Perimenopause & HRT

[Frostycake]

Which tablets/patches/gel do you use if you are mid-forties and peri-menopausal?

Just trying to get an idea of what works and what doesn't.

I want to avoid being palmed off with the poor quality default option by my doctor.

Can you tell me your stories? At the moment, I have brain fog, poor sleep and heat (all the time). Restless legs and anxiety occasionally.

saythatagain is there any chance you could get an earlier appointment with your dr? If not, just focus on the thought that you ARE going to the dr next week, and you ARE going to get something to help you through this both in the short term and in the long term.

It makes me realise how far I've come, when I read your post. That was me. I truly felt as though there was nothing good in my life, when of course there was. Tons of good stuff. Just couldn't see it. Couldn't feel it.

You mentioned you're losing weight - presumably either caused by the runs or not helped by it. Make a point of getting up and drinking water - make sure you don't get dehydrated. Just a small glass each time will be fine.

If you don't have anything specific that has to be done today, read a book, go out for a walk maybe to somewhere you could stop and have a cup of tea. You're depressed. You need to look after yourself for the next week until you get to the dr. If it's not raining where you are (and actually even if it is) get yourself outside and breathe some fresh air. It'll be a bit better for a while.

In the meantime, and also help. Hope your day gets better.

Thanks for your continued kind words Chin.
I got up and started doing my cv, which, along with yesterday's revelations with regards this thread, has buoyed me up a bit.
My dh is completely onboard with me and has been very reassuring.
Yes, I can see myself that I'm depressed, but knowing that I'm at the docs at the end of the week is helping me. It's these darn nights where I wake up and spend the remainder of the night going over and over in my head what a mess my life is.
Of course, in the moments of lucidity I know that to be totally wrong, but that isnt so clear at that deadly time of night.

Hello

I am in my 40s and peri menopausal. My symptoms are primarily anxiety, insomnia and low mood. Yet I can go for a few weeks at a time feeling perfectly normal again, but then it all goes pear shaped. I have been on such a roller coaster this last year

I have just been prescribed Estradot 25mg with 200mg of Utrogestan to be taken on days 15-26.

Unfortunately, when I picked up my script I was already on Day 13 of my cycle. So not ideal to start HRT mid cycle really. But I put my patch on and took my first Utrogestan last night.

But, I had the worst insomnia ever. I don't think it was linked to my HRT really, it's only been 3 days.

But I have decided to stop everything, and wait until my next period starts. That way I can have 2 straight weeks of oestrogen before introducing the Utrogestan again.

Hello TheGingerTree,
Sorry to hear of your problems. I have no idea what to expect when I go to the docs on Friday. I'm uncertain if I am peri menopause or 'just' depressed!
What I do know for sure is that I cannot go on living this nightmare.
Feel free to off load just as I have...and found some real solace in doing so.

GingerTree I wish I could help you work out your prescription but I must admit to being very uneducated about which kinds of HRT are available and their benefits/side effects.

If your insomnia continues for more than 3 nights, and you have been good about not drinking too much coffee/alcohol etc, and have taken a reasonable amount of exercise then I think I would go back to the dr's and ask him/her about it. I would insist on a small prescription for mild non-addictive sleeping tablet. The dr gives you a prescription to see you through this or he writes you a sick note and you start taking time off work.

pinkfrocks says it in an earlier post - we have to start educating ourselves about menopause and how to deal with it. So take it from me - your prescription may very well start to kick in and eliminate the majority of your symptoms, but in the short term you need some help with sleep to enable you to function properly.

saythatagain did you sleep any better last night?

Thank you chin up. I started getting panicky about not sleeping last night so gave in and took 5mg of diazepam half an hour before bedtime. A last resort for me but I knew my panicking would likely stop me sleeping again. It's a vicious circle.

Anyway, I slept well and feel much calmer as a result and better able to be objective. I won't resort to diazepam tonight regardless. I think I'm generally anxious about this progesterone part of my HRT because I've heard how it can cause low mood/anxiety and I really don't need any extra dose of those as I'm doing great providing my own already.

But that's an excellent idea about trying a sleeping tablet in the short term thank you. I am praying that this HRT will cure my insomnia because it is so horrible. It only started a while ago and arrived out of the blue. At first I would only ever get one night of it, but recently it's increased to a few nights in a row.

Insomnia is a prime symptom of menopause- in fact along with flushes it was the main reason for my taking HRT.
It worked for me in 3-4 days but in theory you need to give it 3 months.

I am not boasting here (really!) but I have never had mood swings ( some anger outbursts but that was teens living at home so go figure...) and have to say that exercise has been shown to be very effective with moods. Some research has shown it to be as effective as HRT. It is also as effective as ADs for mild depression.

I walk a lot- around 2-3 miles around 4 x a week. I am sure this helps with mood and also meno symptoms- so a bit of 'self help' goes a long way as well as HRT.

Ginger please don't go down the sleeping tablet route- your dr is only allowed to prescribe enough for 3-4 days for patients in extreme distress. All sleeping tablets are addictive and they should not be used for more than a few days .

ps- my MIL was given diazepan and became addicted for over 20 years. Not a good move

Hi pinkfrocks

I had no idea that insomnia was so common during peri menopause. The first time it happened to me I was so shocked. I had always been such a good sleeper. I couldn't think what on Earth was wrong with me?

I wasn't thinking of using sleeping tablets on a regular basis at all. In fact I am very much hoping that they very soon won't be necessary at all now I am on HRT (crosses fingers). Did HRT reduce your insomnia within just a few days of starting it? That sounds promising. But did it get rid of it completely do you think?

As for diazepam, I know exactly what you mean my ex partner's Mum took them for over 25 years back in the 70s and 80s. I think they were handed out like sweets back then.

But nowadays they are far, far more controlled and your GP is usually very frugal with them. Mine made it very clear to me that they were for emergencies only, and that if I used up all 12 in just a few weeks then he simply wouldn't prescribe them for me again. As it is I have averaged much less than one a month, as I still have a few left.

I just thought that taking them for a few days once every few months wouldn't cause any harm.

when I was pre-HRT I would find my body clock was all over the place. I'd go to bed at normal time and then feel wide awake and hot the minute I was in bed. I would also wake up a lot during the night- maybe 3-4 times. Within less than a week of HRT this had stopped.

That sounds familiar pinkfrocks.

I go to bed at my normal time, following the same routine. Even feel sleepy. But I lie there and lie there and CANNOT drop off. A few times it feels like I nearly drop off but I get this surge of adrenaline/anxiety which shocks me out of it.

Most times I do eventually fall asleep (at about 3am) but I am still wide awake no later than 6.30am. But oddly I don't feel that tired the next day. Just a bit grey and wired.

Occasionally I just don't get to sleep at all. Literally lie there all night. And that is vile.

Most of the time I do get to sleep okay. But I still can't ever seem to sleep past 6.30am, no matter how late I went to bed. And I feel the quality of my sleep is less now. And I no longer wake up still feeling nicely drowsy. Oh no. I snap awake like a meerkat.

Fingers crossed that the HRT works on me as quickly as it worked on you. Do you ever get insomnia nowadays?

I don't sleep late and never have- most days I wake around 6am and maybe doze a bit. Generally doesn't bother me.

I think you ought to try to stop worrying about it- anxiety is a big factor in insomnia.

Hello everyone,
I did sleep better last night, but that was because I took a sleeping tablet.
Like TheGingerTree said, I was starting to get panicky at th thought of yet another night with no sleep. The knot in the stomach, increased heart rate etc.
Anyway, after spending a weekend I'm abject terror of how I was going to cope at work today; all was fine and dandy.
As usual, I started my mantra of 'remember this feeling', so I'm really hopping that I will sleep again tonight. I won't be having another sleeping tablet.
Having read the posts so far, I'm uncertain as to whether I require betablockers, HRT or something for anxiety/depression.

I'm currently on holiday. Didn't bring enough of my little Activelle magic pills with me so I'm rationing myself to one every other day.

Guess what.

Get sleepy. Go to bed. Lie there. Awake.

Took me a while longer to drop off to sleep last night. But I did and slept fine. Woke up slightly later than usual which was nice.

I do think you can almost talk yourself into not sleeping before you get anywhere near your bed.

Say you could always just do a 3 month trial of HRT and see how you get on with it?

I might ask the doctor about HRT after reading these posts.
I didn't sleep particularly well last night, but managed to remain fairly philosophical about it.
Another question: is there a particular type of HRT that is better than others? I do remember to stay away from anything starting with prem.

It's preferable to use patches or oestrogen gel (with a separate natural progesterone) because you need less when it's applied through the skin and there is a lower risk of blood clots.

Some GPs aren't really 'into' gel but it was the first thing my consultant chose for me and it's brilliant.

Having said that some women don't like to faff about applying it and prefer a patch but I don't fancy a patch stuck to my bum all the time.

Hi - can I join in please? Am 48 and peri. Have all the same symptoms as described and my gp has recommended HRT in the form of mirena coil plus oestrogen cream - anyone with any experience of these please?

It'll be oestrogen gel, not cream.
That is supposed to be a very good combination. I turned that down as I am quite sensitive to progestogens and didn't want the coil but it's definitely worth a go.
gel is brilliant because you can start with a small amount- one pump- and then increase to 4 if necessary to get symptom-relief.

So, without sounding like a complete idiot; I could rub on some gel and that possibly could relieve me of these symptoms?
How would the doctor distinguish between requiring HRT or ad's?
Again, I'm not trying to be purposefully obtuse/thick.

:) no of course you are not being thick.

Many consultant gynaes think it is more appropriate for women in the peri meno and post meno stages to supplement their dwindling oestrogen levels with HRT if they have symptoms, rather than try ADs that have many more potentially serious side effects.

Do you have typical peri symptoms? Flushes, night sweats, insomnia, anxiety, lack of energy, dry or spotty skin, weight gain, irregular periods or longer/ shorter cycles and so on?

It's a case of the proof of the pudding!
If HRT works for you then that is proof you needed it.

Thank you pinkfrocks

So, my 'symptoms': itchy skin, low tolerance, very, very emotional, unable to cope with work, low self esteem, irritable, moody, crabby, miserable, inability to think clearly, no self worth, very, very emotional, lack of strengthening, sleep deprivation in extreme, angry, worthless, emotional....I could go on and on and on.
I hope, hope, hope I sleep tonight.

....anxiety, thumping heart, fluttering heart...
Blimey, is it ever going to feel better?