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[Snowbear]

Hello. Apologies for the double post. I also posted this on the Personal Experience board but I wasn't sure of the best place to post so I put it here too. Its rather long!

I'm a 53 year old post menopausal woman and had my last period 4.5 years ago. Until HRT I had constant and severe hot flushes. I also have shed loads of other symptoms. I've been getting in a right mess chopping and changing HRTs.

About April last year I went on Estrogel for a few weeks. I felt I was getting nowhere and stoped it. I can't remember timescales but I then went on Elleste Duet Conti for eight weeks around June/July. It was 2mg estradiol and 1mg noresthisterone. It soon stopped the hot flushes. That happened in about two weeks. My severe all over body pain was still there but reduced. My migraines were a lot better and the vaginal dryness improved.

But, I was getting side effects. I was crying non stop, angry and irritable, I had swollen painful breasts most of the time I was on it apart from the first couple of weeks, started getting night sweats which I hadn't had since peri, my ‘brain zaps' which started when I stopped an SSRI antidepressant got a lot worse and stayed worse the whole time and generally, I was suffering from all the things I used to get when I had PMT. My hair was falling out in fistfuls. My chronic fatigue reached narcolepsy levels and was severe and constant on that HRT.

I then stopped it and a few things started calming. But the pain got excrutiating again and I felt hot flushes creeping in. I ended up cutting my HRT in half. I couldnt get an even cut so I was yo-yoking about with doses. I did this for about a month. I think I even went back to normal dose for a few days at the end! Somewhere along the line, my severe LPR/GERD improved to about 80%.

I then stopped early September and decided to try to grit my teeth through the menopause. My hot flushes stayed away initially. I had a massive withdrawal migraine. Around a month or so later, the hot flushes came back with a vengeance. My body pain became worse and I felt like my bones were breaking! Then the GERD/LPR came back worse than before. I'd lost the side effects of the HRT although my hair was continuing to fall out in fistfuls (and still is).

I then went back on Elleste Duet Conti. I didn't have the strength to go to the doctor and get a different one so I just used a 3 month pack I already had. I've been on it 2 months. Doctors prescribed lansoprazole for the stomach acid and I was very reluctant to take it as I'm scared of medication. I've been trying to take it. The HRT took much longer to start working this time, possibly because my oestrogen had plummeted and also because I think it's not absorbing as well because of the lansoprazole.

It took about 3-4 weeks this time for the flushes to stop. The vaginal dryness is slowly improving and my body pain, although severe, is less severe than with no HRT. My LPR and GERD are horrendous still. Things got complicated as I suddenly developed hives for the first time in my life. I don't think it was lansoprazole as I stopped it and the hives continued. They were all over my body and I was watching them all quickly appear. They calmed down after about five days and taking a couple of antihistamines. I eliminated all possible causes, except HRT. My skin has continued to itch like crazy and I'm still getting one or two hives. My scalp is covered in itchy flakes. I stopped the HRT for three days as a test and the itching calmed down but seemed to restart after restarting HRT. I also have dermatitis all around my eyes. It's bright red and itchy. That seemed to calm off HRT but start again on HRT.

I'm just starting to get the same HRT side effects as last time I was on it. Swollen painful breasts, night sweats etc etc. My brain zaps are terrible again.

I don't know whether I need to stay on Elleste Duet Conti a few months to build my oestrogen up and see if this all clears up but my gut feeling is that this is the wrong HRT for me. I'm tempted to stop it again and see if all the severe all over itching and dermatitis clears up along with the other side effects and a reduction in the brain zaps.

After doing this, I will see the doctor and discuss a different HRT such as Femoston Conti. I'm not sure about patches because of my hives and the noresthisterone in the patches. I'd rather have a more natural progesterone.

Does this sound like a good plan? Does anyone have any suggestions? I'm a mess! (I'm also very ill with loads of other ridiculous physical, mental and neurological symptoms. Psych meds are not an option for me as I react to them.) Thank you for reading my ramblings!

[Dotty]

Sounds like you need some good advice from a knowledgeable GP or a menopause specialist x

[Snowbear]

Thanks Dotty. I'm going to see a GP next week who specialises in women's health.

[Dotty]

Let us know how you get on

[Hurdity]

Hi Snowbear

So sorry to hear about your problems with HRT and that it's not working for you. Btw re where you post - some of us in a hurry tend to look at this board first - in fact sometimes this is the only one I look at, but di look at the others now and again and especially for those with no responses - as I think do other members -so would have got to yours eventually - but great you've got a response now.

Right I would say DEFINITELY change HRT. This one clearly isn't working for you. First it's tablet HRT and not recommended for those with stomach/digestive problems as you have as it can make them worse and lead to nausea etc. As you say now you are taking stomach meds you may not be absorbing them anyway. TRANSDERMAL is the way to go (not Femoston).

Second you are taking continuous combined HRT and whilst this is a no-bleed type - the continuous progestogen can give rise to side effects some of which you mention. Also as it is testosterone derived, symptoms like hair loss may be more likely to occur. Not sure about the hives - but others have reported this - could be the fillers or could be the progestogen?

You don't say what dose estrogel you were using or what progestogen but from what you've said I would recommend patches - Estradot are very small and unless you are very sensitive you can avoid skin irritation by being very careful how you take them off and if you feel itching try not to scratch the area itself. Also being careful not to rub the skin to get rid of the marks where they have stuck. If you use Estradot then you would need a separate progestogen - the natural one is Utrogestan ( micronised progesterone). Look at the preparation on the top menu (pale green banner - Treatments, HRT preparations) and you will see what's available. Have a good look and a think before you see the specialist GP so you know what the options are, what you would like to try and why.

I am in my 60's and only tried continuous combined HRT once  - won;t go into the boring story but it was when I tried low dose oestrogen (which didn't work). Any higher would have meant progesterone every day which I don't want. I use approx 50 mcg Estradot patch together with Utrogestan (used vaginally - off licence - GP is fine with this) every 6-8 weeks and get a small withdrawal bleed. I have no side effects ( well I feel a bit tired and headachey on the progesterone but not all the time but I can cope) and no crying or irritiability or anything like that - all is calm . Once you are post-menopausal your HRT (if right dose and right product for you) should keep you on an even keel compared to when you were fertile with hormones fluctuating wildly.

You need to watch your vitamin levels too if you are taking stomach meds as these type of meds (are they proton-pump inhibitors?) can  inhibit absorption as you pointed out - but maybe your stomach problems will improve when you stop taking the tabs? I don't really know about LPR/GERD - is it a medical condition or more like an over-sensitive stomach that can be sorted out eventually with diet and indigestion tablets as an alternative? I have been prescribed meds like this in the past but didn't take them.....

Anyway hope this helps and let us know how you get on with the GP - do ask if you have any more questions

Hurdity x

[Snowbear]

Thanks Dotty. I will let you know what happens.

Hurdity, thank you for your lovely reply. I really appreciate it.

I will definitely ask about the estradot. I didn't know you could use the utrogestan vaginally. Is that the capsules or is there a separate gel or cream? I will look online and talk to the doctor about this as a trial. I hope it works!

The stomach meds are PPIs and I've stopped them. I think they were actually making me worse! I'm also very medication sensitive and I was scared of taking them and scared of the long term effects. I've started taking licorice dgl which is meant to be great for reflux problems. I'm looking into other supplements too. I've also cut out caffeine as this burns through my throat sinuses and ears. I'm eating a strict diet to heal my oesophagus. I'm getting a camera down my throat in April to check what's going on.

Thanks again for your kindness. It means a lot to me.

[Hurdity]

Hi again Snowbear,

No problem!

Re the utrogestan - it is exactly the same capsule taken orally as used vaginally except you have to take 2 x 100 mg and these are tiny balls so a bit trickier to poke up when used vaginally but OK  -the 200 mg single dose (now only used for fertility) was somewhat easier to insert. It is used vaginally off-licence in UK but many consultants and some knowledgeable GPs prescribe it this way - but as it's the same thing you can just use it vaginally if you choose. Limited research shows that for a given dose more gets to the uterus when taken orally. There can be more side effects from oral use because of the metabolic by-prpducts from going through the liver. Not every woman is sensitive - and it's more like fatigue or sedating effects. Best thing is to try it and see. Some women hate it. I tolerate it. Musn't repeat myself!

Good luck - and also with sorting out your stomach problems. I go through phases of chewing a lot of those indigestion tabs and also avoiding alcohol which affects my stomach after too many days of alcohol every day!

Let us know how you get on....

Hurdity x

[Snowbear]

Hi again Snowbear,

No problem!

Re the utrogestan - it is exactly the same capsule taken orally as used vaginally except you have to take 2 x 100 mg and these are tiny balls so a bit trickier to poke up when used vaginally but OK  -the 200 mg single dose (now only used for fertility) was somewhat easier to insert. It is used vaginally off-licence in UK but many consultants and some knowledgeable GPs prescribe it this way - but as it's the same thing you can just use it vaginally if you choose. Limited research shows that for a given dose more gets to the uterus when taken orally. There can be more side effects from oral use because of the metabolic by-prpducts from going through the liver. Not every woman is sensitive - and it's more like fatigue or sedating effects. Best thing is to try it and see. Some women hate it. I tolerate it. Musn't repeat myself!

Good luck - and also with sorting out your stomach problems. I go through phases of chewing a lot of those indigestion tabs and also avoiding alcohol which affects my stomach after too many days of alcohol every day!

Let us know how you get on....

Hurdity x

Thanks so much Hurdity. I saw the doctor this evening and she was so lovely. I talked to her about Estradot patches and Utrogestan and she said that was exactly what she was going to suggest. She said the Oxford Menopause Clinic (I can't remember the name but it was something like that, I think) use that combination for women as it's more natural. She said I could try different doses over time until I get the dose that works best for me so she's willing to work with me in getting the right balance, which is great.

I will keep you posted. (My internet use is sporadic as I have severe neck and shoulder pain and don't often type.)

Thanks again for your help.