Please be honest - Perimenopause

[JustLaura]

Please be honest. I want to hear the truth.

I don't think I'm that far down the 'peri-road' as still having 12-14 periods a year but what feels like 40+ Perimenopausal symptoms. I'm late 40s.

I feel absolutely horrendous, tired, groggy virtually every day.

Is this how it is for you?

Is this the future? Will it be like this forever now?

Thanks

Wow. That's the exact dismissive attitude that women have faced for a long time until the 'latest fad'🙄 actually started being taken more seriously because some doctors don't actually want women to suffer through anymore.

I'd say in her late 40s she's able to tell the difference between being 'simply a bit tired' and not feeling like herself or good at all.

And she has already seen the GP.

And no the solution isn't to take it easy for a day or 2 and stop fussing. Jesus Christ.

I had 3 years of debilitating peri symptoms before I figured out that's what they were - from age 46-49. My main symptom was utterly crushing anxiety that came out of nowhere, along with, genuinely, about 20 other symptoms including all the usual (though no hot flushes) and some other really weird ones like non-stop internal vibrations as though I'd swallowed a vibrating mobile phone. Tingling legs and arms. Heavy, achy legs and joints. Tinnitus. Gum problems. Weird electric shock feelings and jerking limbs. Feeling like death every morning. Grinding fatigue. Panic attacks and something akin to mild seizures. Ectopic heartbeats, palpitations, seriously low blood pressure causing me to regularly pass out (like 75 over 50 low). Dizziness. Itchiness. Feeling like I was going to die. I went to the doctors a couple of times. Was referred to cardiologist for palpitations. To neurologist for the seizure-like incidents. Had brain MRI and EEG. Nothing found.

They were very thorough. But not one person mentioned perimenopause/menopause. I was put on sertraline for anxiety. It did help with that, but not with the physical symptoms. Eventually saw a private menopause specialist who prescribed HRT - most symptoms now vastly improved, though joint issues are still stubborn - I also have one-sided hip pain and didn't really connect that as being part of all this, so interesting to read lots of others have the same!

Would you consider trying HRT, OP? Is seeing a menopause specialist an option for you? It's expensive but you get a proper amount of time to discuss things and be listened to. It doesn't work for everyone but was a turning point for me. I found it really hard to make other lifestyle-type changes when I felt so fucking awful, but once the symptoms were more under control I've been able to do that too.

Really hope you get to the bottom of it 💐

HRT was a game changer for me but I know it isn’t for everyone. I had arthralgia caused by peri so very achy everywhere and it turned out to just be lack of oestrogen so within days of being on patches the pain disappeared.

Peri started late 30’s for me- no change in monthly cycle at all but many other symptoms! Am approaching mid 40’s now and feeling much better than I did a few years ago.

This ^^ was me.

I thought if only some of what I'm feeling is peri related, that's potentially treatable so I'll see if it can be attempted and see what happens.

Went to Dr (female) and conversation was roughly like this:
Me: described symptoms and feelings and uncertainty as to whether hormones could be a factor, but given other possible reasons were not going away anytime soon I thought worth trying to treat hormones to see.
Dr: let's do all the tests, blood thyroid etc to eliminate other illnesses that can present like that.
Me: ok great thanks.

Results came back. Nothing to see here.

Me: what next? Worth seeing if hormones are affecting me?
Dr: yes, absolutely, these symptoms are concurrent with peri menopause. Nice guidelines say that age of being 40+ and symptoms alone are reason enough to prescribe (if there are no contra indications like family history of breast cancer etc), but we do it on try and see basis, so prescribe for 3 months only and report back.

These are the treatment choices <describes patches gels tablets and different pro and cons> these are the risks of each <describes> (nothing concerning to me).
This is why it helps and how it works <describes that>.
Me: thanks, listening to all that I think patches would be worth a go thanks.

She was an ace Dr, and actually listened.

Two days later I was wondering if I was having one of my rare and random 'good days'
One week later I was my old self again.

Thanks hrt you've changed my life entirely.

I was 47 then. I'm now 49 and still love it. Have just need to increase my dose as was on lowest level then.

Just to add, my colleague went through similar process to me, but took her a while to find a treatment that worked well for her, so I was lucky to hit gold on first attempt, that doesn't happen to everyone.

Also to add a friend of mine went to a female Dr (in her 30's) who told her that peri menopause didn't exist and it was just a fad and sent her away with anti depressants.

Another friend of mine was told she had to try anti depressants first. Did a year of that, going through all the 'getting used to the treatment, worse before it gets better' etc... It did help her mood a bit but not the exhaustion and aches and pains. Then she went on hrt and it's now her old self again.

Blood tests for hormones during peri aren't all that helpful because we naturally fluctuate so much and even more so when you add in an unpredictable cycle. While a really low oestrogen level would support a peri diagnosis a 'normal' level could be you on your 'best' day, it gives no indication what's happening the rest of your cycle.

I have no health conditions that mean I can't take HRT so I used superdrug online Dr to get my first lot of HRT... one month in and perhaps feeling a little less 'meh' but it hasn't been the game changer I had hoped for yet.

Will it be like this forever now?

No. I'm out the other side. It does get better, honestly.

Everything you are saying is peri through and through.

Yes it could be other stuff, but you've had your blood tests and your collective symptoms couldn't be more classic.

You absolutely don't have to suffer this. Hrt treatment could make all this a distant memory! I know cos I was you and that's where I'm at.

Also hrt has many protective effects. It reduces your risks of lots of things including (of the top of my head, there are lots)...
Osteoporosis
Bowel cancer
Vaginally atrophy (look that up if you want to see what massive fun that is)

Every single cell in the female body has oestrogen receptors.
In cartilage its role is to manage the hydration of the tissue, which is why when you are low in oestrogen you ache... The cartilage dehydrates and shrinks and joints are less well protected. It especially affects wrists and hips classically, but can be felt in any joint.

In the brain it causes brain fog and anxiety.

I had one sided aching. The hrt fixed it, the reason it was presenting asymmetrically was because I was bone crushingly exhausted, not as fit as had been as was time poor and exhausted so when I was doing physical tasks I was favouring one side.
The hrt got rid of the aches, and gave me my energy back. So I feel my old self (which when you've been that low feels like being super woman) and I had the inner resources to carve out some time for exercise (fantastic yoga class which has strengthened and sculpted me and sorted the asymmetrical body use I'd - unwittingly - got into a habit of).

Sounds like you have classic peri symptoms. Try HRT and see? It was transformative for me.

Everything you gave mentioned absolutely could be related to peri. They could also be something else

Hip pain and shoulder pain are extremely common. bursitis is a common reason. It can flare on and off for years. Forearms too.

You are late 40s so it's pretty impossible that you wouldn't be fully into peri.

HRT helped enormously.

One blood test can't tell you what the profile of your hormone cycle is doing.

In a healthy young female the hormone cycle on a graph would like like a regular wave of the oestrogen and progesterone dancing in a regular predictable rhythm.

In perimenopause the same graph could look like a cardiogram if the heart was a flea in a box at a rave.

If a blood test is taken it is a single day snapshot. At which point you could be anywhere from at your lowest ebb of hormones to highest or anywhere in between. It would reveal diddly squat about the range, rhythm, pattern or extremes of your hormone fluctuations.

Your age and symptoms alone are enough to try hrt. Assuming you've ruled out the thyroid, blood vitamin deficiencies etc etc (which you have,).

When I asked my Dr if hrt was a good idea. I was concerned as I had never done well on hormone contraception. She said all hrt is doing is supplementing your own hormones, if it doesn't help you can stop, but there is literally no reason not to try it (unless you have family history of hormone sensitive cancers).

If you try it and it doesn't work you have risked nothing except the posibillity of massive improvements to your well being.

Seriously. Stop faffing with supplements and so on and get back to the GP and as for HRT. For many GPs the trigger words are "hot flushes" so tell them you are having those and get started on the patches.

I recognise SO many of the symptoms you are talking about - the upset and tearfulness, aching teeth/gums, sore hips, general groggy feeling.

HRT will not cure it 100%, I have woken up this morning with sore hips despite being on patches. But it does improve matters considerably. You don't need bood tests. If you are over 45 and presenting with peri-menopausal symptoms (which you are), then you should be treated as if you are in that stage.

Interestingly (to me anyway)

One of unexpected things I had pre hrt was a strong inclination to have alcohol every day.

Alcohol has some oestrogen like effects - I have since learnt - (hence why heavy male drinkers often get increased breast tissue - moobs if we're being flippant) and alcohol gives satisfaction to the oestrogen receptors in the body, so it is common in peri to want alcohol more, as it is self medication basically.

So one of the reasons I'd got a bit of weight gain was because I was reaching for the bottle almost every day, just one drink but almost daily.

I don't feel that urge anymore.

But the oestrogen like effects of alcohol is one of the reasons for the stereotype of the middle aged women who drinks... There is a biological basis for to be a bit of a common thing.

My GP surgery gave me 35 minutes with the practice nurse who is on some kind of menopause crusade - I got HRT and some great advice from her.

She did it after hours as she said, the NHS only let her have 20 mins and it’s not enough to really get to the bottom of what is the best hrt treatment to start with.

Your symptoms sound like classic peri. Remember that most women in their late 40s will benefit from HRT. Unless you are high risk for endometrial cancer then it’s not a bad idea to try HRT, OP. It has other benefits aside from relieving menopause symptoms, such as protection against osteoporosis and similar age-related disorders that affect women.

Evolution did not intend us to last long after our child-bearing years so we are fighting nature here. That takes a lot - exercise, diet, supplements, and medical treatments like HRT.

My symptoms were getting too much, that’s when I turned to HRT and so far so good.

I have stopped drinking alcohol and I’m slowly cutting down sugar and fats. Swimming and cycling more. Next step will be introducing weights in some way, along with strengthening exercises and maybe some yoga/Pilates.

@dutysuite It certainly sounds like Perimenopause.
I initially didn't think all my symptoms could possibly be Peri.
Like you, my GP hasn't mentioned Peri whatsoever....

Thanks @EricTheGardener

It helps that someone has very similar symptoms to me. I think the lack of quality sleep is making me worse and that may be the main reason my BP is rising.

I've started to take Menopace yesterday.

My symptoms are wildly different depending where my cycle is at. Ovulation then 2 weeks prior to period are the worst.

Thanks so much for this. Yes I’ve had the thyroid test all fine. I think I will definitely revisit the conversation with my GP about HRT.

I went to my GP with the NICE guidelines, a list of symptoms and said I'd like HRT. I was quite young so went on the pill first which managed things for a while but HRT was better.

Great. Give it a go.
Unlike annuity depressants which you have to taper down gradually if you want to come off... If you aren't getting on with the hrt you just stop it. No issues.
Just be prepared that some people get on better with different types, so if you don't feel much improved on the first thing you try, don't give up, try different approaches to see if another is a better fit.
Again the effects are entirely day to day, so you can swap from one to another easily once it is clear one isn't making much difference.

Here is another thread on this topic some of you may find helpful and it's interesting,apart from the discussion itself, as the op came back and updated.
https://www.mumsnet.com/talk/menopause/5009681-please-help-debilitating-anxiety-in-perimenopause

I feel the same OP. I’m 44. Sleep badly, stubborn weight gain that won’t shift (still a healthy BMI but not optimal for me to feel and look good), tired all the time. Brain fog, dry mouth, brittle nails, face aged overnight. Blood tests all normal except for low folate - in the ‘ normal’ range but right at the bottom.

I eat healthily, weight train twice a week, walk loads and take supplements. Drink very minimally. I can only conclude it’s perimenopause. I’m figuring out the next steps but I will probably use my private health insurance to seek some help.

@Whatanidiot123 I was exactly like you at the same age except for weight gain, except I've never struggled to lose weight if I needed to.

So I did the following:

Took an iron tablet every 48hrs with a vitamin C tablet and raised ferritin to 70 in three months

Started HRT - patch and utrogestan, then swapped to the Mirena Coil which was a game changer for my iron levels and my mood - went to the highest oestrogen patch then added testosterone and now I have sex again!

Both things have made a tremendous difference to my mood and general wellbeing. Also my colleague tells me that my skin looked radiant within a couple of months - I can't see it, but I took the compliment!

Regarding weight gain, 1200 cals strict for 4 weeks and I lose 8lbs.plus I do 4 or 5 miles of power walking a day when I'm trying to lose weight.

I'm also doing a lot of physio for bits of my body which appear to be hypermobile, but didn't show up until my oestrogen left the building and I thought were just running injuries!

I'm starting to panic whereas I used to be really laid-back.

I've just read an article about a lady who has had hip pain for years, had an MRI, told her there were benign tumours so she just lived with the pain but it turned out to be cancer years later.

I've come through the panic attack now but I'm increasingly having panic type feelings over things that I logically would have understood previously.

All this is peri symptoms - it is mad how much can be down to it.
How are you feeling on the menopace?

Thanks @BlueMoanday

I'm 4 tablets in on the Menopace.

I'm not sure how fast I might see a change but I have slept a bit better than usual so far. I feel like I'm getting more 'triggered' by things (been like this for months).

Initially I 'just' had physical symptoms, but panic mode is a relatively new feature of me!

I have a lot of things going on with my elderly Parents too so I do need to factor this in too.

@Twentybottlesofbeer thanks - really helpful to see what is working for others. i am sure I would lose weight on 1200kcal if stuck to strictly but i have no willpower and unreal sugar cravings - I don’t give into them much but I feel like I’m already constantly battling. I’ve never been overweight before but I’m worried that I’m going that way.