Post menopause and hot flushes

[Isabelle70]

I am post menopausal for about 2 years or so, have the mirena coil for post menopausal bleeding.
To date no symptoms apart from weight gain.
The last few months have been suffering with hot flushes at night waking up around 3 times. I did think it was because of the heatwave so have changed bedding and sleep wear, still waking and getting them in the day as well.
I have visited the Dr and she has suggested doing more exercise, drinking no more coffee, and drinking peppermint or other fruit teas.
I left feeling deflated, I only have a couple of coffees, I enjoy them and feel cutting them out, will have no enjoyment day to day. Is this what life will be like now, not able to have anything you enjoy?
She said try this for a few weeks and then go back.

Is there a reason why you aren't considering HRT or your GP isn't suggesting this?

You say you have the Mirena for post menopausal bleeding.
Can you explain a bit more? Sorry in advance for asking questions but trying to understand why your GP isn't suggesting HRT.

Being prescribed a Mirena coil for bleeding post menopause usually means you had a diagnosis of endometrial hyperplasia.

Were you investigated for that with a scan and biopsy for your post meno bleeding?

How long ago did your periods stop before you had post menopausal bleeding?

Only reason for asking this is the usual treatment for hot flushes would be HRT - you've already got the coil which is the progesterone part so you'd only need to add a form of estrogen.

Have you asked for HRT? Symptoms don't stop post meno- many women have symptoms for many years and use HRT right through to their 70s and 80s.

Maybe if you can give a bit more background to where you are, we can help.

The Dr wanted me to try other alternatives rather than medication straight away, if felt like too much medication can be issued. I did ask for HRT.
The post bleeding was a couple of years after periods stopped, I had internal ultrasound, biopsy and something else. Was all completed under private healthcare.
This Dr can be good and sometimes bad, we do have a menopausal clinic at the surgery so I will look for an appointment in a few weeks, should be more helpful.

So when you had a biopsy was anything found? I don't quite understand why you had a mirena coil fitted. It would only usually be fitted post menopause if you had a thickened womb lining or as part of HRT.

Sorry but your GP's behaviour is not acceptable.

Suggesting you reduce coffee from 2 cups a day, drinking fruit teas and exercising is not good practice. It is unlikely it will treat hot flushes.
Lifestyle is important - the exercise- but if you want HRT that's your choice.

YOU asked for HRT.
It's not your GP's choice to let you have it when they decide - unless there is a medical reason why it's not suitable.
There is no such thing as too much medication if you need HRT.

will you go back and say you want HRT?

The biopsy was clear, and I did have a thickened lining twice so the consultant fitted the coil.
I agree, the Dr was dismissive, stop the coffee and have fruit teas and read the NHS website. I left the appointment and went back to work feeling defeated thinking that’s it.
I really don’t want to be waking of a night as then I start thinking of work which is very stressful, but that’s another issue!
I have a new duvet, all cotton and 2.5tog. The windows wide open and fan on and off all night.

Jfc. Some doctors are a nightmare op.

Go back. Don't ask. Tell them you want HRT. You only need oestrogen patches or gel to work alongside your mirena.

Start at 50mcg/2pumps. I bet you any money your sweats will stop. If they return, go up to 75 patch/3 pumps. The total joy of mirena is that you don't need any additional progesterone.

I'm on 100mcg patch and mirena and it more than controls my endometrium (scan at start and scan last week 2yrs later showed nice thin lining).

Good lord. How are intelligent doctors still coming out with this shit.

And fwiw I have a brilliant diet and have always exercised regularly. Weights and yoga etc. And I was still waking up absolutely drenched three times a night.

I started HRT in my late 50s for this reason, I had my old Mirena removed at 10 years old and started getting hot flushes, went onto 2 pumps of estrogen gel and a new Mirena and it stopped almost overnight.

Do you have a docto at your surgery who specialises in Women’s Health /Menopause? Most GPs seem to know little

I’d say you should try HRT - as others have said you have the Progesterone so you just need some Oestrogen prescribing as a starting point. I have Lenzetto - it’s a spray which absorbs really quickly.

Try that first and it should ease your hot flushes . You may need to tweak the dosages- and may need to add some more Progesterone too as despite the Modena protecting your uterus it doesn’t supply a lot of Progesterone to your circulatory system and you may be low in that hormone too.

There are some good groups on Facebook with in-depth info on this

Yes, there is a menopause clinic and I will look to book an appointment there. The Dr I did see does have an interest in women’s health and fits coils and implants so I thought she would be helpful.

To add - many people (including GPs) believe that once you are post menopausal then it's all over. It's not - your body will now ALWAYS be low on the hormones that you had before. It's not a linear progress either - levels will fluctuate somewhat but always heading down..

I have read up quite a lot on menopause, and done some training courses so I think I know enough to at least sort my own issues.

If you think you don't want to take HRT- then consider the impact on your health in later life. Women become significantly more likely to have heart problems as the protective hormone, Oestrogen, is no longer available. Bone health, cognitive issues, joint troubles - all can be helped by taking the hormones. Of course we also need to be watchful of diet, and take appropriate exercise.

It's a whole new body you are dealing with now.