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[Lizab]

I visited the doctor to follow up since beginning hrt. I was told that because my current hrt brought on a period, the estrogen is sufficient and I don't need an increase. That makes sense. I wonder what's making me feel so bad.
He is willing to raise the estrogen, if my thyroid labs prove to be normal.

[CLKD]

Thanks for the update.

[Hurdity]

Remind us of what you're taking and your periods/age etc - it's always difficult to try to catch up with posts on other threads and understands what's going on!

Hurdity x

[Lizab]

I'm 39. For six weeks, I've been taking .375 estrogen patch with 10 days per month of micronized progesterone 200.I had a few years of heavy periods close together and endless periods and spotting, followed by two years of skipping periods 3-4 months at a time. FSH tested over 100 last year. I've been through ultrasounds and biopsies, all normal. My thyroid was stable, until I visited my gp with what I think are menopause symptoms last October. He attributed my symptoms to thyroid, in spite of normal labs, and tinkered with my dose. I became severely hypothyroid, and we reinstated my old dose of thyroid. I had my first labs drawn today since being back on the original thyroid dose.

I understand the thought behind my doctor's plans, but to me it obviously all began when my periods went scarce. For years I've followed a mostly textbook pattern of perimenopause, aside from my age, and my gp, a gynecologist, and a midwife, all want to blame my thyroid. Everytime an adjustment is made, it takes 2 months before I can have labs to prove it was a wrong move, then at least 2 more months to get it back to normal, all while I'm still suffering from the menopause issues. I'm frustrated with all this dragging on. Just for reference, my thyroid had remained stable at the same dose for 10 years, except for some months during and a few weeks after my last pregnancy, when my dose was temporarily lowered. Every other time they've made adjustments, it's been in response to irregular periods, and after trialing it for the 8 weeks, they see my labs and put me back on my original 100 mcg dose.

So, I feel sure these are, at the root, menopause issues. But if, as he says, I have enough estrogen, then what?

[Hurdity]

Ah yes I remember now - sorry - I can't remember everyone's situation!

Right well that is ridiculous (what the doc says). If you have a bleed on HRT it just means that firstly you are getting enough oestrogen to stimulate the uterus lining and secondly  - more importantly - that the progesterone dose is sufficient to shed it! It doesn't relate to symptoms whatsoever and if your periods are that irregular, and your FSH is consistently high, and you are that young then presumbaly you are not ovulating much of the time. That dose is not even licensed to prevent osteoporosis - for that the minimum patch dose is 50 mcg.

If you are having menopausal symptoms still ( flushes, sweats, low mood, anxiety etc amongst others) then it is obviously not enough - but in any case you need a higher dose at your age regardless of symptoms!!! Please find another specialist or at least a gynae who can give you a higher dose.

There is a whole section on premature menopause here (and follow the sub tabs)
http://www.menopausematters.co.uk/prematuremenopause.php
(Top left tab -  Menopause/Prem menopause etc)

Yes it is important to monitor thyroid throughout menopause and if you start HRT but it doesn't mean to say that they should ignore menopause! Your future health could suffer if you don't take sufficient oestrogen, and you are at or near menopause at 39.

Hurdity x

[BeckyBoo]

Hi I'm new on here and would just like to follow this thread if thats ok 

[Hurdity]

BeckyBoo - you can follow and post on any threads you like, and say what you like, whatever the subject and whether you are new or old ( literally in my case  ) - as long as you keep to forum rules and the registration agreement. Sometimes we argue discuss but it is mostly amicable

Hurdity x

[Lizab]

Thank you, Hurdity. I am ranting a little bit because I'm frustrated that the thyroid is part of this now. My menopause symptoms, when I first sought help, mimicked over medication of the thyroid, even though my levels were only high-normal. It made sense that the thyroid could have been behind all my symptoms then. So now I've swung to the other side, with low thyroid, and that needs to be corrected. I feel like I've wasted so much time chasing the wrong problem. He is leaving me on my current .375 estrogen for now, until the thyroid is in order. That also makes sense to me, as obviously my whole body is out of balance at the moment. We can't throw excessive hormones in the mix hoping it all settles out.
I should have blood results within a day to know where everything stands now. I'm sure after all is settled, he'll be open to helping find relief. In fact, he questioned me about depression, then said as a first step fix the thyroid issue, then if needed add more estrogen, and if all that fails, we'll look at other options, which I took to mean therapy and/or antidepressants. It's the weeks and months of trial that are disheartening, along with that one little bit about sufficient estrogen sticking in my mind.

It does make me feel better that you explained sufficient estrogen to produce a bleed doesn't necessarily mean sufficient to offer relief.