The Menopause conundrum - who do we believe?

[Stridingthroughtheglade]

There seems to be a thicket of information out there, at the same time a dearth of actual rl advice and help! Need some advice negotiating my way through the problem please.

I am in my late fifties. Had a full hysterectomy with ovary removal nearly five years ago.

Went on HRT immediately for six to eight months but I wasn’t given any info about it and it didn’t seem to do anything in particular so I stopped taking it.

Only now, when it’s a few years later, I find myself not sad but just flat, no energy, no motivation, physically sluggish, don’t care about anything. My hair is receding and falling out. I have loads of bristles appearing on my chin and dark hairs on my upper lip. My limbs ache. My back hurts. I’ve gained weight. Any minor task that previously I would sail through, seems to be an enormous burden and I need to psyche myself up to do it, for hours and days in advance. Afterwards, I am exhausted. I’m existing, not living.

I have been offered anti-depressants but I am not sad and I don’t have anything to be depressed about. Good long marriage, lovely adult dc, ok job, ok home, supportive family, great friends, interesting hobbies. My life is a breeze compared to most people’s.

So where do I go now?

I see Dr Claire Newsome (is that her name?) all over sm. She talks about HRT as if it is a necessary, preventative treatment for most women. I understand the risks of HRT have largely been disproved but who do we believe? She seems very sincere and obviously I don’t begrudge her a living, but how much do we trust in what she says?

I’m a keen gardener and trust that nature knows best in most things and we get in to trouble when we meddle with it.

So the options are:

** ADs

** HRT

** diet and exercise

Sorry for long op, but what exactly should my next step be please?

How does everyone negotiate this issue?

I've been struggling for the last few months, especially with sleep, weight gain, mood swings a a lack of energy/motivation.
My last period was in September but I often get symptoms like I'm going to have another. I don't feel ready for HRT, don't know why exactly, I think it's mainly because I hate going to the GP!
I've started to take magnesium in the form of a spray and this appears to be helping a bit with the sleep issue. I also take valerian if I really can't get to sleep.

I got 3mo hrt from my gp to try on the basis that it wouldn’t do any harm in 3 mo (any small risks it has are more long term use). I felt better in a month to six weeks so I will def be continuing.
why not just try it?

Depression is not always sad.

Sometimes it's what is described as flat affect - not feeling anything in particular. Can't be bothered to do stuff kind if level.

So anti-D's might help.

Personally I find HRT helps my aches and pains but other people find it doesn't make a difference.

Getting outside also helps me - I go and see the swans at my local wildlife reserve, and also do wild swimming although it's not a good season to start that.

My understanding of hrt is that it smooths the transition. I’m committed to taking it for 5 years and if there is better evidence to support taking it long term, I’ll consider that then.

I think relying on pills without looking carefully at diet and exercise would be foolish. But diet and exercise is for the long term - building muscle and bone strength, fitness, flexibility and balance for a healthy old age. More and more evidence is indicating the importance of a healthy gut biome and the links with everything that goes wrong in our bodies. But I think if you’re unlucky enough to have a rough menopause, diet and exercise won’t be enough in the short term.

In your shoes, I’d go to speak to a gp who is up to date and informed about menopause.

Probably all 3 to be honest. but try to do the diet and exercise first, particularly eliminating sugars, I really noticed a decrease in my aches and pains when I did this (bread primarily and other starchy/refined carby based foods)

I also take magnesium as that is suppose to help with sleep, anxiety and aches and pains.

You could try the menopause reset by mindy pelz. She also talks to Dr Chattergee on his podcast about it...I have just started following her plan

I personally love my HRT - it's made me feel like I did in my 40's. Hot flushes, aches and pains, loss of libido all went away. My late DM did have breast cancer but she had it after the menopause, so the risk from HRT is pretty low for me. I do make sure I check my boobs regularly though.

It's not a conundrum- menopause is so different for each women that expecting a simple rule book is naive

There will be no one fix. I am in the mists if a terrible perimenopause, I have always been terribly affected by my hormones and this is never more true. I did a complete overhaul as was all over the place. No one thing will work. You need to sort out several things.
Personally I would try HRT and lifestyle changes first and foremost.
HRT
Add exercise (improved mood, weight loss, strengthen, improved mobility, reduction of joint pain etc).
Change diet (anything that regulates your blood sugar). It's like miracle for me in terms of mood and pain and stopping eating.
Adding fun and joy (I joined a choir, go clubbing and play netball - which I'm proper shit at but love!)
The difference is huge. Before I was faffing about trying bits and bobs til a GP said you need to do more, no one else will do it for you. I had a bit of a sob but realised it was true.
One life. One body and no one else gives a fuck really but me.
I am happier, bouncier and fitter than I have been in a long time. Still some issues that won't go ( I have fibromyalgia to add to the joy but this has been helped too )

Why don't you give HRT another try. You took it 5 years ago, the patches will have improved in that time.

I personally don't get the reticence about HRT. Medics were happy to prescribe the contraceptive pill for decades to me. I've found HRT to be really helpful. I'd rather have a comfortable life than live in miserable pain.

The Human Being Diet (HBD) is very effective for this age group. Look it up on Instagram and buy the book. It has transformed how I feel and I've lost 1.5 stones. It's common sense eating, portion control, fresh food. It could rejuvenate your life.
There's a welcoming supportive community of women on Instagram.

Please go back to your GP and ask for a referral to a proper menopause specialist. I'm sure they can find a combination that will make you feel much healthier and happier.

I love being on HRT. I had an early menopause and really regret the time I struggled by with just herbal supplements, because now I know I didn't have to just grin and bear all those horrible symptoms.

It took a bit of trial and error to get the right combination of pills, gels and pessaries for me but it was so worth it! For me taking a very low dose of testosterone has really given me back a lust for life. No extra weight, healthy hair and nails and enough get up and go to look forward to enjoying long walks every day and doing fun things instead of just work and chores.

I am very grateful indeed for all these replies. Thank you so much for them!

But everyone is suggesting a different thing which is really the essence of my problem!

How do I know which is best?

Or should I do what bellac11 suggests and try all three? But one at once so I know which is working?

That’s a very good point about the pill ColourByNumbers88!

Well you should sort out your diet and exercise anyway so that's a red herring

You just need to decide
Do you want to do that and see if you still have problems or do you want to try one or the other at the same time

Yes. Fair enough.

Yes! 😃. Thank you!

That makes the decision simpler but of course I have zero motivation to exercise or eat more healthily atm while feeling so grey.

Edited bit: And, thinking about it, going for a full on no-meds potential solution is a decision in itself.

But maybe I am overthinking 😬 and it’s the inertia talking.

I'd do it the other way round. While you're feeling so flat and demotivated, the last thing you want to do is exercise and eat healthy food. You want the sofa and a packet of biscuits.

I'd see a really good GP or menopause specialist and get on HRT as a first step. Have a look at the Balance website and find out about the types of HRT, and go armed with knowledge: https://www.balance-menopause.com/subject/hrt/

Get settled on HRT for a month or two, then start getting outdoors: a walk with friends, a short run, cycle - whatever, just get some fresh air.

Then start adding in some healthy breakfasts. Then some healthy lunches.

Just take it slowly - accept it's a bit of lengthy journey and be kind to yourself. You just don't have the oomph to do it all at once - I know I certainly didn't - and actually, when you're feeling so flat, even taking the step to see the GP/menopause specialist feels HUGE.

I found the book 'The Menopause Manifesto' by Dr Jen Gunter helpful. She goes through the physiological changes associated with menopause, & also tries to disentangle them from other changes which happen as we age but that are not directly menopause related. She also talks through HRT & the evidence base for what it can & can't do.
I liked it because unlike so many sources of information, she's not 'all women must take HRT!', but also not 'HRT is poison! Take this alternative course!'. (She herself does take HRT, because of a family history of osteoporosis.)
She also talks about the role ADs can play for some women. But also, as above the strongest message is the benefits of exercise for a healthy move into older age.

Menopause is a hormone deficiency condition. Replacing the deficient hormones is a no brainer. Nobody thinks I shouldn't take thyroxine for my deficiency.
It doesn't go away. It's not about transition. We need the hormones.
Diet and exercise are always important

"Need"

Children don't need high levels of those hormones

Many people feel justI fine thank you without adding back hormones my body has decided it no longer wants or needs

Menopause isn't an illness that needs treating

I’m peri, and my symptoms came on quite quickly, with awful daytime and nighttime flushes (and associated insomnia), and terrible rage.
I saw a BUPA meno Dr (£300 - I would recommend this service, it worked very well for me - 1 hour very thorough appt with the Dr, follow up after 12 wks and 12 mths access to a nurse-led helpline, but it might not be for everyone).
Had a detailed convo re HRT options. I’m now on gel and oestrogen tablets, and it worked wonders on my symptoms very quickly.
So I’m very pleased with HRT, for me.

I tick all the boxes you have stated in terms of symptoms and I had a hysterectomy too but can’t take any HRT or anything natural that stimulates oestrogen as I had breast cancer. So the struggle is real! I have to fill my days with little jobs and stuff to focus on every day otherwise I would definitely slide into depression. I find I can be really demotivated but the less I do the less motivation I have. It’s a horrid cycle. I’ve had therapy/counselling and have regular massages, nails done etc with an amazing beauty therapist which is a real treat and like therapy itself. I talk kindly to myself and give myself days to just be or feel sad rather than try to snub the feelings all the time and fight against them. I hope through some trial and error you find something that works for you x

I'm off to the gp next week to hopefully get HRT , your op is exactly how I feel.

It does need medical treatment for some women @aswarmofmidges

"who do we believe"

I believed my GP who saw me and told me I needed HRT. I believed the uro-gynae who looked at my vaginal prolapses and told me I needed HRT. I believed my body that was failing in multiple ways that I needed HRT. I believed my brain that was causing me to cry all the time and ruin my relationship with DH, that I needed HRT.

I already do the diet and exercise. I lift weights. I walk in nature. I practice yoga and breathe.

And not one of those things stopped my hot sweats!