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[Hollybobs]

Firstly thank you for any help / advice offered, I'm still somewhat shocked and confused about my diagnosis that I'm hoping members can help. This is my first post, hope this is the right place to discuss.
Background is I'm 41 years old, never had children. Very skinny but healthy (had my weight investigated several times with no issues identified although some of my medical colleagues in the past have been convinced I've got thyroid problems - been tested 4 times)
February this year my periods stopped completely. I've also had some weight loss, wasn't particularly concerned as I'd been experiencing a considerable amount of stress. My sleep has been up the wall, woke many times with hair soaking wet but just figured I'd got hot. Supplemented between meals with whey protein and carried on regardless.
In June I had a terrible episode of abdominal pain. The beginning of the week, I started having very mild hot flushes randomly through the day. Certainly nothing to the degree I've seen other women experience. By the Friday I was having what I felt was period pain and was using hot water bottles to relieve the cramps. The pain become worse, in particular lower right abdominal region. I didn't feel I was experiencing a gastro bug but my whole abdomen was bloated and cramped and nothing seemed to relieve. The pain become excruciating and I was vomiting with the severity. My partner is a dentist, he was very concerned and took me to out of hours GP.
They took a brief look at me, said they couldn't examine my stomach as it was so bloated. Tested my urine with dipstick, finding blood in my urine. Diagnosed me as having colic and to follow up with my GP about my lack of periods and bloody in my urine.
Seen my GP practice (locum) a few days later (already feeling better but I had lost several lbs in weight)
Urine retested, that was clear. Sent me for blood tests of which my FSH was deemed high (53)
Locum told me I was menopausal, gave me some literature to read and to come back when I'd decided about HRT. He also prescribed me buscapan which I've taken when I've been experiencing stress and this seems to work well. Not sure if this is IBS due to menopause, but seen it reported.
Discussed bombshell with my partner (dentist) We felt that the locum was probably right and because of my low body weight and partner suspects a loss in muscle mass, I returned to see my own GP about starting HRT.
My GP was somewhat alarmed by locum diagnosis because of my age. Sent me for further hormone tests and a pelvic scan. Scan same back with a small suspected dermoid cyst on my right ovary, referred to gynaecologist.
Gynaecologist consultant was ill when I went but seen a junior Dr in a "one stop" clinic where I had a TV scan which they felt was a dermoid. I was a bit dissapointed here as I was convinced whatever was on my right ovary was responsible for all the problems I had been having. (I am relieved it's nothing nasty obviously) Based on my GPs hormone tests I also had an increase in LH. Apparently there was a discussion between the hospital, the laboratory and my GP that despite my oestrogen levels being within range, I should start HRT.
I have a repeat scan next month to assess any change with the dermoid.  Seen my GP practice and the locum has prescribed me elleste duet 1mg.

What I've not mentioned is amongst all this, I had a spinal injury back in 2015. I crushed L3 according to private chiropractor I seen. Did lots of exercises (which I still do) and whilst muscle spasm went and I recovered, I've been left with a constant dull ache at the base of my spine and my hips. I had just accepted this was the residual after effects of my injury.
So 4 days into elleste duet, my back pain stops. Completely. To say I was elated was an understatement. I'm confused why it's done this but so happy that I wasn't for questioning.
Then 4 days into the green tablets and the back pain is not only back but with with an absolute vengeance. Literally I've been walking like a cripple at times and all my physio have been painful to do.
I'm now at the end of the green tablets, according to instructions I'm due a period but that or any PMS type symptoms have yet to appear. My hot flushes seem the same. Possibly more restless during the night but that could be my back pain.
I've done some googling. Ive come across a med paper where slender women with low scoring bone scans have been treated successfully with elleste duet for the back pain. My friend who is a GP is suggesting I have a bone scan but I don't think I meet the criteria for a dexa scan as I'm too young.
I also don't understand why I could have such a positive response with the oestrogen alone when apparently my oestrogen isn't low anyway? Similarly, I don't understand why the back pain would come back with the progesterone. I'm hoping at the moment that this is just a glitch and things will improve further in with the HRT?

Sorry for very lengthy post. It's been upsetting enough to be told I have early menopause. I'm confused to my diagnosis and my FSH and LH being high when my oestrogen isn't low. Then the surprise of a chronic pain problem dissapearing when I have had oestrogen yet return with the progesterone? Any input / reassurance would be gratefully received. I'm also completely open to considering private dexa scan / endocrinologist referral if members feel it is justified.

[Dancinggirl]

Hi and welcome to MM
I had a premature menopause- I went into peri meno in my mid 30s just after having my second baby.
I am now 61 , had HRT treatment on and off for 25 years but since stopping HRT,  18 months ago, have developed gastric problems and lower back pain - now diagnosed with deterioration in spine between L3 & L4 - so bulging disk😳. I really empathise with your pain.
Early menopause is actually quite common but GPs not good at picking this up. High FSH indicates meno but you are probably still peri meno so oestrogen levels will fluctuate in peri which results in normal  oestegen readings at times.
 If you are very slender then a bone density scan would be a very good idea, especially if you are already getting spinal problems.
The lower back pain you got with the prigesteone part of the HRT May have been to do with your body preparing for the bleed - so your uterus was waking up and pressing on your damaged vertebrae. Oestogen will increase collagen so this helps with joint pain. Muscle loss is also to do with low oestrogen. Oestrogen is beneficial for many things, particularly protecting you heart and bones.
As your partner is a dentist, he may be able to use his medical knowledge to support you better - if I were him I'd get you a specialist gynae for proper advice. It is essential you have HRT till at least your mid 50s. You may have been peri meno for some time so it's going to take time for the body adjust to the HRT and for the hormones to work their magic.
Hopefully your next scan will give you some more info  - you need some proper specialist advice to protect your long term health. You may well find your weight stabilises once you've been on HRT for 4-6 months.
Many women react to the progesterone phase of HRT quite badly and some side effects are usual with any progesterone type.  You might to better with Femoston sequi??? -   Kinder progesterone in it.  However, you may have to experiment with various types of HRT till you find the best one for you.
Read up all the info on this site, print out the stuff on the various HRT types to aid discussion with you doctors.
Also check the Daisynetwork site that's for POF ladies. There is a section on this site about POF as well.
Keep posting. DG x

[Butterfly22]

Hi I don't have much advice but wanted to say I had an early menopause too, sometimes it's a comfort to no yr not alone, as can be devastaing  news.
I'm sure you would get a bone scan as I've had them for quite a few years. Xxx

[Cassie]

I had one too at 38 been on the rub on gel and utrogestan since then and it works very very well for long term treatment i can highly recommend and perhaps better than tablets as its via the skin that the gel is delivered, tablets can also make one very bloated so perhaps find out about a gel or patches considering you will be on the hrt for a lot longer than most ladies.

[Dancinggirl]

Hollybobs
Do be aware that there will be many posts from ladies advising you use particular HRT regimes and these will be recommendations from personal experience.
Cassie is on a very popular HRT regime these days ( Utrogestan is considered very natural and bioindentical) however, do bare in mind that we are all different so the Utrogestan type of progesterone doesn't suit everyone - I personally found Utrogestan gave me more side effects than any other progesterone!!! Used orally it can make one very sedated and used vaginally it can irritate the bladder and vaginal area - many women do find it great.
Oestrogel or oestrogen patches are very good but the gel allows you adjust the dose of oestrogen to find just the right amount you need each day to feel good. Alongside Oestrogel, applied daily to inner thighs, you can use 12 days of either Utrogestan or Provera each month to facilitate a shedding of the womb lining which is the bleed/period (which is why you need to use progesterone).
I do advice you stick with any particular HRT for at least 3 months to allow the body to settle - chopping and changing can cause more problems.
Over my 25 years of HRT I tried just about everything. My best sequential regime in my 40s was 2 pumps of Oestrogel  daily with 10 days of Provera each month. Then in my 50s I had a Mirena fitted (which meant I had no bleeding at all after the first few weeks) and continued with Oestrogel alongside.
We are all different and you need to find what gives the most benefits with the least side effects - no HRT will be perfect.  DG xxx

[Hollybobs]

Thank you so much for your responses. I agree I do need to give the elleste a chance to settle my hormones down first before I can know if it's working for me. I think I will just bear in mind that I may have further episodes of back pain when I change over to the green tablets in the coming months and not over do a things. (Have to admit when my back improved and I felt more energetic, I naively thought my troubles were over which with hindsight, was a bit ambitious!)
Thanks you for the input on bone scans, I thought there was a protocol and I wouldn't be eligible but I will enquire with my GP.
I think I'm also going to try some collagen supplements and maybe some other vitamins for mature women to see if they help as the comment about oestrogen effecting this is enlightening. When I did injure my back, one thing that I did notice was my back felt weaker the week prior to my period and I seemed prone to injury. The chiropractor said this was because hormones increase the laxity of joints and ligaments so I'm hopefully supplements might address this.
Thank you all so much for your input. I haven't really got any close friends who have experienced the menopause so I've been feeling somewhat isolated.
With regards to the elleste. I finish my first pack tonight. According to the instructions, I could still have a period within the first 5 days of the 2nd pack. If I don't, is this any cause for concern?

[Dancinggirl]

Hi hollybobs

If you started the HRT with low oestrogen levels then you may not get a good bleed at first - it can take time for the oestrogen levels to build and give enough of a king in the womb to shed. Not every women gets a bleed in sequi HRT either.
You may actually need a higher dose of HRT to get full benefits - time will tell. Hopefully they will do blood tests after being on HRT for 3 months to make sure your oestrogen levels are good enough to protect your heart and bones - with early meno it's very important to maintain appropriate oestrogen levels.
I was lucky when my meno symptoms started in my mid 30s, I had a GP who had started her career as a gynaecologist and she gave me very good advice. She simply said, “if I was her daughter, she would insist I use HRT.”
One if the first things my GP insisted on when blood tests showed I was peri meno, was to send me for a dexa scan - I already had some bone density loss!!!
Supplements can be a help at times but there is no substitute for a good diet. Small amounts often, highly nutritious food and make sure you have enough calcium rich foods eg dairy, plus plenty of fruit vegetables. Omega 3, vitamin D and magnesium are good supplements to take to help bones, joints and improve energy. My brother-in-law is a gastonenterilogist and says everyone needs VitaminD supplements in winter and even year round if you don't get enough sun. Oily fish is good for vitamin D and Omega 3 so try to have this 2-3 times a week.
As you have an ongoing back issue, I actually don't think the progesterone caused the return of the pain - it's probably very sensitive to anything.  I simply have to be really careful these days - I had a mri to look at my spine and my L3& L4 are compressing the disk between these vertebrae and causing it to bulge and become inflamed. The disks will never go back to what they were and I get electric shocks in that area regularly. I had a epidural injection of steroid in the disk which has helped enormously - I wouldn't personally see a chiropractor for this type of problem - manipulating this type of injury might make things worse. I would like to suggest you see a rheumatologist if you back problems don't improve  for more specialised advice.
 I was a professional dancer and I'm still active but find I can't do anything that puts any strain on my lower back these days - I just have to manage things with very gentle exercise to keep my core muscles strong and do lots of brisk walking. The key advice I got from the rheumatologist was to not sit for too long, just keep moving.
Good luck DG x