Argh, what now?

[SnailMama]

I am 38. Since I had my son five years ago my hormones have been crazy but it has become so much worse in the last two years. I had no period three years after giving birth then it came back and it was crazy. I thought it had to settle but it got to the point of nearly daily bleeding. I had tests and scans and was told all was fine but likely perimenopause (last bloods were 2024). So they gave me the hormonal coil for progesterone and gthen several months later, put me on HRT for three months earlier this year, however nothing changed and they took me off it, cold turkey. I was fine, but six weeks later I am a total wreck. My chin is covered in painful acne, I cannot sleep, I am crying all the time, I am stressed, my diet and eating habits are weird and I have terrible brain fog. I have had insomnia all my life but this is a different beast. I feel like I am underwater every day. The periods have settled into weird and sporadic, not daily bleeding but random bleeding with no reliability at all. So just to make it clear - I have been on the coil for nearly 9 months, then on HRT for 3 months, then off HRT for a month and a half

What do I do here? Do I need to wait longer for my hormones to settle? Should I ask for more tests? My doctors have been mixed, some have been supportive, others (okay the males) have been wankers. I spoke to my doctor and she gave me amitriptyline or my sleep but holy shit its not good. I am not coping.

I think you've had very poor treatment.

You say 'they' took you off HRT.
Why? Was it not a joint discussion and agreement? You say you were no different but maybe you need longer on it and a higher dose.
what estrogen were you on? The guidance is if after 3 months you feel no better, increase the dose or try another type (eg gel not patches or patches not gel.)

If you have all the signs of peri like irregular periods, then you should stay on HRT. Just go back and insist you want to go back on it but think about the dose- were you on gel or patches?

It was a patch but I can't for the life of me remember what they were. I hadn't completed the course, I ended up throwing a few away. They just suggested I come off so I accepted their suggestion. They said that they felt the coil needed longer to work and I guess from a period perspective, it has, because my periods have settled to a degree, they're random and sporadic but not a daily occurrence. So in their perspective, I guess it has worked? But I feel horrific and I can't tell if this is just everything balancing itself or if I need the HRT longer. I am very confused.

What you need to think about is your bones.
This is why HRT is advised for women with early menopause or who miss a lot of periods before age 45.
Missing periods for 3 years in your 30s will already have increased your risk of osteoporosis a bit and if you are having irregular periods now you may not be ovulating each month- which means your estrogen is low.
This is a risk for your bones and you don't want osteoporosis in your 50s.

Your own hormones won't balance themselves- they are only going to fall as you get older.

Maybe your GP can refer you to a consultant experienced in early menopause and they can be more proactive about HRT? If not, try HRT again but do it properly which is 3 months on a dose / type then increasing if it's not helping- this is standard NICE guidance and your GP ought to know that.

Fuck, I didn't know this. My grandmother suffered from osteoporosis, it wasn't nice. She had thyroid issues though.

Okay, I will contact my doctor surgery again and ask to speak to someone. They told me two years ago I had been put on the waiting list for gynecology because I went through a period of severe vaginal dryness but the appointment never materialised and thankfully, things seemed to balance themselves out. I've been a wreck since I had kids and I guess that is what I was hoping, that I was just seriously disrupted in some way. But I guess five years is a long time for that!

See your GP and insist on estrogen to go with your coil.

Expect to have to do some tweaks to get the dose right but stick with it.

Estrogen Gel is better than a patch because you can increase the dose yourself without getting a new prescription and new patches.

Okay thank you, I will make a request now. I heard a while back that doctors aren't required to study women's health but they really should be because its a fucking nightmare at all ages!!!

& uou should almost certainly be on topical estrogen/pessaries with any dryness

The dryness went away which is another reason why I think they felt the coil would be enough

The coil doesn't help with peri menopause except for controlling bleeding or as contraception.

Ah okay. Well I have no idea then! I feel like I’m on a merry go round of things, some getting better and some worse!

You say the dryness went away- did they check you for cervix polyps? They are slimy little buggers and can mask vaginal dryness as well as cause loads of bleeding.

Yes they gave me an ultrasound and did a thorough check, I can’t fault them for that. Everything is fine in that department. They did a blood test for hormone levels but apparently they’re pointless because levels fluctuate so much. Results were all good though.