Early menopause and poor symptom control

[TulipsAndZombies]

I’m 41 and have been in early menopause/POI for two years. I’m on evorel 100+25 oestrogen patches (higher than usual) and a coil. I have very poor symptom control and it’s is ruining my life.

I can’t sleep, am exhausted, brain fog, major palpitations and hot flashes much of the time.

I eat well, healthy weight, regular exercise, supplements, limit caffeine, no alcohol.

My GP referred me to nhs specialist clinic, waited a year for this and it was so incomprehensibly shit that I’ve cried for hours. They wanted to reduce my HRT to 75mcg patch, despite my oestrodial levels been ~300 (low). Consultant then agreed she wasn’t the best to talk to about this as it was a bit outside her expertise. For context, I’m also a consultant and would never see someone if they were too complex for me, I’d always refer them to a specialist colleague. Anyway.

I just don’t know what to do. I can’t work like this and am reticent to go to newson health as there seem to be concerns about her prescribing, but at the same time I feel like I need it

Have you tried gel instead? Some don't absorb patches that well. Just trial and error.

In early menopause it is often progesterone and testosterone which fall off first. Have you tried utrogestan rather than the coil? Also have you had your testosterone levels checked? I have POI and testosterone has really helped me, I read this is often low for POI.

I would seek private help, it does not need to be the Newson clinic.

I wasn't absorbing well on patches (shown in blood tests) and was switched to gel. Apparently it's common to get on better with one than the other so unless I'm missing something it doesn't seem like this would be beyond the grasp of a specialist.
I'm so sorry, it's horrible isn't it?

Thanks both, have tried the gel, spray and tablets before. Struggle to get symptoms under control with max dose of any of them.

I’ve tried testosterone previously from Superdrug and wasn’t mega low (1.4 maybe?) and then when I used it my vagina did some interesting things so it scared me off it! I know I should try again though.

I’m booked into to see someone privately in a couple of months now

I'm also a consultant. I didn't want to go to Newson but there are multiple other menopause clinics available.

I went with Spiced Pear Health and would be very happy to recommend them.

Or look at the BMS list of qualified clinics.

Yes probably a bad idea to use T on your vagina. I use a very small pea on my foot to keep it well away from everything! You need to look at the level of free testosterone (in case your SHBG is high which will affect utilisation).

Oh I didn’t put it on my vagina 😂 I just meant it got very plump and red and I wasn’t quite prepared for it. Maybe that’s what it should be like, who knows.

I might try putting it on my foot though, hadn’t thought Of it.

Thank you @AnnaMagnani have found someone from that BMS list, fx!

After reading an article, I got my GP to prescribe citalopram off licence. It's an antidepressant but if you aren't depressed it damps down night-time hot flushes in an almost miraculous way. If you are depressed it doesn't have the same effect, apparently. I took the minimum dose for a couple of weeks then chopped the tablet in half. From the second night I slept properly. I was early 40s too.

@muddyford Did you have any side effects with citalopram? I'm post menopausal, can't have Hrt ( secondary BC) and on hormone blockers. I'm feeling ruined. Hot flushes/ sweats each and every night.

Thanks.

None at all. Was incredible.