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[devonhil]

thanks for clearing things up Hurdity and silverlady. I had no idea that so many UK HRT products are bio-identical already. It's good to know that when we do manage to get HRT we're getting the good stuff!

It seems that that the bio-identical bit is more true of the oestrogen side of the treatment than for the progesterone? I have seen quite a few threads where members are on progestins rather than progesterone. I think some GPs aren't aware there's a difference

Quite a few people here talk about having problems with progesterone-intolerance. Again, it would be interesting to know whether that's to progestins rather than bio-identicals.

Sadly, the internet is full of bodies claiming bio-identicals are no safer - some even imply they are more dangerous as they haven't been tested as thoroughly     Lucky for us, most of them are based in the USA which is very behind in it's HRT research (or more in thrall to drug companies..)

The two thing I find particularly sad about this forum's members' interactions with their GPs are:

1. how many of the doctors don't seem to believe their patients when they say they are peri-menopausal or menopausal! Why on earth would we make it up?

2. how older post-menopausal women are treated. How cruel to suddenly pull the hrt rug from under someone's feet and state that they can't have it any more? I've read time and time again on this forum words to the effect of '"I want quality of life more than quantity" - I completely relate to that myself.

Taz - just read your recent post. The interesting thing about risk factor studies stating things such as "double the risk of stroke" is that the risk is very personal and may be low for a particular individual to start with. The risk of stroke is probably higher for an overweight stressed 40 year old than for a fit 70 year old so to use such reasoning to remove a treatment from someone needs to be based on the individual's health not a knee-jerk reaction. The stress of resumed menopause symptoms on withdrawal of hrt could well cause a much higher risk of stroke than the hrt that the well-meaning GP is 'protecting' the patient from!

All this points to the need for people to be treated as individuals - I think that may be too optimistic of me!

hil x

[Limpy]

limpy - I didn't know that ADs were used for pain relief too. Surely a strange solution for long term pain relief though? (cubagirl's son's GF thinks so too).

Given that ADs are supposed to affect the pain receptors in the brain, why are they a strange solution for long term pain relief?

The Drs have b---ar else to offer for long term pain. ADs may not work, they certainly haven't for me with MS pain, but I can understand the logic of using drugs which target the areas of the brain which are involved in pain.

If ADs are not used then we get onto the drugs used to treat epilepsy, again not something to be treated lightly but needs must........

[Taz2]

I was given amitryptiline to relieve the pain of fibromyalgia and it worked quite well and was at a lower dosage than for treating depression. I think that the older style tricyclic anti depressants are useful for pain relief.

Taz x

[devonhil]

Limpy

I take your point about ADs working on the pain receptors in the brain and so providing pain relief. I just meant that they are maybe a controversial choice given their psychological addictiveness over the long term. Though I suppose plenty of regular pain-killers are addictive too (i.e codeine).

My DH has a chronic condition too (severe psoriatic arthritis) - he's 43 and has had it for 10 years There has been no mention of ADs in his treatments so I'm assuming that they aren't suitable for all types of pain?

I feel for you regarding treatment for your MS - there really are so few options for chronic pain and so many are just downright dangerous. I personally would consider ADs one of the high risk options though..

[Hurdity]

Sadly, the internet is full of bodies claiming bio-identicals are no safer - some even imply they are more dangerous as they haven't been tested as thoroughly     Lucky for us, most of them are based in the USA which is very behind in it's HRT research (or more in thrall to drug companies..)

They (the bodies) will be talking about the (mainly American - but some also in UK) private consultants who prescribe "bio-identical hormone replacement therapy" that I was referring to - rather than the proprietary bio-identical formulations that are tested and licensed for use on the NHS at the specific doses available. I understand that these other ( non NHS) treatments may well not be tested in the doses and formulations that they are given and especially when using progesterone cream (I know someone in Oz that spent a fortune on such treatments), since this is not advisable as giving sufficient protection to the uterus from over-stimulatiom by oestrogen.

Inadequate thought it is, at least the products available have been tested to some extent, at the doses available, even though as menopausal women we would like to see trials involving more women and over a longer period of time.

Some women are only intolerant to progestins - and even then maybe just with some specifically - eg the androgenic types, but some are intolerant to all progestogens. Fortunately these women are in the minority but nevertheless it becomes a depressing struggle to find an HRT type that gives better health and quality of life overall, and some have to resort to hysterectomy in order to be able to take the oestrogen they need.

Hurdity x

[Taz2]

Just wanted to say that SSRIs are often prescribed for hot flushes where other menopausal symptoms are not bothersome. Smaller doses are prescribed than for depression and in some women they work well. Blood pressure lowering medications, in low dose, such as Dixarit are also used to alleviate flushes so although it may seem that anti depressants are being offered for menopausal symptoms almost in error this may not be the case.

Taz 

[Joyce]

I was given combination of Amytriptiline & Gabapentin for neuralgia a while back. I was also attending an osteopath for back pain. He was horrified that I was on both & suggested that the ADs should be stopped ASAP as I could become hooked. I'd never even been warned of that aspect. He said all I needed was the Gabapentin. I came off both though as it gave me a scare. GP said I could take the ADs long term if necessary.

[Taz2]

Amytrip is a really old anti depressant but it's not like a benzo and addictive. I took it for quite a while and stopped without any side effects. The dosage should be really small for pain relief - I was on 10mg and you can take up to 150mg a day so it really is a tiny dose. Were you on a high dose Cubagirl. It is unsettling to be told it is addictive when your GP said otherwise.

Taz x

[Joyce]

Think it was only 10mg Taz, but may have been 20mg. My mouth was so dry too. Pain was always worse at night, but pain always is. GP consulted neuro specialist who suggested the Gabapentin also. Had the pain for best part of 6 months. Get odd twinges now & then, but just take normal painkillers for it.

[Taz2]

Glad it's manageable now. It's difficult sometimes to know what to believe!!

Taz x

[Joyce]

I'm scared of all those types of medication as is my brother. My mum ended up on so many, we called them her uppers & downers. She lived to 80 mind you, but often wonder if her depression & anxiety had been managed better, she would have enjoyed life more.

[honeybun]

Me too. I have diazepam but very rarely take any. I am to much of a coward.
They do have their place though and I'm sure if managed properly then they make a huge difference.

Have you see your number of posts CG 9999. Getting into big numbers now 


Honeyb
X

[Limpy]

I was given combination of Amytriptiline & Gabapentin for neuralgia a while back.

Gosh CG how did you cope with taking both together, how long were you taking them?
I have used them separately and found they both make me very groggy. Brilliant for getting to sleep but not so good for getting on with real life

[Limpy]

Limpy

I feel for you regarding treatment for your MS - there really are so few options for chronic pain and so many are just downright dangerous. I personally would consider ADs one of the high risk options though..

Thanks Devonhil

As you say there are so few options for chronic pain relief, and codeine is a definite no no. The thing is when ADs e.g. - Amitryptyline - Nortriptyline - are used for pain relief it is a very small dose.

[devonhil]

Limpy
 
it's good to know that the AD doses which create pain relief are very small. I think the troubling thing for a lot of chronic pain sufferers is the length of time they need to be taken for - even small doses of a drug create anxiety if you know you'll be taking that dose for 40+ years. I know my DH agonizes over the amount of ibuprofen he takes every day, especially as he is so young. Problem is the alternatives (steroid injections directly into the joints) are also not a very attractive option.

His doctors keep telling him that the drugs he already takes (including injecting methotrexate) aren't dangerous but then again they insist on monthly blood tests which kind of suggests the opposite....

hey ho

hil x