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[Annie58]

Hi,
I have posted a couple of times but am now so unsure as to what to do next. 
I am 56 and I was initially on Prempak C and my GP changed me to the low does Premique at my request due to having very heavy "false" periods. 
My night sweats and flushes returned within a few days of the switch and I am feeling quite exhausted and anxious.  When I returned to see him after 3 months he advised me to give it 6 months.  It is now 4 months and I am trying to weigh up what are the increased dangers if I increase the dose.  There seems so many things to consider and I am also thinking that I will have to go through all this again when I stop the HRT.
I have just had my thyoid checked and it came back fine.  I was getting to the stage where I was hoping it was thyroid trouble as I feel I would be taken more seriously if it was!
If anyone has a similar situation I would be interested to hear from you.
I know at the end of the day it is down to me to decide (and my GP to agree of course).

Thank you!!

[Dancinggirl]

Hi Annie58
I am 58 and starting HRT again after a one year break.  It is a very personal choice about whether to continue with HRT but I believe the risks don't really kick in until after 60. Even after 60 the benefits can outweigh the risks - the increased risk of breast cancer is very small. I believe I am right in saying that too much alcohol, being overweight, smoking and stress put you at greater risk of getting breast cancer than HRT.
Over this last year without HRT I have coped but I was able to reduce my workload, I've paced myself very carefully, watched my diet and done plenty of walking etc. to keep myself as healthy as possible.  The flushes during the day have been bearable but I've found the lack of sleep really difficult to cope with.  I am also struggling with bladder issues and VA.
You have been taking the old fashioned type of HRT - they happen to be the cheapest so GPs tend to prescribe them first. The trend now is to go for the bio identical hormones and to use the transdermal route. As we get older I think it is preferable to use these newer HRT regimes.
I'm using Oestrogel for the oestrogen which means you can use less oestrogen because it doesn't have to go through the liver.  I'm then using Utrogestan which is also bio identical and Dr. Currie described as 'breast friendly'.  I have had issues with progesterone over the years - particularly on a continuous regime - so I am hoping this suits me.
The heavier periods could be due to fibroids so this should probably be checked. If you want to be bleed free you could try the Mirena (I had one for over 4 years) and you then just need oestrogen in patch of gel form - this regime is recommended by many gynaes to women who have heavy or continuous bleeding.
You could try SSRIs as they help many women but they can have side effects as well.
Do read up the info under the headings to the left of this screen.
Hopefully others will be along with their thoughts an advice.  DG x

[Annie58]

Thank you for your reply Dancing Girl.  This forum does make you realise we are not alone, but the choices now are so hard to make.
I am going back to my GP after Christmas and as I am away on holiday from tomorrow I will have some time to think it over.  I think a lot will depend on how well I cope with the heat abroad.  I think my GP would be reluctant to give me anything that costs more money even though he is meant to be the Gyne specialist but I will ask him about bio identical HRT.
I'm lucky that I'm not working as I took early retirement a year ago and I do sympathise with you and others having to work.  I think the lack of sleep is making me very edgy and rather stressed and this can't be good for my overall health.
Yes I suspected I may have had fibroids so when my periods stopped c 18 months ago I was over the moon.  I struggled with the menopausal symptoms for a few months but then went on the Prempak which was what gave me the awful "false" periods.  I would rather suffer the night sweats than go through that again.
My urinary symptoms have improved and are still fine with the low dose Premique - not perfect but a lot better.  My dryness is not too bad now either. 
One thing that is swaying me to stay with the HRT is that I suffer (long term) with back problems and think this is getting worse and my cousin has broken three bones with not taking HRT.  I am not overweight or a smoker and rarely drink so I have that on my side.  I have also reduced down my caffeine intact to 2 cups of caffinated tea a day (from 6 or 7) and that seems to help.  I can't quite get to cutting it out completely, but am going to try in the New Year.
Sorry if I seem to be rambling, I guess I am mulling everything over as I type.
We have our house on the market and are moving long distance next year so I think keeping with the HRT (maybe a stronger dose) short term, might get me over what will be a stressful time. I am also going to ask my GP to check out my back and bone density.
Thank you once again Dancing Girl and best wishes with your treatment going forward.
x

[Dancinggirl]

When I say that the HRT types you are using are the cheapest, the others are not that expensive either so the cost shouldn't be an issue. If you look under HRT preparations to the left of this screen it gives the prices of the different regimes.
If you are happy with the Premique but need the higher dose then try it and see how you feel.
If you have issues with your back perhaps get a DEXA scan to see how you bones are generally.
Also ask about the Mirena as this could be a good way forward for you as a minimal amount of progesterone is absorbed around the body - it's surpposed to absorb mainly where it is needed around the uterus. Using oestrogen in gel or patch from is then really easy and you can have the amount that keeps your symptoms at bay.
It is a difficult and very personal decision moving forward but you are still quite young and we always say on this site " quality of life is very important" .  DG x

[Annie58]

Hi Dancing Girl
Thank you so much for your comments and sorry for my delay in replying (holiday abroad and Christmas intervened).
I've just been to my GP today as my back pain has been far worse and I'm now 5 months into the Premique.  He has prescribed a 10mg dose of amiltriptyline (with paracetamol) at night and I'm hoping that might settle things down.  He won't change my Premique to a higher dose as says it carries too much risk. I've come to the conclusion that I'm happy to stay with my doseage as long as I can get some better sleep. 
I've been waking due to heat fluctuations but then been unable to get back to sleep due to the back and hip pain.
He does want to see me again in a month to see how things are going.  I do feel that I will improve generally if I can get a couple of good nights sleep so fingers and toes crossed!
However, I do still think that I need more investigation with my back, but I'll see how this goes for now.
Thanks again.