Officially perimenopausal, what to expect!

[CVVFan]

I got the full whack, vaginal oestrogen, the gel type too, and progesterone.
my main symptom dry skin and vaginal
dryness. Oh and cycles have become shorter.

How come you bothered to get diagnosed if these were your only symptoms? (Was it part of a wider health check?)

Because the vaginal dryness (and perianal) has made my life unbearable (at times) - can’t wear underwear nor jeans.

and I’ve gained weight no matter how hard I try to shift (and I haven’t changed my diet nor my exercise levels).

Ah that sounds rubbish. How old are you?

I am pretty sure there will be people along shortly to say "WELCOME TO HELL THIS IS YOUR LIFE NOW" etc etc but imo they are drama queens/hormone trolls.

I just turned 41, but the symptoms (along with cycle fluctuations) started just before I turned 40

Interesting!

Your GP has been very cooperative as there are loads of posts here from women your age you are refused HRT as 'too young'.

It's more usual to start with topical vaginal estrogen and see how that works after maybe 3 months (it can take that long or longer.)

I'm usually very positive about HRT but I think at your age and with very few symptoms, it's maybe starting systemic HRT a bit too soon? The downside is you may experience more side effects from that than the symptoms you have.

You might be better off trying a lot of lifestyle stuff (diet, exercise etc)
HRT won't necessarily help with weight loss unless you also change what you eat, how much you eat and increase exercise.

But there’s not much more I can exercise! I’m already training for Hyrox (think at least 2 hours of intense running/ spinning + 3 more hours of threshold/ base) + 3 hours of strength training.

I went to a dietitian and have upped my protein and fibre, but I still gained weight, and eat at a deficit. My thyroid is under control so it isn’t that.

I was surprised about giving me the whole whack, I genuinely only wanted the vaginal oestrogen, but a couple of the American doctors I follow seem to think early HRT is not a bad idea.

but a couple of the American doctors I follow seem to think early HRT is not a bad idea.

Are you in the UK? Did you see an NHS GP?

The US has a totally different approach to HRT and on the whole they are less enthusiastic over it.

I genuinely only wanted the vaginal oestrogen,
You don't have to use it if you don't want to- your call.

'Early HRT' is only really necessary for women with premature or early menopause - ie periods stopped completely before 40 or 45. OR when symptoms become so bad they affect sleep, quality of life etc.

AS I said, there's nothing wrong with starting HRT if you need it but it might be overkill at the moment and you have to balance any side effects you may get from it against the benefits.

I’m in the UK, but I’m American so even after almost 18 years over here I still look for both sides of the story.

I think my skin problems also were misdiagnosed 3 times, so I guess that helped with them giving me HRT. But because it’s also pretty bad around neck, eyelids, and thighs they told me local
oestrogen wouldn’t help much with that.

Yes, I saw an NHS GP.

I think my skin problems also were misdiagnosed 3 times, so I guess that helped with them giving me HRT. But because it’s also pretty bad around neck, eyelids, and thighs they told me local
oestrogen wouldn’t help much with that.

Have you had a diagnosis of the skin problem?
HRT isn't prescribed for dry skin.
You might need a more specific diagnosis from a dermatologist.
Eczema? Psoriasis?

well a dermatologist (via photos) because I couldn’t get an actual in person referral said I had psoriasis.

(before I was told by GPs I had LS and another one said I had eczema).

so the psoriasis treatment kind of got a lot under control apart from the vaginal/labia and the perianal area kept getting flare ups.

after getting fed up I’ve had better luck with lube and Vaseline before I exercise but the dryness in the outer labia is still hard to manage.

my eyelids respond much better to Charlotte tilbury / Dior cream than what the dermatologist prescribed.

so I’ve concluded it’s simply just dry.

Here's hoping it works for you and you feel much better :)

Thank you! If I’m able to wear jeans again without dreading I’ll get a flare up, that’s a win in my book!

So seems two different things - dry skin and irregular periods. Must say I never heard dry skin was a symptom of menopause (I mean your skin gets drier with age but as you have been helped with yours by non hormonal treatments maybe it’s unrelated). Have you had the blood test etc that say you are in peri? You seem in the young side are they sure there may not be another cause to your irregular cycle? As much as I respect the NHS they do seem reluctant to refer to someone more knowledgeable about this than a GP.

But there aren’t really tests for Peri are there? Everything I’ve read and heard (from medical professionals) is that it’s symptom driven.

Dry skin is certainly a symptom: https://www.dermcoll.edu.au/wp-content/uploads/2022/05/ACD-FAQs-Perimenopausal-skin-April-2022-.pdf

You're not too young for peri OP. Dry skin and vaginal irritation are definitely symptoms. Hormone blood test results would be useless so your GP has done the right thing in diagnosing based on symptoms. Congratulations on having one of the few GPs who are actually following the NICE guidelines!

I started HRT last year at 44. It took a good 8 weeks to kick in, but I'm feeling about 90% better than I was. No side effects at all. Managing your diet, sleep, exercise absolutely essential as well but it sounds like you've got that all covered. There are long term benefits to starting early as well, like reduced risk of cardiac disease and osteoporosis

There's a great free app called Balance which you can use to track your symptoms, sleep, and other lifestyle stuff

Thank you! Previous posters were starting to scare me!

Although my symptoms are definitely more low oestrogen related than progesterone.

Yes it usually is the fluctuating oestrogen that messes you up and causes the symptoms. The progesterone is to protect your uterune lining from thickening and increasing risk of cancer

Like any new medication, it can take up to 12 weeks to feel the effect so stick with it and good luck!

But there aren’t really tests for Peri are there? Everything I’ve read and heard (from medical professionals) is that it’s symptom driven.

Blood tests can be done in women under 45 but this is mainly to check there is nothing else causing similar symptoms. The tests include an FSH test but it must be done on certain days of your cycle, for an accurate result.

NICE guidance is not to do them in women over 45.

Well we know for certain it isn’t any vitamin/iron deficiency nor my thyroid. So at least from a deduction pov it does point at peri