What to choose?

[mrsconradfisher]

Saw a Nurse Practitioner today about my current medication and she advised that I make an appointment with her in a few weeks as she is a Menopause specialist to discuss me possibly having HRT. Totally understand how difficult it can be to be taken seriously so really want to make good use of this fantastic but am completely overwhelmed by information and don’t know where to start.

Bit of background, I’m 46 and I think in the throes of peri menopause. My periods were regular as clockwork until 6 months ago and now they have almost disappeared. I have very light bleeding every 6 weeks or so but it’s not a proper period. I don’t have any hot flushes, my main issue is I’m getting horrific headaches (often lasting for days at a time) but very cyclical so they come every 3 weeks or so. I’ve also got quite severe anxiety but for no reason, I just feel in a constant state of panic but I’m not panicking about anything in particular. It’s really making me feel awful. I do take Mirtazapine 15mg but I’ve been on it for 8 years, I take it due to insomnia. I’ve never felt anxiety like this.
I have a Pernicious Anaemia and Rheumatoid Arthritis so I’m used to my body hurting but it’s mostly under control until recently and now I just hurt/ache all over.

My gut instinct is I need something but I react badly to medications, so I’m really concerned it will make me feel worse. How do the patches etc work? And what is the benefit of patches over medication?

My gut instinct is I need something but I react badly to medications, so I’m really concerned it will make me feel worse. How do the patches etc work? And what is the benefit of patches over medication?

'Medication' is all types of HRT which includes patches, estrogen gel or spray and tablets.

It's more a lifestyle choice to be honest with some medical considerations.

Many women are happy with tablets as they are easy to take. They aren't recommended for anyone with blood clotting risks. You may need to check they are not going to interfere with drugs you take for RA etc. Your insomnia could very well be low hormones and many women use HRT just for that.
It may have been a hormonal issue all those years.

Some women like patches, others don't and prefer gel or spray. Gel and spray need a tablet of micronised progesterone to be taken on a cycle, like your own natural cycle.

A lot of this is personal choice and trial and error. If the nurse is experienced, she ought to discuss all the pros and cons with you.

Thank you, that’s really helpful. By reacting badly, I don’t mean life threatening, I just suffer badly with side effects so with AB’s I’m often very very sick with an upset stomach and I can only tolerate one particular brand of the Anti Depressants as I’m sick with the others. I’m leaning towards a patch for that reason (I realise I can still have side effects but I think it’s stomach related so by avoiding tablets it would eliminate that). Do you need gels etc with the latch as well?

This might help @mrsconradfisher [[https://www.womens-health-concern.org/wp-content/uploads/2022/12/09-WHC-FACTSHEET-HRT-NOV2022-B.pdf

I'm on patches, went to the GP about 6 months ago with similar symptoms to you (I'm 52 and they'd been going along for a couple of years).

I don't really have any side effects but feel a huge amount better - like you I have a chronic pain condition so was used to it but the difference is remarkable. I also no longer want to rip my lovely husbands head off every other day.

Going back to regular bleeding has been the worst thing, but the "periods" are very light and predictable, which you couldn't say for what was happening before!!