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[Stillsearching]

Hi everyone. Where to start?

5 years ago, at the age of 55 I was still having regular, heavy and very painful periods. My regular GP's had tried tranexamic and mefenamic acid and ibs relief but they didn't help. Then a female locum suggested the Mirena coil. My GP doesn't fit coils so she told me to go to the family planning clinic. They wouldn't fit one because of my age so I was referred to the local hospital where a doctor did a biopsy and fitted a coil. Hooray, periods almost stopped. At the same time I started having night sweats and incredibly painful joints. My hands felt so weak I couldn't grip anything. Even holding a teapot was a 2 handed job. I was tearful, bad tempered and not a nice person to live with. I was also becoming incontinent to the point where even walking quickly was a problem. My GP prescribed SSRI anti depressants saying that there is no evidence that HRT helps with menopause symptoms and quoting the results of the Million Women Study as the reason for not using HRT.  I took the anti depressants for a year but could see myself that they were causing me problems and not helping at all with menopause symptoms so I stopped them and went back and saw a different GP asking for HRT. Finally he agreed to give me Climaval. For 3 years I was almost symptom free but then it was time to remove the coil which was taken out last November. Before having it removed I discussed continuing HRT with GP and he decided to give me Climagest. AAArgh periods again, this wasn't discussed. After 3 months I asked for something else and was given Femoston conti 1mg/5mg plus 2mg Climaval. Bleeding and spotting started again at random stages of the month. GP said it's because the progesterone isn't enough but there is nothing he can prescribe. I suggested taking down the Climaval so we dropped it to 1mg . No change so we took the extra Climaval out and I've now been taking the Femoston Conti for 2 months. I am still bleeding and am sick of it so today I decided to stop taking all HRT and see what happens. If the bleeding still doesn't stop then I'll know it's nothing to do with the HRT and needs investigating. I am thinking I'll try to give it 3 months.

[Taz2]

Hi Stillsearching - you have had quite a time of it! Just to say that conti HRT can take six months to settle so don't give up yet. The breakthrough bleeding and sometimes constant bleeding is difficult to cope with though and quite a few of us have reverted to sequi HRT which will give a controlled and predictable bleed once a month. You might like to consider this if you find the bleeding too troublesome.

There are also different types of HRT to try. At your age a transdermal HRT might be more suitable - patches or gel. Someone else will be along I'm sure with more information on what might suit you.

You will find lots of support on here!

Taz x 

[Stillsearching]

Thanks Taz,

I feel as though my GPs aren't really interested. One is adamant that HRT is not effective but is dangerous, the other will give me what I ask for but doesn't suggest anything himself. I want to give my body a break from the hormones to make sure that the bleeding does stop. I might decide to give HRT another go but am also thinking of changing GP.

[Dancinggirl]

Bleeding and spotting will occur for the first 3-6 months on any conti HRT.  It could be a good idea to stop the HRT for a while to see how you feel and whether you actually need the HRT - you might be surprised. Taking a break is a good idea.
If you do want to go back with HRT then perhaps try a continuous HRT patch which would give you a good balance of hormones: here is the link on this site :http://www.menopausematters.co.uk/postmeno.php

You could simply get another Mirena - this is used as part of HRT as it is less trouble, keep the womb lining thin and you simply add oestrogen alongside as pills, patch or Oestrogel.  DG x

[Hurdity]

Hi Stillsearching

 

At any point since the age of 55 and with all this bleeding did you have an investigation to check your womb lining for reasons for the heavy bleeding - such as fibroids, polyps or endometriosis ( not sure if this would become apparent late in life?)? A minority of women do have a late menopause but it's always good to be checked out if bleeding is heavy.

I am not surprised you were bleeding randomly with Femoston conti and 2 mg extra oestrogen - what was the doctor thinking? Of course the progestogen would be insufficient because the femoston conti is balanced to prevent bleeding in most women.

I would actually ask to be investigated now personally - because you are probably still getting bleeding because the lining has built up when you were taking 3 mg oestrogen if I understand correctly (the Femoston 1 mg + the Climaval 2 mg and then Climaval 1 mg) - which is way too much and especially for someone of your age ( 60?). This is actually very irresponsible of the doctor who doesn't seem to know what's going on - so I would insist on the investigation even while taking the HRT - to check the thickness of your lining.

I agree that once you have been investigated and all is OK, if the Mirena suited you, then ask to have another one fitted as Dancinggirl says - and then you can add oestrogen until your symptoms settle - and not have to worry about additional progestogen.

In the circumstances you shouldn't need to stop the HRT - but do go to your doc re being referred for U/S scan and preferable trans-vaginal at same time.

Hurdity x

[CLKD]

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[Stillsearching]

Hi Stillsearching

 

At any point since the age of 55 and with all this bleeding did you have an investigation to check your womb lining for reasons for the heavy bleeding - such as fibroids, polyps or endometriosis ( not sure if this would become apparent late in life?)? A minority of women do have a late menopause but it's always good to be checked out if bleeding is heavy.
Hurdity x

I had a scan about 12 months ago when I first asked the gp about removing the coil. It had been in for nearly 4 years which I read was the most it is recommended for HRT. The GP said the advice has changed and coils can now be left in for 7 years. I said I didn't think that was right for HRT. This is the GP who said there's no evidence that HRT helps with symptoms even though I told him how I had been helped. I asked another GP to take it out for me. When she was prepared she said I was bleeding and if she removed the coil I would start having a heavy period. She sent me for a scan. At the scan the radiologist said "You're fine the coil is in the right place." This surprised me so I explained why I'd been sent then she did perform an internal scan.The result was I have small fibroids which are apparently normal for my age and the womb lining was within limits.

I did ask to be referred to a menopause clinic and was sent to Gynae on the same day as a very busy maternity clinic. I was there for over 3 hours and saw 2 doctors together who took notes then went off to talk to someone else, presumably the consultant. The advice was have the coil out and see how I get on without HRT.

I don't feel that I've ever had a face to face talk with anyone who listens to what I'm saying and offers advice to suit. It's all very hit and miss.

There is another surgery local to me where there is a female doctor who lists her interests as including women's health so I'm seriously considering moving.