Hrt choices....I'm lost!

[DaringDaisy]

Desperately looking advice on Hrt. So today I took the leap and went to see my GP after months of awful menopause symptoms, I really have reached a breaking point. I think they will prescribe me some Hrt medication, the GP is ringing me tomorrow to discuss my options. Can anyone advise me on what works for them, any advice would be appreciated. For context I'm 48, last period several months ago, and the one preceding that was also several months ago. Apart from hot flushes I have everything else: insomnia, loss of joy/low mood, very tearful, completely lost any sex drive, thinning hair, very painful lower limbs in the evening.

What advice would you give? What medication would you recommend?
Thanks for any help and guidance.

I like the patches, you just change them over twice a week, and check after swimming or working out that they are still there. I think they are lower risk and easier on your system than tablets.

Some people will notice a difference in symptoms the first week, others will take a bit longer. The GP might have a preferred patch type, just go with what they suggest and you can always try another type after 6 months if you need to.

I have

1. oestrogen patches - the gel didn’t work for me - patches 75mg - helped with joint pain. And hot flushes night sweats - note the lower dose patches didn’t work
2. esteogen vaginal tablets - dryness
3. Mirena had for decades
4. progesterone bio identical - as I had symptoms of low progesterone without it - not technically needed due to Mirena (headaches mostly and insomnia)
5. testosterone for libido / mood - one bottle tostran lasts for 8 months and I get annual blood test

hope that helps

Its really difficult to say. For example some people love patches, others hate them and prefer a gel. Your GP should talk about your lifestyle factors, etc to help you make an informed choice.

Get watching/ listening to a few podcasts. Have a think about your routine daily application vs every few days, transfer risk etc.

Hope you get a good GP and it’s the answer to some of your symptoms.

I’ve not regretted, I could feel some benefit within a week. Keep in mind it’s a marathon not a sprint it can take time to find the right dose and type for you. Good luck

I prefer patches to gel - a quick change twice a week, easy to take with you if travelling vs gel which has to be applied every day and you have to wait for it to dry - a pain if you have to apply it to both arms and both legs every day.
Mirena coil - lasts for up to 5 years, no having to remember to take tablets but best of all is no more periods.

It took about 2 weeks at most for me to feel like I was waking up from a bad dream and realising this was what 'normal' felt like.

Well done making a start with HRT, the symptoms of menopause are so debilitating. For me, I started age 49 (now56) and started on Evorel patches (oestrogen) with oral progesterone to protect uterine lining. It has been amazing for joint pain, and I felt a difference after 3 days! Dose has had to be increased over the years but I plan on never coming off it. (If you decide on patches use bar soap, gels etc leave a film on skin and can cause patches to come off. Bottom cheek is easiest for placement ☺️) Keep us posted

I’ve been to see my GP today. I’ve already got a mirena in so she talked to me about my symptoms and family history and asked me if I would prefer the gel or patches and I’ve got an appointment for three months time to see how it’s going.

I think whatever you do, do start on some kind of HRT. You can always change the method and dose.

I use estrogen gel every day and progesterone tablets days 15-26 of my cycle. Recently added topical estrogen cream for vaginal dryness.

One of my peri symptoms was having regular periods for the first time after 30 years of irregular ones, very inconvenient.

It might be a bit of trial and error so it's worth buying the NHS HRT certificate, I think its £20 for a year for unlimited prescriptions.

I chose the gel because I have very sensitive skin so was worried patches would cause problems. I cant have a merina IUD because it affected my mood when I tried it for contraception.

I think you just have to have a chat with the GP and try things out.

Thank you all so much, really appreciate all the advice. I honestly feel I've hit rock bottom, you have all inspired me that I'll feel like me again. Feeling very hopeful now 😊

I e picked my gel up this morning and had it on two minutes after I arrived home.

I have the gel but may try a patch for my next prescription as its a bit of a faff.

I have been using the progesterone tablets for 12 days a month and I love it. I sleep the best I have ever slept on those pills.

Saying that, I am waiting for my period so I can try the newish contraceptive pill Slynd as a birth control and also the progesterone part of my HRT, instead of the progesterone tablets. Will happily switch back though if it doesnt suit.

I have the gel. It really helped with my low moods - almost immediately, certainly within a week. Apart from the hot flushes, that was my main symptom.

I started HRT a month ago. I got the HRT prescription certificate. I’m allergic to medical tape and plasters so I didn’t want the patches. I use estrogen gel every day and progesterone tablets days 15-26. I’ve not had a period yet on HRT. My tearful low mood brightened after a week. I like the gel cos I can up the dose as needed. ( it says 1-2 pumps on my prescription) I use 1 most days but 2 if I’m feeling anxious or tearful. I’m 48 and had peri symptoms for 2 years before hitting rock bottom with my low mood. Wish I’d started HRT earlier.

It's a very personal thing and what works for one woman may not work well for others. I am doing well on the patches, was awful on the gel. My friend is just the opposite. There are advantages and disadvantages to each method. You are unlikely to be offered tablets in the first instance, transdermal (absorbed through skin) is safer and the default choice. So you have patches, spray or gel.

Patches - not every brand suits everyone, some have reactions to the glue, they can be quite big and crinkly. BUT you only have to apply them twice a week and then forget about them.

Gel - apply every day, you have to let it dry naturally which can mean standing around in the bedroom as it evaporates. You have to avoid things like swimmning for a couple of hours after. But gel is readily available with none of the shortages associated with some of the brands of patch. Can be bulky and heavy to take on holiday.

Spray - not as well known, again it's a daily spray so it's about getting into the routine. Don't know many people using it.