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Author Topic: 38 and Perimenopause : Help!  (Read 7818 times)

schapman

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38 and Perimenopause : Help!
« on: February 25, 2016, 01:32:02 PM »

Hi there! A bit of background on me...

I'm 38 years old and think I'm suffering from peri-menopausal symptoms.  My mother had her last ever period at 40 and my grandmother and her sister were the same.  With this strong genetic tendency to early menopause I was expecting it!

I'm still having a monthly period but over the last two years my menstrual cycle has shortened and is normally around 24 days and is shorter but far heavier than it used to be.  In the last year I have started shedding lots of hair and I'm now suffering from horrible spots which are constantly there as red bumps on the skin and then flare up even more at certain points in the month- Some of which are really quite painful. I can tell my hormones are all over the place as some months (particularly when i have a longer cycle) I feel better whereas others I feel dreadful.  I know my body is susceptible to hormone fluctuations and I suffered terribly when giving up breast feeding and felt like I had flu like symptoms for weeks until I levelled off.

I went to see my GP last summer who when hearing my history and symptoms nonchalantly asked "what do you want me to do".  I asked for a blood test which she reluctantly did do and my FSH was 12 which I think indicates possible ovarian reserve dipping but the doctor didn't do any follow up.  This was 10 months ago and symptoms have worsened since then.

The long and short of it is that I am fed up of the spots, hair loss and feeling "floaty' and quite unwell at times so I've booked an appt with the menopause expert at the practice for this Saturday.  I wondered what I should be expecting from the appt and what you ladies might advise would be a good course of action.  I feel like I'd like to try some kind of hormone therapy but was wondering whether GPs generally do this at my age and if so whether it is better to be a low dose BCP or low dose HRT.  My mother is now 72 and was never offered HRT despite being peri menopausal in her later 30s and menopausal at 40 and as a consequence has suffered with low bone density in her early 60s although this has luckily improved for her.  I'm obviously mindful of this for myself with a similarly early menopause looming.

Thanks in advance and apologies for the waffle!!

Susannah
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Mary G

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Re: 38 and Perimenopause : Help!
« Reply #1 on: February 25, 2016, 02:09:09 PM »

Welcome to MM!

I am sure I was peri menopause at 38 but I didn't realise it at the time.  I was post menopause by the age of 45 and I am now 54 so I have been around the block on this.

I would definitely recommend you start HRT as soon as possible and top up your oestrogen by using Oestrogel.  Oestrogel is a transdermal, bio identical form of HRT has virtually no side effects or risk and the benefits of taking are immeasurable.  The beauty of the gel is that you can adjust it to suit your needs and you will find that your oestrogen will gradually drop so you can very easily up the dose.  I really wish I could have started using the gel when I was 38.  There was an article in the DM about the importance of starting HRT as soon as you own oestrogen levels start to drop because (a) the obvious avoidance of all menopause symptoms and (b) it is far more effective to start HRT before your own hormones drop too low and too much damage is done.  There is no time limit and you can take HRT for as long as you like - I am intending to take it for life. 

I do hope you can get the gel from the menopause specialist.  Please us know how you get on.

Good luck!
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Cassie

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Re: 38 and Perimenopause : Help!
« Reply #2 on: February 25, 2016, 02:25:48 PM »

I agree 100% with Mary G. I started @ 38 as well was on the oral BCP for 2 yrs and went onto the gel @ 40, havent looked bk 10 yrs later, its great.
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schapman

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Re: 38 and Perimenopause : Help!
« Reply #3 on: February 25, 2016, 02:47:17 PM »

Thank you for the replies and the advice.  This site has already been a great help.  My Mum got no help with hers and struggled for years with random things that she now realises were down to the menopause.  Unfortunately more than 30 years on I didn't feel that the first GP I saw was much more helpful!  From my research and reading on here it seems like its now standard practice to put women who are having an early menopause on some sort of oestrogen to preserve bone health and the earlier you start it the better.  I shall see what they say.  The spots in particular are driving me mad.  I wasn't spotty as a teenager so wasn't expecting to suffer at 38!!
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Milamam

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Re: 38 and Perimenopause : Help!
« Reply #4 on: February 25, 2016, 03:10:53 PM »

Hello schapman and welcome to MM!
Just to say that I started perimenopause around 40 (45 now), and when symptoms got really bad at 43 , I started HRT. My FSH then was 10, so not really indicative as to how severe the symptoms might be! I suffered awful anxiety and panic attacks, also my cycle have shortened, and I had night sweats, palpitations and poor sleep. HRT resolved all that.
My advice is to see a specialist and explain all your symptoms, also enotional ones that you might not attribute to menopause at first (I was like that). Maybe a low dose HRT is all you need to go over the edge and regain welbeing. As time progresses, symptoms worsen especially at younger age as we tend to need more estrogen (and progesterone) to function well.
Good luck
Milamam
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Hurdity

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Re: 38 and Perimenopause : Help!
« Reply #5 on: February 25, 2016, 03:54:19 PM »

Hi schapman

 :welcomemm: from me too.

It's good that you are seeing the menopause expert at your practice and I presume this is a specialised doctor? As you recognise already it is so important to get correct diagnosis and treatment if you develop Premature Ovarian Failure - which is what it can be called if menopause occurs under the age of 40. Even if you are over 40 when menopause is likely to occur this is still an early menopause and oestrogen will be needed for future health protection.

I presume you have read the section on this site about Premature and Early Menopause - look at the menus above starting with this tab: http://www.menopausematters.co.uk/prematuremenopause.php (left hand top tab) - and all the sub tabs eg Investigations http://www.menopausematters.co.uk/pm-investigations.php and Management http://www.menopausematters.co.uk/pm-management.php

Also the NICE Guidelines on Menopause published last year are quite specific about the steps that need to be taken.

This is information for the public from the website:
https://www.nice.org.uk/guidance/ng23/ifp/chapter/Premature-menopause-premature-ovarian-insufficiency

... and this is extracted from the published summary guidelines:

Diagnosing premature ovarian insuffificiency

1.6.1 Take into account the woman's clinical history (for example, previous medical or
surgical treatment) and family history when diagnosing premature ovarian
insufficiency.

1.6.2 Diagnose premature ovarian insufficiency in women aged under 40 years based
on:
•   menopausal symptoms, including no or infrequent periods (taking into account whether the woman has a uterus) and
•   elevated FSH levels on 2 blood samples taken 4–6 weeks apart.

1.6.3 Do not diagnose premature ovarian insufficiency on the basis of a single blood test.
1.6.4 Do not routinely use anti-Müllerian hormone testing to diagnose premature ovarian insufficiency.
1.6.5 If there is doubt about the diagnosis of premature ovarian insufficiency, refer the woman to a specialist with expertise in menopause or reproductive medicine.

Managing premature ovarian insuffificiency

1.6.6 Offer sex steroid replacement with a choice of HRT or a combined hormonal contraceptive to women with premature ovarian insufficiency, unless contraindicated (for example, in women with hormone-sensitive cancer).

1.6.7 Explain to women with premature ovarian insufficiency:

•   the importance of starting hormonal treatment either with HRT or a combined hormonal contraceptive and continuing treatment until at least the age of natural menopause (unless contraindicated)
•   that the baseline population risk of diseases such as breast cancer and cardiovascular disease increases with age and is very low in women aged under 40
•   that HRT may have a beneficial effect on blood pressure when compared with a combined oral contraceptive that both HRT and combined oral contraceptives offer bone protection that HRT is not a contraceptive.

1.6.8 Give women with premature ovarian insufficiency and contraindications to hormonal treatments advice, including on bone and cardiovascular health, and symptom management.


For your doctor to say "what do you want me to do about it" - is appalling.

Hope this helps :)

Hurdity x
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schapman

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Re: 38 and Perimenopause : Help!
« Reply #6 on: February 25, 2016, 05:46:03 PM »

Thank you so much for all the info.  Hurdity I phoned up the practice and asked which GP specialised in menopausal issues and was given the name of the doctor I'm seeing.  I guess I'll find out on Saturday how much of an expert she is!!!  I've read the links you suggested so at least feel that I'm going in with up to date information.  I'll let you know how it goes and thanks again x
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