What do you wish you'd known about perimenopause before it started?

[Miltonma]

Self explanatory thread title I think but thought it'd be useful to gather information for others. I also want to see Dr Louise Newson's clinic and still learned more from this group.

• First line choice for medication is often Estrogel (2 squirts) and Utrogestan (200mg for 12 days)
• Start small with the Estrogen. I used too much at first. A large pea size is perfect for me.
• Your periods are likely to stop on hrt even if you are just perimenopausal
• Rub the estrogel over a decent area and then let it dry by itself. Don't rub it in.
• Restless leg syndrome can be a symptom of perimenopause
• GPs can be a pain and you'll need perseverance but use the NICE guidance to help get your prescription

What would you add?

*[Post edited at OP's request to remove one line]

• You can take Utrogestan vaginally and then only need one tablet
• Utrogestan should only be used for 12 days not 14.
• It doesn't matter when you take the Utrogestan in your cycle.

Don't take estrogel and Utrogestan at the same time. They have to be 3 hours apart

@Miltonma Why? What is the theory behind that?

Did you mean to post you went to see Louise N or you want to see her?

Newson centre posted a video that shows you how to place your gel:
One full press of the pump is a normal amount and you should rub it in on the top half of your arm until it’s fully absorbed
I think where you rub it is important too, it can’t be just anywhere, top of arms and inside thighs are ok
Newson also advised me 200mg utrogeston for 14 days, so I think it can vary

You can also take Utrogeston 100mg for 24 days.

Going back to the question the OP asked, my twopennethworth is

• no two women are the same

-cycles may start to do odd things years before your last period -cycles may become shorter, longer, bleeding may be heavier or lighter -don't expect all your symptoms to stop once your periods do (mine only started once I'd had a final period at 53-ish) -don't suffer trying to do it all 'naturally' if you have tried everything. HRT is usually safe for at least 5 years. (And I say that as someone who was adamant I'd never need it or use it.) -save/spend your money to see a specialist if your GP is not offering you treatment you need. There are so many ways that HRT can be tweaked to get the right 'fit' that GPs don't know about.

Night sweats are a symptom. I had no idea. I also thought hot flushes mainly affected the face and chest. Mine start in my lower back and creep up to my bra strap.

Rage and sudden bursts of crying at ridiculously small triggers. My PMS symptoms (such as they were) were just irritability, mostly born of annoyance with stomach cramps. The emotional swings of peri have been really quite something to experience. And probably to behold...

Go into peri- and menopause with an open mind.

If you start getting very short cycles with heavy periods, a Mirena might help and you can keep it in for the progesterone element of your HRT. I wish I'd done this in my early forties, when I had some very embarrassing episodes at important career moments. You shouldn't be worrying about where the nearest chemist is when you should be preparing your talk and clearing your mind of other things. You shouldn't have to check a venue for the nearest loo when you should be networking or simply enjoying other people's company. You shouldn't be feeling too tired to leave the house because you're anaemic.

When you enter menopause you shouldn't feel flat all the time. Even when you're doing something you'd usually look forward to with excitement. You shouldn't have a feeling of unspecified anxiety most of the time.

Don't put up with it.

The biggest thing I've learned is that what has worked for me re HRT isn't necessarily what has worked for my friends.

@oneglassandpuzzled

Go into peri- and menopause with an open mind.

If you start getting very short cycles with heavy periods, a Mirena might help and you can keep it in for the progesterone element of your HRT. I wish I'd done this in my early forties, when I had some very embarrassing episodes at important career moments. You shouldn't be worrying about where the nearest chemist is when you should be preparing your talk and clearing your mind of other things. You shouldn't have to check a venue for the nearest loo when you should be networking or simply enjoying other people's company. You shouldn't be feeling too tired to leave the house because you're anaemic.

When you enter menopause you shouldn't feel flat all the time. Even when you're doing something you'd usually look forward to with excitement. You shouldn't have a feeling of unspecified anxiety most of the time.

Don't put up with it.

The biggest thing I've learned is that what has worked for me re HRT isn't necessarily what has worked for my friends.

@oneglassandpuzzled

This really resonated with me. I’m 44 and for the past two years my cycles are getting shorter and my period incredibly heavy. I’m not in any pain and have had smear/ultrasound/various checks to rule out anything nasty. But it is SO debilitating bleeding so often and so heavily. Have had some awful moments at work (leaking spectacularly in the middle of a presentation etc). Also am anaemia and currently taking iron to try to get my levels up.

I hadn’t considered the mirena as the contraceptive pill is contraindicated for me due to a previous problem with my liver, so assumed mirena would be the same?

I’ve finally had enough and have got a telephone appointment with my GP next week to try to push for some help. I’m going back to the office next week, and after my period this week where I was bleeding through a tampon and towel within an hour, I’m dreading work! There has to be something I can do!

Perhaps the mirena might be acceptable as it’s not taken orally and is more localized? It’s so awful when important work moments are compromised by a flood, isn’t it, HotTomatoes!

Expect to get bitch slapped by any unfinished business you’ve been trying to ignore. It’s very scary but can be liberating if you work through it.

If you have got a Mirena (I'm on my second in my early 50s) you might not know where you are as you have no noticeable cycle. Then you might think you are suffering with anxiety and depression and seek help for those rather than considering HRT. I seem to be past the worst now and no physical symptoms so I haven't pursued HRT but still have really got no idea where I am in the whole process thanks to the Mirena.

That sounds really negative WRT the Mirena, it wasn't meant to be, overall it's been amazing, no periods for many years. But I do wish that I had twigged that the whole low mood / unspecified anxiety thing might be hormonal.

Anxiety can be a key symptom, and it doesn't always feel like fear, more like constant adrenaline you can't switch off.

Your days of long, deep sleeps are over. Take a moment to mourn them and then move on. You can survive on less sleep than you think. HRT will have an insanely amazing impact on your sleep, but it won't ever fully return to what it used to be.

Absolutely about the anxiety/adrenaline feeling. Most people know about hot flushes but symptoms are so wide ranging and can easily be passed off as something else, particularly if you have an early menopause.

@MissKeithsNeice

Your days of long, deep sleeps are over. Take a moment to mourn them and then move on. You can survive on less sleep than you think. HRT will have an insanely amazing impact on your sleep, but it won't ever fully return to what it used to be.

Amen to this. 4am and 5am wake ups are pretty standard now and it's hellish but you do eventually accept it!

@MissKeithsNeice

Your days of long, deep sleeps are over. Take a moment to mourn them and then move on. You can survive on less sleep than you think. HRT will have an insanely amazing impact on your sleep, but it won't ever fully return to what it used to be.

Not necessarily. I have had the anxiety / low mood stuff but no sleep problems.

@Snowdrop30

Anxiety can be a key symptom, and it doesn't always feel like fear, more like constant adrenaline you can't switch off.

Am so with you on this.

That it starts a loooong time before your last period. I had no idea that symptoms could begin 7-10 years before menopause.

My sleep is good now on hrt.

Be alert for vaginal/bladder soreness, itching, urgency and pain. That was the only really troublesome symptom I had for ages and I ended up self diagnosing - was being treated for thrush and cystitis when it was VA. Get that treated ASAP - many women only need local oestrogen in tiny doses - and stay on treatment for life.

I think im heafimg into or are already in peri menopause...

My sleep is shocking. I wake about 4 or 5 am or i cant sleep at night until about 2.

3 periods last month, all three v painful and very heavy. Im currently feeling like im heading for another.

Ive been bereft today....god knows why...feel like im irrationally loosing the plot.
These episodes have been growing in frequency

Watching this thread with interest

I feared I may be entering peri, reading and relating. Good to know I guess :(