I've been prescribed HRT!! What's it like?

[MortyFide]

I was lined up for a mirena coil change with the GP today, but having had peri-menopause symptoms for over a year (probably two), I was determined to have a conversation about those issues while I was there. I've had FSH tests before but they were normal last year.

The GP called me to cancel the appt anyway due to coronavirus, but I listed my symptoms on the phone with her - and she instantly suggested trying HRT. I'm glad but I'm suddenly worried about what to expect!

I've had a mirena coil for 10 years so when I eventually get a new one it'll be my third. I don't have periods at all, but my other symptoms are:

Rage and intolerance/irritability
Low mood, easily tearful
Brain fog and loss of confidence
Hot flushes of a kind (bright red/purple face and chest for an hour or so, sometimes on one side only)
Leaking urine
Occasional night sweats/overheating
Nausea at night and some mornings
Breast tenderness
Joint and muscle pain

I've been prescribed oestrogen gel, plus progesterone just until I get my new coil (then I can ditch that apparently and just use the gel).

I've read that some women felt like they got their life back! I'm excited but nervous...any experiences to share?

Oh. I'm 47. And I forgot to mention the weight gain around my middle and the poor sleep!

I'd agree that you get your life back. I'm 60 and have been on it for years. All my symptoms disappeared after a few weeks and I felt "normal" again. I've tried going off it a couple of times, but the symptoms come back straight away so I'm taking it for the foreseeable future now.

HRT has been an absolute lifesaver for me, and "amazing" is the only word I have for it. All of my symptoms were gone almost immediately.

Your GP is ace! I've been prescribed oestrogen gel, plus progesterone just until I get my new coil (then I can ditch that apparently and just use the gel).

The coil or progesterone protects the womb while you take oestrogen. The gel is the safest option of all. Like stellabelle I came off HRT for a while because my GP was concerned about me being on it long term but the menopause symptoms were so severe i asked to go back on it and was referred to a menopause clinic who prescribed the gel.

I have the same combine and it works well though I have had to change application sites recently as it seemed to stop working on my inner thighs and outer arms.

It helps me sleep and stops me feeling hot and most importantly gives me some zest for life again.

I'm also impressed at my GP - I moved to this area 3 years ago, and they have been consistently excellent for EVERYTHING.

Gosh I'm so excited to start, I've kind of grown accustomed to the perpetual misery and irritability but it's struck me that maybe life doesn't have to be like that? I would really enjoy feeling a bit of confidence and motivation again, I feel sort of..."outside" of myself, iyswim.

I'm sure my DH will be delighted when I'm not biting his head off too.

My underlying fear is...maybe none of it is hormone related at all, maybe I am just fat and useless and stroppy

I realised I had lost the ability to have fun. That’s sad. I have had a really awful year but HRT has let me enjoy the good bits in between the challenging parts.

Oh, that's brilliant! I have been putting off going to the GP about a similar list of symptoms because I have a Mirena / no periods and none of it is extreme. Last week I was finally going to phone them after talking to a friend then thought they wouldn't want to be bothered right now with all this CV stuff going on, maybe I should give it a try. Thanks for sharing!

You're welcome!

Where to start, progesterone first tonight or oestrogen pump tomorrow morning? Shall I try half a pump to start?

I made a right tit of myself on the phone to the GP - when she referred to the oestrogen gel I said earnestly, "And is that something that you insert vaginally?"

There was a pause and she said slowly, "Nnnooo, you just put it on your upper arms..."

OMG what a twat

HRT gave me a quality of life back. No more hot flushes, no more blind rages, no more mood swings.

If anyone tries to take mine away, they’re taking their life into their own hands.

You’ll be a new woman . I had flushes for five days before I picked up a prescription . Also slept better .

I've been requesting this from my doctor for around 3 years. I had a fab female doctor who agreed, but left the practice before I got my prescription and have been back to square one ever since with doctors who dont listen or dont take me seriously.

That's frustrating Notbabiesforlong - have you looked up the NICE guidelines for menopause, your GP should be following those? It might help you to know how to pitch your case, if they aren't offering it to you - I was under the impression they give you the info and the risks, and you choose for yourself? Maybe there is a reason it isn't suitable for you, or its too risky?

When I first asked a GP about it last year, she was kind and understanding but clearly felt the symptoms weren't severe enough (based on my responses) to warrant HRT at the time - she even prescribed some medication for the urine leakage (which I never took). But she did say that if the symptoms became dramatically worse or were unmanageable, to go back and I could try oestrogen patches. I've had a shitty time the last few months with various life things, but I haven't dealt with things the way the old me would have done. I worry far more than I used to and get anxious about stuff that wouldn't normally bother me.

Keep going back and making a nuisance of yourself until somebody listens - or be shrewd and try to work out why you don't meet the guidelines for a prescription!

The trouble is it is a different doctor each time, and hard to get an appointment. And each temporary doctor sends me away with something to read etc....delay tactics!

I have been in with screenshots of the guidelines too, but haven't been forceful enough. Last time they mentioned referring to the menopause clinic which will be great, but I seem to need to try to get yet another dr appt to get the referral.

Endless...

Aaargh how maddening. Are you over 45? They seem to be much freer with it once you hit the golden age...

Yes maybe it's a question of being very positive and confident with what you want - our generation is (probably) accustomed to seeing a GP, describing our symptoms then waiting expectantly for a diagnosis and treatment - but the current approach seems to be "patient led", i.e they ask us what we want from the consultation. I went in with dreadful bedbug bites once, which a pharmacist said looked infected (cheap hotel, lovely) - the GP looked and then asked me what I thought it was and what I wanted from the appointment! I think I just stared at her with my gob open. I thought it was obvious...?

I am about to apply my first hit of oestrogen. I'm scared of a full pump, might go for half to begin with!

Can HRT make it easier to lose that extra midriff weight? It's so bloody stubborn.

@NotBabiesForLong How much have you stated clearly that you want to try hrt?

IMO the conversation ought to be along the lines of..

I'd like to try hrt because I have XYZ symptoms and they are affecting the quality of my life.

I've read all the research and understand the small risks.

I don't have any risk factors so if it's okay with you I'd like to start on some, ideally not tablets, but transdermal as it's safer.

You don't need a referral to a menopause clinic.
These are for very difficult cases of meno.

You are from what you have said a very simple case where any decent gp ought to be able to prescribe hrt- it's not rocket science!

I suspect meno clinics will get pissed off with GPs sending women to them who really do not need to be there.

Blimey I applied about half a pump to my upper arms at about 7.30am - now I have a period headache and cramps and feel very muzzy headed. No bleeding so far.

Is that usual for a first timer, or does it mean I don't need it at all? Haven't taken any progesterone yet, not till tonight.

I think it's a coincidence. Half a pump is a minute amount and you should not feel the effects.

I've used it for 12 years. I had to use a full pump to get any benefits then another pump to control night sweats.

Why are you taking progesterone straight away? It is used for 12 days per 28 day cycle (usually) so you can go for 15 days before you start it. Yes, you can use it now for 12 days but it's best when starting hrt to get the estrogen levels right before adding progesterone.

Is it Utrogestan?

Yes, utrogestan - no idea why she has said to start immediately, unless it's because I have a 5 year old mirena coil due to be removed, and I have no cycle as such?

When I have a new one fitted I can do away with the utrogestan apparently, I just use the gel in conjunction with the mirena. She did suggest that I should be using contraception, but my old coil is still in so why do I need to?

I still feel headachey and queasy - we're on our way up north and I've slept for the last hour.

Personally , I'd use the gel for 2 weeks then start Utrogestan after day 15. That is more like a normal fertile cycle where we have estrogen building up to day 14 or so, then progesterone for the 2nd half of the cycle.

You need to experiment with the estrogen gel to get the right dose before adding Utrogestan.

I have seen a private meno consultant for 12 years ,using the gel.

Sounds sensible...thanks Jingling. Feeling more human now so must have been coincidence!

This is giving me some hope. My symptoms are exactly the same as yours, OP and I am on year 3 of my second mirena. No periods with it at all and I’m 44.
I had a phone appointment a few weeks ago but the GP couldn’t have been less interested. I will try again with a different one and the NICE guidelines.

Ooh you're just on the cusp of the age barrier Parrot - go in brandishing the guidelines!

@MortyFide There is no age-restriction for HRT. Women under 45 might be given FSH blood tests just to either confirm they have early menopause , or other health conditions, but it's not mandatory to test.

There are loads of women under 45 using hrt. The only advice from Nice is that blood tests are not to be used in women over 45.

They can be used on younger women to establish what's going on because premature and early menopause is a medical condition.