Trying to decide re HRT

[tass1960]

I am 55 and haven't had a period for 2 and a half years. I had made the decision not to take HRT and just try and muddle through. I was managing fine until I started getting vaginal dryness - I have been prescribed estriol 0.01%l but don't really know if it's working since my libido has all but disappeared and am a bit scared to try and be intimate anyway. My memory is non existent. The only other problem is more recent - my body feels like it's been battered - my shoulders, elbows, hands, knees, ankles, feet and back are almost constantly aching - I have just realised that this could be down to menopause.

Am considering speaking to my GP and I suppose my question is has anyone started HRT after struggling along without it and if so did it help? Does it help with the atrophy and dies it help with the aching body and memory? I would also be interested to know what type is best - am thinking I would prefer a transdermal type but would be interested to hear opinions on this too.

Try not to worry . There can be all kinds of reasons for raised liver enzymes- anything from a virus to something taken over the counter. Do you have symptoms of gall stones? Why was that suggested? Even if you have, transdermal HRT is possible. Your BP may well be high due to being at the drs and feeling anxious- a single reading means nothing. Did she not suggest a home BP monitor so you can check it yourself for a week?

If she is unsure what to do, ask for a referral to a specialist or take yourself off and pay the £150 -ish to see one yourself.

Hi Tass,
Totally agree with PollyPerky; ask to see a specialist.
Do you have a history of BP?
Could just be 'white coat' syndrome; I have this. One reading does not mean anything at all. What time of day was your BP taken?

Thanks for replies. By the time she did imy BP today I was anxious and tearful tbh.

My BP has been raised on and off over the years but not enough that they have been concerned. On the other hand I (am trained as a midwife though no longer practicing) was a bit. I didn't have any other worrying symptoms so I never really bothered the docs with it. I always feel they think you're a bit of a hypochondriac if you try and tell them their job.

I have been keeping an eye on my own BP and it is very labile. I even did a BP profile and it was borderline. So yes she did suggest a home BP monitor but they have a waiting list and it could be a couple of months. Anyway, I asked the nurse when I went back for the repeat bloods at lunch time what it entailed and it turns out I can do it with my own machine. Am starting it tomorrow and the blood results (FBC, ESR and LFT) will be back by Wednesday.

In summary by the end of next week I will be armed with all the information (except the liver scan). I have been reading a lot, as recommended on here, and had already decided that transdermal would be my preferred option anyway (although I don't know what the prescription was for). There was no discussion! I definitely don't want patches. My skin breaks down if I have Elastoplast on for more than 5 minutes. I will go back in 2 weeks (to give them a chance to analyse the BP profile) and if there is no progress will ask to be referred. I hadn't thought to go private but that will be my next port of call.

No real symptoms of gallstones. A couple of twinges occasionally that could be but nothing diagnosed or even consulted about.

You can buy a BP monitor from Amazon ( or Boots) for around £20 or less.
TBH for the cost of a couple of pairs of shoes, you could get an appt with a gynae (but make sure they have an active interest in menopause - not all do or are sympathetic) and get some expert advice.

Thanks Polly - I already have a machine. I dont know why I didn't just say that to the doc. I was bit surprised by the whole turn of events and flustered. I know the consultants at our local hospital though not from a menopause perspective. I am going to have everything written down the next time I go to the doctor so there will be no confusion. Thank you so much for your help. I am slightly worried about my BP as it has remained raised today. I know it can be controlled with medication however and hope that doesn't mean I can't start taking HRT. I will update as soon as there is anything to report.

BP readings this morning 146/91 and 139/86 - much much better :)

You'll know all of this but are you doing all the right things re. lifestyle to reduce it? ( regular exercise, low booze, low salt?)

Yes Polly - I exercise loads tbh couldn't really do any more - very low alcohol intake - as for salt am not so sure but will be watching from now on and be more salt aware. Am on it and feeling positive ...

I've also done some research today and I know where to find specialist advice if necessary - our hospitals don't seem to have menopause clinics so I can either go to a private hospital (but the doctors there seem to specialise more with incontinence and prolapse and that sort of thing). There is somewhere I can go and I am actually going to phone them on Monday and ask some questions. Am not sure if they can prescribe HRT. They fit coils and prescribe contraception and it says they have a menopause clinic so it's worth a try.

Two things. The first one is that, if you're going to go down the private route, I would find a consultant gynaecologist who is sympathetic to women who want HRT. The second thing is that testosterone can be prescribed to help your libido. Have a look online. You will only get a private prescription for this -- it's not available for women on the NHS.

Docs tomorrow after bloods tests came back normal and BP Profile is normalish - high end of normal but I think it should be OK - I really want to use the transdermal gel having read a bit about different types - does anyone know if there is a difference cost wise ... I will be so pissed off if there are any more reasons to delay.

Cost should not come up as an issue. HRT is dirt cheap compared to many other drugs.

RRP costs here

www.menopausematters.co.uk/treatafter.php

So - finally after 8 weeks I have a prescription. I said that my preference would be a transdermal gel but she said because they are oestrogen only they weren't suitable for me. I had an idea that I had read on here that there was a way round it but I couldn't remember what it was. Anyway I have got a prescription for Evoril Conti patches.

She is still slightly concerned that my liver bloods were a bit askew but did acknowledge that other factors could cause this. Then there was the BP profile which showed that my BP is the high end of normal. I have to have an ECG with a view to starting medication for that depending on the results. We discussed exercise (can't possibly do any more), reduce salt and alcohol (hardly ever drink and could possibly reduce salt intake - I have been doing this already) ) - then the scales - can definitely do with losing a stone so am on it.

All in all not perfect but on the right track and I can't thank you all enough for your input.

Hi there Pleased you have got something but your GP is a bit confused tbh.
Yes, gel is oestrogen only, but you can use a separate progestogen alongside it- taken either daily or for 10 days a month (which would be cyclical.) There are lots of women using gel who also use progestogens as a separate product. Seems like this is all too complicated for some GPs.
The way you use gel is to add in something like Utrogestan ( micronised progesterone) for 25 days a month if you don't want a bleed, or a synthetic progestogen like Norethisterone. The doses for these are all in the info GPs have access to.
All I'd say is watch out for how you feel on combined HRT. I'd not use it myself because I don't like the PMT type symptoms from using progesterone daily. I prefer to still have a cycle ( 8 years post meno) although the bleeds are a nuisance.
Hope you get on okay! Menopause Matters forum is a good source of info too- you'll find much more there from women who can help you.

Thanks Polly - I knew I had read this somewhere - have a terrible memory and couldn't remember exactly what it was - I guess I can try and see how it goes - I know that sometimes it is a bit of suck it and see scenario - I suspect I won't get on with patches anyway because my skin gets all red and raised if I have a plaster on for more than 10 minutes. To be continued ...