Night sweats help please. Black cohosh or HRT?

[mrsjackrussell]

I think I'm definitely going through the menopause now. I'm 50.
For the last 3 years iv had irregular periods and night sweats so I then take black cohosh and it all goes back to normal then I stop taking it and within a few months it all starts up again. Apart from 4 months last year when I wasn't taking it and I had non stop bleeding for 4 months. Had a scan all OK. I don't know whether the cohosh actually worked or if it was just coincidence.
Forward to now and no period since October.
I'm having night sweats and it's affecting my sleep badly and in turn my life.
I'm disabled too and get horrendous cramps and what with my husband snoring.
I'm thinking about taking the black cohosh again but I'm worried about the side effects re. Liver damage. Iv been put off HRT by others saying its not good to mess with your body which I agree with to some extent. Also with the HRT would I then have to stop it again in the future or is it for life?
Would all of the menopausal symptoms come back?
Coul d I have some advice please from you lovely people

Jingling bad form to call a poster out!

I'm sorry Nel- I don't know what you mean by my bad form. I haven't called anyone out. I do know though that it's against 'the rules' to speculate on usernames and past posts.

I've reported Wind's post, which I think Nel was commenting on.
I'm not sure what wind is getting at.

As far as the individual choices we make between HRT and supplements...

Many women feel perhaps wrongly, that this is an inevitable process that we just need to get through to the other side of, that will bring its own benefits eventually.

After a lifetime of being at the mercy of hormones, including contraceptives, choosing to take more feels a bit counterintuitive.

I have been taking supplements, knowing they are of uncertain efficacy, on the basis that they may help and there's nothing to lose.

If I can get HRT without getting periods, then I'm all for it!

Pickle you could have a Mirena? They are known for reducing/stopping periods. Then you could use whichever oestrogen you liked alongside it

Sorry the Mirena is your progesterone component of hrt

Trouble is that the HRT actually prescribed by our local GP surgery tends not to be patches but what are seemingly the cheapest tablets available. Four women I know locally who have been given HRT have suddenly put on weight (six pounds or so) and had headaches. Perhaps it is water weight, but if that happened to me I would find it distressing, as they did.

Then they have to wait three or four months for another try at something else. Given that for quite a few women, there’s a chance the worst of the symptoms might actually subside within a year or two, it doesn’t seem worth the effort of trying to get an appointment.

I do well with eating Linseeds, chickpeas and taking red clover to ingest as much plant-based œstrogen-mimicking substances as possible. Much to my sadness, I now have to accept that more than two small glasses of wine a couple of times a weekend, chocolate, sugar and too much cheese really do adversely affect my sleep. I went into menopause reasonably fit and at a BMI of 21 and i have to work very, very hard at keeping like this.

I also had some Accupuncture earlier on. It seemed to help with sleep.

I think the reality of what’s on offer on the NHS doesn’t always match the ideal.

Weight gain would definitely upset me too however there’s no evidence to support hrt causes it, plus, if it did, my symptoms were so bad a few extra pounds compared to quality of life would be worth it.

Also, I started hrt at 37 so it would be way more than a few years for me so it’s worth doing research and making the effort to find one type which suits. I remember having to try several different types of contraceptive pill - this is no different really.

I had mirena- twice. It didn't stop my periods, in fact possibly made them worse.

I'll see what the GP says.

I'm worried about the weight thing- I'm already morbidly obese, but stable. Last thing I need is anything else!

I barely drink, and don't have caffeine. However, I do eat crisps and chocolate when I'm miserable. I'll have to try harder and see if that is having an effect.

Oh sorry it didn’t work for you! Hope you find something which suits

@picklempopcorn (love your name BTW!)

I'm not trying to persuade you to use HRT but one point is worth picking up on...

You mentioned years of hormones and contraception etc.

The estrogen in HRT ( bar 1 brand) is the same as our own. It's not artificial or synthetic but made from yams, as is natural progesterone.

Compared with the Pill it's as natural as you can get and a far lower dose than any CCP.

On a different note- have you ever thought of using My Fitness Pal (online and free) to help with your weight? Being obese increases the risk of breast cancer hugely (by 6 x according to the graph I linked to) and can also make meno symptoms worse.

I've done all sorts re my weight- MFP was great first time, keto was great first time. I've had bereavements and other stressors which meant that staying stable was a good as it was going to get. I don't look morbidly obese- I'm active and energetic, although I have joint issues not related to my weight. I do get tired, and need to be careful not to overdo it.

And the oestrogen may be natural, but that doesn't mean it's my friend! I'll have to wait and see.

Many women feel perhaps wrongly, that this is an inevitable process that we just need to get through to the other side of, that will bring its own benefits eventually

Sadly there are no benefits from loss of estrogen other than no periods. 1:2 women get osteoporosis when over 50, of which 1000 a month die from complications of a break.

All the organs of the body depend on estrogen (in women)- heart, bones, brain, bladder, skin, etc.

You can offset this without HRT to a degree, but it takes a lot of effort for life - exercising including resistance work outs, staying a sensible weight, keeping brain-active, and so on.

Dr Newson...I guess she's not paid by big pharma

Er, actually she is. From her own declaration of interests page on her business website:

"I have had financial relationships (lecturer, writer, member of advisory boards, attendance at meetings and/or consultant) with Pfizer, Meda, Mylan, Besins, Replens, Regelle, Sylk, MonaLisa Touch and La Roche-Posay. These companies have had no control of the content of any lectures, articles or other work I have done for them."

From her 2016 editorial in BJGP:

"Louise R Newson runs a weekly private menopause clinic at Spire Parkway Hospital in Solihull. She has received money from Meda to develop non-promotional patient information leaflets on the menopause for distribution to GPs across the country for their patients. She has received money from Mylan to attend the 15th World Congress on Menopause in Prague in September."

Guess she was a pt convert. But why wouldn't you work for Big Pharma, if you're convinced their product is fantastic.

I don't think BJFM is a proper journal in usual sense of that word. It's a professional magazine. Many drug adverts including a 2 pgr for HRT (latest issue was October 2018?). Although they do (did) have peer review as well, they seem to mostly commission articles, editorials, feature articles and survey results rather than original rigorous research. BJFM doesn't seem to be indexed in Pubmed.

@medschoolrat

if you are genuinely a doctor, based on your user name, you ought to know that the 'financial interests' when declared like this usually amount to no more than perhaps a contribution towards travelling costs for these lectures or seminars. They are not being paid commission for uptake of various drugs.

If you read the website of LN or indeed talk to her- which I assume you can, if you are a doctor- you would know she also gives information on alternatives to HRT on her website.

This applies to almost all consultants (she's not a consultant as it happens) who carry out any research, give presentations or similar.

If you are a doctor and have attended lectures and workshops over the years, you will be aware of the element of 'financial interests.'

Receiving small payments- like may £50-£100 for expenses is not being 'paid' as if she or any drs are bribed or on commission.

If we really want to get picky, you should also be looking at the medical reps who target GPs and who offer all kinds of 'sweeteners' for buying their products.

One would hope that these professionals are able to think independently about what's best.

As shown here on her website

Newson Health works to improve women’s and healthcare professionals’ understanding of the menopause, and as is common within the industry, on occasion pharmaceutical companies contribute to the cost of providing this education. However these companies have no input into or control over the content of our work, all of which expresses our independent views

As i say if you are a doctor, you would already know this.

I take the cheapest bog standard hrt tablets.

I've lost weight slowly through eating low calories and exercising. I've started running. Before hrt my joints hurt too much to run and if I ever made myself (thinking it might improve my mood and energy levels) I was exhausted for days. I wasn't expecting hrt to cure joint aches but it has, and my energy is so much better, I think mainly because I am getting better sleep.

I am motivated to lose weight because I genuinely believe being inactive and overweight contributes to ill health far more than hrt.

That sounds hopeful, Fazackerly! I think I'll be giving it a try, if only to rule out other health issues I'm trying to address.

Was that meant to be a challenge? (ps: I found the gold mines)

Here is the list of Louise Newson's interests. You can see for urself. As of April 2018. From pharma companies, she has taken fees to help set up her website, do "advisory" work, give talks, write things, do media work, do education... oh, and travel. Also probably paid by newspaper to write articles. That's the stuff she has admitted to so far.

She's a fully paid convert of course, I can believe that. She doesn't need them to pay her to say what she says. She fully believes. The problem with COI is it means that one loses objectivity, regardless of the sincerity of starting position.

Newson has long own page for her failure to fully declare COI, including product promotion work.

In late 2017 LN contributed this presentation but declared no Conflicts of Interest. It's so damning when authors aren't forthcoming. (The cover up is worse than the crime....?). Elsewhere LN was criticised for straying into nutrition advice without good evidence.

You cannot correctly say LN is not paid (a lot & often) by Big Pharma.

Very interesting Med. So a lot more than just travel costs then.

I'm not sure of your agenda here @medschoolrat, because you only came onto this thread to criticise Dr N.
(Or rather to correct me.)
That's fine- I still hold her in high esteem.

I suspect if you do the same search (good way to spend a Sat evening !) on the top UK gynaes who also give talks , you will find the same.

As a dr - if you are one and I think your posts say you are- you must surely know that this type of thing is par for the course? Many doctors receive fees for talks and of course, writing features though on that score I can tell you that some of the features are in fact ghost written- the doctor is interviewed and the feature is written with their byline, but the journalist gets the fee.

Edzard Ernst is not a reliable source.

Have you never some across him before?

Picking someone up for talking about pro-biotics? FGS.

My very low key rural GP probably dreams of being paid millions by Big Pharma to prescribe cheap hrt to knackered 52 year olds.

I am really disappointed @medschoolrat that you have bothered to find quite frankly, all of this rubbish.

None of the links you have posted have any credibility.

One is from a doctor- with nothing on his 'About' page other than he's in Manchester.

The drivel about her fees for writing features is just that (I'm a medical author so am in the trade.)

The extracts about My Menopausal Vagina are valid- Jane Lewis is a 'normal woman' on meno forums and talks openly about all of this.

Most of these extracts you linked to are from people who are not known nor especially well respected.

They have an agenda. Good luck to them.