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[GypsyRoseLee]

http://www.earlymenopause.com/bcps.htm

This is a very useful article explaining the difference between the Pill and HRT in treating peri menopausal symptoms.

The more I read the more I am thinking that really I should be on the Pill. I am still very young for all this peri nonsense, as my symptoms really kicked in with a vengeance at only 42, but looking back there were definite warning signs as early as when I was only 38.

Early menopause runs very strongly in my family. At now 44 I am the oldest woman in my immediate family to still be having her own periods. Everyone else was finished and done by 42!

I think that even though my periods are now much lighter my menstrual cycle is still quite strong, if that makes sense. Still very regular, give or take 2 days. I could definitely tell when I was ovulating, lots of clear mucus and feeling very 'frisky' etc  I have never had a hot sweat. I have never suffered with any vaginal dryness (often the opposite to be honest). Never had any problems with headaches.

The article I have linked to explains that how HRT is adding extra hormones, which isn't ideal when you are still producing plenty of your own hormones. So some times you will be getting too many hormones etc. And you might struggle with fluctuations as a result.

So I think that this is why pre HRT and even now 10 weeks into HRT my anxiety/depression seems to go away for a week or two, then come back for a week or two, then go away for a week or two etc, etc with sometimes random 'good' and 'bad' days dotted in between 

The Pill shuts down your own hormones completely so you only get the dose in the Pill at a very steady rate, and also a higher dose of hormones than is commonly available in any HRT. No ups and downs through the month. Just a few off days/PMS due to the withdrawl of oestrogen/progesterone.

I can hack a few days of PMS once a month. But this up and down all the time and never knowing when is killing. I think that waiting for HRT to stabilise me will take a very, very long time. And won't actually happen until my hormones levels drop to post menopausal levels which could be years from now (though not too many going on family history).

[GypsyRoseLee]

Also if I do decide to go back on the Pill and it's more effective than HRT then I will have to eat lots and lost of very humble pie 

Because 18 months ago when I first started with peri and went to my GP describing the mood swings and the sudden insomnia and the awful random anxiety she DID mention going back on the Pill  But I just thought she was talking nonsense and that I was far too old to go back on the Pill and very flatly refused it 

In a way I will be gutted if I go on the Pill and it works for me. I could have saved myself 18 months of Hell if I hadn't been so stupid!

[Taz2]

Maybe it will work for you Gypsy! Peri takes around eight to ten years and as the normal age for meno is seen to be 51 then I would think that you are right on target to be peri meno to be honest and not early at all.  I now know that my increasing PMT symptoms in my forties were definitely peri-meno. I too didn't have any menopausal symptoms such as hot flushes or lack of libido and there is no way I would have considered taking HRT purely for the anxiety and irritability. You do sound as if you are right on track and if the pill helps then I would say give it a go! I didn't consult a doctor during those years as I hadn't really heard of peri.

Taz x

[Annie0710]

This is really interesting !
I'm on oestrogen only due to hysterectomy and have been for years really fine but since peri I'm messed up, thank you, I'll get on reading

Annie xx

[BrightLight]

Hi Gypsy - I think you are on the right track - because you are following your instincts, if that leads you to believe HRT is not right for you at the moment, then I would trust that.

I am not using HRT (I am 45) and have thought about it on and off for nearly six months since I had a high FSH reading and my first missed period - I then had a normal FSH reading and three 28 day cycles.  Basically I know that things have changed, not even sure I am ovulating regularly anymore because like you say, I used to 'know'.  I have had regular periods up until recently when two came close together.  All my regular 'signs' of where I am in my cycle have gone out of the window; the cervical mucus, the slightly larger breasts, even slight mood changes etc  They do come, but not in the usual order I never had PMT badly or problems at all, but now that things have changed I realise there was a rhythm to my cycle that was subtle yet reliable.

I am explaining all this because I waited before taking HRT which I was advised to take immediately the FSH was high and actually by ladies on here, of course I appreciate that protection of heart and bones is an important thing but.........I would urge any woman, if possible to NOT PANIC and realise that perhaps there really is an optimum point at which HRT is really helpful and before that other remedies might be better.  Because, what you say is so right, the hormones are still cycling in a random fashion and I genuinely believe there is a period of time where this is meant to occur and our body adjusts. Adding extra hormones just doesn't make sense to me unless hormone levels are very very low and I presume this is when hot flushes, night sweats etc come into full force, which is why HRT is mainly prescribed on the basis of these symptoms.  I haven't had hot flushes, which I take as a sign that although my estrogen might get low and be steadily getting lower, there is enough there to cause bleeding and not have hot flushes.

Now this might be a simplistic view, but it's one that I am going with I have definately had symptoms of high estrogen, but not always pleasant ones and I presume that is because progesterone is low, when there is no ovulation etc if I had added hormones then I think I would still be out of balance because as you say, my own system is still strong at some points - albeit malfunctioning quite often.  At the end of the day the body is preparing to stop the system completely and finally will get the message and things will slowly wind down.

I think if the symptoms are really hard at this point the pill totally makes sense to me.  Another thing I want to say is that a gynaecologist advised me that actually only quite low levels of estrogen are needed to protect bones and as long as there is still a bleed then some is being produced.  My advise is basically to take things slowly but surely, appreciate that your body is changing, trust that it might actually handle things given time and explore all your options regards supporting yourself in gentle ways that don't tax your system so much.  HRT is a very powerful medication and totally valuable - at the right time and dose - which in itself is difficult to manage.  I have my eyes and ears open to the possibility that I will need HRT at some point, but I really don't know, the GP said I would only have a few more periods and that would be that, perhaps he is right, until that time I am holding out, because I might produce my own hormones for a while without too many really bad symptoms.

I also suffer with anxiety, but I know that is not just the hormonal stuff and the hormonal stuff does shift fairly rapidly and I am learning to sort of ignore it and keep my head looking forward to when all that stops.

I've waffled - just wanted to say trust yourself, you sound very intune with your body and I hope you find just the solution you need right now x

[Limpy]

Thanks for posting the link Gypsy, it looks really interesting.   

[GypsyRoseLee]

Hi Taz

Yes from about 38 onwards I noticed my PMS was definitely morphing into something different and worse. Starting much earlier and not ending until my period finished. Some months I was only getting about 10 'good' days if I was lucky 

I think while you're peri menopausal and so still producing quite a lot of your own hormones then the Pill seems to make more sense to me. Especially when you're only really reacting to the fluctuations caused by your own hormones jigging about willy nilly and the awful dips in mood and the anxiety they cause. It seems sensible to shut down my own hormones entirely and just absorb a nice, regular dosage from the Pill.

I think trying to use HRT to control these fluctuations and my subsequent reactions to them is a bit like  trying to thread a needle while balancing on the roof of a moving car. Just too hit and miss.



 

[GypsyRoseLee]

You're not waffly at all brightlight 

I love the fact that there are so many women on here with intelligent opinions and observations. So far, I have never had any missed periods or even an irregular cycle yet. have just checked back through my diary and before HRT my cycle was 24 days, 25 days, 26 days, 25 days, 27 days etc, so really quite regular still.

And like you, I don't think my own oestrogen is too low as yet because I haven't had any of the symptoms associated with low oestrogen such as night sweats, hot flushes etc. But I do think my oestrogen is really fluctuating and THAT is what is causing all my anxiety and the periods of very low mood which I can get. If the periods of very low mood/anxiety were just a day here and there I could handle that. But 11 days in a row? It's no joke 

I'm not going to rush into anything. I am still going to give HRT another 4-6 weeks to see if it can stabilise me any better. But having  read that article I now understand the difference between HRT and the Pill and think that HRT is perhaps just not subtle or sophisticated enough to control my fluctuations. And that (for the time being) I need something which is going to shut down my hormones entirely to give me some respite. 

[Dorothy]

Thanks for posting this.  My GP advised remaining on the pill for the higher levels of hormone due to my age (40) so it is encouraging to read something that backs this up!  However, I am always a bit bemused by the claim that the pill overrides your natural cycle as I experience quite a lot of fluctuation when taking it.

[GypsyRoseLee]

From what I understand Dorothy, the Pill shuts down your own ovaries completely (which is why it's used as a contraceptive). This means you only receive the hormones present in the Pill which are quite a bit stronger than found in HRT (which is why HRT can't be used as a contraceptive).

I think you can still get PMS on the Pill (I know I always did) because you are reacting to the withdrawl of oestrogen/progesterone when you have the 7 day break at the end of each pack. Is this when you get fluctuations or are they through out the month?

[Poppyflower]

I am with Dorothy. I am just transitioning from BCP to HRT for that exact reason. I did not take the break from the pill, and instead took it continuously as advised by my specialist. No need to have a withdrawal bleed, and therefore suffer with symptoms going on and off the pill 3 weeks at a time. Specialist informed me that if always on BCP continuously then lining is not building up and no need for a bleed. I tried three different pills as well as the BCP patch each for three months. For myself personally I was still having symptoms, but I believe it was from the different progesterone in each pill. In theory shutting down the ovaries does make sense and I believe you can do this using the 100mcg estradot patch. Also for me personally, I have come off of the BCP so I can sort out if having symptoms from the different progesterones or from my own cycle breaking through. It is all really one big experiment, and still have not found what works best. Although everything I have tried except for one birth control pill had made me feel better than not using anything. So,forward with the battle and hope I have my answers sooner rather than later.

[Briony]

Really interesting article. Thank you! As you know, I am in a similar situation regarding pill vs HRT. Having read some of Hurdity's recent, really interesting  posts, I now think  my issue is due to the progesterone in Qlaira which isn't bio identical (the estrogen is). This would account for the timing of my fatigue and spotting (which I had, incorrectly, blamed on too little/much oestrogen).  I feel so noticeably better on Qlaira in terms of  anxiety that I don't want to give in easily. but the fatigue, when it occurs, is debilitating and progesterone is the more likely cause, I suspect.

My options, if I did change,  are either a different, possibly stronger/single phase pill (taken without a break) or else a much stronger patch with Utrogestan. The only reason I gave up on this regime previously was the dip when I stopped the Utrogestan, so I am hoping my GP may consider a continuous regime even though I do still have periods. having now taken both 20 and 30 mg of oestrogen orally, I would definitely want to try a much higher patch than the 50 mcg I had previously.

I spent ages putting together an email for Dr Currie yesterday, only to realise she's not doing email correspondence until the end of June. I guess I should have checked this first!

And like you, I don't think my own oestrogen is too low as yet because I haven't had any of the symptoms associated with low oestrogen such as night sweats, hot flushes etc. But I do think my oestrogen is really fluctuating and THAT is what is causing all my anxiety and the periods of very low mood which I can get. If the periods of very low mood/anxiety were just a day here and there I could handle that. But 11 days in a row? It's no joke 

Don't be mistaken into thinking low oestrogen always causes the 'typical' symptoms such as hot flushes, night sweats, VA etc. My oestrogen has been classified as low on a number of occasions (41  and lower) yet I have never had a 'classic' symptom, hence the reason I have had three years of unnecessary tests, MRIs (even a brain scan!).

[GypsyRoseLee]

Can I ask what sort of fluctuations do you get on the Pill, Dorothy and Poppyflower?

[GypsyRoseLee]

Ah that's interesting Briony? I always thought low oestrogen caused the classic meno symptoms.

[Poppyflower]

I gues

Can I ask what sort of fluctuations do you get on the Pill, Dorothy and Poppyflower?

I guess that is what I am trying to figure out. When I began my perimenopause journey it was HELL! Out of the blue one day I was a completely different person....long story short the sudden onset of mental difficulties were the worse. I had not ever had any of these issues in the past and really thought something was seriously wrong with me....sound familiar to anyone Anyhow I think the main issues for me on the pill was that I had to take the estrogen and the progesterone at the same time and was not ever able to discern if I was still having issues due to one or the other. I am pretty sure however that it was the progesterone in the pills. some of them were ok, and some sank me into a deep depression, and I did not realize until I came off that it was from the pill! With that being said I really do believe that "shutting ones own hormones down" during perimenopause is probably the way to go and I am going to achieve this taking the two separately hopefully! To answer your main question though once in a while I would still feel some fuzziness to my head, unable to wake in the morning as well as that jolting awake at about 3-4 am. once in awhile it would also seem like the other symptoms were just on the edge as you described but just did not quite break through. The pill could work really well for you as it does for others I think if you believe it could help then give it a try!