HRT or natural alternatives

[Rupertpenrysmistress]

Hi all.

I am finding it hard to get the right information to make a decision. My GP has agreed that I am in peri menopause. I am 44 and am having some awful symptoms that are affecting my sleep and general life/work. All the usual stuff night sweats, can't sleep, joint pain awful heavy irregular and painful periods and brain fog, keep forgetting everyday words and threads if conversation. I am so tired. I work in a senior health care position so am worried about my work.

I have been told I can consider black cohosh or red clover or HRT. The only relevant history is focal migraine. I am normal BMI and blood pressure. Maybe too much wine but I am active and eat well

I am not sure which to try if I try alternative I have been to give it at least 3 months. I am a science based person but happy to try alternative, I just can't find much evidence to support its effectiveness.

Would appreciate opinions from both sides. My GP says it's my choice.

Spend a day reading the fact sheets here and listening to the podcasts with the experts.

www.menopausedoctor.co.uk/

Your need RESOURCES on the tab.

There is also a lot of info on the British Menopause Society website and their sister site Women's Health Concern.

Also look at the website Menopause Matters (owned by a consultant gynae.)

THis is one fact sheet on peri meno

d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/483/Perimenopause%20and%20HRT%20v15-03.pdf

HRT is safe and usually extremely effective. It is also good for your heart health and bone density, especially if you've started peri on the slightly younger side. I've been on it since I was 40, and I'm 48 now. It was an absolute lifesaver for me and gave me my old self back.

Thank you both. I will look at this I thought from what I read I wanted to go for HRT but don't want to discount an alternative. My concerns are the lack of hormones and bone protection from the natural option. Thanks jingling I hoped you would reply.

I have read some of those articles thanks to to jingling I am sort of settled on micronised progesterone and either patch or gel oestrogen. I suffer from focal migraine so have read that I should go for the lowest dose of progesterone so, figure with a gel for the progesterone I can increase if needed.

I have to say as a nurse I find HRT complex but from what I have read this combination seems best for me.

Does that seem reasonable jingling? I cannot find enough evidence to support natural alternatives in regards to bone & heart protection.

I don’t think herbal remedies can help with bone and heart health. You can make sure you are having loads of protein and calcium for bone health (sounds obvious but if you are veggie/vegan not always). HRT is the way for me btw.

I suffer from focal migraine so have read that I should go for the lowest dose of progesterone so, figure with a gel for the progesterone I can increase if needed.

I know nothing about this. The Migraine Trust says HRT is fine for women with migraine.

Have you read their website?

With micronised progesterone there is no 'low dose' it's a standard of 200mgs x so many days per cycle, dose although you can reduce the gel to a lower dose (but no point really.)

Just jump to HRT
Amazing

Ok thanks sorry no aware of the no low dose. I did look at the migraine trust who said as low a dose as possible of progesterone for aural migraine. I might look at the combined patches then. I am just aware of the need to adjust doses and thought it would be easier in split hormones. Shows how much I know. This is why I love MN thank you all so much.

I've had a quick look at the MT website and can't see anything about low progesterone in HRT.

This is the link if you want to check :)
Maybe you looked at another page on their site?

migrainetrust.org/live-with-migraine/self-management/migraine-and-hormones/

I looked at the British menopause society and that says the lowest oestrogen dose to control vasomotor symptoms. My GP didn't mention lower doses! I find HRT so confusing. All I know is that I could not take the combined pill with my migraines.

I’m reading this with interest as I need to make an appointment with my doctor to discuss HRT but not really sure where to begin.

@Rupertpenrysmistress

I looked at the British menopause society and that says the lowest oestrogen dose to control vasomotor symptoms. My GP didn't mention lower doses! I find HRT so confusing. All I know is that I could not take the combined pill with my migraines.

The advice for all women is to use the lowest dose to control symptoms - that's just the norm.

So if you use a patch, it comes in different strengths of estrogen.
Gel can be adjusted by you.
Tablet forms are either 1mg or 2 mgs oestrogen.

The combined Pill is totally different to HRT. No similarity at all.

HRT as estradiol (the estrogen) is identical to our own.
Micronised progesterone is identical to our own.

None of these exist in the Pill.

All you are doing is replacing your own hormones with the same type.

Have a look at the website of Dr Louise Newson under Resources. There is loads of info there. Videos, fact sheets, podcasts with other consultants.

It's worth considering progesterone delivered locally which I think requires lower doses for comparable impact - so mirena coil or pessaries.