Think I need more oestrogen?

[LittleHag]

Brief history. Always suffered with my hormones, PMS and PND. At 43 noticed my periods suddenly got much lighter and much shorter, and cycle went from 28 to 24/25 days.

Then, out of the blue, I started with insomnia, very early waking (feeling so stressed and wired), mood swings and intermittent anxiety. Physically I developed achey ankles and palpitations but no hot flushes.

Long story, short, got referred to a Menopause Clinic and started HRT with 25 mg patches + 12 days Utrogestan, which did nothing. Increased to 50mg patches and there was some slight improvement but basically spent the whole summer feeling pretty flat much of the time with just a week or so of normality each month.

Finally got another appointment at the clinic, but had to see a locum who was useless. I explained I was still feeling very low at times with intermittent anxiety. She refused to increase my oestrogen patch (told me too much oestrogen could cause diabetes and breast cancer). Instead she tried to push me to have a Mirena, despite me telling her it sent my PMS through the roof when I tried it years ago.

In the end she got quite irritable with me and insisted I accept a prescription for Elleste Duet 1mg, which I know contains less oestrogen than my current 50mg patches so I don't see the point in even trying them. Plus the progesterone in them is the dreaded Norethisterone which is first generation, old fashioned and notorious for causing PMS symptoms. So, no thanks.

I have booked to see Dr Annie Evans in desperation, but it's 10 weeks until my appointment. So don't know what to do until then? My GP won't prescribe anything higher than a 50mg patch and just keeps pushing ADs at me. The thought of 10 more weeks feeling this flat and hopeless is horriblehorrible. Can't get excited about Xmas or anything at all, just dragging myself through the days, feeling so miserable, until the next few 'normal' days (at the moment only about 1 in 3 days is a normal day).

Thanks for listening xxx

I am finding Menomood a help. It has St Johns Wort as one of its ingredients. It might be worth a try...

However, I'm no expert in the field of HRT, so hope someone more knowledgeable comes along soon.

I can say, though, that I truly sympathise with the situation. Its Sh*te!

Someone with more knowledge will be along soon, I'm sure. I told my GP I was feeling really down and she suggested Agnus castus . I was a bit sceptical, but imy mood has improved(could be coincidence) . I'm not on HRT because it made me loopy, as did notistherone, but on the pill, Qlaira, which is supposed to mimic natural hormones more.

Poor you

I think you are right. You are short of oestrogen.

How old are you now?

Sorry to hear you have had some poor treatment- the locum at the clinic ought to be shot for spouting such tosh! HRT causing diabetes? Er...no don't think there is any evidence anywhere showing this-and up the age of 51 the risks of breast cancer don't apply because you are only replacing what you ought to have up to an average meno age.

My understanding is that 1mg is too low for someone under 50 who is peri because your own levels would be quite high. You are also less likely to absorb as much oestrogen from a pill compared to a patch even 'dose equivalent'.

You might like to find and print off the new NICE guidelines on the menopause and take to your GP because they state quite clearly that ADs are not suitable for women with meno symptoms who do not also have a diagnosis of clinical depression.

What are you using now- are you using the 50mcg patch or taking the 1mg pill- or neither?

TBH you'd be wise to accept the patch and then see Dr Evans when you appt comes. Any chance she has cancellations and you can see her sooner? Or would you be open to seeing someone else (another consultant) who is just as good? Can help you with names by PM if you want.

Thank you for your replies, it's so nice to get some support from women who know what it's like.

I never dreamed that the years before the menopause could be so dreadful. I assumed I'd have a few flushes, then my periods would stop and I'd be over it. Can't believe I was so naive!

For the last couple of years I've not known how I'm going to feel from one day to the next. Some days I feel 95% normal and other days I am in a very dark, scary place. It's ruined my life really.

I am 45 now and cannot bear the thought I might still be going through this is 10 years time.

Pollyperky I am back to wearing a 50mg patch for the time being. I did move on to trying the BCP instead for about 3 months but it was a bit of a disaster (realised I really can't tolerate the synthetic progesterone).

But the patch really isn't helping to be honest. I wore 50mg patches for a few months over the summer and didn't notice a huge improvement then either. When I was at the clinic the locum looked at my bloods from last year and said I was 'borderline' whatever that means? So God knows what I might be now?

I really appreciate your offer, but I need to wait until March so I can save up to see her, although I have asked to be put on her cancellation list.

It won't go on for 10 years if you get the HRT right.

Also- there is no requirement to come off HRT- ever. It's decided on an individual basis and many consultants are happy for women to stay on it forever.

You had an early menopause- that's before age 45. Premature menopause is before 40.

Can you go back to the menopause clinic and see someone who is not that locum? Or ask your GP to do a blood test to see what your oestrogen levels are when on HRT- you may find they are still low. You should have asked what 'borderline' was- on the high side of 'normal' or below normal? And was that when you were on HRT or not?

If you were not on HRT then 1 blood test is no good; you need 1 on day 3-4 of your cycle and 1 mid cycle and sometimes repeated over a few months when in peri.

You might find this useful infoDaisy network you don't have POI but you did have an early menopause and some of the info applies to that.

This is a chart showing all HRT
www.menopausematters.co.uk/perimeno.php

I expect that Dr Evans will prescribe Oestrogen gel which I think she likes as do most good meno consultants. It allows you to alter the dose yourself from 1-4 pumps of gel per day until you get symptom relief. It's a shame your GP won't prescribe this now then you could try it. Is it worth asking?

Might be worth trying something like Menopace in the meantime - I don't think it works for everyone but as a 'top up' for HRT while you are waiting it might help a bit. Worth a go.

Thank you Polly.

I am very frustrated because the Meno Clinic won't give me my blood results over the phone. Instead I have to wait for their doctor to write to my GP with them. Then I have to get a GP appt to be told what they are. So that will be a few weeks then.

Plus I have little faith in my GP as before he told me the results of my previous bloods were 'normal', but the clinic doctor told me they were borderline.

I can't wait to see Annie Evans and I am already on her cancellation list. I know we are lucky to have the NHS but I have been in 'the system' now for over 18 months and I am no further forward than I was when I first visited the Meno Clinic. It's been a complete comedy of errors, from seeing a doctor with poor spoken English to another doctor 'forgetting' to write me a script because she nipped off at the end of our appointment to bag a piece of birthday cake (I am not joking).

I am seeing my GP tomorrow because I am running low on patches and I need a course of Utrogestan to shed my womb lining. She is a new GP and I hear good things about her, so I am going to ask her for oestrogel rather than 50mg patches.

I experimented with applying 75mg patch yesterday (cut a 50mg in half) and although it's very early days I do think I woke this morning in slightly brighter mood.

The previous doctor at the Meno Clinic told me I would need 'at least' a 50mg patch, and probably higher. So it was so frustrating to be told last week by that Spanish GP that they were going to try me in Elleste Duet 1mg which is so much less oestrogen.