Can menopause just happen with no symptoms?

[OraclesandOmens]

I only just noticed it’s been about a year since my last period. I’m 50. I have been taking the pill, but there are no bleeds between breaks. My boobs are bigger but otherwise I don’t have anything else different. Would this count as being in menopause? Should I just go straight into HRT and can I stop my pill? The only other possible symptoms are interrupted sleep and tiredness, but I’d put both down to work stress.

Ive read very little about menopause. Did anyone else get it like this, and is this even it?

Yes - the vaginal cream is something many women could take - perhaps it should be a Mumsnet campaign!

Totally agree! The vast majority of very old women suffer from regular UTIs which have a strong correlation with vaginal atrophy and yet as far as I know, there’s no push to prescribe topical oestrogen to address it. Instead it’s antibiotics

Yes a no / very low symptom menopause can happen . It happened to me after years of bad PMT . I’m a different person It’s like a bird being let out of a cage . Goodbye periods . Thank god .

Lucky you!

I do t think you can say you’ve gone through it while you are taking the pill. Why not come off. ( use condoms) and see if they restart. I’m 54 and mi e stopped at 51. A few hot flushes for a few months but otherwise great. No HRT but have started the vaginal oestrogen in the last year as a protective measure against vaginal atrophy.

Agree!

Older women especially in care homes seem to suffer a lot and it can be fatal if it spreads to the kidneys.

Vaginal estrogen should be almost mandatory- like using hand cream- as it's so weak and safe even in your 80s and 90s.

I had no idea VA was a thing to look out for. Off to google.

IME GPs are not very knowledgeable about thus aspect of menopause. For example, it seems to be well known that you can use vagirux more than twice a week, but trying to get my GP to prescribe that is impossible because it's 'not in the BNF'.

I've had to buy some more privately.

I really think the genito-urinary aspect of menopause would be a great @mumsnet campaign!!

On reading (skimming) an nhs page, it seems you can’t take any creams etc if you have any history of blood clots, spotting, cancer which would mean they are unsuitable for a lot of older women.

Me neither. It's often euphemistically referred to as 'dryness'. In fact that's what the gynaecologist said she could see when she did my hysteroscopy and I just thought, but I dont feel any dryness so maybe I will ignore this.

It was only when I received the letter she wrote to my GP that she called it VA and my eyes nearly popped out.

I really, really wish Dr's would not use euphemisms with patients because it can be very confusing 😒

There is no risk of blood clots or increased risk of breast cancer when using topical oestrogen. It’s a tiny dose with little systemic absorption.

As Dr Paula Briggs mentions here, there are very few women unable to use topical oestrogen

https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

edit - have attached a couple of videos from the British Menopause Society and vaginal atrophy/cancer, which might or might not show at some point, but can be googled on YouTube

I thinks that's just systemic hrt. Creams and pessaries for VA are local application only.

I’m a similar age to you, op. My periods stop on the mini pill but come back (after a few months) when I stop taking it. My gp says that’s common for older women on the mini pill. So you may have gone through menopause or you may not- while you’re taking hormonal contraception it’s not possible to say for sure and the “no periods for a year” rule does not apply. Therefore the advice is to carry on until 55 (or stop and see what happens, but would suggest condoms in the interim).

https://patient.info/sexual-health/hormone-pills-patches-and-rings/progestogen-only-contraceptive-pill-pop#does-the-progestogen-only-pill-stop-periods

Sorry I think my understanding was they were in advisable if you had any blood clots, thrombosis, stroke/tia, cancer history, not that they caused them.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/vaginal-oestrogen/who-can-and-cannot-use-vaginal-oestrogen/

Yes. It used to be called ‘an easy change’. My cleaner had one, she just didn’t understand ‘what all the fuss was about’ 🤷🏻‍♂️

I’ve known several people who have sailed through, they usually have healthy lifestyles though like don’t drink, exercise etc

I had a Mirena coil and so no periods. I got to about 55 and assumed that I was probably in menopause. I've had no symptoms apart from VA - nothing. It's just a wee bit easier to put on weight, but I haven't really had a lot of trouble losing it when I've wanted to. Never bothered with HRT, thought I'll leave it for those who need it, although I've just ordered myself some Gina to try to sort out the VA, which doesn't trouble me too much but I reckon it might later.

Not everyone suffers dreadfully. Some of us just get lucky.

To be honest, the NHS website is sometimes out of date on things.

I suspect they may be using the guidance that applies to systemic HRT rather than topical estrogen - because the leaflet in the packs for vaginal estrogen contain exactly the same information that's in systemic HRT.
Consultants have been trying for years to get this changed.

What's on that link is not correct. There are some women (very few) who are not 'allowed' vaginal HRT after cancer, but that's quite unusual and discussed on an individual basis with a team of specialists.

The people who write info for NHS websites are not necessarily doctors or specialists.

Oh not this myth again! Lifestyle helps but there are plenty of women with super healthy lifestyles who have menopausal symptoms.

I think most of those symptoms mentioned would be rife in older females so that’s probably why it’s not pushed for them. The page is focused on oestrogen cream/pills for vaginas not other HRT so presumably was written with that in mind.

Quite. I know someone who sailed through menopause who is overweight and does fuck all exercise

diet & lifestyle & exercise will help but the idea that everone who struggles with menopause is an overweight alcohol guzzling couch potato is nonsense

Did you read my post?
The misinformation on vaginal estrogen is because the person who's written the info has relied on the list of side effects of systemic HRT. The leaflet in vaginal estrogen products is identical to the leaflet in systemic HRT (in terms of side effects and risks.)
This is a manufacturing mistake and many consultants are on record (Youtube) saying how they have been trying for years to get this changed.

It's also not true that 'older females ' (by which you mean over 50) all have those conditions.

It's not 'pushed' (offered) because many women aren't educated on vaginal atrophy - which is now called GUM- genitourinary symptoms of the menopause - and neither are many GPs.

Yes, my periods spaced out ( which took my a while to realise) and then stopped, that's about 4 years ago and the only symptom I noticed was that for a couple of months I got "hot flashes" - very brief about 30 secs long a couple of times a day which I actually enjoyed. I also assumed that I would take hrt but don't see a reason to at present, I would like a dexa scan to check on bone health but no idea how I would go about this, assuming privately.

Just google dexa scan near me.
Start with local private hospitals, but you may have to travel into a city.
Get a proper scan of your spine and hips, not a heel one which is a cheapo thing and not accurate. They cost around £200 and need doing every 3 years unless you've a problem and need doing more often.