Advice needed - Pollyperky if you are around that would be brilliant!

[Apocalyptichorsewoman]

Am 48. I started with hot flushes around 44 or so - mentioned it to GP and he huffed a bit and said that all is well and if I can get by without HRT that would be best.

Am a game old bird so thought fine!

Am now 48 and I havent had a period for 16 months - cool.
A bit of joint pain and a bit of anxiety that I didn't have before but am ok - still getting the hot flushes etc.
But the nights are crucifying me! I get palpitations along with the hot flushes.

I go to sleep - duvet on - duvet off - and repeat. But the worst is the palpitations when they start. It's like someone has attached a cord to my chest, and suddenly someone yanks me upright sweating and feeling like I'm dying. Then as the sweat wears off, I realise what is happening - but the experience is awful!

Am starting a new job on Monday and could do without it.

I'm 5 foot 3 and 8 stone 5lb, and I had migraines on the POP but no migraines since. No history of BC in family and I do plenty of exercise. My BP is 107/67.

Would HRT help? What about the migraines? If I took it would I gain weight? Would I be at more risk of strokes? What preparation would be best?

Don't worry - am also making an appointment with another GP who is sympathetic to HRT, so will be discussing it - but just wanted some thoughts...

And I know that palpitations can be part of the menopause but equally maybe not so would be happy if they wanted to exclude other stuff with a 24hr tape that would be ok...

Would HRT help? YES most probably.

What about the migraines? Many women find they are better on HRT (mine were due to less fluctuation of hormones.)

If I took it would I gain weight? No only if you eat too much because metabolism slows down at meno age anyway with or without HRT.

Would I be at more risk of strokes? No not from patches or gel Your base line risk is not altered.

What preparation would be best? Transdermal is best (patches or gel) plus a separate progestogen (Utrogestan or Norethisterone)

Best to start with a sequential type ( you will have a bleed every 4 weeks most likely) but this way at first you will be able to judge the effect/ dose of each hormone in turn (as in a normal fertile cycle) which is harder if you use a continuous sort of 2 hormones in 1 patch.

Polly - That is brilliant - Thanks! Can I ask - I know that I sound dense - but what is a sequential type? What does that mean? I know I should google it, but still...

So the transdermal would be oestrogen and then progesterone on top?

www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/How-it-works.aspx

I am not PP, just wanted to ask if you tried cutting out caffeine to reduce/stop the palpitations.

Will go and look at That - Thanks!

Lljkk- I don't drink tea or coffee but I will certainly have a look to see if there is anything that I am missing...