How do you know when it's over?

[missl1]

This may be a naive question, but how do you know when the menopause is over? Is there a day when you wake up and you think I'm back to my old self now? Is there a day when you no longer feel furious, foggy and erratic?

I'm early menopause and have been told I have to take HRT until I'm at least 50 for bone density and heart protection. For the first 9 months on Femoston 1/10 I maybe felt a bit better, but for the last three months I'm back to feeling rage and impatience, almost constantly. My hair is falling out in clumps - luckily I have a lot of it - and I have constant lockjaw-type anxiety.

I plan to go back to the GP to see if anything needs to be altered or adjusted but I just want to know, what's happening to me right now? Is it a further drop in my natural hormones that's making 1/10 less effective?

And then back to my first question, how do you know when it's over?

In theory, the menopause is never 'over' because post-menopause (definition = no more periods) lasts for life.

In Post-menopause, your estrogen level without HRT is 1% of what it was before. For some women this means some symptoms last for life- hot flushes and then more serious issues like bone density loss, heart disease and pelvic floor /bladder issues start.

That's why more women are now using hrt for life as when they stop their symptoms come back or they get bone loss.

It sounds as if you need a higher dose of hrt- how old are you?
Women having early menopause need more estrogen than women on hrt in their 60s or older, usually.

Ask for a higher dose or try a transdermal type which gives the options of a higher dose- patches or gel.

Thanks for replying. Yes, I suppose the question is when do the symptoms end. But, as you say, they may never end. In which case, I'll get myself back to the GP and stop naively thinking I may wake up one day feeling fine. I'm 47.

My mum also had an early menopause, never took HRT and, although she's as fit as a fiddle, I'd say she's been in a menopausal rage for the last 30 years ;-) I don't want to follow suit.

Last time the GP wasn't keen to put me on a transdermal type. Not sure why, but maybe if I'm in it for the long haul, which sounds a possibility, I'll have a wider discussion.

Thank you.

Over? I wish. I am 64, been on HRT for 15 years. Have moved to patches as I do 3 or 4 Long Haul flights from NZ to UK each year (well normally) and apparently patches reduce blood clot risks.

I have stopped using HRT around five times and each time the symptoms come straight back. I have no intention of trying again.

Also, another question, if you're on a continuous HRT like Femoston 1/10 or 2/10, which for me seems to induce some sort of 'fake' bleed at the end of each packet, how do you actually know when your natural periods have ceased for more than 12 consecutive months? In many ways, I'd rather know what's going on... maybe I need to raise this with the GP too? I don't know what options are available. I'm only just realising I know very little about the menopause :-(

Last time the GP wasn't keen to put me on a transdermal type.

Probably cost

Menopause specialists are telling GPs this is the default type and all women should use it. Pills are old fashioned although femoston has one of the safer progestogens in it.

Also, another question, if you're on a continuous HRT like Femoston 1/10 or 2/10, which for me seems to induce some sort of 'fake' bleed at the end of each packet, how do you actually know when your natural periods have ceased for more than 12 consecutive months?

All HRT is continuous but ones which give a bleed are called 'sequential' ( they follow a cycle) and ones that are no-bleed are called 'continuous combined' (2 hormones every day.)

The answer is you don't know when your own periods have stopped but it's not really important. If you want to stop HRT at 51 ( age of average menopause) you will see if your own come back :)

Right, thank you again. This makes sense. I had terrible problems years ago on a continuous combined contraceptive pill so I think this was why a sequential HRT pill was prescribed. I remember having that chat with the GP.

This time I'm definitely going to chat about the patches as an option.

I feel better just for having these conversations. None of my friends of a similar age say they are experiencing peri/ menopausal symptoms as yet so I can't really ask them and I'm not keen to ask my mum as she is so vehemently anti-HRT.

I’m 51 and had my last period 3 or 4 years ago (can’t actually remember as were every six months for a couple of years then just stopped). My GP doesn’t seem interested or concerned regarding HRT and I’m lucky enough not to have any real ongoing issues though I use topical oestrogen for dryness.

I’ve always assumed life would just continue and tbh I feel pretty normal for now.

OP when did you start your symptoms? I’m 46 and have had peri for years but definitely feel I’ve entered the meno phase now. I am avoiding hrt due to previous breast cancer, even Dr Newson says it shouldn't be first line of defence in that situation, but I am concerned about bone/heart health. I thought early meno was when you stopped periods before 45 or do I have that wrong ?

Went on hrt aged 38 - it def masked the symptoms but was always at the back of my mind that one day l would need to come off it so l used lockdown as an opportunity to see if the hot flushes came back. Very pleased to say they didn't, l manage my bone density by doing weight bearing exercises and running and l no longer stress about coming off it. So l feel now, aged 44 that l am through the menopause but everyone is different x

Sorry Tooty I'm getting all confused with my terminologies. I'm not sure if I'm postmenopausal yet - as the HRT means I always have a monthly bleed of sorts. I guess what I meant to say was that I started with perimenopause symptoms fairly early at 42 - hot flushes, night sweats, disturbed sleep, and mood swings - always so grumpy in the early evenings. Those things in themselves weren't too bad, the thing that prompted me to start HRT was the GP's concerns about bone density and heart protection - my grandma and my dad both died early of heart attacks.

What I think is happening now, after further thought, is that I'm starting to react badly to the progesterone in Femoston. The first two weeks of Femoston are OK, but the second two are awful. I experience migraine type headaches, and the other symptoms - rage, impatience, anxeity - which I thought initially were peri/menopause symptoms returning. But now, when I think about it, they only return in the last two weeks when I'm taking the pills with progesterone.

The GP has advised a blood test to rule out other factors - iron deficiency, thyroid, etc. but I'm pretty sure it's the progesterone in the HRT pills. She won't discuss alternatives until after the blood test results come back though.

Fishfingers I plan to start some weight training as soon as this lockdown rubbish is over. I'm trying to find a PT to give me some advice - at least at first. But I'd like to find someone who specialises in exercise for women in/ nearing the menopause. I live in London so shouldn't but too hard but if anyone has any recommendations that would be fab.