To ask you what to do about my hormones? (41 and in meno)

[SSYMONDS]

I have been feeling rough and stacking on weight for a couple of years. Today I got my blood results from a trendy designerHRT consultant in Harley st, and frankly I am in shock.

I thought she might say my horemones were a bit all over the place but she said essentially I am in menopause, quite far in and she wouldn't expect me to have another period naturally, there are no more eggs. She said I must be exhausted and was surprised I hadn't aged more

Oestrogen, I should have over 1000, I have 0.44 - or 'essentially none, not enough to measure''

Progesterone I should have 75 - 'none again'

Free testosterone should be7, it is 0.6 - 'so again none'.

Another marker is FSH (this is your brain trying to stimulate hormones when it notices your body is lacking.) You would expect 4 or less at my age. I am 136.6 which is 'extremely high. older post menopausal women might normally be between 50 and 90'

The only hormone I have in an acceptable range is DHEA at 5.8 (between 0.3-11 is acceptable.)

She has prescribed a bespoke hormone cream (P, O and T) that she is having made for me in a pharmacy to my prescription. I will get it early next week.

She said to expect:
The first month could be a bit rough. Might actually feel worse. Random bleeding, very tired, poor sleep, puffiness, sore breasts, spots etc. It's unlikely to make me moody though (less than 5%). Then after the first month I should start to feel better week by week. I should gradually improve and be back to where I should be in 6 months max.

I was a bit upset and she said that I should know that it isn't fair but she can put all the hormones I should have back in my body. She said I will have more energy, regain my muscle mass, sleep better, concentrate better, have elevated mood and libido and my skin and hair and weight will improve.

She also said that I had done the right thing by figuring this out and that without intervention I would age 10 years in the next 2, and be at much higher risk of osteoporosis, heart disease, altzheimers and cancer. She said whatever happens I must take some hormones as not taking them would impact on my life expectancy.

I am totally freaked out, I feel so suddenly old, and like no wonder I've been struggling lately. I'm a bit out of my depth as I know nothing about hormones so ANY interpretation or advice is welcome. Thanks

Thanks again for the support - I've been awake all night thinking about it.

I've decided I'm not in menopause - I have a hormone imbalance - as this feels less old.

I agree - doing it naturally is not for me, especially at this age.

The bioidentical bespoke hormones are in tiny doses so apparently I can stay on them as long as I like.

So glad I caught this when I did. Hopefully things are about to start getting a lot better.

To those asking, I'm seeing valaria Anacampo in London. I think she's very good.

Hi there

This has been moved from another section?

Ok, I'll try to be brief which is going to be hard!

First, there is no need to pay a fortune for designer hormones at the 'G' clinic- is that where you went?

The 'made in a lab for you hormones' are not regulated. You can get exactly the same on the NHS or, if you prefer privately, from a couple of excellent consultant gynaes in Harley St. (i've gone to one for 10 years.)

I'd not go as far as saying it's a 'scam' they offer, but they make a lot of money from vulnerable women who do not understand that the bio /body identical hormones can be found in your local pharmacy in regulated amounts. What you have is not regulated.

At your age you are having an early menopause. Your GP should deal with this with conventional HRT or they can refer you to an NHS gynae.

The reason what you are taking is not regulated is because the blood tests you had are not reliable- they only test your hormones on that day- and the HRT you were given is based on those results. You can get exactly the same but better treatment by using Oestrogel ( on NHS prescription) and work out yourself what you need to help your symptoms. The dose is from 1 to 4 pumps daily. At your age you ought to be the starting dose of 2 pumps which is the researched amount to prevent osteoporosis. In addition you could use micronised progesterone ( branded as Utrogestan) and a testosterone gel.

I'm sorry you have had to fork out hundreds of £££s to get something you could have on the NHS, or you could pay £250 for 1 consultation with a reputable gynae and then have your HRT on the NHS via your GP.

Here are some links on it all. have a good read and honestly, my advice is to ditch the G clinic and if you must go privately, see someone who is a consultant gynae.

Bioidenticals

Heather Currie is chair of the British Menopause Society

Extract from the Mail and comments from top gynae Nick Panay

^However, some experts question whether it's possible to measure an individual's hormones, because our levels change all the time.
'We have been talking about individualised HRT for years, and in principle we agree with the concept of tailor-making a prescription based on a patient's age and history,' says Dr Nick Panay, consultant gynaecologist at Queen Charlotte's & Chelsea Hospital and Chelsea & Westminster Hospital, and past chairman of the British Menopause Society.
'The side-effects of HRT, such as nausea and breast heaviness, do tend to happen when women are given too high a dose, so it should always be given in lower doses.
'But there's a bit of controversy as to how much one can individualise. There's so much fluctuation in hormones. If you do a blood test in someone who's still having a menstrual cycle, the results will vary according to where they are.'
He adds: 'I don't think we can individualise as much as Dr Gluck thinks, and I don't think we need to.
'We try to find the middle ground - as long as we can replace hormones within the appropriate ranges, it will suit most women.^'

Thank you Artura

Yes, thank you artura. Great stuff.

And polly - so good of you to write in full like that. You make some great points.

Yes, I am at the G clinic that you mention....

I like the bespoke prescription idea because it results in taking much lower doses so I can stay on it a very long time and there's less likelihood of a side effect or increased risks.

Also, am I right in thinking that NHS HRT doesn't include testosterone? I definitely need that as I'm not producing any, and my libido is not great.

It's great that the stuff on the NHS is now bioidentical - can you get creams or does it have to be the sticking plaster?

It was expensive, but the clinic only charged me half price for my consultation because it didn't take as long. And they've said they're happy for me to do my bloods through the GP in future and only pay for consultations- which actually aren't too pricey.

The actual hormones are about £50 a month which I pay directly to the lab, which I think might be a separate company.

Do you think it could be dangerous to have something unpatented? I was under the impression that the only reason it's not regulated is because each prescription has a different amount of each hormone so not available for generic testing?

Essentially it is just horemones in a cream - nothing else. So just replacing what should be there.

I agree that a blood test will only ever be a snapshot, but am wondering if a snapshot is as at least as good as no snapshot at all?

I am genuinely trying to understand all this - I do hope you don't mind me asking all this and am keen to hear anything else you have to say

Just to correct you on a couple of things:
You need a dose which works. At 41 you need a reasonable amount of oestrogen to protect your bones. This is at least 1.5- 2mgs oestrogen daily for most people. If you used Oestrogel, you would use the standard dose of 2 pumps as a minimum.
There is no benefit in having a tiny dose- far from it.

If you have been 'sold' that as an advantage, that's disingenuous of the dr.

The second thing is that women using 'mainstream' body-identical HRT can stay on it for life. So again, I'm a bit worried you have been 'sold' (literally and metaphorically!) a regime which is marketed as being 'safer' when in fact there is no difference.

At 41, your risks on HRT do not kick in until you are 51 at least (age of average menopause.) The tiny risks don't start until 5 years of use- so we're now looking at you being 56 (15 years on HRT) before you even need start to consider risks.

You can get all you are using on the NHS (Oestrogel and micronised progesterone capsules.) The testosterone too- the recent NICE meno guidelines say women who need testo in addition to oestrogen should have it. (Have a read of the guidelines- all online.)

£50 a month is a lot. I pay for my HRT (2 items not testosterone) and it costs me around £15 a month on a private prescription.

And yes, there is a small chance that the products you are using could cause harm as the labs may not be regulated regarding quality control. There is no way of knowing what small, private labs do. They may be fine, they may not be.

Thanks for the replies... and corrections!
I think I have made the right decision for me, but I'm not particularly invested in persuading anyone else for now as I'm still feeling my way. I'll post again soon saying how it's going in case anyone's interested.
Thanks again for everyone's time.

How are they managing the progesterone part of HRT with you? If that too is a cream, the evidence is it's not absorbed properly in order to protect the womb lining. Have you been put on sequential HRT ( with a monthly period) or continuous? Do you know what dose of estrogen you have been given?

It IS up to you but being really blunt, the person you saw is not even a gynaecologist- her profile shows she has other areas of interest.

You had some really good advice on this thread from Artura- saying the same as I am. You are 'classic' prem meno and the treatment needed is well within the expertise of either a good GP or a consultant gynae. I'm sorry to sound negative but I am genuinely worried for you, because you have said you do not know much about menopause & HRT generally and the sort you have been given.

There are many specialist gynaes in London who can help you for far less money and who are better experts. Given that you will need HRT for at least 10 years, either you carry on paying - I expect it will be almost £1K a year when you add in the consultations and fees for the prescriptions- or you change to the NHS or a private dr who is less expensive.

My main concern is that the treatment you are having may simply not work, because the creams may not be quality controlled and work. So your bones etc may not be protected as you think they will be.

Even if you don't agree with me, you ought to take note of the advice of the BMS shown in the link I left- the advice from Dr Currie.

Polly, I understand you are concerned and it is important to you that I come to the same conclusions as you, but not everyone is the same. I genuinely appreciate the information, but I am grown up professional with 3 degrees. I work in health. I am doing a great deal of research and I can be trusted to come to my own decisions in my own time.

You have to let people find their own way.

I'm not sure why saying you have 3 degrees is at all relevant. Are we now having to pull rank over who has the highest educational qualifications?

I've used 'designer' HRT for 10 years from a top gynae consultant far more qualified than Gluck and her team.

That's irrelevant in a way because what I've said in my posts to you is simply draw your attention to the facts as reported by the British Menopause Society.

If you are going to get all defensive over this, and not even engage in the points I've mentioned (ie dose, type of HRT etc) as a point of discussion when people are trying to help you, then carry on with your choice.

I mention the degrees in attempt to dissuade your condescension. I've been polite as I can be Polly, but really, you sound very tense and bossy. Your points may well be helpful but your tone gives me a headache.

That's me done on this thread.

I'm not being condescending. But you are not listening or even accepting that the treatment may not be the best. It would eventually exasperate anyone trying to help you!

You said yourself that you knew nothing about this, right from the start. listen to the facts of the BMS! They are the experts and if you care to read the link all I've done is reiterate what they say.

op, polly has been on these threads for years and really knows her stuff, even if you feel you are being bossed a bit, I would read her advice and take note of it.

Yep, those links she's put up are really worth reading. Especially if you are in early menopause.

Sadly I think sometimes people think money=better is always the case. In healthcare it's just faster usually. Hippocratic oath and all that. I'm very happy with my nhs issued HRT and I didn't need a crapload of tests to decide it was happening! Especially as he blood tests only give a snapshot of levels the minute you're having the blood test - levels of hormones that are fluctuating (like in, er, menopause!).

Hi SSYMONDS I hope you're not feeling disheartened, after posting for advice. You can and will feel better, and I'd like to hear how it goes for you. Polly def knows her stuff, and it is wise to get lots of info before putting stuff in your body. Sorting out early/peri/post menopausal symptoms for my patients is one of the really rewarding parts of my job. I see so many women feeling utterly miserable, exhausted and fed up, and with some simple treatments and advice they can feel so much better. Hope it all goes well for you too.

Polly really knows what's she's talking about, she really helped me. I have 5 degrees btw but they're not in the hrt area!

Hi,.
Had anybody got experience of taking cBHRT prescribed by a private Menopause Clinic? And is worth buying (expensive individualky prepared medication?..
It is quite expensive and I'm checking if o can afford £100.00 plus a month.. Not sure yet....!.
My blood test results showed rock bottom with Progestetone, ACTH and Testosterone..
Kind Regards,
Booblet

Anyone tried cBHRT from a private clinic where they custom make your individual prescription?
I'm not sure I can afford the £100.00 plus a month...
Is it worth it?
Anybody have experience with this?
Kind Regards,
Booblet