How do you know it's time for HRT?

[LefttoherownDevizes]

I am 46 and still having regular periods. They are horrifically floody though, massive clots but still every 29 days. Think I'm still ovulating too.

I do, however, have vaginal atrophy which is making me go out of my mind. And just the rage, like PMT rage but for much longer. Allied to that I'm much more anxious, super tired yet sleep is really bad (and have to get up lots to wee).

Everything aches too, but has done for years. Definitely much more stiff though. Finally really sweaty and smelly (as an aside can anyone recommend 100% cotton nighties that won't make me look like something out of Jane Eyre).

I've a Drs appointment to ask for vaginal oestrogen but wondered if taking about other subprime? As periods are still regular not sure if anything else appropriate?

Thanks

^symptoms

I wonder this. Because of flooding I had to go on the progesterone only mini pill back to back and it has sorted me out, no periods at all now. But because of that I don't know if I need HRT? How would I know.

Make sure you get the gp to prescribe some tranexemic acid for heavy periods just in case you start ''flooding''. I have some in my handbag, even though I never get periods now thanks to back to back pill.

Sounds like you are over due so.e HRT.
I would definitely be having a chat with your GP about your options.
I was tbe same as you this summer but I'm a lot older and still having periods.
I got a Male doctor and my heart sank but he. was fabulous. He had me in for blood tests to rule anything else iur, asked me a 100 questions and once I had the result if the blood tests he prescribed HRT.
Huge huge difference within days. Anxious ness over nothing gone, tbe heat that rose from my neck into my head stopped. I sleep better. I'm not 100% in perfect shape because of HRT but I'm a much much better than I was a few months ago.
Have that convo with your doctor!!

A GP will only prescribe a couple of months anyway so why not try it? If it makes a difference then you have your answer!

Thank you!

I have tranexamic acid and it has been in the whole a game changer, I've always had to avoid hormonal contraception due to family heart history and progesterone only ones triggering migraines and making me suicidal. Hence avoiding thinking about it.

I'll see what they say, thank you!

I had an endometrial ablation in my early 40s that totally changed my life. It isn't successful for everyone but I went from dreadful flooding every single month, terrible pain and exhaustion to only needing a panty liner when I had my period! I only wish I had had it done sooner. Might be something to mention to the doctor as a lot of those symptoms might be coming from the horrendous periods.

I started HRT when I felt I'd tired everything else and my consultant (gynae- meno expert- but was seeing him for something else first) agreed.

I was already exercising a lot ( 3 mile energetic walks most days)
No booze for years - allergic to it.
Really healthy diet with loads of lentils and chickpeas ( good for plant estrogens)
Little sugar

My sleep was all over the place and I was getting very tired (which is really bad for your immune system, by the way.)

So, advice is clean up your lifestyle if you need to, and if it's good already, try HRT.

Your GP ought to give you 3 months as a starter as that's the recommended minimum trial.

@LefttoherownDevizes Cotton nighties- try John Lewis (online) they have some that aren't too Jane Eyre!

I'd say you could have started on HRT some time ago - you're well into perimenopause symptoms.

I'm same age as you OP and had same symptoms. I also had regular but unbearably heavy periods. I recently started HRT (Mirena + estrogen patch) and things have massively improved. Best of all, no periods! Look into the mirena coil. It does release progesterone and I know you've had problems with progesterone but it's a very low dose. Worth a try?

Thanks, I've always turned down Mirena as I tried exactly the same version of progesterone in a mini pill as a trial to see if I could tolerate it and ended up in hospital with a suspected bleed (turned out to be a particularly nasty missive) so even GP agreed best to try something non hormonal.

I have never tried oestrogen though as was told it was too risky but I think the thinking on this had changed, am hoping having both will help

I completely understand your reluctance. The levels of levonorgestrel in mirena are lower than in the mini pill. But it's not for everyone.

I had the mirena for super heavy and long periods when I was mid about 47. After about 18 months my periods stopped.
When I was 49 my periods returned after 11 months of no periods and so did a rage/extreme PMS feeling each month. That’s when I went to doctors and got Oestrogel, the combo of that and the coil has really worked for me.
During my late 40’s I really struggled with night sweats but I haven’t had any since taking the gel. My friends who are a year younger than me are now having the sweats, flushes, mood swings but I feel on an even keel.
I’m 52.

Thanks, definitely something to consider, and all how quickly they can take it out if I don't agree, it was only when they tried to section me they works agree to take my implant out, GP would not accept they were linked (was fine about 48 hours after having it taken out)

Just want to update to say I'm starting Evorel Sequi patches tomorrow.

Had phone appt today and she offered lifestyle/anti depressants/HRT so I took her up on the latter, she had bloods/BP from recent tesappt.

Follow up in 3 months. Glad it was ready but feel a bit funny, was prepared to be in for long-haul.

Here's hoping it works. And thank you for your encouragement, wouldn't have been brave enough to ask otherwise

Great! See how you go 👍

I'm not even mid 40s and had all you described.

Fatigue started to become unmanageable. Joint pain has been around for a few years.

Rage, weird on edge feelings and over heating at night were new ones in the last two years. Inability to focus on some things. Tingling hands and feet too.

I noticed a lot of improvement to pain in the first few days and I feel like it's only improving day by day. It's been nearly one month. Energy has improved hugely

Good luck! I hope it really ally helps.