Perimenopausal - please come and talk to me about HRT.

[LurcioLovesFrankie]

My cycles having been getting shorter and shorter - down to 20 days this time, with a very short follicular phase (ovulation now on about day 7!) So I guess I'm perimenopausal. I've got some minor symptoms: waking up in the middle of the night feeling too hot; killer night of insomnia just before period; loss of libido (not too much of an issue as I'm not in a relationship, but makes me feel like I'm not me anymore, IYSWIM).

Reading around websites (including NHS one), it looks as though the most effective and safe way to take HRT is for about 4 years before the menopause and maybe a couple afterwards. So I guess what I want to know is:

Are my symptoms bad enough to make HRT worth it? (It's the loss of sleep that gets me - DS, nearly 4, is finally sleeping through reasonably reliably so it's a real bummer that just as he's no longer waking me, my own body decides it's going to go haywire and wake me instead).

How do I tell when is the right time to start taking HRT? 4 years before something that hasn't happened yet isn't that helpful as a piece of advice! Is my short cycle length a good indication?

What are the mental/emotional side effects of HRT? I can't take the pill because it makes me depressed and unable to think straight (I'm a research scientist, so I notice anything that takes the edge off my mental abilities).

Any thoughts from fellow peri-menopausal or already menopausal (or medically trained) MNetters really gratefully received. (I'm already doing some of the non-medical things, like exercise, sensible diet, no caffeine, apart from my major chocolate habit).

I wouldn't consider using hrt unless I was really suffering, tbh.

Can't comment on the hormonal side of things but I know if I eat even a little bit of dark chocolate at the end of the day it has a pretty dramatic effect on my sleep. I noticed it even more when I wasn't consuming any other types of caffeine. Might be something to consider?

Thanks for the replies so far - yes I should chop chocolate out (went chocolate free for a couple of months, then someone gave me a box for my birthday, my god I was hyper!)

My symptoms were very similar to yours, the insomnia was killing me, I found it really debilitating and the hot flushes were very unpleasant. I looked into HRT and decided to give it a go, even though I had always said I would never take it.

I was prescribed Elleste Duet 1mg and the relief from insomnia and the hot flushes came almost immediately. I have been taking it for 6 months now and feel wonderful, better than I have in a long time. I did suffer from PMT including tender and swollen breasts and a quick temper when it came to the progesterone part of the pack but taking Evening Primrose Oil has eliminated that. My periods are now regular, shorter and much lighter, I sleep like a top and my thinking is a lot clearer, no more mind fog.

I have never been able to take the pill either but have had no mental or emotional side effects with HRT. Maybe that's because I'm simply topping up my declining hormones rather than overriding them.

I know it's not for everyone, I never thought it would be for me but it has made a real difference to my wellbeing.

As someone going through the same, with grumpyness, occasionally spots (never had them before) and mental 'fuzzyness' I raise my hat to you, coping with a 4 yr old on top of it all!

Thanks timefor. That's the sort of first-hand experience I was hoping to get. Your comments about progesterone are really interesting. I had IVF and (after my experiences on the pill) was bricking it at the thought that the hormones might make me depressed, but found the levels of progesterone for that were fine, so maybe there's something in your idea that simply replacing missing levels of hormones is a lot less disruptive than the larger doses used in contraceptives.

I took HRT for about 3 years, as I had an earlyish menopause - and had my kids really late, so totally relate to sleepless nights with young one!

I had patches, and found them really easy to use and yes, they made me feel a lot more like 'me' and less exhausted. My symptoms weren't that bad (exhaustion, insomnia, aches) but I started getting regular migraines - as I did in adolescence - which with two young kids, in my 40s, was just depressing. I took the lowest dose.

I'm now 51, and stopped the HRT a year ago - very easily, no withdrawal or menopausal symptoms at all. Apart from vaginal dryness (treatable locally with pessaries or oestrogen cream), I have no symptoms at all - apart from wishing I were younger

ps I also had IVF, twice, and like you found the hormones quite tolerable.

Well, I do think it makes sense. I also have an underactive thyroid so take thyroxine which is also a case of replacing a hormone.

I have found I'm much more mentally alert. I wouldn't say I was depressed before but something was definitely going on because I feel much brighter and clearer of head. I was also suffering from vaginal dryness which was horrible! It was really uncomfortable and as I'm single it wasn't related to sex. Of all the symptoms I was experiencing that was the last to disappear but now it has I'm in tip top condition!

Wow, lots of useful posts, thanks.

Lisaro - I think a 4 year old is easier than what my DM had to cope with - she went through the menopause while I went through puberty :)

Elibean - good to know it was OK to come off HRT. One of the things I was worried about was the idea that I might just postpone symptome rather than escape them.

Timefor - I've had an overactive thyroid in the past so have taken thyroxine (as part of block and replace therapy). Interestingly, what I'm going through now feels a bit like the early stages of an overactive thyroid (I'm waiting to get blood test results on this before I pursue the issue of HRT, though I'm pretty sure it's not thyroid).

Ha ha Lurcio - it was the same with myself and my mother. Hell isn't the word.My father said later he used only come home (Navy) to referee.
I( wondered if some of my symptoms were overdosing on thyroxine as I take 150mcg daily, but as my results are always borderline not high enough it surely is the start of the menopause.

OP

I think you need to re-think some of your assumptions!

Why do you think the safest way to take it "4 years before" meno?
The very latest research said that if you can put off for a few years until after your last period, that is safer in terms of breast cancer.

Also- you have no means of knowing when your last period will be- so how can you judge this " 4 years before"?

The other point about coming off it- i know 3 people who were on it for 10 years, and they all had the return of hot flushes after stopping, which lasted some time.

The latest thinking is that 5 years is safe, up to 10 years is okay- but a slightly higher risk of breast cancer- but not a huge risk as depicted in some newspapers etc.

The stats were from the Million Women Study which only last week was questioned by other researchers.

I've been on HRT for 3 years- started at almost 54 when hot flushes and insomnia meant my life was getting harder! I don't know how long I will stay on it- I also had low bone density so it helps that, as a positive side-effect!

Most drs here give HRT as tablets or patches. I use an oestrogen gel and progestins every 3 months- I have been told this is safer than taking both hormones daily or in a month.
Personally I was at a "I can't stand this any more" stage and my symptoms were more than a mild inconvenience. I have friends in their 50s who have had no symptoms at all- so everyone is different.

Not sure how old you are- but HRT taken under age 50 doesn' "count" towards you "safe" 5 years use.

I have just stopped HRT at the age of 49. Had an early menopause and went on hrt for symptom control. There are lots of different hrt options. I found that I couldn't tolerate oral progesterone - made me depressed - so I had a mirena coil fitted and just took oestrogen tablets. This suited me really well and I have been fine on this treatment for past 5 years. I understand that if you have an early menopause there is no increase in breast cancer risk as you are just replacing hormones that would normally be there anyway. I have decided to stop treatment now that I am nearly 50. So far the unpleasant symptoms haven't returned. I think this a personal decision. You have to get all the information - risks v benefits and decide what is best for you. Good luck!

Am following these "perimenopause" threads with interest as I think I am starting to have symptoms myself.

Am really interested in what LongAndTheShortOfIt said about the mirena coil. My GP has been recommending the mirena for a while now and one of the reasons he put forward was that it can act as a surrogate HRT for those years before the menopause. Haven't seen this argument anywhere else though.

I'd started with perimenopause before I had my hysterectomy. I was put on HRT immediately and it made a huge difference. I've been on it for four years now and I'm staying on it till they refuse to allow me any more tablets.

I can honestly say I've never felt better. I used to get frequent headaches and rarely get one ever nowadays.