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[july17]

Could anyone advise or provide experience with coming off prempak c please. I've taken for about 4 years due to hot flushes, anxiety and lack of sleep but was still having regular periods, I'm now 54 and asked the GP how do I know if I've been through and finished the menopause. Saw a different GP today who told me it was difficult to test when already on hormone treatment! She asked me about symptoms and when I mentioned migraines she took a second opinion from a senior GP and told me to stop taking it immediately as she was concerned about a stroke. Quite concerned as to what's going to happen to me when I stop taking, so any advice appreciated. Told to go back if symptoms are bad and there are other options?

[Hurdity]

Hi july17

 

Sorry to hear about your problems and migraines.

You don't necessarily have to stop taking HRT if you get migraines. I mean did they suddenly come on severely and suddenly recently - or how? Is it during the progesterone withdrawal phase ie a day or two after stopping the combi tabs? If so or if they are cyclical then this is normal pms. I started to get pre-menstrual migraines when I was still having regular periods just before peri-menopause, and I still went onto HRT and continued to get them monthly. In fact I never mentioned them to the doc as I didn't realise they were migraines ( as I didn't get aura).

There are several different types of hRT you can try and in fact transdermal HRT ( patch or gel) is recommended if you get migraine:

Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine

http://www.menopausematters.co.uk/atoz.php#GlossM

Normally at your age you could have a try if continuous combined HRT ( no bleed) to see if you are post-menopause - but equally some women like to stop for a bit to see whether they are post-menopausal and whether symptoms recur, so no harm in doing that if you want to, for a while?

You may well get a sudden recurrence of symptoms if you stop taking it so it is generally recommended to stop gradually so that sympotms come back more slowly - but in the circumstances you might not want to do that.

Sorry that's probably not much help - but really it's up to you - if you want to know if you are post-menopause or not, and then deal with the symptoms if/when they arise - by trying a different HRT preparation (although I think you could do this now...).

If you really don't want to stop you could have an e-mail consultation with Dr Currie ( on home page of this site) at a cost of £25.

Hurdity  x