I didn't realise HRT would feel like such a shot in the dark

[JillyLooper]

I know I'm very lucky to have it available. But I hadn't realised it was just so much trial and error. I'm in probable perimenopause, and different symptoms come and go horribly whether I'm on HRT or not. Don't know whether to up or lower the dose at any time. The same signs can be related to too high or too low of different hormones. No one can tell me much to guide, apart from "try it". It's mayhem. Anyone else feel the same?

Whilst I agree that diet and been healthy is an important part of managing perimenopause in the main it's down to hormones. And that is often down to genetics.
Some of the healthiest people I know have the worst menopausal symptoms and some of the most unhealthy sail on through.

Go and have your hormone levels checked preferably at a Menopause clinic. Most GPs don't have the knowledge to prescribe HRT accurately.

I didn't find this. I took what my GP prescribed in the dose that they prescribed and it's been absolutely fine. I take a fairly low dose.

I believe private prescribers prescribe way too much - the amount of people taking 4 or more pumps of oestrogen seems nuts - must cost a fortune for a start.

It takes at least 3 months to have a consistent effect so why not just try what your GP recommends and give it 6 months.

Fiddling with dosages is bound to have you up and down!

Maybe Lenzetto spray would suit you better.

How long have you been taking it for? The first few months are a little all over the place while you dose up with oestrogen and your body adjusts to progesterone (mine took a few months anyway).

I have been taking HRT for two years and it works very well for me.

AND I have quit drinking, take a lot of supplements, eat healthily, exercise and get plenty of sleep.

Thr nurse at my GP says she spends most of her time trying to sort out issues with women who are being prescribed way too much oestrogen and testosterone.

And hormone level tests are notoriously inaccurate.

Take the simplest lowest dose you can and give it longer.

I've had two different types and strengths. I outgrew just the tablets on a small dose and moved into the capsules and the gel and they saved me. But I was in menopause starting it all so maybe that made a difference?

Interesting to hear all these different experiences. I didn't react well to the contraceptive pill when I was younger (shocking really how little info there was in the 1980s when I first went on it) and I'm imagining the reaction to HRT might be similar for me. As in, weight gain, mood swings, breast tenderness etc. So for me at the moment (mid-fifties, still having very regular periods) I'm putting it off for now. Never say never though.

Try magnesium if having sleep issues.

This is me, too. Bad reaction to contraceptive pills and now peri menopausal (48) but resisting HRT due to bad experiences with fucking with hormones most of my adult life.

The single thing that sorted out my menopausal symptoms was making pretty hefty and drastic dietary changes for a couple of years. But due to illness and bereavement I’m back to eating ‘normally’ and I’m finding all my symptoms slowly creeping back in.

If anyone is interested in trying it (I wish you better luck with it than I had!) - I cut out sugar, dairy, alcohol, gluten, caffeine and UPF. I slept well, my joint pain went, my depression and anxiety went, no more panic attacks, no more skin rashes, I obviously lost weight, and I went from pre-diabetes to being within normal range.

As PPs have said, if for whatever reason you don’t want to try HRT, try a.n other lifestyle change to see if it helps you.

Yes me too. Maybe actually being in menopause (ie periods had stopped for a year) made a difference. It's been great.

I had the perimenopause from he'll. I regarded it as a payoff for never having had an issue with menstruation. My GP was dismissive and hopeless.

I went to see a gynaecologist who chatted it all through with me for 30/40 minutes and suggested a combination of pills and patches and wrote his recommendation clearly for my GP with an instruction about what should be prescribed and an alternative tweak if necessary.
.it cost me about £250 15 years ago and was the best money ever spent. It's all history now and as a woman in my mid 60s a distant memory. All symptoms have gone with the added bonus of no periods. I sweat less, I have much reduced normal discharge, I have no periods, life becomes free again.

OP, if the progesterone is making you feel terrible it might be that you need to increase your oestrogen. When mine was low progesterone made me feel worse, but I tolerated it ok once my oestrogen was increased.

Personally I'd put it off as long as possible if you can cope. I really believe the best results come when you are in menopause rather than perimenopause and everything is so crazy. But I'm sure it works for some peri women.

I’ve had no breast pain with HRT. I used to take EPO for it but don’t need it now.

YANBU OP. Also if you are trying to manage other medical conditions at the same time it is also a nightmare. Frankly I can’t believe women have the same working conditions and retirement age as men. The fact is nobody has prioritised this for research otherwise doctors and women would have much better intelligence to work from. We should be furious (and not just because of a hormone imbalance 🙄)

There has been some ropey advice given especially from private clinics who promise the world but whose solution for everything is just increase the dose. It’s bad advice.

Agtee with pp suggesting you stay on the lowest dose you can and give it more time. Constantly adjusting the dose is going to bring its own issues.

Also consider whether there may be other things at play- check your thyroid, iron, vit D etc. after years of menopause symptoms being ignored it now seems as if we’ve gone too far the other way and all symptoms are ascribed to menopause.

As I understand it, the contraceptive pill is much stronger, the hormones in the pill are not the same as your own and it's designed to override your system, whereas hrt is a much smaller dose, contains hormones chemically identical to your own natural hormones and tops them up. It's more like topping up your b12 or vitamin d if your body is having trouble producing enough of those. The difficulty is getting the dosage right and different women absorb it differently too.

Damn, it all sounds really complicated.

I’m 51, never taken the pill, in peri - at least my periods are getting increasingly random & I’ve had a few hot flushes at night so I think I am - & my memory’s getting worse so I thought it could be worth asking about HRT for that but it sounds as if it might not be.

It's not at all complicated. I've always just got hrt from my GP. Hot flushes seem the key to them prescribing it.

I hear you, OP. I’ve tried a couple of types and I’m not sure I see any benefit apart from in the two weeks of Utrogestan I sleep better. I read an article about osteoporosis and at the moment that’s the reason I’m carrying on.

Can HRT cause thinning hair? Mine is noticeably thinning.

Testosterone can.

Listening to Dr Sarah Jarvis recently on radio 2, she was quite clear that testosterone is unlikely to be needed as it gradually diminishes from our 20s and then stays stable. But women are asking GPs for it because of media hype and private clinics. In a blind trial, those on a placebo reported the same improvements.

I thinknthis is a dreadful observation. I am 64 and worked successfully through perimenopause with three promotions. The issue is not the retirement age. As a feminist I expect to work to the same age as a man and the extension to the retirement age and lifting of statutory retirement has made up for the seven year break Inhad when my children were young.

The inequality comes from the fact that women receive sub optimal healthcare when compared to men and that's a structural inequality built into the psyche of NHS provision. It was a young, female GP who told me to consider giving up work rather than HRT to cope with menopause. She turned bright red when I asked if she'd give up her career at the expense of not receiving optimal treatment.

Why should a person's career suffer because they have a womb together with the loss of income, purpose and professional identity?