HRT and my painful joints

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Hello ladies, i have just finished second month on HRT : 1/10mg Femoston sequi with 1 pump of Oestrogel each night. After 2 months, poor sleep is no more, low mood has been alleviated completely, dry vagina resolved with Vagifem, however my joints and muscles are getting far worse. Every joint is affected, still do yoga every day but now on a 'beginner' level as everything hurts so much, walking is almost agony, stretching etc helps for a few minutes then all back to nasty aches and pains. Is there anyone like me who could give me their experience ? Should i suffer it out until i get my review at the end of Month 3 ? I want to continue, however i am often wondering if HRT is to blame for my worsening joints; i know oestrogen should help so i am confused. I would like to prepare myself with good info before i see my meno lady as i feel there must be someting out there that could help me. I am 50, vegan (with lots of protein, Mg, D3), 52kg so not carrying extra weight on the joints. Your answers greatly appreciated !

Out of interest, why are you using a mix of tablet HRT and gel? Why not a higher dose of Femoston or all gel and maybe Utrogestan?

My guess is that your estrogen levels are still low and the joint pain would have started regardless - it won't be caused by HRT.

1mg Femoston- so you won't absorb 1mg as a lot can be lost in digestion. 1 pump gel = 0.75mcgs. In total you might be getting 1.5mgs estrogen. Over two months, this is nothing.

Why don't you swap to gel? The you can titrate how much to get relief. Or have you tried the other progestogens and don't get on?

Or use femoston 2mgs?

Hello Polly, yes joint aches were very much there when i started Femoston, however getting worse steadily. After one month on femoston alone i went back to meno lady and asked her myself if i could supplement the pill with a bit of gel and she said yes but no more than 1 pump a day for the time being. I think she wants to know how i get on during the first 3 months which i can understand. I do get on very well with the progesterone in Femoston, no side effects whatsoever, but i agree with the poorer absorbtion in pills, ideally i would like to use oestrogel and the same progesterone that's in femoston, i have read, searched online but i don't think there are any dydrogesterone pills only. So would it be possible (in your experience) to take 2/10mg Femoston and ask for extra gel due to poor absorption of oestrogen through digestion ? Does it make sense ? :)

I do understand what you are saying but long term transdermal estrogen is safer. So unless you want to use HRT for only a couple of years it might be best to think about changing over anyway to gel or a patch (I've never taken pills.)

Likewise, Utrogestan is safest re. breast cancer with dydrogesterone (in Femoston) coming 2nd to it. You can't get dydrogesterone separately, that's right!

If you are happy with Femoston then try the 2mg dose for 3 months and see how you feel. That (if any is lost in digestion) would give you roughly the same as the starting dose for gel. 1.5mgs.

The 'rule' is 3 months of anything so you need to try it a bit longer. It also depends on your age. Estrogen falls very quickly around 2 years post meno when women may need a higher dose. In peri it's just ironing out the blips a bit .

Thank you for taking an interest in my post Polly, i cannot see my meno lady for another month, until the first review, however i have plenty of gel to get me going + Femoston 1/10mg whilst waiting. Will it still be safe for me to up my dose of gel (2 pumps a day + femoston) and still have adequate progesterone ratio ? Since they make Femoston 2/10mg, i could do supplement with an extra pump (0.75mcgs x 2. + 1mg femoston), would the dosage be too high and mess up progesterone ratio ? I know It sounds a bit technical but it is the sort of question i cannot seem to get an answer anywhere and it would make sense to know for us all. Any idea ?

I see what you mean. 2 pumps of gel= 1.5mgs then you'd have 1mgs of Femoston so 2.5 in total approx.

I think you'd be okay with that because, as you say, 2mgs femoston is probably about the same.

You could try one and a half pumps of gel first with it. Just don't press the pump right down, or press it down for two full measures and throw half of one away.

I'd add to the above points- it's only my guess. You need to ask your dr when you see her but one month won't make any difference because some women are on long cycle HRT which is anything from 6 weeks to 10 weeks, under supervision.

As always thank you Polly for taking time to answer and help so many ladies like me who could do with some guidance, i am very grateful !

Ami thanks for that, i am going to search for this article right now, i have always been convinced that joint aches are peri symptoms, i am not the only one suffering from that, i also know that sometimes clean diet, regular exercise, lots of water and mindfulness are not enough to control pains unfortunately, this is why my hopes rest on HRT.

Not impressed by the extract from Dr Fanu- for the simple reason that vaginal or topical HRT is not absorbed into the system. It can't possibly be responsible for any improvement beyond vaginal dryness /bladders. This is why it can be given to women who have had breast cancer, usually.

I would say that the vagifem has no effect either - it is only the equivalent of one tablet per year.

I know lack of oestrogen exacerbates arthritis - something my friend had a problem with at 35 following her hysterectomy and sorted when they got the hrt level right.

I take vit D to help with the joints and magnesium some of the time too (it is a bit of a laxative - there are some expensive ones that are less so). Also, fish oils. (Then ibuprofen on a bad day )

It helps to do regular exercise/moving and not too much standing around - a good walk helps but going round the shops is painful.

I'm definitely no expert but from my still limited readings i know vagifem doesn't help the joints, i take it and sorted the itching and that's it, you are right Terry, a good walk loosens me for a while yet standing at the checkout is agony; i will update at the end of the month as i want to give my experience to all the ladies who are in my situation .

Hi, I have just started to read your thread with interest as I have terrible achy joints and muscles and have just started femoston 2/10mg and things feel worse, my symptoms are the same as yours, walking is okish but standing at checkout or cooking is very painful, I was wondering if your feeling any better now ?

Hi Jazzy, after 18 momths on Hrt and now on Femoston 2/10mg for the last 6 months, my joints got worse since last year, i tried everything, and still my hips and back are awful so because i got no joy with gp nor physio, i took the private route and went to see a consultant who ordered MRI scans of my joints and i finally got the answer last month after at least 3 years of weak joints. My cartilage has thinned a lot in my hips and some of the lower back vertabraes, causing osteoarthritis, i was told that so many women experience joint damage at the beginning of perimenopause because oestrogen is essential to the building of cartilage along with collagen, i should have taken HRT at least 5 years ago, it would have helped. So my hip joints are so bad i am having a double hip operation next month and i cannot wait because of the constant creaking and pain, my lower back has osteoarthritis and i am learning to build my core muscles with private clinic i am with. I am so happy i found out what was going on even though the outcome was not great, however HRT has been fantastic, i have no more bad symptoms , i sleep like a baby and i finally know what was wrong with my joints.

Hi,
Your story sounds like my nightmare can you let me know which private consultant you saw, was it a gyny as I'm having no luck with the go and have bouts of physio and femoston just seems to be making my symptoms worse🤔
Thanks

hi. Hope this thread is still live. I've just joined! I've also been having similar joint aches particularly in the hips and lower back, but just everywhere. I've been given Estradot patches which none of you have mentioned, and wondered if anyone knows anything about this. I've also been given Utrogestan capsules. I don't normally take medicine if I can help it and I've had the medicine at home since before Christmas without starting, but the symptoms have come back and feeling much worse. Also with real fatigue, low mood and energy. Any advice or thoughts from anyone would be so welcome. I'm worried about starting and feeling bad or anxious as I'm away from home for work a lot. Thank you for any thoughts or experiences!

Well the answer is start HRT! it's not 'medicine' it's replacement ( as in the name :)) Hormone replacement therapy.

it's adding back and topping up what you had, not taking a foreign substance to your body.

If it doesn't suit you, you can stop. Don't see the issue.