Hrt patches and ads?

[Baddz]

My go thinks I am in menopause/peri menopause.
I am 42 and am having lots of troubling symptoms, and my periods are now slightly irregular and only last 2/3 days (instead of 7)
I am getting horrendous hot flushes.
Headaches, nausea, need to wee all the time, almost psychotic rage the week before my period, hugely sore boobs, palpitations....it's really really affecting the quality of my life.
I have had a blood test and an ecg andI am hoping to see her again on weds.
Has anyone used patches and ads together?
That's her suggestion.
I am all for anything that could make me feel better tbh :(

The Heat isn't doing me any favours tbh.
I'm so sorry your symptoms are no better. Do you have a night splint to wear? Maybe a visit to your dentist? The pain I was in after some dental work was incredible and my dentist dx tmj pain.
Have you got a neuro appt?

Peter- have they checked you for any infections? Did you have a look at the COB Foundation site? You might get a bit of relief from your pain by changing what you eat and drink, and /or using vaginal oestrogen cream. You could have urethral pain etc from low hormones ; 1:4 women need vaginal cream as well as systemic HRT but it can take some weeks to work.

Will look at the website. Will talk to gynaecologist but I look pink underneath but it is definitely a possibility, thank you. I took a urine sample in & it didn't show anything on the stick. I asked if it could be an infection in my bits Don't want to say it but I have had this for a month & at that time my husband had to have antibiotics for an infection in his mouth (sorry). I mentioned this to my gp (was embarrassing) and he said unlikely. I asked for bloods to see if I have an infection or some underlying cause between my face spasm and my problem underneath. He said no see the consultants as it was not his specialism. I know that's true. My face feels like tingles and worms & my chin was twitching. The worst is the pain low down. It's on the left hand side sort behind the mound (?) referred pain. It's just making me so sad. I can go all night & not need a wee. It's like its not connected to bladder but is around there. I don't described it very well. It doesn't seem to involve my bladder as much today.

Not seeing a neurologist. Maxilliofacial & gynae. Have a mouth guard. Wore it last night. I know I have to get through but the thought of work next week feels like a mountain & my holiday to Mexico in 2 weeks impossible. Someone must know what's wrong. If I go to face guy & he says 30% of my patients feel like you then I maybe would be more confident. I know life isn't fair & that isn't a way to think but I'm so sad

Do look at the site. You can get pain without having frequency as well- some people have one, or the other, or both. It could be stress, just like stress can cause IBS. sorry you are suffering so much- have they not offered you pain killers? Amitriptyline and gabapentin are often used for this kind of bladder pain.

That's why I mentioned amitriptyline.
It was a life saver for me.

Some years ago ami was licensed for use for bladder pain, but the dose is a tiny amount- starting with 5gs and going up to 10mg. This is compared with 75mgs for depression and it's not given in the same amount.

Good heavens! What on earth????
I clicked on this thread as I was interested in the subject.....

Baddz - in answer to your question - I agree with some of the others - you should not need to be prescribed ADs as well as HRT for all the reasons given. Do try the HRT and give it a decent amount of time, and if necessary change type, before deciding you need something else. Many women need to try several before setlling on something that works for them, as well as changing dosage now and again as time goes by and as we go through menopause and our hormones settle. I think someone may also have suggested vaginal oestrogen as well as HRT for urethral and bladder problems (ie estriol cream or Vagifem) - but HRT alone may help initially. I use both - HRT and vaginal oestrogen - started with just vaginal oestrogen, then later started HRT instead, then even later resumed the vag oestrogen.

As for all the hoohah (however you spell this) - er who exactly do you think should post on here eliottsmam ? I am flabbergasted at the venom with which you attack another poster for providing helpful information to women who are trying to find out stuff to help them through this distressing time.

I mean we are all unqualified (well I imagine most of us) ie we are not medics but many have degrees, some have studied science to research level ie PhD. Are all these women unqualified lay people and therefore their comments should be dismissed? Some of us are very well read and are fortunate enough to be able to understand what we read and pick out the good science from the rubbish - and use this ability and knowledge to try to help others in the best possible way. How dreadful to shoot people down like this!

In terms of selective quotes - well of course we all post what we choose but recent review sources are the most likely to be the most up to date - eg the national (BMS) and international menopause societies (IMS), NICE, the Royal College of Obstetricians and Gynaecologists (RCOG). If you go to these sites you will find proper science and no quackery nor biased judgements I would say.

Some posters provide helpful summaries to these - and of course it is important to provide links as well so that readers can look these up for themselves if they so wish. This is all extremely useful!!!

A good summary paper on women's health at menopause is this one from the International Menopause Society "The Prevention of Diseases after Menopause" in whic the role of HRT is discussed and reviewed, as well as lifestyle factors. www.imsociety.org/downloads/world_menopause_day_2014/white_paper/wmd_white_paper_english.pdf

Apologies for digressing OP but I felt I had to comment!

Bella...thank you for your post.
The Dr just mentioned in passing that some women use both. Perhaps this is outdated info?
I have been using the patches for 5 days now and am pleasantly surprised that I haven't had a skin reaction tbh!
We are on hols next week so am hoping I feel a bit better by then!
Very, very tired again today.
Busy week ahead due to school stuff and planning for the hols.
Peter...how are you?

Please don't talk to me like I'm a child. I don't care who posts on here!

Giving helpful information is one thing. Taking over from the 'Dear Claire' of the 70's is a brilliant power trip - till you screw up with incorrect advice!
Being well informed or having a degree does not qualify someone to tell people what dose of medication they should take, reduce AD's and increase hrt etc. etc.

They won't be there to pick up the pieces if it all goes wrong, will they!!

As for venom, I consider someone patronizing anyone who dares to answer back or disagree, not only venemous but downright dangerous.

Telling someone that because they don't comment elsewhere they're suspect or must 'namechange'.

I didn't even know you could 'namechange' until Dr. Pink said, but now I think perhaps she's talking from experience, and she's not the only one!

Every time I do make a comment on anything, I have the good doctor breathing fire at me. If you are at all concerned about the OP and her problem, stop point scoring and tell your pal to do the same.

Um...thank you everyone who has posted.
I appreciate it.

Baddz, I really do hope you find some improvement soon.

I apologize for using your thread to retaliate, it sometimes seems that some people wait in the sidelines to have a pop.

I'll say once again that if hrt helps you that's brilliant. If Ad's help you, that's brilliant too. Don't be swayed by the prejudice of others. It's your health and your life that matters.

I won't comment further on your thread, no matter how badly provoked. Good luck to you.

Thanks.
I will update I promise x

Hello. Went to face man today who did some bloods & confirmed he thinks it's muscle related but I am having an MRI on Friday to rule out neuropathy & MS. Could you please let me know the background as to why oestrogen cream (?) helps with bladder pain. Starting on some amyriptyline tonight.

Peter- the bladder and urethra have a lining that is dependent on oestrogen to keep them healthy- that means able to fight off bacteria and stay in good condition. The lining has oestrogen receptors meaning it responds to oestrogen to maintain its surface. If this lining /surface thins due to less oestrogen circulating it makes it more vulnerable to damage ( ie physical trauma through sex) bacteria and inflammation (through certain chemicals in food and drink. ) and dryness. This is the reason that post-meno many women suffer with bladder and urethral problems.

You may have an inflamed urethra which means it will be painful. You could have a thin bladder lining which means that normally innocuous substances that you are eating and drinking are causing the nerves in the bladder to react in a way they'd not if the lining was thicker. Hope this makes sense!

Eliott- where do you think women are going to get all these drugs they are being 'advised to take in various doses' on a forum? Unless they buy them off the web then they are prescribed. They have to see their dr to get them.

They can't change the dose unless they are on some kind of drug where they self-titrate and where this has been agreed.

The more you continue these rants the sillier it looks.

Been okish today. Only been to the toilet about 5 times. Just went before bed as not much there & I feel like my urethra is on fire & my bladder is sore. Seeing gynaecologist on Wednesday. So fed up with it all. It almost feels like my urethra is broken. Which is ridiculous because it's fine in between. Can't sleep again. Will change my diet tomorrow. Just want some bloody peace

It does sound like vaginal atrophy which also affects the bladder and urethra. Or Painful Bladder Syndrome. Both are horrible- I had PBS for years and years treated with anti histamines in the end and which got much better from local HRT. (Forgot to mention that the use of HRT in the vagina passes through the vaginal walls into the surrounding tissues- urethra and bladder.)

Every time I do make a comment on anything, I have the good doctor breathing fire at me

Eliotsmam

I don't know what your problem is. You came to this forum asking for independent advice. You have made it clear that you don't like Menopause Matters because 'it's not independent' ( not sure how that applies to all the women on that forum.)You have also dismissed the British Menopause Society for the same reasons. Presumably you will feel the same about the IMS and maybe even NICE?

Bellaciao has made some relevant points. This is a forum. It's for women to exchange experiences and give advice. This applies to every forum on Mumsnet. People don't have to be qualified psychotherapists to advise on Relationships, and they don't have to be drs to give advice here.

Suggestions that a higher or a lower dose might help are just that- suggestions which have to be discussed with a dr.

loosing the will to go on. cancelling my holiday to mexico as i am in so much pain with my bladder. seeing the gynae tomorrow but dont know how my bladder eurethra hurts so much. will ask about the cream but i dont know how to get through the days.

Oh Peter
That's such a shame but I understand where you are coming from.
I'm worried about my UK holiday next week!
Still got brain fog here, and still feeling yucky.
I hope the Dr can suggest a treatment plan.

That's awful Peter. As someone who has suffered, I do understand. In the meantime take ordinary pain killers- paracetamol, not ibuprofen which is acidic and may irritate it. Have you tried bicarb in water ( a tiny bit - like 1/4 teaspoon) which makes your wee less acidic and may ease the pain.
Don't drink tea, coffee or acidic fruit juices, or anything fizzy and especially not cola. You might find a warm bath helps.

Thank you. I am a school secretary & I have to smile all day & I just want to run away & hide. I will ask about the cream but I don't know where to go from here. I will wait & see what he says but I've only been on the HRT for 2 weeks but I thought it would make some difference. Thank you for listening I have isolated myself so much & my sister & best friend try to help with positive texts but I just want to feel better

I'm only 6 days in and no change here (but early I think)
I am finding it very hard atm with the DC - it's end of term and they are both tired and kranky...as am I!
I have a meeting to attend tonight too ....I do hope no one irritates me! ????

...pop pop
Hi Baddz
"The Dr just mentioned in passing that some women use both. Perhaps this is outdated info?"
Yes some women use both - because they are prescribed both by their doc. As has probably been quoted on here (sorry haven't read all the back posts again!) - if not this thread then another - the new draft NICE guidance on managing menopause says:

For vasomotor symptoms -
"1.3.3 Do not routinely offer selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) as first-line treatment for vasomotor symptoms (flushes) alone."

and for psychological symptoms:
"1.3.5 Consider HRT to alleviate low mood in menopausal women.
1.3.6 Consider cognitive behavioural therapy (CBT) to alleviate low mood and anxiety in menopausal women.
1.3.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults)"

I'm sure the link has already been posted but here it is again:
www.nice.org.uk/guidance/gid-cgwave0639/resources/menopause-draft-guideline-nice2

This is a major step forward in giving menopausal women the treatment they deserve (if they are able to have it and want it) without being fobbed off and sent away with a "there there" clutching a bottle of happy pills as a panacea!