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?

Louise Newson. Not Claire Newsome, I think?

I'm confused @Tiredbehyondbelief ? Is this the OP @Stridingthroughtheglade or someone else?

Has OP disappeared?

Op, I'm sorry, but you went "against nature" and had a hysterectomy. So I think that ship has sailed. You should not have stopped taking your HRT then. The fact that you didn't feel anything us a sign it was working - you had lost your womb and ovaries, and your body didn't make you melt down. That's a win.

Personally, I would go see a gynaecologist. You need tailored advice based on your specific needs, including the fact that after a hysterectomy, you chose not to continue your meds.

I’d try anything except HRT - as someone who developed breast cancer after being on it for less than a year. There’s a significant rise in the type of breast cancer that is exacerbated by HRT. And when I had genetic testing, the two questions they ask are about hormonal contraception and HRT.

Not a fan of Louise Newson- I think she pushes the idea HRT is a cure-all (and gets well paid for doing so) when in fact it’s more complicated than that- HRT is great for some women but just as it’s a disgrace that women who need HRt are sometimes palmed off with ADs, so it’s wrong when women with complex health issues are told that HRT is some sort of panacea.

OP, in your shoes I’d go back to the GP and ask for a referral to a menopause specialist gynae.

I'm really sorry you had BC and hope you are ok now.

The newest research into HRT using micronised progesterone, show no extra cases of BC in 5 years of use.

The research shows that in some women HRT may accelerate an existing cancer, but doesn't actually cause cancer. This is here by Dr H Currie.

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

Obviously, women are very afraid of the risks and for some even a tiny risk is too much. But the stats are a guide, to help those choices.

@daisypond I developed endometrial cancer with no other risk factors, although HRT possibly didn't start it the consultants seem to agree it would've fed it and made it worse, I had to have chemo, and the cancer is now more now more likely to recur, whereas if I hadn't been taking the HRT it might not have spread. When I read into the research, the fact that I have had problems with my hormones all my life might have indicated that HRT wasn't great for me. I was encouraged to go on it and increase my dose despite me raising questions a few times about whether the progesterone was being absorbed or not, I think it wasn't, which is why my womb lining built up. I do think HRT is helpful for some women, but I also think it's over promoted without enough of an individual look into women's unique situations.

No it wasn't. It was a snide, snippy, I'm alright Jack post. Says to me the poster is more in need of hormones than she realises. Just because one person doesn't think they need HRT doesn't diminish the benefit that can be gained for the majority. I would probably have taken my own life by this point without it and intend never to come off it.

Nature didn't intend us to live beyond child bearing years. But we do. And I want those years to be as full and active as possible, not held back by weight gain, aching joints, crippling brain fog, depression, osteoporosis, anxiety etc. The benefits of HRT last way beyond the immediate.

Well it's not for everyone. HRT exacerbated my symptoms and caused severe IBS. My GP refused to believe it was the hrt and sent me for bowel investigations which found nothing. Stopped hrt and all symptoms gone. There was a very large study that showed women on hrt are twice as likely to develop GI issues, probably because progesterone and oestrogen cause delayed gastric emptying. Then there was the horrendous heavy periods and bloating thanks to progesterone. I feel much better off hrt and lost all the weight I gained on it within 3 months of stopping. I'll take hot flushes over the hell hrt caused me any day.

The growth associated with HRT is in lobular breast cancer and its several subtypes - also very hard to detect, and no designated treatments.

Nature in as much as it has an intent certainly did expect us to live past menopause - along with a small number of other animals

It wouldn't have gone to the effort or menopause otherwise

The theory is that raising children is better with grandparents helps

There is for example a line of thought that the sleeplessness is a benefit - granny gets up with the kids giving mammy a good nights sleep

The earliest texts have humans having a normal lifespan of 70 years

Do the diet and exercise - even if it doesn’t help menopause it will set you up for healthier and more active years ahead of you.

I think with menopause there is a bit of trial and error. I’ve just been reading about controlling cortisol levels through increasing melatonin and reducing stress, to allow the body to focus on oestrogen. The premise is that if the body is making cortisol it’s not making oestrogen.

Around 20% of women will get through menopause with very few symptoms other than periods ending, so it’s hard to tell what actually works.

HRT helps a lot of women, I’m lucky in that diet, exercise and lifestyle seem to be helping me without HRT. I think there is some trial and error involved but as I said at the beginning, taking care of yourself has so many additional benefits it’s a bit of a no brainer.

The theory is that raising children is better with grandparents helps

It IS just a theory! And has been debunked by as many people as those who believe it.

If you look at the average lifespan of women, it's only recently that they lived beyond 50-ish. Of course, many died in childbirth or from diseases we can now control with vaccines or other meds. At the same time, however, although we are living longer, a huge number of people (men and women) have very poor quality of life after 70 owing to multiple chronic illnesses, the majority of which are lifestyle related.

@daisypond I wasn't aware of that. Can you explain why that should be?

Here's example of a research paper about lobular breast cancer, and HRT, it concludes that the biological mechanisms are uncertain www.ncbi.nlm.nih.gov/pmc/articles/PMC4075765/ - on a quick scan it's not immediately obvious what type of HRT they were talking about, but most women in the UK are probably now on the newer forms, which is what the oncologists that we speak to if we've got or had cancer are more likely to be referring to in terms of the changes that they're seeing.

What about start with 2 of the three - HRT and improving diet and exercise?

If you still feel shit after 3 months, there's IAPT and maybe antidepressants if you are actually depressed, rather than it being winter, you haven't been eating well or exercising and you're feeling the effects of not continuing HRT.

So stop struggling and treat it. Historically women didn’t live long enough for it to matter, so I don’t think nature had much of a chance to rectify it. My thyroid packed up due to pregnancy. Also a natural process - often needs medical ‘treatment’.

Studies show the risk is less than being overweight. Or drinking alcohol. I’m working in those two and reckon I’ll have myrick back where it was pretty soon. Plus I can enjoy my life now - that’s worth some risk.

Menopause isn’t an ‘effort’. It’s a system stopping. Nature doesn’t get everything right or good.

I will just say re diet and exercise that when I hit perimenopause I was exercising 4- 5 times a week, a mixture of Cardio HIIT classes, Pilates and Zumba. I was very fit and was lifting weights which is recommended.On top of that I was walking at least 10000 steps a day My diet was no processed food, lots of fruit and vegetables, lean meat and fish. Perimenopause hit me like a train. No amount of exercise could stop me gaining 3 stone, my teeth starting to fall out, anxiety, rage and extreme panic attacks.

So if you have a good diet and exercise already how does diet and exercise help with menopause?

Unfortunately now my only symptom that remains after HRT ( which saved my life) is a total.lack of motivation or drive to do anything. It's horrendous and I've tried so many things to get it back. Vitamin B12, Ashwangha, iron, lions mane, saffron.... I'm hoping testosterone will help me.

That makes a lot of sense, thank you again Jinglingspringbells

Crikey Movinghouseatlast that’s certainly a very clear example of the benefits of HRT. Hope testosterone does the trick for you.

My lack of motivation and drive, having previously been quite a driven person, is the thing that I find most debilitating of all the symptoms tbh.

What makes you think I haven't treated it? I never said I hadn't. God knows how bad it would have been without the drugs.

I hope that you update us in 6-12 months, let us know what you tried & how it went.

How does everyone negotiate this issue?

I can't answer because I haven't had your issues so I haven't had your choices. Sorry, not much help! My situation is "It's not broken so I don't fix it."

Good luck OP, and I hope you manage to find some strategies that help you.

Forgive me if this doesn't apply to you, but I think a lot of us around menopause age have a lot of other stresses - work / kids / elderly parents etc etc etc - that can also cause many of the same symptoms.

Before lots of posters shout at me, this doesn't mean we shouldn't treat menopause symptoms, but I do think in some cases HRT has become another 'mother's little helper' for women who actually have much broader problems.

I know for myself, when as is often the case I'm run ragged with a combination of work & caring responsibilities, I suffer from a lot of things that described in isolation sound like straightforward menopause symptoms. But when things ease off a bit, they resolve themselves & I feel really well.