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.

Yes. Honestly. Hang in there till that visit to the dr.

This time next week (hopefully) you'll have an appropriate HRT prescription - although if they need to do a blood test etc first the prescription may be delayed until the results are in. In that case, I revert to my earlier advice of asking for short term relief in the form of non addictive sleeping pills & a short prescription for a mild sedative. It's what I had from my dr and it lasted for 4 weeks and then never repeated.

It's going to get better. I used to use an app on my phone to calm me down iSleep Easy to try to help me calm down when lying in bed, and Take a Break which is what was called "Meditation Oasis": Sleep Better, Anxiety Relief and Walking Meditation. I found it quite calming but the woman's voice might do your head in. She could be a bit too calming at times. But hey - it worked, to a point. Search for it in the App Store and see if you can listen to a bit before downloading - can't remember now if I paid for it or if it was free.

say If you haven't had any of these symptoms before then it's likely to be linked to your hormones. If on the other hand you have had a history of emotional or mental health issues (anxiety etc) then the link might not be so clear.
All I'd say is that although HRT will probably help you loads, don't forget there has to be a big element of self help as well. It's no good expecting HRT to 'do it all'. This is a time of our lives when we really have to start re-thinking diet, exercise and generally looking after ourselves so we have another healthy 40 years!
Cutting out refined carbs and sugar is a good start, as well as caffeine plus the obvious stuff like increasing vegs and fruit- 5-7 a day.
Exercise is important both for mood, and muscle strength. If you don't already exercise then maybe start because that may help your insomnia. By exercise I'm talking about 45 mins brisk walking a day- not necessarily going mad in the gym!

Reading this says what I think that everyone is different same as taking contraceptives and other medications. Normal HRT did not agree with me, I had really heavy periods not like my normal period. Luckily I had not had periods for a number of years when diagnosed and had to wait for a while but was eventually prescribed the bleed free HRT which is brilliant. Before this I tried a couple of other HRTs plus anti depressants. Sorry to be a bore but it might be a case of trial and error to find what suits you best. I also found that my HRT did not resolve my night sweats completely but I am now on setraline and find that this works.My only other suggestion is change your lifestyle and diet , I have not managed to do this as yet but working on it.

Roll on tomorrow for me, when I'll hopefully be able to put across, without crumbling into a crying wreck, how I'm feeling. I absolutely take onboard what previous posters have said about lifestyle and exercise etc.
I spend my working day on my feet, moving about for eight house. I acknowledge that this isn't the same as going out for a brisk walk, but tbh, I'm utterly shattered at the end of every working day.
I would expect to fall into my bed absolutely exhausted, but no, alas, come 2am/3am, I'm awake ruminating and anxious ridden.
I just hope I am able to put across succinctly how I'm feeling and come away positive.

saythatagain I was wondering how your doctor's appointment went? Did he/she give you any help with HRT etc?

Hi Chin
Well, the doctor, female, was lovely. As I predicted I blubbed, but managed somehow to get it all out.
The upshot is that it's not certain I'm starting the menopause, so I'm going to have some blood tests to check hormones and also she mentioned thyroid, which is not something I'd thought about.
Giving the list of my issues, particularly work and the severity (in my eyes) of my anxiety, she has prescribed florexatine (sp?).
She had mentioned betablockers, which I was more than happy to try, but as I'd had Prozac before and it worked for me, she didn't see any point in trying something different. We also discussed CBT to.
I came away feeling a lot better about the whole situation thankfully. I'm back there in a fortnight to discuss things and perhaps up the dosage etc.
I don't know whether it was just going and off loading to a health professional, but the permanent knot I had in my stomach has ceased too.
I'm not saying I'm anywhere near being on the right track, but at least I've done something.
The next big thing for me is to look for another job. The doctor said about taking some time off because I was so wound up, but my worry there is that if do have time away, I won't want to go back.

say I'm not sure if you have meno symptoms or you are suffering from anxiety. Do you have any meno symptoms like flushes, sweats, and of course a change in periods?
If you don't, then it seems as if you are suffering from anxiety and CBT may help rather than drugs which will only mask the feelings as long as you take them.
Are you able to describe why work worries you so much?
Are you in a job that is too hard or demanding for you, or what?
What is your fear about re. work?

That's great that you had a sympathetic doctor, and that she has arranged blood tests for you. You do need to know whether you are in the menopause or not. I think on that basis it's not such a big deal that you have a couple of weeks relief (by medication) from your symptoms.

As pinkfrocks says, if it is anxiety rather than menopause it is much better to work on the underlying cause. CBT is a slow process though, and may take a little time before you feel you are back in control of your life. However, as you discovered on Friday, it's still just a great feeling to offload all your concerns and have someone to really listen to you.

Take care of yourself over the next couple of weeks, and I hope that you get some good sleep, some exercise and a better feeling of being able to cope.

I have just started my second month of HRT for perimenapause ,I use sandrena gel and uterogestan . First month I used 0.5 mg of samdrena gel and 200 mg of uterogestan days 1-25 of cycle and towards the end of the cycle I experimented by increasing the sandrena gel to 1 mg which was the prescribed dose . I found myself to be labour and tearful during this time , roughly a week before my period . I also had sore breasts . I slept better , hot flushes reduced and palpitations seemed to stop .
Second cycle I decided to keep to the 0.5 mg sandrena gel dose and I decided to reduce the uterogestan to 100mg days 12-25. The reasoning behind this is that it is proportionate to the oestrogen dose which is half that prescribed .
I have not had sore breasts this month but feel the hot flushes and possibly disturbed sleep are there in the last week if my cycle .
I know I am sensitive to hormones as I became depressed on OCP in the past whichbis why I am being cautious and pretty sure the lower dose of oestrogen suits me better than the normal dose. Does anyone have any advice on the dose of progestigen - am I ok with 100 mg instead of 200 mg

I am still waiting to see someone at the menapause clinic . I have health insurance with nuffield - vitality - wondering if I should use that or just carry on as I seem to be a lot better then before i started the HRT

@Tahiraellah

Who prescribed the initial dose for you? It's completely wrong! Sorry to bear bad news.

If you are in peri you should be on a seqi regime (giving a monthly bleed.) This follows your own natural cycle as it would be. (Assume you ARE in peri as you have posted in a 'peri' thread.

The dose is the normal dose of Sandrena- 1 mg- and 200 mgs Utrogestan for 12 days out of a 28- 30 day cycle, usually starting on day 15 (15 days after starting the gel.)

There is no way you take 200mgs daily for 25 days- no wonder you felt crap! Who told you to take that dose????

If women use it continually- 25 days a month- the dose is 100mgs a day.

I think you need to see someone who can prescribe properly.