came back when I ate them again so it might be worth trying

PollyPerky Wed 25-Oct-17 08:22:27

It's important to understand that the hormones used in modern HRT are NOT the same as in the Pill. They are a) natural [same as your own] and b) in far lower doses.

The clue is in the name Hormone REPLACEMENT Therapy.

No one should compare their previous experiences of the Pill or other hormonal birth control with HRT.

HellonHeels Wed 25-Oct-17 08:59:00

Thanks Ellen and Polly

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