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 sort of agree. Except there are some things like hot sweats and prolapse caused by atrophy, are blindingly obviously only going to be menopause.

There are some things HRT havent changed for me, such as worrying about things all the time and feeling jumpy all the time. But if I think about it, this is my personality, it just got amplified in the few years before I took the HRT. So it's still there now I'm on HRT and isn't likely to ever disappear.

Oh for sure - lots of things really obviously due to menopause & only going to respond to hrt or other medical treatment like the vaginal cream. Just that it's easy for it to become a catch all for any symptoms, and mean other factors can get lost

I disagree with you. Unfortunately menopause makes it harder to deal with the stressful situations. So everything becomes totally overwhelming rather than being dealt with. I was having panic attacks, explosions of rage and anxiety, and absolute inability to control emotions which made matters worse. Lack of sleep makes all these things much worse.

When my mum died I was pre perimenopause and I was very aware that I was stressed and unhappy but I could deal with it and didn't become a total mess.

What I experienced during perimenopause in a very stressful situation nearly killed me. Lack of sleep, awake at 4am every day, then having to work with stress and anxiety constantly churning was a very different experience and I wish I had asked for HRT at the time. I thought it was all due to the stressful situation I was in.

It's very telling that the peak suicide age for women is 51.

I guess like so many things it varies by person? I was also very overwhelmed / explosions of rage and anxiety etc in my early 40s, & had I posted on here then would definitely have been suggested HRT. They resolved pretty much immediately when I split from my now ex-H (despite a whole bunch of other stressful circumstances).

HRT is only prescribed to women over 45 if they are symptomatic. Under 45 you need blood tests to see if you are perimenopausal.

HRT treats a lack of oestrogen. If you don't have a lack of oestrogen then it won't work. If you were not perimenopausal in your early 40's then HRT wouldn't have helped you and wouldn't have been prescribed.

My inability to cope with a stressful situation was definitely due to oestrogen depletion

I didn't have blood tests, but I assume I was in peri-menopause at the time due to very erratic & increasingly widely spaced periods, plus other symptoms which were resolved with hormone cream. I'm really not anti HRT! I just want to make the point that it isn't a cure-all, & it's important to look at one's life more widely. For some women, other factors may be important & need addressing.

I've just got back from my gp appointment to ask for HRT. He wants to do a load of blood tests first to rule out thyroid, B12 deficiency etc . I'm 59 and I guess it's good that he's being thorough but I was so hoping he would just let me have it. I honestly can't cope with feeling so foggy and out of it, it's affecting my work because I can't remember things.

Following this with interest. I have an appointment to see a private gynae next week who is apparently open to HRT. (I live abroad and most drs are set against it and I dont know anyone who is actually taking it here). I feel desperate tbh. My job and my relationship both rely on something getting better. I am not surprised that 51 is the age where suicide is higher risk for most women but it is oddly comforting. Maybe things get better! I can't concentrate, can't sleep, can't remember anything. My joints hurt to the extent that I have become less mobile and am doing less exercise than I was a year ago. My hair is falling out. My teeth and eyesight are getting worse. I am dizzy and tired. I can't remember the last time I laughed or had fun. I must be a bundle of laughs to be around at the moment....

At 59 it’s likely that you are post menopausal. Your GP is right to investigate your general health thoroughly . It would throw up a few red flags that you have pretty much gone through peri and menopause without too many problems but now present post menopause.
I spent two years thinking my menopause symptoms were deteriorating when in actual fact it was vit b12 deficiency and the onset of cancer. After surgery to remove my tumour I felt like a new woman, so much more energy and motivation physically. Unfortunately just as I got my mojo back I had radiotherapy. Combined with Anastrazole I’m now knackered. I have 3 more years of Anastrazole, once I finish taking it I should feel a lot better.
I was post menopausal at diagnosis of cancer so I had a glimpse of what it would be like without the Anastrazole. I can’t wait for October 2026.

@Angrymum22 I had a few years of night sweats which have mostly gone now . I didn't think about the cause of my brain fog being anything else but the menopause tbh .
I hope you keep well and get your mojo back.

Thank you for the good wishes. I will return and update!

And no flaming here Sadik I think you make a very good point as many women my age are juggling teens and young adults, a job, and elderly parents. That isn’t the case for me though, I am freer now than I have ever been parenting wise, my parents and in laws are dead, and I work fewer hours too. So I have no reason to be stressed.

Noted about possible B12 deficiency- thank you to those who’ve mentioned that!

You have my sympathy Cappuccinfortwo I could have written your list of symptoms!

I feel completely normal on my HRT. Loads of energy. Skin and hair still good. Upbeat and happy. They’ll be wrestling it out of my cold dead hands if they try to take it off me down the line.

Louise Newsome, in case no one has said.

I just came off for a week to see what happened. Could barely move. Not exactly nimble on it but feel like Simone Biles now I'm back on it, in comparison.

I’m under 45 and have been prescribed HRT. The doctor did blood tests first to rule out other things but all came back normal. They didn’t check hormones as they said they wouldn’t get a true picture at this stage as my hormones would be all over the place. I have been prescribed combi patches as I still have my womb but I haven’t used them yet. I’m still doing my research and find threads like this really useful. I have hot flushes, poor sleep, anxiety and mood swings more than ever but I’m concerned about the cancer risk.

Newson.

in case anyone Google’s her!

Thank you for clarifying.

She is massively active on tv, radio and sm atm isn’t she?

I have to adopt a rather critical and cynical approach for my work so apologies if this sounds a bit harsh bc I obviously don’t know her at all, or her intentions, and she seems very genuine.

At the same time many campaigners with a huge sm presence, who broadcast frequently on radio and tv, are often not short of a buck.

Having said that, I think we are all very grateful for the very important role she has played in highlighting the issue of menopause.

Again, as an ordinary person, it’s difficult to know which advice to follow? Most people will say “your gp is trustworthy” and most are, but they are also hidebound by lack of resources and time constraints.

So all of the above adds to the confusion about where to go for objective advice?

PS I think a poster on this thread posted very positively about their experience at her clinic.

@Stridingthroughtheglade There is masses of objective advice- or rather, science. If you are unsure, have a read of what's out there.

You can read the info on the Women's Health Concern, which is a sister site of the British Menopause Society, and also Menopause Matters, run by female NHS consultant Dr Heather Currie, awarded a MBE for her work in menopause.

Just because someone ( a dr) offers private menopause care, it doesn't mean they are not being honest about benefits and risks.

Her clinics are full because so many women were, and are, getting no, or terrible , responses from GPs about menopause and being refused HRT.

She's made it possible for a lot of women to get help which they were denied.

I think that at this point of her career, money is not the driving factor. Her husband is an NHS consultant.

Just try HRT for 3 to 6 months and compare how you feel then. If there is improvement in your symptoms, stay on it.
8 years ago I had very similar symptoms to you and I reluctantly went on HRT. I've never looked back.

Thank you for your pointers to the science, that’s very helpful indeed.

Yes, I totally agree that she and her clinic are filling a massive need. Women’s health in general is a very poorly researched and resourced area of medicine. And good for her for setting up a private clinic. And as I said previously, she appears very genuine.

The problem is, so does my gp who I have known for half of my life, who offers me ADs instead of HRT. She’s a really excellent gp in all other ways: professional, trustworthy, hard-working, goes the extra mile in a crisis. So who do I trust?

My point is that, in this world of conflicting advice, it’s very difficult for the lay person to know what to do for the best.

Yes if I’m not deemed too old I will try and give it a go.

"My point is that, in this world of conflicting advice, it’s very difficult for the lay person to know what to do for the best."

You see, this is quite a new phenomenon. Until quite recently we'd have done what our doctor told us but now attitudes have changed and patients are expected to give informed consent, which is good if you can get the info but in myriad cases you can't know the pros and cons for your exact situation.

I am peri and suspect my life would be improved by hrt but I know I react badly to hormone treatment and think I'll go insane if it takes ages to get right so I'm staying off it unless my symptoms get bad (really OK right now). But then I worry I'm missing out on the protective side. But then have to balance that with health risks. It's just impossible.

I do agree with pp, you could just try it for a few months.

There is absolutely no reason why you can't be on it whilst your doctor also investigates vitamin deficiencies and thyroid issues either.

Maybe she's just not as clued up on the menopause as in all other areas of her work? I'd go with the specialist advice tbh. I'm on HRT, have been for about 3 years, made a good difference, not totally life changing but certainly enough to make it worthwhile imo

The problem is, so does my gp who I have known for half of my life, who offers me ADs instead of HRT. She’s a really excellent gp in all other ways: professional, trustworthy, hard-working, goes the extra mile in a crisis. So who do I trust?

Maybe it's not about WHO to trust but WHAT to trust?

You should trust the science. Not one individual doctor who you like.

If NICE decided 8 years ago (after years of consulting with specialists and looking at evidence) that ADs were not appropriate (and rarely work if it's a hormonal issue) then you should trust them.

Most GPs are very behind the times on menopause and HRT. Not all, by any means, but very few appear to take up the professional development courses that the BMS runs (online) throughout the year at a very low cost.

I'm not personally taking hrt, my feeling is that putting artificial hormones into your body is not a great idea except in exceptional circumstances (eg premature menopause or sudden due to surgery, then weaning of gradually). I'm a few months since last period now and all is fine. Perhaps I got lucky, perhaps it will all go downhill at some point but the meds I am taking is a multi vitamin and mineral supplement

I take HRT for symptoms but also for the longer term protective benefits.