I'm going to the doctor his week. I dont know where to begin!

[notacooldad]

I started the menopause about 2.5 years ago. I had patches.
They eased some of the symptoms but not all but it seemed good enough at the time.
Currently my worse symptoms is vaginal itching at night and first thing in the morning.
I stopped patches about a year ago. I thought I was done with the menopause but the itching still continues. I have been given creams but nothing has worked. I've been checked for infection or other issues but there isn't anything.
About 2 months ago menopause symptoms seem to have started again. I'm having mood swings, not had a full night's sleep in months. The worse thing to return is the brain fog. I forgot about something at work and it caused a serious issue. I have no idea why I forgot. It's set off disciplinary action. A week later I made another mistake. This is a job I know like the back of my hand and have been doing gor years.
The only thing that seems to have gone away is anxiety attacks that I had but Ive gone the other way of not caring about much!.
What on earth is going on with me?
I guess I need some treatment but I don't know what to ask for. Im feeling pretty miserable 😕

Why did you come off the patches? HRT delays the onset of menopause, so you will go through the process when you come off it. Naturally, hormone residue is in your system when you first stop HRT, but gradually all the symptoms come back. Unless there is a strong medical case for staying off it, go back on the HRT and perhaps get some topical remedy for the itching?

Unless there are solid medical reasons not to, you probably need to go back on HRT and have vaginal pessaries to prevent atrophy (should help the itching). It's fine to stay on it as long as you need.

Why did you come off the patches? HRT delays the onset of menopause, so you will go through the process when you come off it.

This is a myth and Dr Louise Newson has a Q&A on this.

https://www.balance-menopause.com/menopause-library/hrt-in-later-life-or-after-menopause/#:~:text=Many%20women%20think%20that%20taking,This%20is%20not%20the%20case.

Does taking HRT just delay the menopause?
Many women think that taking HRT just delays the natural duration of the menopause in your body. This is not the case.

If your symptoms return when you stop taking HRT it is not because you have been taking hormones, this is because you would still be having symptoms of the menopause at that time even if you had never taken HRT.

An untreated menopause can cause symptoms for many years; the average length of time is around seven years but for many women, symptoms can last for decades.

In peri, symptoms can come and go for years. After your last period, some women have menopause symptoms for decades (see above) or for ever. You never get your estrogen back again, and although some women feel no effects of this, many do.

I have been given creams but nothing has worked.

Was it Ovestin? Or Vagifem?

Did you use it as directed- 14 days every day then at least 2 x a week after that (forever- or symptoms will come back, just like your hands get dry if you don't use hand cream.) It can take months or weeks to have maximum effect, then you need to keep reapplying it.

@JinglingSpringbells
I've never understood this though.

If the symptoms are caused by dropping hormones then why wouldn't you get them when you stop HRT. Surely at that point you are back to dropping hormones. How would you not have symptoms ?

I came off the patches because it was getting more and more difficult to get a doctors appointment and they wouldn't do repeats and after a while I though because of my age I the menopause should have epassed. Im 59.
I've had topical creams and so far nothing seems to make it subside.
I'm fine in the day, it's night time and morning. I've woken up in the middle of the night with ' the itches'
I ca t remember the name of the cream. However I took it as directed and set an alarm on my phone so I didn't go out of synch with my timings.
Thank you for the replies.

There's a difference between what @mugglewump said originally and what you're asking now. She said HRT 'delays' the menopause. That's not the same as symptoms coming back after stopping hrt.

Nothing can delay the menopause as the definition is 'no more periods' (no more eggs in the ovary.) HRT doesn't delay that.

HRT can alleviate the symptoms of loss of estrogen. For some women the symptoms last a short time ( a couple of years) but for others they last 20 years or more. I've been told there are women in their 80s+ still with flushes and sweats. With HRT the test is to stop using it (if you want to) and see if you still need it to control symptoms or for other reasons as a treatment for bone loss.

I came off the patches because it was getting more and more difficult to get a doctors appointment and they wouldn't do repeats

HRT needs an annual review after the first review at 3 months. This is in the prescribing guide for GPs. You should be able to get 3 or 6 months of it on a prescription. If your GP wasn't doing that, query it with the practice manager.

@JinglingSpringbells
I'm still not understanding nor has anyone ever been able to explain clearly WHY symptoms don't start once you go off HRT.

The symptoms occur because of a loss of hormones. Replacing those hormones therefore halts the symptoms. So when you stop and those hormones once again deplete why wouldn't your body go through that period of low hormone symptoms again?

Everyone is different. There are loads of women on this forum who say they have never had any meno symptoms either in peri or years into post-menopause.

Some women have flushes, some don't , some last for ages, others hardly at all. All our bodies are different in the way they react to loss of estrogen.

I assume that some women find that their bodies gradually adjust to less estrogen over time. But how long that takes varies hugely from 2 years to 20, to never!

The advice with HRT is to have a break from it to see if you still have symptoms but to give that trial at least 3 months. If symptoms are there, re-start it if that's what you want to do.

Look up Lichen Sclerosus- this causes Vaginal itching.