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[Hurdity]

Hi dogdoc

Just catching up as have been away so from me too....

I see you are beginning peri-menopause at quite a young age and sorry to hear about all your symptoms.

Also that you've obviously read up a lot about menopause, interested in all of it and what's happening to your body, and wanting to take control - good for you!

There are so many points in your posts - firstly the bit about stroke risk etc. At your young age, taking HRT is not thought to increase the usual risks cited, and you should replace oestrogen until at least the natural avergae age of menopause of 50-52. As Dr Currie says on this site at age under 50 the benefits exceed the risks: http://www.menopausematters.co.uk/balance.php

If you want to read a scientific paper about menopause, diseases and risks of HRT (and I see you like that sort of thing  ), there was an excellent summary paper published to mark World Menopause Day last October and was posted on this site, entitled "Prevention of Diseases After Menopause" http://www.imsociety.org/downloads/world_menopause_day_2014/white_paper/wmd_white_paper_english.pdf

Re stroke it says " .... the risk of stroke from MHT (menopausal hormone therapy) is rare and of the same magnitude as seen with other medications  such as statins and aspirin used in the prevention of CHD in women. When initiated in women < 60 years old and/or < 10 years since menopause, the benefits of MHT (menopausal hormone therapy) outweighs the risks, as MHT statistically significantly reduces Coronary Heart Disease and all cause mortality.....". The discussion is quite complex relating to different ages of treatment (with HRT), and age since menopause and re-analysis of the WHI study data. If you haven't seen it already I'm sure you will find it interesting reading 

Regarding oestradiol levels - I see you've had several measurments at the same stage in your cycle. Just to check that we're all talking with the same units of measurements as in UK the units are pmol/l and in US they are pg/mol - not sure what they are in Canada but from the figures you've given it does sound like pmol/l?

Even so - is that really low for Day 3? It looks to be within the range for Day 5 which would be higher than Day 3?

I am interested in the idea of being able to shut down a cycle at 50 mcg estradiol too. I can't imagine how this would happen although my knowledge about the detailed hormonal changes is rudimentary!!  I mean the pre-ovulatory peak is enormous and I would have thought 50 mcg wouldn't have an appreciable effect on the cycle to switch it off completely but would be interested to have a mechanistic explanation (if I could understand it  ).  I thought the Mirena worked by protecting the endometrium rather than having any systemic effect - but will be interesting to find out....

When you say you are taking oestrogen against the advice of your doctor - I mean I presume you have persuaded them to give you a prescription for it rather than self-medicating? In UK as you've probably read many GPs who are not specialists do not recognise some women's symptoms as being due to perimenopause but many specialist gynaecologists do - from menopause clinics or privately. Unfortumately there aren't enough of these available to women on NHS so many women have to argue their case with the doctor (or pay for a private consultation) and the outcome is very dependent on how open they are to being educated!

It sounds like your symptoms are abating through your treatement, and as Suzyq says - I do hope this continues! 

Hurdity x

[dogdoc]

Thanks so much ladies.

Hurdity the 129 was day three estrogen. I never got a middle cycle peak one until after I started on the estradot 25 and on estrogen it was 500. Yes that us pmol/L same as uk.

Yes my doctor prescribed it but not too happily. She knows nothing about hrt and certainly not when it comes to perimenopause. The obgyn says because my fsh is normal it's not perimenopause
And that I have enough estrogen. When I asked about low estrogen symptoms like vaginal dryness, dry eyes, irregular cycles, heavier cycles, headaches, insomnia etc she says she doesn't know. Maybe stress. She thinks maybe severe Pms or pmdd but this doesn't explain my changed periods , cycle length , vaginal dryness etc.

When I show them the symptoms chart I keep showing marked worsening if symptoms at the expected time of ovulation and then the week before my period they shrug shoulders.
Are these not low levels of estrogen? I have 129 as bring nearly menopausal on my chart and 500 at mid cycle peak being the peak if a menopausal woman on estrogen.

You think maybe I've jumped the gun? I'm pretty miserable no doubt and might sell my soul for. Full nights sleep.
Tara

[CLKD]

Nope.  You know enough about medications to be guided by how you feel, not a Doctor who has no idea about menopause!  Let us know how you get on!

Tell your obgyn that many Consultants in the UK don't use hormone blood tests because of the irregularity of results, they 'go' on symptoms only!

[dogdoc]

Thanks CLKD. It's really hard. I would like a doctor to look me in the eye and just say yes, it's absolutely perimenopause. The anxiety of not knowing for sure and having no doctor back up my suppositions is increasing my stress exponentially. Hence my desire to go see the specialist in the states.

If it's not perimenopause then I have a chronic neurologic disorder, with a psychiatric component that no one is able to diagnose.
Peri seems like it would be the obvious answer

[CLKD]

Peri is more likely  as when you are feeling logical, you know is true!  Hopefully now you're here, with us, you will be more relaxed and able to ask questions, the answers of which you can take back and use to your advantage 

Why do GPs go into the profession if they aren't interested in at least being sympathetic! we all need to feel validated and not being a nuisance when we walk into the surgery!

We have a thread - what have you done today - that you might like to join in with ……. and have you read about The Strange Woman in My House? 

[dogdoc]

Thanks CLKD I will check those out. I already feel better after coming to this site.
The support of so many women going through the same is extremely beneficial. Particularly when I'm not 'in my right mind'.

Tara

[Hurdity]

Hi dogdoc

Apologies if my post didn't come over very well - as I was very tired having worked away at the weekend and went through your post trying to give any info or comment as I thought helpful or as I understood!

It really does sound like your doc is not clued up at all - and you were seeing a specialist too? Surely anyone could see that if you are having irregular cycles and a lot of those other symptoms that this is due to your entering early menopausal transition - or maybe late reproductive phase if the irregularity is only slight at this point. Also I understand that FSH is extremely variable anyway so how can a doctor rely on this measurement alone and deny symptoms?

The information on this site says it all:

The diagnosis of menopause and the menopausal transition should be made from a combination of factors with most emphasis being placed on the pattern of periods and presence of menopausal symptoms. In the late 40s, early 50s, the absence of periods or infrequent periods along with symptoms such as flushes and sweats can alone be used to diagnose the menopausal transition and blood or urine tests are unnecessary.

http://www.menopausematters.co.uk/diagnose.php

If you are having symptoms which are being alleviated by taking oestrogen - then surely that is the answer? Are there no specialists nearby that you can see without having to take the drastic step of flying to another country?

I do hope you manage to find a way of acknowledging your current hormonal state and continue to feel better 

Hurdity x

[CLKD]

It would seem that Canada is short on meno support 

[dogdoc]

Short on meno support. Lol. Yes absolutely.

I've spoken with 4 obgyn's and had 4 answers. Although most agree it's hormonal they don't agree on how to go about 'treating me'.

My local obgyn wants to chemically shut down my ovaries with Lupron and do add back hrt with combo continuous. I asked if this was successful if I could get a total hysterectomy. No. She would keep me on injections for a decade or so until full menopause.

Second obgyn ( still in canada) would shut me down with Lupron and add back estrogen only. If I was going well on this after a few months he'd do a complete ovariohystetctomy.

3rd suggested mirena or ultrogestan with low dose estrogen patches and increasing until symptoms are controlled. 4 th was Dr currie on this site whose suggestion was similar. I tech to believe the last two recommendations since these women 'specialize' in meno. I'll give it a go.

[CLKD]

>wave<  [how's the weather?]

" ……  a decade or so until full menopause  …… "  that would be when exactly 

I would 'go' with Dr Currie's suggestion  - then let us know how you get on!  Why would a Medic want to 'shut down' ovaries when they are going their 'natural' way ……. it happens eventually.  You are probably in peri-menopause stage so need to protect heart and bones!

[Dancinggirl]

Yes dogdoc - If Dr Currie has suggested the Mirena with oestrogen in patch or gel form I would go with that.  You could try the micronised progesterone first of course to see how you feel.  The beauty of using Oestrogen gel is that you can adjust the dosage - starting low and then increasing gradually till you feel good.
I think shutting you down or having hysterectomy is a bit extreme at this stage. Let us know how you get on.
DG x