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[onion relish]

Hi All,

My name is Lucy, I'm 52 and have been on HRT for a year.

I went on it to help my hot flushes. I have MS and each flush was literally crippling me.

I started with Elleste Duo (1mg I think), and for the first month I can honestly say I felt better than I have for at least 10 years. I was like a new woman! I managed to sleep quite well, the flushes stopped and I had more energy. After that first month, though, it was all downhill. I was also quite shocked that my periods were as bad (heavy, painful) as ever.

Then the bad stuff really started... I had PTSD twenty years ago, but it had nothing on the anxiety I started having.

By March I was suicidal, went to the GP who gave me Diazepam. That worked on calming me down a bit, then the penny dropped and I realised that the anxiety was probably related to the HRT. I used to have severe PMS which contributed to the breakdown of my first marriage. I would turn into a monster once a month and my ex would look at me like I had 2 heads on my shoulders - which, of course, made me worse. The Prozac I was given for the PTSD stopped it in its tracks. The only other time my PMS was under control was when I used a triphasic Pill without a break - no period and no PMS. Wonderful times.

I went back to the GP and told her I thought the HRT was affecting me so she put me on FemSeven Sequi. This helped my anxiety and I started to calm down. It's also given me "normal" periods that don't chain me to the loo for a week for the first time in at least 15 years. However, I had difficulty keeping the patches on and was going through so many boxes, another GP switched me to Evorel Conti.

These patches stick like the proverbial brown stuff and I'm not averse to changing them twice a week (though my skin is itchy and I'm having red patches that at least show me where NOT to put the next patch. At least the patches don't stink like the F7S). I'm also still having fairly light periods. Yay!

BUT, I'm now back to having quite severe flushes and my arm is like a windscreen wiper in bed (duvet off/on...off/on - I'm sure I'm not the only one who gets this). Daytime is worse.

So, can anyone help me with a suggestion for my GP next week please? The flushes are killing me. Some people with MS have something called Uthoff's Syndrome which makes us sensitive to heat and temporarily very weak. By the time my strength returns, I'm having another flush and it's really getting me down.

Would it help if I said I think I'm sensitive to Progesterone(Sp?) - the second half of the month hormone - though I might be barking up the wrong tree. Apart from the PMS, I've had many miscarriages and each pregnancy was a nightmare of all-day sickness throughout. I literally could not lift my head off the bed without heading for the bathroom. I started my periods at 8, they've always been bang on 28 days, the Pill made no difference to my PMS (apart from the year I spent on Trinovum with no bleed breaks), and my periods have always been horribly heavy.

In an ideal world, I'd love to find the HRT that stops my flushes (the reason I'm taking it), without setting off PMS and anxiety. Periods, I can cope with I suppose. I would also like to avoid tablets if possible, as I already rattle!

So, any suggestions? All gratefully received as I'm totally out of my depth here. Oh, and I'm rural West Wales so if anyone knows of a meno clinic anywhere in Wales, I'd love the details as the last GP I saw (haven't seen the same one for 4 years - and I'm a regular at the surgery!) told me there were NO clinics in Wales and I wouldn't be eligible for any in England - that surely can't be right?

TIA, Lucy.



 

[Dancinggirl]

Hi and welcome
It could be well worth having a Mirena fitted as this will usually result in no bleeding after the first 3-6 months. Less progesterone is absorbed round the body with the Mirena, so usually fewer side effects, however, progesterone effects can be felt initially but this tends to settle.
Once you have the Mirena, you can then use as little or as much oestrogen as you need to control meno symptoms. You could use Oestrogel, oestrogen pills or oestrogen only patches.
Sometimes flushes can be a sign of poor thyroid function so do have this checked.
DG x

[onion relish]

Wow, DG, that was quick. Are you having a boring Saturday afternoon like me?

Thanks for the reply, though I forgot to mention I tried Mirena a few years ago but had it removed as it caused me to bleed non-stop. I also had a horrendous time with insertion due to my dodgy (like the rest of me I suppose) cervix. I wouldn't be the first in the queue for it, but I may have a go again, though.

Thanks again.

[Dancinggirl]

Perhaps still try the Oestrogel but use a seperate progesterone - either Provera or Utrogestan - as these are kinder and may suit you better.
It's trial and error with HRT and I'm afraid most HRT combos will bring some side effects. DG x

[onion relish]

Thanks again Dancinggirl.

Does the progesterone come in a gel form?

I had thought of asking for the gel then using the progesterone patches, but not the oestrogen ones in the Evorel pack IYSWIM. If they do the progesterone gel I won't have to.

I'm really reluctant to take any more pills than I have to as I'm already up to 34 (minimum!) a day. My OH has to sort through the prescriptions when they arrive as I get lost.

[daisysareyellow]

Thanks again Dancinggirl.

Does the progesterone come in a gel form?

I had thought of asking for the gel then using the progesterone patches, but not the oestrogen ones in the Evorel pack IYSWIM. If they do the progesterone gel I won't have to.

I'm really reluctant to take any more pills than I have to as I'm already up to 34 (minimum!) a day. My OH has to sort through the prescriptions when they arrive as I get lost.

Hi OnionRelish
Sorry to hear you are having such a horrible time. It was your comment about the amount of pills you are taking that peaked my interest. Are they all medication or is some supplements and vitamins? I ask this because my father was on a lot of medication for his migraines and bi-polar. He had a major geriatric episode of bi-polar about 10 years ago and had to be sectioned. Whilst he was an involuntary patient, my brothers (doctors) and his treating doctors went through all his medications carefully and worked out a regime where the medications would not work against each other. He was also given some vitamins. In the end, he was on about 4 meds a days along with vitamins and the last years of his life were the best as he was a properly functioning human being again. Sometimes when you take a lot of medication, they are actively working against each other and can make you feel dreadful.

[Dancinggirl]

Hi onionrash
Daisysareyellow makes an excellent point. It could be well worth having your medication reveiwed to see if there are any contraindications or, as she has mentioned, things missing that could help your situation. Progesterone doesn't come as a gel Unfortunately but Utrogestan capsules can be used as a pessary into the vagina, however I don't think that's going to help your dilemma.
Reducing meno symptoms can be difficult, as HRT can bring unwanted side effects and it is the benefits versus side effects one has to consider - so basically, is it really helping?
Look under 'treatments on this site, print off all the info and discuss things with your doctor. It could be worth asking to be referred to a meno clinic for more specialist advice. DG x

[onion relish]

Hi both, and thanks for your replies.

All meds from the GP/neurologist/pain clinic. Reviewed annually.

The only new thing that I think has made my anxiety/depression worse has been the Elleste duet - I explained that to the locum GP (another one I haven't seen before) today and, guess what? She gave me a script for... Elleste Duet!

I asked was there ANYTHING else I could try to reduce the flushes without me having to take the tablets I'd had before and she said NO, take the tablets.

I asked if I could be referred to a meno clinic and was told she didn't think there were any in Wales. At this point I'm more than willing to travel.

So, ladies, if there are no meno clinics, who else could I be referred to? Gynae? Would my GP be able to refer me?

I really do NOT want to take these tablets. Hell comes to mind - literally - for me. The periods, the mental health problems. I don't want to go down that road again, stated that quite clearly, but was given that prescription.

I'm quite depressed now. And my MS has helpfully (not!) decided to kick off tonight as well. It never rains...

[peri]

Hi onion relish

Sorry to hear you're having such a hard time.  For what it's worth I didn't like elleste either, it made me feel terrible.  The Patches and gels are where it's at now and also don't have to pass through the liver like tablets so are much better for you. I don't think your locum knew what she was talking about.

If you put your postcode in at the top of the site and do a search it'll tell you where your nearest menopause clinic is.

Don't give in, it sometimes takes a few attempts with hrt to get it right.  Wishing you well x

[onion relish]

Hi Peri,

Thanks for your reply. I've put in my postcode but it comes up blank. I've also tried clicking on the map but again, nothing comes up.

I'm in rural Wales and am depressingly used to poor health service access, but I'm willing (and used) to travelling for my health appointments. The locum was thumbing through the BNF but couldn't find anything on HRT until I told her I was on Evorel, then she looked that up.

I'm sorry you had a rough time with Elleste, too. Can I ask if you suffered badly with PMS when you were younger?

[peri]

That's a pity, are you able to travel to England?  Yes pmt became a problem for me in my early forties, culminating in peri menopause about 47/48.  However, looking back I think I always had a couple of 'off' days every month I just hadn't made the connection.  Interestingly I could never tolerate the contraceptive pill it made me feel unwell and flat in mood and that's exactly how elleste left me feeling, I wouldn't touch it with a bargepoll x

[onion relish]

Oh Peri,

I feel for you. I was like that. I discovered that taking the Pill without break for a holiday cut the horrible feelings so carried on without a break for a year. Not good, granted, but I was under a HUGE amount of stress at the time and could cope with neither the PMT weeks not the horrendous periods.

That came to a stop when my old GP twigged what I was doing when he asked why I was asking for my prescription too soon.

I just wish yesterday's GP would have at least listened when I told her I could NOT tolerate Elleste. It wasn't even as if I was rushed there as she seemed nice enough, explaining (what I already knew).

She was quite young, though, so maybe experience will give her insight into the fact that not everyone can tolerate the "popular" (pushed by drug companies, I presume - after seeing this happen a lot when I worked in a hospital!) options.