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[knitgirl]

Hello,
I have been reading through many posts and googling the internet since I was given the possible diagnosis of premature ovarian failure at the end of November last year.  I am 43 years old.
The diagnosis is based on blood tests - FSH and LH and an ultrasound that showed no activity in my left ovary and possible folicle in my right.
I have had the bloods redone as my gynaecologist said we needed to redo them before she will confirm diagnosis - and discuss treatment.

I had a polyp which was removed with a hysteroscopy just before Christmas, and my Gynae suggested, mnutes before proceedure, inserting a Merina coil.  She said it would help prevent further polyps and was a contraceptive. What sold me was that she said it was painful to put in, and since I was under general anesthetic, this would be avoided.  She said they were easy to take out!

I am feeling really confused about what treatment I should have.  I understand the need for HRT given my age. But I am really not getting on with the Merina.  I seem to be up and down emotionally all the time and constant period type pains.  I tried Micronor after my 1st child and was mad for 1 year, so took myself off it and left contraception to DH.

I am very tempted to have the Merina taken out.  I can't see the point in the contraception element since my ovaries are not working anymore. But have read on here that people use it with oestrogen.  I am wondering if this would make it better. 
I am also seriously overweight (BMI - Obese) so am scared that Merina is not helping my attempts to lose weight (I have been trying since my youngest was born - 6 years ago!)
Also am still bleeding, had a heavy period, and then its just spotting.  I went to the gynaecologist because I wasn't having periods - I was quite enjoying that!

I am also confused about all the terms perimenopause / menopause - my bloods seem to show I am post menopause so not sure where I fit in.  I haven't had any symptoms apart from no periods, but the last couple of weeks I have felt really miserable, very tired and hot and cold at night.  But is that the Merina and not menopause symptoms.

Sorry for such a long post.

[CLKD]

Oh you ramble on, there's usually someone to listen  . 

Have you read the Daisy site, sorry can't remember the full name but there is mention here.  [goes off to look  ]

"The Daisy Network has a new website at https://www.daisynetwork.org.uk , it's a nationwide support group for women suffering with Premature Ovarian Insufficiency (POI).
Membership is £20/year. "  Emma posted this recently.

Don't know much about the Mirena - sure someone will be along with advice!

[knitgirl]

Yes I found the Daisy site, but it felt like it was more for people who were still trying to conceive.  I am very lucky and I don't want anymore children. 4 is enough - although feels like too many at the moment.

I think the hard thing is that I don't know anyone who has gone through the menopause.  My mum passed away 11 years ago and Dad thinks she went through it at about 52 - so no hereditary early menopause on my mums side.
But my SIL told me she is going through it now and my MIL went through it early too - so I am really concerned for my girls - I have 3.

Just feeling confused about what is available as I am so distrusting of doctors 

[Dancinggirl]

Hi and welcome to MM knit girl
I'm sure this is all a lot to get your head around.  Do read up all the info on this site to get really clued up.
It sounds to me as though you are getting some good advice and treatment - at 43 some HRT is important to protect your heart and bones in the long term. Some bleeding in the first few weeks or even up to 6 months after the  Mirena is fitted is normal and should settle soon - but I do wonder if your still producing some hormones yourself and still technically peri meno - the fact they will be doing further blood tests is good. If you aren't producing much oestrogen then the progesterone in the Mirena may be causing some problems but adding some oestrogen - preferably as patch or gel - would probably balance things out better. Your night time symptoms could well be because your oestrogen levels are low. Initial fatigue from the boost of progesterone in the Mirena should also settle.
The Mirena is a favourite with many gynaes as it often solves problems like fibroids/polyps etc. - it can be used in peri and post meno, it protects the womb lining from thickening and allows the women to use as little or as much oestrogen she needs to protect her long term health and control any menopause symptoms.
If you aren't on any oestrogen yet I think you should ask if you could try perhaps some Oestrogel - you can start with just a low dose of one pump per day and see how you feel - you can easily increase to 2 pumps per day later as and when you feel you need to.
If you can loose some weight then this will really help your situation - I know this is tough but there are good clubs you can join or your GP practise may be able to help. Do try some brisk walking - it's the best exercise.
Keep posting - we are here to support you.  DG x

[CLKD]

Apparently our GP Surgery can prescribe gym sessions  [perish the thought] …….. how old are your MiL and SiL?

Once you get your hormones sorted you will be able to advise your daughters ;-).

[knitgirl]

My SIL is 46 now and my MIL will be 70. We are not very close (I am not the DIL they wanted!) but it came up after my hysteroscopy, since my MIL has had this proceedure twice and then when I explained to my SIL that I might be in menopause, she said she was and that MIL went through it early too.

I am one of those people who has a gym membership they never use, but have been seriously thinking that I should start doing something for my bones.

Re the weight, I have been very tempted to join Slimming World! I did Weight Watchers 12 years ago after I had my first. My sensible head says that these clubs don't work, and that all I need to do is watch my refined carbs and eat healthily, but it's not working.  But then the wine is probably not helping much either!

[Hurdity]

Hi knitgirl

  from me too.

As you have recognised the single most important thing you can do for your future health is to lose weight so that you are within the healthy BMI range. This alone should help you feel better. You seem to know what you should be doing so it is a question of willpower I'm afraid. It isn't just refined carbs you need to cut down on - but carbs completely, + any refined food + fat. If you are able to cook food from scratch using fresh ingredients you can regualte it yourslef - and for instance go without the pasta rice spuds  etc - starting with one meal a day and try to give up added sugar completely, and limit wine to the weekends. There is information on the NHS site and on here about all of this:
http://www.menopausematters.co.uk/diet.php
http://www.menopausematters.co.uk/weightgain.php

There are also some thread on weight loss fairly recently - I think in the This and That section so you could post in there and compare notes with others. Definitely increase that exercise. I know what you mean about the gym - I never do that but go to exercise classes instead.

As for the HRT - it is surprising to bleed straight away on the Mirena if you are not taking oestrogen and you did not bleed before. As Dancinggirl says though - if you have very little oestrogen of your own, then the Mirena can overthin the womb lining and cause bleeding. I would be surprised if this happened so quickly - but I imagine perhaps the whole procedure and operation has upset your system a little.

How long were you without periods before you had the procedure?

You can't tell exactly where in menopause you are from blood tests - just that you are somewhere along the journey because as your gynae says - it depends when the tests are done - but at your young age it is important to know. I agree you must have some oestrogen. I use a patch but this is a matter of personal preference.

Your symptoms could be partly due to menopause and partly temporary effect from the progestogen in the coil but as Dancinggirl said this should settle.

I am surprised they didn't offer you HRT after the blood results. If you really don't get on with it (the coil) then you would have to try a different product eg Femoston tablet HRT which is well tolerated, or an oestrogen patch/gel with separate progesterone. At your stage if you hadn't been without periods for a year you would have to have a monthly withdrawal bleed though (the HRT type would do this eg Femoston 1/10) - which shouldn't happen with the Mirena - once the initial bleeding settles. All the different types are at the tabs above - under treatments.

Hope this helps

Hurdity x

[knitgirl]

Thought I would update as I have had my 2nd FSH levels - they are 16 which is half the first which was 30
So despite my ultrasound showing little/no activity in my ovaries, it seems that I may not be in menopause.

So I have asked my gynae to take out my Mirena coil - which 4 children, a teenager and 3 school age children, I cannot cope with the side effects.

I did wonder if the FSH levels might have been affected by the coil, since I didn't have it when I had the first bloods done, but a quick google suggests not.

I'm not sure what is wrong, since I hadn't had a period for 3 months before I had the hysteroscopy and not sure if the bleeds I've had since have been periods or caused by the polyp/hysteroscopy/Mirena.

Feeling more confused, so keen to see what my gynae suggests!