Hot flushes after HRT

[HRTpatch]

I have recently come off HRT after 8 years and suddenly have hot flushes which I never had pre HRT.
Fuck me...they aren't good are they!
Anuthing I can take to help?

Yes, HRT!
Reason for flushes now is your estrogen levels will be almost zero- they keep falling.
Why did you come off HRT? How old are you now? If you were told to come off it by a dr, that is wrong. There is no time limit to HRT (latest NICE guidelines.) I'm in my 60s and have used it for 11 yrs. Excellent consultant who knows his stuff.

Do you want to go back to HRT?

My decision..cant find one which doesnt give me a monthly bleed.

I don't understand that. There are loads of types which don't give a bleed.
Continuous HRT, here.menopausematters.co.uk/postmeno.php

I have tried 7 different types. Conti made me bleed for 31 days.

Hmmm yes that can be what happens. I tried conti for 3 weeks and gave it up for the same reason but only one sort. I've stuck with sequi and just put up with the bleed. Seems to be the lesser of all evils for the moment! I suppose you could try the Mirena or give conti another go- bleeding can go on for 6 months.

I have bled for 46 years
Apart from hot flushes I feel ok

46 years? You mean you had periods for that long?

Why not try the Mirena plus estrogen?

I don't want a coil at all.
And yes...started periods at 12. Sick of sore boobs, bloating and general feeling shit once a month.

Some things that might help include giving up booze, lots of exercise and weight loss if you need to. Might not get rid of them but I find they are more frequent and severe if I put on a few pounds.

I suppose you might want to reconsider why the Mirena is out of the question if it would help.

It sounds as if you don't have the dose finely tuned enough if you are suffering all the PMS symptoms on HRT.

Have you used gel/ patches and Utrogestan? With medical supervision if you are so intolerant to progestogens, you could ask to try long cycle HRT which some of us do. That's having a bleed less than once a month ( usually once every 2 months.) Unlikely your GP will agree or even know about it, but with monitoring( a scan of the lining annually or so) it can be a workable option.

Have just been to Doc's and have finally decided to go on HRT. Am 57 (58 next month) and had no periods for 18 months. Have really suffered with night sweats and hot flushes, literally cannot put up with them any longer. Doc. has given me tablets and not patches as I thought would get. Seem to have read somewhere that tablets are more of a risk?? Can anyone advise?

Consider Mirena. Mirena plus oestrogen patches have been a bleed-free, side-effect-free godsend for me.

Consider Mirena. Mirena plus oestrogen patches have been a bleed-free, side-effect-free godsend for me.

The problem comes that if a woman is progesten-sensitive, often she will bleed continuously even with Mirena. That was certainly my experience with Mirena and I tried it twice. And if she is menopausal or perimenopausal, it might not be possible to administer the drugs that stop that continual bleeding (I had them and they still didn't work although in my case I was using the device as a contraceptive). BUT, and this is a BIG but, what could work is if you have a gynae who specialises in menopausal women and who understands that this woman is progensten-sensitive and the side effect she experiences is continual bleeding. Then perhaps a Mirena can be trialled, in combo with a different form of HRT to control the hot flushes, but with the understanding that if the bleeding doesn't abate within a reasonable time frame, other options can be explored, not fobbed off for months and months with 'it will settle' because often times, in women who experience continual bleeding from progesten-based devices or pills, it won't. And again, of course, it has to be with a consenting patient.

Is there a chance, OP, that you can visit your GP and be referred to a gynae who specialises in menopause?

Queen, can you perhaps provide some links to doctors who might be able to help the OP? Some cases are more complex than others.

In my case, HRT worked to control my hot flushes and sweats, I did combine this with a lot of self-care, which I noticed even before I went on HRT helped somewhat (I don't drink or smoke but lost a stone and stepped up the exercise A LOT and that did have an effect).

But in someone who doesn't want bleeds, there needs to be options and treatment open to her, IMO.

I hated the Mirena, FWIW. It just made me bleed and bleed and bleed, even with drugs to stop it (all they did was turn it to brown sludge), and I also experienced a number of very negative side effects, but I was using it for contraceptive and in my 40s.

Just really wish there was some real help for menopausal and perimenopausal women experiencing negative effects that doesn't involve fobbing off or throwing up hands saying you have to suck it up.

Seriously, would men put up with hot flushes and sweats? The only male pill was withdrawn from trial due to negative side effects, but women deal with these all the time. It makes me very angry, how much perimenopausal and menopausal women are told to put up with side effects no man would be told to endure and denied access to treatments which might be able to help them. A lot of people don't realise that hot flushes and sweats can be debilitating and affect a woman's life, well-being and even her livelihood. In my case, my flushes and sweats were affecting my sleep and therefore my job. But hey, fob them off and look askance at them when they need referral to someone who can do more for them. I can see why the OP doesn't want Mirena. I was fobbed off for months when it went wrong. I was in tears, trying to get my second one removed and had to tell them I was going to take it out myself, and I was!, to have it removed after a year of continual bleeding.

I could be wrong (I don't have a uterus any more, so no bleeding here), but isn't it the progesterone/progestogen that causes the proliferation/bleeding? I just have oestrogen as Oestrogel - would that be an option?

Here is hoping, and again, with her consent, she will find an appropriate physician who can help. Consent is so important. I felt that mine was co-opted, put to the side, if Mirena didn't work for me, made to feel like a fantasist, imagining, exaggerating when in reality about 15% of users experience a number of negative side effects. And even when I told them I was taking it out myself, instead of being immediately offered an appointment for its removal, was given a lecture about cervical shock and potential consequences of self-removal. The second time I had to tell them that I no longer consented to this treatment, and treating the issue as such, a non-consenting patient of sound mind forced to endure a treatment by their lack of assistance to remove it despite informing me of the potentially serious consequences of undertaking such a procedure myself and I wrote a note myself and told them I wanted it added to my notes, that I did not consent to this treatment and their refusal was force on me. And I had a friend and my husband in there with me.

LeftRightcentre Are you in the UK? something in your style makes me think not.

The problem comes that if a woman is progesten-sensitive, often she will bleed continuously even with Mirena.

No that's not how it works.

Progesterone is the 'dampner' for estrogen. It's like estrogen is the hot water in the bath and progesterone is the cold. You want the right combo for lukewarm water. Using this metaphor, lukewarm water= no bleed.
If the ratio is wrong, bleeds will occur. it's nothing to do with being 'intolerant - which means side effects.

Bleeding on the Mirena happens because the uterus lining is not being thinned enough by the coil's hormones- usually a lot of estrogen being released which can happen in peri when women's ovaries go into overdrive before they shut down.

It can take months for this to disappear - slow process.

And yes, it doesn't work for all women.

Yes, I am, but English is not my first language and I learned it abroad so you are correct about that. Just trying to help out the OP here because not one should suffer from hot flushes if it can be helped and if there's a way she can stop those and also not bleed then positive result for her. Really hope she can find a physician who can work with her for the two ends.

*It can take months for this to disappear - slow process.

And yes, it doesn't work for all women.*

I waited one year each time. It did not happen for me even with the medications. I had to go much trouble to get it out but also I was in my mid 30s the once time and another in my 40s and it was not for the menopause. But like the OP I had tried also the mini-pill with similar result, bled and bled. The HRT worked for me but I know for others it requires more consultations and the OP might need this.

When this happens to a woman she is often adverse to Mirena and other forms like this so it's important to work with such a woman. She needs knowledge she can have when she sees her doctor, IYKWIM and a plan in place in the case it doesn't work for her. Or, of course, she can choose to deal with the hot flushes, that is an option as well, of course.