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[Pollyanna]

I'm a 56 year old, intelligent, insightful and am no stranger to menopause and how we are all affected differently by it.

Around ten years ago I had an endometrial ablation, following very painful periods. The procedure went well, and I was extolling the virtues of it. My periods stopped and no more pain.
All was well until a few years later when I was hit with the most excruciating pain whilst driving into work one day.

Managed to see my GP who referred me to an awful old fossil of a male gynaecologist who didn't even tell me what the problem was, but instead suggested that I have everything removed. Uterus and ovaries.

I had little knowledge then of this but I felt his suggestion was radical to say the least.

After research, I discovered a female gynaecologist in Bristol, Caroline Overton. She does both private and NHS but i paid privately to get a quick consultation with her.

What a contrast to my previous experience.
After a thorough examination and scan, I was diagnosed with Ashermans Syndrome which is where part of the lining of the uterus grows back.

I was given options but at that time, I decided to have a TVH. Caroline said that there would be no need to remove my ovaries but that I might go plummeting into full menopause.
I'd been peri for a year or so with awful anxiety and mood swings. Had never considered then that anxiety was a symptom of menopause.

Hysterectomy went well and I recovered really quickly. But yes, within a month I felt like an old woman. No sweats or flushes really, but high anxiety, confidence malfunction, aches and pains, palpitations, hair shedding.  As I'm very thin, I started to look gaunt.

It was s no brainier, I was started on 50mcg of oestrogen only HRT in patch form.

Felt amazing and the only adjustment I had within that year, was a reduction to 25mcg.  I stayed on that for years but obviously I was ageing and my ovaries were no longer kicking out any of my own oestrogen.

Two years ago, I became exhausted and depressed. I have to add that I've been through quite a bit in my personal life but I've always been able to optimistically see to the future.  I became almost bed bound with exhaustion and was diagnosed with CFS/Fibromyalgia.   

During the past few years, things have slightly improved and I have days where im my old self...positive, warm towards others, good energy levels and motivated.

I still felt though, that my hormones weren't in balance and so I went to the Marion Gluck clinic to check out compounded hormones.

I was interested in the argument that even without s uterus, women benefit from progesterone, and even a bit of testosterone.

It was expensive for the consult and losenges (I chose those instead of the cream).

I had a mix of oestrogen, progesterone and a tiny bit of testosterone.

Within a week and even in a tiny amount, I felt suicidal. I contacted the clinic and was advised to stick with it, but as I live alone and no support, my mood frightened me.

Ha...in the upside, my hair was beautifully shiny and healthy but I was seriously mentally not good. I was also struggling to stay awake.

After a few weeks of reducing amounts, I gave them up.

Since then I went back down to Estradot 25mgs and only once bought some progesterone cream to try.
Yes, for me, progesterone is evil stuff.

The latest is that as my aches and pains and exhaustion was coming back, my GP suggested I up my oestrogen to 50mgs.

I've been in that higher dose for 5 days. I've gained some fluid retention but my skin and hair have improved.

BUT.....,I'm hugely anxious now.

It's such a fine line with me....too much oestrogen gives me brain fog and irritability, too little and I'm like an old woman.

We all know it's not an exact science and we are all different with our reactions but I was wondering if it's worth sitting out another week, to see if my body just needs to adjust to this higher level.

Blimey....that was an epic message so I'm sorry for the length of it.

I'm a new person but I'd love to hear others stories if you are my age, and only use oestrogen HRT.

X

[Hurdity]

Hi Pollyanna

 

So sorry to hear about your ongoing health problems and struggle to find the right HRT.

I started at around 54 during the late peri-menopause transition and still happily using it 10 years later - but I still have my uterus so still need to use progesterone which I do on a 6-8 week cycle ( so still get a bleed) - under medical supervision from my GP. I dislike the stuff too! For most of this time I have been using a 50 mcg oestrogen patch (only increased slightly recently due to starting testosterone as well).

As you still have your ovaries, if at all possible I would try to continue with the 50 mcg oestrogen if you can - this is the amount licensed to help protect against osteroporosis and the standard (average I suppose) post-menopause dose - any temporary side effects as your body adjusts to the higher dose should settle and stabilise.

Have you had any blood tests at all - as you have no uterus? It may be that your oestrogen levels have become very low. Without a cycle it is difficult to determine how far post-menopause you are now likely to be. The other thing is have you had your thyroid tested? Many women suffer symptoms of CFS and fibromyalgia syndrome due to underactive thyroid sometimes Hashimoto's) and also from low testosterone - which could be  partly responsible. A clue to T being low is absence of libido or any sexual urges at all. Testosterone replacement is only recommended once oestrogen levels are adequate - but as you say you recognise the need for this in some women.

I hope this helps and do ask anything else that we might be able to help with. I do hope you begin to feel better from increased oestrogen dose - and you manage to bear with it

Hurdity x

[Pollyanna]

Hi Hurdity

Lovely to hear from you and, thank you for sharing your experiences.  It helps a lot.   Since I posted my question, I had a call from my GP who has suggested that if I can bear the side effects from the 50 mcg patch for another week, it might just be a case of allowing it to setting and my system to readjust. 

Yes, I've had so many blood tests done over the past few years.. I'm a pin cushion.   I did question the thyroid thing and asked to be put forward to an endocrinologist to have further tests.  However, as my levels were seen as 'normal', the appointment that I had booked, has been cancelled by them.  I've been tested for so many things.  On paper, I look to be so  healthy, it's crazy that my moods are affected.   It's interesting that you say 50mcg is an average dose.  I've probably been struggling with the lower dose, thinking that was normal, for all these years.   My libido has always been great although I had a complicated relationship with someone that ended a while ago now, and I've struggled getting over that.   It's always difficult isn't it, to define between cause and symptoms.   I've no doubt that if life was dandy, then my libido would be great.   

Regarding testosterone..... as I was getting a lot of course hair growth on my chin, I would avoid testosterone like the plague.  However, I do wonder if that was occurring because I'd only been on a low dose of oestrogen and my adrenals were pumping out too much cortisol.   As a lay person, there's only so much science based evidence I can read and take on board. 

What I have noticed after only a very short time on the 50 mcg patch, is that the hair growth on my chin has slowed down.  Honestly, I was getting dark, course hairs that I was having to pluck every morning, and sometimes twice daily.   I'm blonde and not a hairy type women and so this was bothering me a lot.   I have definitely noticed a slowing down of that, and the hair on my head is much healthier.  It was brittle as heck before. 

I'm going to ask for another batch of blood tests when I see my GP next week, if she'll agree to it.   She did say to me a while ago that if you're on oestrogen HRT, then the blood readings won't be that accurate. 

Thank you for your advice.  It's honestly, really useful.      Pollyanna x

[CLKD]

Anxiety can be eased by medication.  Either regular anti-depressants which also help anxiety or by taking Valium or similar 'as necessary'.  Knowing that I have an emergency drug to take when anxiety floors me [no exaggeration  ] enables me.  Regardless of whether your anxiety is hormone driven, you may need to take something along with HRT in order to feel better.

[Hurdity]

Hi again Pollyanna

I answered on your other thread about testosterone. I realise some women do need additional help even though they take HRT (such as ADs, therapy, mindfulness, behavioural strategies etc) but this should only be after getting the right HRT first, if the reason for anxiety is hormonal.

Hurdity x

[CLKD]

Whether the anxiety is hormonal or not, it needs addressing as a separate issue.  For me it could mean the end  .

[Pollyanna]

Hi CLKD.... I'm aware of the effects of valium and anti depressants.  Again, it's  a personal thing but my anxiety is as a result of hormone deficiency and so I prefer to balance hormones than take those medications.  They are great if you are depressed but for me, the cause is hormones.   

Hope you're okay though.   

[Suzi Q]

Have you tried beta blocas they worked wonders for me

[Pollyanna]

Hi SuziQ 

No, I don't need Beta Blockers, but I'm glad they work for you. 

I guess what I'm trying to illustrate is that, even though I'm an informed and body aware women, it's only since I've (recently) been on a healthier dose of oestrogen (for me), that I realise the past few years of depression and anxiety (on and off) was hormonal based.   
We are all very different and so we all respond differently to medication.   Important though to understand what the underlying 'cause' is and not necessarily compare ourselves to others. 

There are many women who are very opposed to any kind of HRT, either because they've been scared into thinking they are going to get cancer, or made to feel guilty by the holistic health crowd.   I personally feel very frustrated when I come across women in their 30's, who have done a short course in holistic health, and who have never experienced menopause, but who like to give unsolicited advice.  It's incredibly patronising.

It is of course, a choice that is very personal.  I am lucky that the benefits I gain from being on oestrogen only patches, far outweigh any possible risks.  The quality of my life is far better now than it's ever been, but I'll admit that this has been because I have spent many many hours over the years, researching, asking questions and by trial and error.  You have to be proactive. 

I went to see my GP this morning and she was amazed by how different I look and come across, since I've upped my oestrogen dose.  I"m back to my old self.  I spoke with her about the possibility of trying a small amount of testosterone gel as I've read on here that some women do well on just a tiny amount of it, for motivation.    With respect to my doctor, she admitted that she isn't that familiar with the uses of testosterone in menopause and so she's going to do some research (via the endocrinology department), and get back to me.   I'm hoping I can get this on the NHS, as I doubt I'd be able to afford this privately.   I've spent a fortune the past year or so on private HRT consultations and clinics.   

So, I feel that there is a tick in the box of 'health' concerns now, and for the first time in around three years (since I was diagnosed with chronic fatigue syndrome, when in fact I was depleted of oestrogen), I feel well enough to go back to the sort of work I used to do, without worrying that I won't be well enough to cope. 

I love this site.   

[Tempest]

Pollyanna, we share the same experiences of raising our estrogen dose! Annie has experienced the same too.

Can you tell me if the anxiety has now settled? I'm trying to slowly titrate up the patch doses - I'm at 25mcg at the moment. I agree TOTALLY that the cause is hormonal, due to Annie's and my experiences (we now have a triplet to add to the family in you)!

You look absolutely beautiful in your avatar, by the way! xxxxx

[Pollyanna]

Hi Tempest

I am finding it so difficult to get th balance between lethargy, and anxiety.

Okay so I have 4 boxes of Estradot patches here. I have probably increased too much, too soon.

Titrating more slowly would have been better.

I am cutting the 50 mcg patches, so that I get 37.5 dose.

There is no free-floating anxiety on this dose. However, I feel sedated almost. I could sleep at the drop of a hat.
I'm also gained my weight even though my diet is v healthy and I've never had weight issues before.

I have also started itching (all over) and that's very strange. Even my scalp itches.

My hair, that was breaking off and getting very thin, is looking much healthier.

My nails also much healthier, and growing fast. Vertical ridges gone.

Constipated though. Urgh!

Oh, and I'm getting thrush. Never suffered from that before really.

So.....I think I may go back down to 25mcg, like you, and see if that feels better.

I was concerned about bone health but then I've read that even a low dose (25mcg), is protective.

Are you anxious on the 25mcg?

I think it's important for us to remember that it's normal to be anxious, in response to a difficulty we may be dealing with. But if I there's anxiety all the time, that's not good.

Cant remember sorry, how long have you been on the 25mcg?

And, thank you for the kind compliment. 🙏 X

[Hurdity]

Hi Pollyanna

One thing you can be sure of - is that oestrogen does not have a sedative effect (which is a characteristic side effect of progestogens) - quite the opposite in fact - it is the hormone that stimulates and lifts mood - at the right dose of course.

I can't remember if you have mentioned thyroid issues - but maybe an idea to have a blood test if you are suffering from fatigue or if the sleepiness persists, especially if you are gaining weight without changing diet? The other reason could be that your mood has lifted so you are feeling more relaxed rather than low mood and anxious due to low oestrogen?

Yes it's always a good idea to increase in small doses and acclimatise, especially if your body has been without it.

Re being anxious - I think much is made of this on this forum and I quite agree a certain amount is normal. I never use the word anxiety because it sounds like an illness or condition rather than a normal response to certain things. Personally i say I am a worrier and always have been but I have never "suffered" from anxiety - if you see what I mean. I worry hugely about some things - perhaps less so now I am older and also since retirement - when working I would worry for days about training events etc I had to deliver! I used to deal with any worries by imagining the time after which the event I was worrying about had finished, and tell myself that the time will pass and then the event will be in the past! Sorry I'm digressing - but yes worrying all the time is not healthy and can impact our physical health too.

I hope you manage to settle on this new dose so that you feel better all the time

Hurdity x