Talk to me about the bone crushing tiredness of menopause

[TheMarbleFaun]

I seem to be permanently knackered - never get enough sleep & I feel like every afternoon I need to take a nap - is this normal?
Are there any supplements I could try ( or any other tips) ?
For info I’m 47 and been on HRT about 3 months (Elleste duet 1mg)
Thanks in advance!

biddybob the waking drenched and vivid dreams sounds familiar. I'm 48, so a similar age to you. I've no idea about my periods, as I don't have them on the mini pill.

The other week I had my first hot flushes, I definitely had the heart racing with those and felt awful.

I can't sleep, get night sweats, and am so bloody tired. I am eating slightly less than normal and somehow have gained 3kgs without doing anything different. I vary between a normal 28 day cycle, then sometimes to 90, and the last one was 70 days.

I''m 53.

I’m tired too. The night sweats and hot flashes are no fun. It’s hard staying awake during the day. I’m just tired day and night. I’m in my 40s. What is going on? Do I need HRT?

And yes eating terribly as I’m so tired and putting on weight. I want this to stop!!

I saw my gp this morning, she spent a long time discussing options with me. The main issue is I had a dvt after my first pg (severe pre-eclampsia, c-section) which means it's a case of managing risks. So, I've got some clonidine to try to see if it helps with the night sweats/hot flushes, I'm having a blood test tomorrow as my minipill stops my periods so it's not possible to know if they have stopped due to hormones. Then I have to decide if I want the mirena coil + oestrogen gel, which is less risk, as it's not oral hormones. A 7/1000 chance of a recurrence of dvt, which is quite small.

Hi everyone - I'm 50 next week and not sure if I'm peri or not. I'm experiencing the bone crushing tiredness and brain fog but not much else apart from periods (which used to be very heavy and anywhere from 4 to 11 weeks apart ) now coming every 26 days and being much lighter - however I had my first coil (Mirena) fitted in 2017 (wish I'd done THAT a few decades earlier!) and wonder if its more the effect of that?

I get occasional night sweats but generally nothing else. I'm exercising every day, keeping my weight down, reducing carbs (to minimise the belly gain) to consumption either just before or just after a workout, reducing alcohol and taking starflower capsules and a H & B female multi vitamin. Oh and I'm also on 20mg citalopram a day which I did try to come off last summer on the advice of a male doctor after my female doctor the year before had said stay on it til menopause is done!

Can anyone suggest anything for the tiredness? Reducing sugar and fat helps and I'm taking magnesium tablets but heard somewhere that they have to be taken at a certain time for maximum effectiveness?

Hi blooby10 I have been advised that magnesium should be taken before bed as it relaxes you. I take solgar calcium magnesium and zinc mix along with Menomin supplement that has all the Bs biotin and all the omegas in plus a turmeric tab- I still get very tired suddenly but mainly after I’ve consumed too much sugar or lunch ! I’ve suddenly developed a sweet tooth that I never really had before was always more of a salty snack person - now I want both !!

@Choccydoodle thank you!!! I take mine at bedtime (simply so I don't forget ) along with the other vits. Might try the turmeric tablet too as you've just reminded me that I heard somewhere that it was recommended

I do already take Solgar magnesium with B6. I notice when I don't take it, so it must work . I low carb and low sugar, only have 2 coffees, those in the morning and switch to green tea in the pm. I do yoga, weights and walk a lot, but the last few weeks lack of sleep don't help. I'll see how the clonidine works and then start looking into the mirena coil. How's it worked for you, Blobby10. I just need some sleeeep.

Ah, sorry for the horrible typos and grammar, I really haven't slept properly for about 4 weeks.

I am eating slightly less than normal and somehow have gained 3kgs without doing anything different
Same here, gained 4kg by doing nothing different. My sweet tooth has almost gone to be replaced with a savoury tooth. I am now after the shock of gaining so much weight on a diet.

My main current problem is the shortage of hrt. I have been on it now for 3 years, I know I cant cope without (unless it will get me off a multiple murder charge? ) my last script could not be filled and now I have to collect a new one with a different drug and no guarantee that in 3 months i will be able to refill it. I want to cry.

I'm really sorry to hear of all of these women suffering but in all honesty, why are none of you trying HRT?

@Blobby10 There is a damning report on Twitter today by Dr Louise Newson (menopause/GP) showing that 68% of women were prescribed ADs instead of HRT by GPs.

NICE guidelines say ADs are NOT to be given to women in menopause for mood swings and meno symptoms, the first line of treatment is HRT.

You are possibly tired as a result of incorrect treatment.

As for supplements- the Royal College of Gynaecologists did a survey of all of these and none produced any results when they looked at the science. Black cohosh may help a little but it can also affect the liver and is not for long term use.

JinglingHellsBells I've been OK until the last few weeks, but I suppose I need to weigh up the risks for hrt. I'm going to try the clonidine and see how it works for the night sweats and hot flushes then go from there. I think it likely I will end up with the mirena and oestrogen gel, tbh. My gp was very sympathetic and agreed that night sweats for 3-4 weeks was unacceptable.

Thank you for your links earlier, they were very useful.

To put it bluntly, GPs are massively letting down women who are peri-menopausal, menopausal, and post-menopausal.

@quirkychick
The point is that NICE has summarised all of the research on HRT , its risks v benefits against ADs, which is why it says ADs have no place in the treatment of menopause (except in women who can't use HRT .)

Your GP is going against medical advice and this is not right.

The risks of DVT do NOT APPLY to transdermal estrogen . You are possibly at a greater risk on the mini pill ironically as it' s a synthetic progestogen.

It is not listed as a contraindication ( DVT many years ago) .

^^ that

@JinglingHellsBells - I've been on the ADs for nearly 10 years and decided that after last years attempt I would wait until menopause done and dusted before trying to come off them again! I'm sure the tiredness is more down to hormones and not sleeping properly than the ADs as its definitely worse the week before my period.

@quirkychick I wish I had had a Mirena fitted years ago - it would have saved me so much period misery as they were so very heavy and painful. Doctor said I'm OK to keep it for 5-7 years or until menopause is over!

Agree with what JinglingHellsBells says
I struggled with tiredness/ anxiety/ insomnia for about two years but in the end HRT was a no brainier.
It hasn’t solved everything but I definitely feel better for taking it

@Blobby10 That's a bit back to front though if you don't mind that expression!

Peri can last for 10 years. So rather than using ADs you could have been using HRT.

No one is saying the ADs are making you tired, simply saying they arent helping the symptoms. This is medical advice- ADs do not help meno symptoms other than flushes in women who cannot under any circs use HRT.

This isn't my opinion, it's the advice of meno specialists.

Also- meno is never done and dusted for lots of women. The symptoms can last through the 60s, 70s and 80s.

Blobby10 thanks that's helpful. I found similar with this mini pill, it stopped my periods. It just means I have no way of telling when they would have stopped naturally and I would have entered menopause.

JinglingHellsBells is clonidine an AD? I thought it was a blood pressure medicine that helped with hot flushes. We looked up the the risks of dvt with mirena and oestrogen gel and it was 7/1000 against 2/1000 risk if it anyway. Very low, I feel.

I’m 45 and had my last baby at the start of my menopause at 40. I’ve been on HRT for a year as the night sweats and tiredness we bad bad bad - literally changed the bed sheets twice on the night etc. HRT helps, an hour or longer a day walking helps, my thyroid was shot to pieces and failing and my iron levels under ‘very low’ since medication for those two everything has been better.

Yes you are right @quirkychick
It is a BP med.

However, the same principle applies that HRT is the first line of treatment.

If you want to google- loads online- you will see that the only real no-nos for HRT are recent cancer, recent blood clot, recent heart attack. Nothing else matters (except a very strong history in immediate family of b cancer.)

Also, the medical info says that transdermal estrogen does not raise the risk of blood clots beyond the individual's baseline risk.

NICE

1.5 Long-term benefits and risks of hormone replacement therapy
Venous thromboembolism
1.5.1 Explain to women that:

the risk of venous thromboembolism (VTE) is increased by oral HRT compared with baseline population risk

the risk of VTE associated with HRT is greater for oral than transdermal preparations

the risk associated with transdermal HRT given at standard therapeutic doses is no greater than baseline population risk.

1.5.2 Consider transdermal rather than oral HRT for menopausal women who are at increased risk of VTE, including those with a BMI over 30 kg/m2.

1.5.3 Consider referring menopausal women at high risk of VTE (for example, those with a strong family history of VTE or a hereditary thrombophilia) to a haematologist for assessment before considering HRT.

You might also be better off on natural micronised progesterone rather than a synthetic type as in the Mirena.

I am taking hrt it has made a big difference !

Thanks, JinglingHellsBells, that's useful. Can I get natural micronised progesterone on the nhs? I was told that I could only have oestrogen gel if I had a mirena (though I was given that advice quite a long time ago).

I tried hrt for 3 months and did nothing for my sleep. I tracked it for 12 months and it was actually worse when I was on it. I now strongly believe that my poor sleep was caused by surges of oestrogen, not the other way. It is getting slightly better as I am entering the full menopause.

The only thing that helped me has been amytriptiline. I was reluctant to try it due to the reported side effects but it's been great for me. It helps getting into a deep sleep, not just being asleep. I only take 20mg so not the dose you would normally take as an antidepressant but it has helped my moods too. The bonus is that it also helps with the need to go to the toilet at night.

It is not addictive and can be taken as ans when needed. As I do get used to it, I now only take it two or three times a week. The only downfall for me is the increase appetite, but learning to control it.

We are all different and what works for one person doesn't mean it will work for others. It is sadly very much a case of trial and error for us all.