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?

Yes I agree.

Its trial and error as we are all different.

Also been diagnosed as type 2 diabetic- and that's the same. What helps one makes it worse for someone else.

I agree it's trial and error. I do think testosterone and huge doses of oestrogen are not necessary and if women feel that they are then it's likely something else is going on.

Oohhhhh. That’s interesting. I wonder if I was very diligent about taking bone strengthening supplements I could just ditch the HRT. Will speak to doc.

It took me ages to find the right dose. Peri means your hormones are all over the place which doesn't help. It does settle eventually but it takes time
Sorry !

No don't ditch the oestrogen and prog if you have weak bones! Just don't use testosterone.

Oestrogen is thr first line preventive for osteoporosis

I felt the same after responding badly to the contraceptive pill. Even posted on the menopause board about it.
In hindsight i had a lot of peri symptoms which I ignored. Three years out from ceasing having periods I started on 100g utrogestan and a patch. I feel absolutely fine after a month. Less irritable, sleeping better, improved libido. Very surprised that it's felt so seamless. I feel quite grateful for this stroke of luck, as I was expecting migraines and mood swings ( due to previous history)

I am also taking a good all round vitamin supplements aimed at women over 50, and b6/magnesium supplement. I walk and swim every week too, and try to avoid overly processed food.

Finally someone has cracked the whole menopause issue. Stand down Davina, it's not real, just something fat, unhealthy people get.

Are there really people this hateful towards women in real life or just the incels on mumsnet. Absolutely vile comment from I suspect, a very unhealthy male.

I do think maybe being very slim and fit and mentally in a good place with a happy life MIGHT lessen the need for hrt but it's unlikely to make a huge difference. Nice in other ways though! I certainly don't feel 'lesser'taking HRT!

How is this helpful?

Can you not hear how judgemental this could sound?

Can you not understand that some women (who eat healthily and excerise just as much as you and your sisters) have different endocrinology/gynae? Some women, from the outset have heavy periods. Some light. Some get cramps. Some don't. Some have regular cycles. Some don’t. Some have 2 days of bleeding. Some have 7.

It is like you coming onto a thread where someone is asking for help with heavy periods and saying "I have very light periods and don't drink alcohol/eat bread..."

Wow I knew there was something I was missing in my battle to relieve my menopause symptoms. I need to be healthy. Great, I'll stop HRT immediately.

Although I’m glad for you that you managed menopause well yourself with no HRT, I think it’s a dangerous message to insinuate that a) HRT is something that should be ‘avoided’ and b) that you can prevent damage caused by sudden drop in hormones through ‘healthy’ lifestyle alone.

For many women, peri-m and menopause can be debilitating. The reduction in hormones can cause significant health issues, physically and mentally, and result in strained personal relationships and have adverse effects on their professional life. The average age of peri-menopause coincides with the highest rate of suicide and leaving work for women. Proper support and medical intervention in the form of hormone replacement can avoid some very serious problems.

Sorry, not sure if this is for me. I don’t have a diagnosis of weak bones, I meant that because I’m not sure I’m seeing a benefit to HRT I’ve been considering stopping taking it. I would have already, had it not been for an article I read about how HRT is so useful for bone health.

This is precisely why I stated go to a menopause clinic or consultant. GPs and surgery nurses don't have specialist knowledge.

I’m not saying you should go on HRT - that’s a personal choice - but I absolutely loathed the pill, it changed my mood, my skin, my personality even! But get on really well with HRT. It has taken the edge off my rage and has also stopped my unpredictably heavy bleeds and awful headaches.

So I wouldn’t rule HRT out based on your experiences with the pill.

I saw a private specialist because I wanted the time and expertise and I’m happy with that decision.

As PPs have said, many long term conditions require several attempts to get the medication right, and then medications cease to be effective with time. It’s not for lack of research, it’s because humans are complicated biological machines.

Medicine is getting a bit more personalised, but it is never going to be perfect. People can continue to report side effects etc once a medicine is on the market and this may refine the prescribing message over time, but it will still be a matter of stats. So a dementia medication (which are still in trial and have been for decades) might be better for early onset than late onset, but only in actual usage will that be discovered.

Thank you all again. Some very helpful thoughts and ideas here. I'm sorry to everyone else who's been struggling.

Interested in those making connections with responses to hormonal contraception. I always felt good, and slept well, on the progesterone only mini pill. And I think Utrogestan has improved my sleep overall. Problem is, the nausea from the last couple of times I took it has interfered with that. I suspect I didn't wait long enough after food, and/or took it too close to bedtime.

It's a right pain to find a time to take it... one hour before food or two hours after! I go for about 9pm as we are usually done with dinner by 7pm but sometimes I forget and have a snack whilst watching TV - grr!

Utrogestan is amazing for my sleep. I love it.

I'm not sure how helpful that would be as I'm guessing my hormones are fluctuating a lot throughout the month and a blood test would only tell me what was happening on one day. Am having particularly bad symptoms pre ovulation so if I could have bloods done at that specific time it could be helpful. I've got a lot of other chronic health conditions so there is a lot in the mix to unpick.

@Blanketenvy I think the general advice is to go on symptoms not hormones if you are over 45, though once you have started on HRT it can be worth checking oestrogen levels to see if the body is absorbing it properly

I’ve had a nightmare with it - went onto everol sequi and on it for three years until GP said I had to go onto Conti. Immediately felt terrible - aching boobs, just general weirdness so started cutting the patches in half to reduce the dose. Then started bleeding again so went to GP who advised a scan and a biopsy which has led to them saying I haven’t gone through the menopause yet. Having a hysteroscopy this week which I am a bag of nerves over. I can’t help but feel that if this was a ‘men’s issue’ it would be better dealt with. All seems like guess work and I am not sure the celebrities who are paid to push HRT on us (looking at you, Davina) are helping the situation.

If find it strange that oestrogen is prescribed at a constant level through a whole cycle (in perimenopause), I would have thought looking to mimic the natural rises and falls would have been a good idea, especially to try and counteract some of the negative symptoms women get when they are on cyclical progesterone. Has anyone ever been prescribed it in this way? I would be interested in any trialling anyone has done as it feels like this should be the way it should work.

I think that because we always have a base level of oestrogen in our bodies pre menopause, trying to mimic a cycle (with all the factors of different women absorbing oestrogen differently anyway) would be difficult.

In mass medicine, there is a lot to be said for simplicity of administration, otherwise compliance drops off - unless something is literally saving your life, in which case you handle a regime of going to the hospital twice a week for two hours or whatever. A medicine that is difficult to take will have lower efficacy because more people will use it incorrectly. It’s why some types of the Pill come with a placebo week so that you can have that type if you find it difficult to remember to stop and start. Etc.

@MainStreetOrHighStreet I lost a lot of hair when my ferritin tanked. Have you have a full iron panel inc ferritin and transferrin?