Should I be offended?

[canijustrunawaytojointhecircus]

I had a total hysterectomy mid 2019, so was obviously thrown into menopause. I am in my mid 40's.
Prior to my operation, I was a fit and healthy (although overweight) person. My hysterectomy was necessary due to me regularly needing A&E trips each month (often by emergency ambulance) as the pain of my periods was so intense I would pass out, whilst flooding (tmi, sorry).
Since my operation, which I recovered from brilliantly, I have struggled. I have struggled with my weight, with insomnia, with brain fog, with a feeling of imposter syndrome, with my moods and most debilitating, with horrific hand and feet pain. I still keep myself fit, with various exercises, but this is becoming harder and harder with my muscle and joint pain.
I use HRT and have regular check ups with my Practice Nurse to review. To be fair, the Practice Nurse is very good and has always responded positively to my ailments.
But, I am getting worse. I get up each morning not wanting to continue the day. It is all just too much.
Cue my DH (we have been together for 30 years) saying to me last night "I have been talking about you with my friend who's wife was also destroyed by menopause. She went to see a menopause specialist and has been completely transformed. Shall I book you an appointment??"
I really don't know how to feel about this. Pleased that my DH has recognised my struggles and wants to help? Or offended that he is discussing me with a (not very close) friend, feels I have been destroyed and has decided I need "fixing"?
I am just being an over-sensitive, moody, hormonal old lady or am I justified to feel slightly offended?
For reference, although my DH and I have been together forever, we don't have the best relationship anymore and often look at each other and think "why are we still together??"
Thank you for reading this far

[quote canijustrunawaytojointhecircus]@JinglingHellsBells when I last went to see my practice nurse, she swapped me to the pump gel. We talked about my weight issues and she said that HRT will make me gain weight, despite my best efforts to avoid it. She recommended one pump per day (yes, just one press of the pump).[/quote]
I don't think she knows what she's talking about.

The starting dose for gel is 2 pumps. Weight gain is not related to the dose.

For someone your age, that dose is not enough which is why you these symptoms.

It's completely unscientific to say it will make you gain weight. The research shows HRT does not make women gain weight (although some swear it does.)

I've used gel for over 12 years and put on no weight.

She doesn't sound especially well trained in menopause or HRT.

If you pay to see a menopause dr they will simply tell you I expect to increase your dose. You can do that now, by yourself.

'I don't think she knows what she's talking about.The starting dose for gel is 2 pumps'

Tbf many people start on 1 pump then increase as needed.

The fact the op has had no improvement though would surely have been the point the nurse would have then said increase to 2.

@canijustrunawaytojointhecircus One thing you ought to be aware of (and your nurse too) is that surgical menopause in your mid-40s puts you at the same risk of long term diseases the same as women who have an early menopause (this is before 51.)

The medical advice for early menopause is to use HRT to the age of 51. This is simply replacing your own hormones that you would have had. You can read about it here- pages 8, 9, 10 cover the important point. www.newsonhealth.co.uk/uploads/2021/06/Menopause-and-me-A-guide-for-younger-women-v15-03-2.pdf

In this link you can see the list of HRT - estrogens- and those with a * are suitable for bone protection. If you scroll down to Gel you will see the dose for Oestrogel is 2 pumps (and can be increased to 4.)

The risks of no or low estrogen are osteoporosis and heart disease.
You are getting some estrogen, but only a tiny amount. The amount required to prevent osteoporosis is 2 pumps.

I think it's an excellent idea you see a specialist. I'm sharing here what mine has told me (over many years) and it's a shame your nurse is misinforming you.

www.menopausematters.co.uk/treatafter.php Types and doses of estrogen

Gosh no wonder you feel terrible on such a small dose of oestrogen. Many women your age will need 4 pumps, plus vaginal oestrogen. I’m on a 100 patch (same as 4 pumps) plus vagifem plus an estring and feel great. On anything less I really struggled.