HRT options or natural remedies to start with?

[Authenticcelestialmusic]

I am thinking I’m going to have to make a gp appointment to discuss peri symptoms. I am 44.
I get a racing heart, feel anxious in the night (I have something to worry about but I’ve never had anxiety or depression before). Regularly wake in the night. neck pain that won’t go. I feel flat and a bit meh. I need to make a really important decision soon and I feel foggy and cloudy. I’m a morning person and mornings aren’t good either.
My bmi is normal. I walk 8km a day. I eat fine, only allow myself 1 coffee first thing.

Does anyone have any advice about what the best options are?
Also any advice on herbal/natural remedies?
I take vitamin d daily and K2. I don’t take any other medication.

HRT

It prevents hair loss
Thinning bones
Middle age spread
Lack of libido etc etc

I’ve met a couple of female gynaecologists (I work in the nhs) who have said they don’t intend to stop it as the benefits outweigh the risks to them.

It’s personal choice on if /when to start HRT. Best options…also personal choice but estrogen used in the U.K. is body identical, transdermal being best via patches, gel or spray. Best progestogen can be by oral micronised Utrogestan (body identical) or combined in patch or Mirena coil (fit and forget for a few years though fitting might take a few months currently).

Way of taking is is different if still having periods-sequentially rather than continuous.

www.balance-menopause.com/menopause-library/explaining-menopause-hrt-and-the-alternatives-video/

balance-menopause.com/uploads/2021/09/Perimenopause-and-HRT.pdf

It's worth being aware that the risks - albeit small- of HRT don't apply to women your age. You can read this online on medical sites.

The use of hrt at 44 is just topping up your own hormones.
Counting the risks only starts after menopause (for many women that is 51). This is on the site Menopause Matters under early menopause. It's written by a meno gynae.

So really there is little point experimenting as you could go on for years tryingnew things like supplements- most advise you try them for 3 months at least to see any benefits.

The other option is the combined contraceptive pill which is given to women under 50. There are two that are very similar to hrt- the estrogen is the same but you also get contraception covered. They are Qlaira and Zoely.

Might be worth thinking on that if it's relevant.

Thank you for the replies. I have been very proactive!

Had a gp appointment today about another matter (which ended up taking 30 seconds). The chap was lovely, never seen him before. So I had a chat with him and he has requested several blood tests. Including:
T4/TSH
FSH/LH
FBC
And Hba1c
I have not yet had chance to deduce what all of them are but one is hormone levels and one is a thyroid check.
I can have them done next week.

Thyroid -because some symptoms can be due to it not working right.
Follicle stimulating hormone & leuteinising hormone
Full blood count-can show size/amount of red/white blood cells, platelets & if further checks need doing if you are low in iron/B12
Hba1C -Average blood sugar over the last couple of months to check for diabetes.

Sounds like a productive visit to the GP.

HRT, 100%.

@Authenticcelestialmusic

I’m also pondering whether to go down the HRT route too so reading all the comments with interest.

@BeLessMe thanks for that. Yes it appears it was. I was there for less than 5 minutes too!

@Perperinotchicken yes I’ve been pondering for over 6 months. Vit d solved my problem last time I felt fuzzy but not this time. Let me know how you get on if you go to the gp.

I’ve been ridiculously proactive today and have booked acupuncture too. The only thing I’ve found that works for my neck pain!

I have personal stuff I want to do and change this year and I want to feel good/my best to do this so I have my fingers crossed that I find a positive solution.

Menopause is a hormone deficiency. Women need oestrogen for many bodily functions and can suffer serious symptoms of this deficiency (as you have experienced and advised). Would you try herbal remedies for other hormone deficiencies? Like insulin?

Individual choice - but I believe that because menopause only affects women, it's seriousness is downplayed. You need oestrogen to keep you healthy so my opinion would be to replace that hormone properly. You should really look up the risks of HRT v oestrogen deficiency and decide upon the best course of action for you.

Would you try herbal remedies for other hormone deficiencies? Like insulin?

Didn't mean that to sound as snipey as it reads! I meant something like - are you the sort of person who does herbal remedies for ailments? Or are you downplaying menopause?

Thank you for responding @spudjulia I guess I wondered if it was worth trying something else first. I understand it’s hard to work out if your levels are low as they fluctuate over the month. So a normal test result may not mean normal levels all month. Last time I was foggy (a few years ago) I took a high dose vitamin d and then I felt fine. The gps first comment was let’s check your thyroid, but he has ordered a variety of blood tests, I just hope I see him again.

I have used Chinese acupuncture before for migraines and was amazed at how well it worked so I am not anti alternative options. But I was actually thinking magnesium or b12 etc. Neither of which I have ever tried. Also the mirena coil or contraceptive pill suggested above I have now read about too. I’ve always avoided the pill previously (I have a copper coil).

I feel pretty alone on this. My mum hated hrt and I don’t really have anyone else to discuss it with. I totally agree that women’s issues are downplayed. I was a bit shocked I was taken seriously today. I just really want to get it right.

But I was actually thinking magnesium or b12 etc.

Unless your diet is seriously lacking, you shouldn't need supplements.
Many frut is and veg are high in magnesium ( do a search) and b12 is easy to get from food.

A lot of women swear by supplements but if they really worked, for everyone, drs would prescribe them.

Acupuncture can help symptoms but won't prevent bone loss or heart disease- both risks with early-ish menopause. (and at £50+ a session is very pricey!)

The risks of low estrogen from your early 40s far outweighs any downside of hrt.

Game changer

46 started HRT 6 months ago

Evorel 25 patches originally then 50 as some of the symptoms weren’t going away

Symptoms:
Racing heart
Feeling of doom
Anxiety
Thinking I’d not wake up if I went to sleep
Getting to sleep really quickly and the awake 2 hours later or other way around!

For me the impact on my mental health has been significant. At one point I never thought I’d be happy again, along with the rage!!!!

dr gave me the option of AD or HRT and I just thought I’d try HRT first. It’s working for me, but be prepared for some playing around to ge tit right. It hasn’t interferes with my periods too much. In fact they are now like clockwork!

(And the patches are much easier than I thought :) )

@Authenticcelestialmusic I've found a fb group useful - 'totes merry peri' or along those lines. Just for people to talk to. It's a big group with a wide range of experiences, and plenty of women to answer your questions. I've found that group very well versed (in general) on peri and meno issues and current guidance.

Also the balance app (and follow the menopause doctor, who runs that app). It's current medical and peer reviewed guidance.

Do some reading and find out the actual benefits and risks. It sounds like you've got some really significant and rubbish symptoms and you don't have to endure them. I don't think some vitamins will be able to help. (Although actually vit d supplement can help with lots of other things). Vitamins or herbal remedies won't replace the oestrogen you need. Reading up on your options will help at any gp appointment, and get an idea of what sort of thing sounds right for you. But like PP said, be prepared to have a bit of trial and error. It's so individual, there's no 'right' way and chances are you will need to tweak whatever you start with.

Thank you for your replies. I am going to get the bloods taken next week and then push for HRT. Patches I think from what I’ve read so far.

I started watching the Davina programme again yesterday evening and will finish it today. I can really relate too how she felt.

I do hope it makes me a bit happier too. I’m okay but I don’t feel the normal me!

I'm 55 and on tablets. [Femoston 1/10].
Seems like most people here do patches or gel.
On my third month and working well for me [was still having periods when started].
My gp felt my risk levels were low despite my ancient age. Hope he is right!
Sleep improved, anxiety and brainfog less overwhelming..

Brainfog is the bit I’m struggling with. I really rely on my memory and being able to think on my feet at work and I just feel sluggish and foggy.

I’m used to sleep deprivation but I’d prefer not to have to either read or MN in the early hours. I sometimes wake at 2:30am and don’t get back to sleep! Luckily it’s not every day.

I do think it’s pretty poor that this is not discussed more. I was looking forward to my kids sleeping through and now it’s me awake in the night (my poor husband did most of the night wakings as he was a sahd now he has me reading in the night!)

I do think it’s pretty poor that this is not discussed more.

To be fair, menopause has had news headlines for at least a year. It's been in the papers, in women's mags, on radio, social media etc.

Interviews with drs, petitions to parliament for menopause 'leave' etc.

it's discussed almost too much for my liking!!

@lljkk

it's discussed almost too much for my liking!!

I'm a bit worried about the quality of the information/discussion as well as the quantity

I have noticed that one of the best known menopause sites will put a post on FB or Insta which then will get queries from women posted under it, many of which are responded to by other posters who are not qualified to give that advice and are not always correct. They also seem to allow a "GPs are all rubbish and want to fob you off" attitude to stand unchallenged and, while some are, I do think most are doing their best
Dr Naomi Potter (drmenopausecare) and Dr Annice Mukherjee (the.hormone.doc) are more balanced than Balance in my opinion.

I’m not taking any HRT

I’m managing everything holistically by adjusting my diet. I have found yoga incredibly helpful too.

Seems to be working for me – I’ve noticed a decrease in :

Palpitations
Brain fog
Mood swings
Hot sweats / night chills

And I sleep like a baby.

Having said that, I’ve got no emotional stressors in my life right now which I find is a big contributor to sleepless nights, brain fog and palpitations.

Might be worth speaking to your employer too just to make them aware this is where you’re at and trying to find what works best for you. It shows you’re being proactive which most employers should see as a positive.

Hello,

I tried various things like magnesium, taurine, b vits etc.

They did definitely help with sleep. After a while though, or when ever my body was stressed through illness or work, symptoms would be extremely bad.

I was a little younger though, 43, turning 44 and was also still breastfeeding a little. However reducing that/ night weaning made everything worse somehow! Unless I was just going down hill anyway.

I tracked symptoms and periods (was regular but very short, one day really) and after 10 months saw Gp. V helpful and I wished I'd gone for it earlier, didn't know you could have hrt and breastfeed though. I'd been working out whether to stop completely; he'd have been devastated though! Its been a good few weeks on my trial dose and there's a big improvement. I may go a little higher at review. DS is now naturally really cutting back himself too. Both happy :)

Good to get thyroid test too though.

Id had racing heart issues on and off for a few years. Self diagnosed pots at one point (I'm hypermobile)! The dizziness and brain fog had become debilitating.

Oh and sleep is so much more improved. I do think I need a slightly higher dose of patch though.