My body and mind is buggered - could this really all be down to peri/hormones?

[Picklemeyellow]

After years of very heavy bleeding, very thick uterine lining (22mm), recurring uterine polyps and severe anaemia, I opted for an ablation to thin my uterine lining.
I now have a very light 4 day period.
I think this may have been the start of my hormones going crazy.

I am 50 and am suffering from some awful physical and mental health issues which are greatly impacting my life.

I don’t suffer much from day or night sweats so not 100% sure if it is all down to hormones or not?

I have had IBS and gut issues for decades but this has ramped up significantly over the last few years. I suffer daily nausea, upper gut issues, bloating, has, diarrhoea and it is just awful, every day. I have had endless gastro tests (colonoscopy just last month) and scans but nothing shows.

I am stuck on an emotional
rollercoaster. I could feel ok(ish) one minute and will start bawling my eyes out the next. I wake every morning filled with such a excessive anxiety that it actually makes me feel very unreal as though I have lost control over f my mind (I have suffered anxiety all my life but this is on a whole new level).

I am so low and depressed, there is no joy in my life (I lost my part time job a few months ago and I care for my 80 year old mum who has Alzheimer’s). Life is shit. I have scarily dark thoughts of walking in front of a lorry, these thoughts scare the shit out of me.

I have zero interest in sex (not had it for months) and I’m sore and itchy down below. My poor poor husband is living with someone who no longer wants sex with him and is an emotionally unstable monster!

I just want to sleep or stare at the wall all day.

The anxiety and gut issues are the worst thing ever.

BUT I am petrified to go on HRT. Firstly because I am scared it will exacerbate my gut issues which I barely cope with and secondly and most importantly I am so very scared of the risk of breast cancer.

Our 48 year old friend has just had a mastectomy and is convinced hrt caused her bc, obviously she will never know for sure but she now has to face treatment and the possibility she may not survive this real threat to her life.
She had no risk factors or lifestyle.

I have a low bmi, never smoked, don’t drink and (as far as I’m aware) no family history but I am still petrified. I had my dc in my 30’s, struggled with breast feeding and just those things alone put me at a slightly higher risk. Obviously as does being a woman over 50.
I go on menopause support groups and will be told there is no risk with modern hrt but that’s not 100% true is it? There is still a risk and from all the research I read, that risk gets higher the older you are and the longer you are on it? Have I left it too long? Should I have gone on it several
years ago?

From what I read, body identical oestrogen gel and Utrogesten has potentially the least bc risk but my gp doesn’t want to prescribe me this, she has prescribed hrt patches because she says the pill version increases blood clots (even though I have no blood clots risk factors!). Im
not so keep as the progesterone side of this isn’t body identical is it? Is it a synthetic version? The mirena drove my anxiety through the roof, would this too?

Please help me put everything in perspective. The fear of the bc risk and fear the hrt will exacerbate my symptoms (particularly the gut issues) is stopping me from trying it but how can I keep living like this? Or will it get better once I pass over to menopause?

Oh, I am also concerned hrt will cause me to bleed. I am experiencing awful
pain during my period, since the ablation. It’s as though the blood is trying to come out but can’t because of the scarring. I am concerned hrt will exacerbate this but my GP can not answer this and I am
on a 9 month waiting list to see the gynaecologist!

Are you able to afford to see a private gynae/meno specialist?
They would explain all the risks, types of HRT you can try etc.
You'd usually get an appt within 2-4 weeks.
Cost about £250.

From what I read, body identical oestrogen gel and Utrogesten has potentially the least bc risk but my gp doesn’t want to prescribe me this, she has prescribed hrt patches because she says the pill version increases blood clots (even though I have no blood clots risk factors!

The risk of blood clots is with tablet form estrogen - not micronised progesterone (Utrogestan.)

Pretty bad your GP doesn't know this.

You could consider the Mirena coil, which is no-bleed HRT for most women.
For reassurance, the latest research shows no risk for 5 years' use of Utrogestan.

Sounds like you've got a combination of things that are contributing to this, some of which are perimenopausal symptoms.

It's highly unlikely that a couple of years on HRT caused your friend's breast cancer. You are 50 so in the age range for regular mammograms, so even if you did have something (whatever the cause - you don't sound like you've got a genetic risk, for a start, then there's the positive lifestyle elements), it could be detected incredibly early.

Patches have a very good risk profile, as does the pessary for the symptoms of atrophy that are affecting your physical sex life. They contain different types of progesterone (I didn't get on with one type as contraception, but was fine on another, for example) - and it's protective against heavy bleeding.

It cannot be promised that everything would be fixed with HRT, as it's not just hormone levels affecting you (job, mum, etc) - but it could ease a considerable number of things that are making your life just so unhappy at the moment, giving you relief so that you are more able to cope with the other stressors.

You're incredibly low risk - why not listen to the GP, slap a patch on your backside and a pessary into your sore, thinning, itching vaginal tissues and see how you feel after three months?

I had horrendous anxiety kick in, along with night sweats.

My ibs didn't get noticeably worse.

I'm now on patches and the anxiety is completely gone, night sweats much less.

Would 100 per cent recommend.

I can only speak for myself but I'm into the perimenopause/menopause (prob the latter but can't say for sure as haven't had a period in a year and a half but also have the mirena coil) at 48 years old - and HRT has made a huge difference. I don't have gut issues, but complete lack of libido, low mood, inability to see joy in the future, sleeplessness, nights sweats, irritability are all my constant companions now. HRT isn't a miracle cure but has definitely helped alleviate these - I have the mirena coil, oestrogel, and the vagisil pessaries. Might still need sertraline - I've also separated from husband and had a bereavement- but we'll see how it goes. It's just a bit of a shit time and I hope it's a transitional phase and this isn't it for life now. Sending sympathy.

JinglingSpringbells* Sadly I just can not afford to go private right now, my redundancy pay is running low and I still haven’t got another job yet as I feel so poorly I just can not face interviews etc. I need to get my arse in gear but I am feeling so bloody sorry for myself!
I can’t tell you the battle,I’ve had with GPS over this. I have been back and forth with symptoms since the age of around 45. Was told back then I wasn’t in peri as I still have a cycle. I changed GPS now this one is warning me about blood clots risks etc. I have tried the Mirena pre-ablation but it sent me do-lally. If I have another it would need to be inserted via a hysteroscopy by my gynae due to the ablation.

NeverDropYourMooncup I think that’s the issue with this current exacerbation of my poor mental health, it is preventing me from seeing things rationally. I had my first (and thankfully clear) mammogram in March this year. And even though very apprehensive, I was all set to try the hrt but this awful news about my friend as set my mind full of doubts - again! I know that I need to just bite the bullet but so bloody scared too.

Octavia64 That is reassuring, the anxiety is completely ruining my life right now. I’ve been prescribe Evorel Sequi and Evorel Conti. Is this the HRT you take?

horseyhorsey17 Thank you. I hope they continue to help you, especially all you are going through atm. This is such a tough season in our lives, so much going on.

I'm sorry to hear about your friend with BC but the latest medical thinking is that it takes 10 years from an abnormal cell to develop into a BC that can be seen and found. HRT may in some women accelerate the growth, but it's not a proven cause-effect. (I will post a medical blog for you to read this .) There is actually no science to show that HRT 'causes' BC, despite the stats. It's more complicated than that.

These medical sites might help.

[[http://wwwmenopausematters.blogspot.com/2016/04/hrt-and-breast-cancer.html

Bear in mind that the stats in the above blog/research are all based on older types of HRT and do not include Utrogestan.

It's also important to focus on quality of life. This is explained here by Prof Michael Baum, breast specialist [[https://thebms.org.uk/publications/bms-tv/ scroll down- near the end of the page on the right.

If you can't afford a private appt, maybe a private GP? They are about £100 because frankly, yours sounds hopeless. They are giving your misinformation all of the time.

Thank you. I have previously watched Prof Baum’s video, it is reassuring.
I think I have read somewhere that his own dd went on dd, under his advice.
I just can not afford anything privately atm but will check if I can get to see a different GP at the surgery.

I use Sequi (which includes Conti for 2 weeks), together with Vagifem Oestradiol.

The amounts that you'd have in three months to a year are so tiny that whilst you would have relief from symptoms, if you decided not to continue after that point, it's not going to have made any difference to your theoretical risk. And the pessaries carry zero additional risk in the 2019 meta analysis.

My understanding is that transdermal HRT doesn’t increase your risk of blood clots (oral tablets do).

Personally I’ve tried both estogel/utrogestan and although the patches can be annoying (esp
in summer) I feel sooo much better on them than the gel - I think I’d need a higher dose of the gel than the standard 2 pumps which would mean a higher dose of utrogestan too.

Breast cancer risk is definitely related to length of treatment with HRT, so using for a few years around menopause isn’t massively high risk imo. Nobody can know if your friend wouldn’t still have developed breast cancer even if she hadn’t been on HRT.

I would have struggled to keep working without it- a high stress high intensity job and 2-3h sleep a night don’t go well together. Now I might have the odd bad night every few weeks rather than every night.

it hasn’t ‘changed my life’ miraculously but it has given me back the well-being of maybe 5 years ago. I started it age 46 and was still (still am) having regular as clockwork periods

https://www.menopausematters.co.uk/risks.php

This link might help a bit as well.

Picklemeyellow ·
Hiya, came across your post, wondering how you are and all the women here are doing? Peri menopause can be a pain. I have all sorts of symptoms.