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[kinola67]

Hi all, I hope someone might be able to help! I am 50 and started having what I now know were menopause symptoms just over a year ago. Starting with major changes to bowel habits, bloating and then terrible joint pain along with severe fatigue. So after many doctor's visits and phone calls, blood tests, gynae ultrasounds and a colonoscopy to check out bowel, I then started hot flushes in August and realised after another blood test that I was in peri menopause! So I started to take menopace, vit D and cod liver oil, herbal tea and early bed and things started to calm down a bit and I felt a bit better towards the end of last year. At the same time I was put on the waiting list for the menopause clinic we have here in Edinburgh and had an appointment with them in January. By this time I was managing to keep the pains under control and wasn't sure if I needed further help but we decided it would be helpful to know where I was along with the menopause so we could decide next steps if the pains were ongoing or coming back worse. I have been on the mini pill for quite a few years as I suffer from ovaian cysts on my right ovary. As far as the cysts go the mini pill completely changed my life, no more cyst pain and pretty much no bleeding for years. I did have some bouts of irregular bleeding toward the end of last year which I've not really been able to explain. Anyway the consultant advised coming off the mini pill to see where we're at. My next appointment at the clinic was only a couple of weeks after I stopped the pill and I felt fine, infact better than before, no symptoms! We did discuss HRT and she gave me all the information so that I could decide on that if things got worse again. I thought perhaps that was it and I've been there and done it! However, now (about 6 weeks after i came off the pill) my cyst pain is back with a vengeance and I don't know whether a. to live with it and painkillers to see if it will go away b. go back on the pill to see if I can get back to where I was before but hopefully with no menopause symptoms. I suppose what I'm wondering is whether it is Ok to still be taking the mini pill throughout the menopause if then decide to have HRT if the pains etc return, and if I do go back on it, is the progesterone in the mini pill likely to cause more symptoms because of the imbalance in my hormones assuming the oestrogen has dropped? but if the oestrogen has dropped why am I forming cysts again (with no bleeding)? Last question - why is it all so bloomin confusing!!  Sorry this is such a long post

[Dancinggirl]

Hi and welcome to MM kinola67

It is very normal to be going through menopause at your age and the symptoms can be a shock. We all experience the menopause differently and through the peri meno stage symptoms can fluctuate greatly for some years.

Regarding the pain you are getting; it is probably a good idea to get this checked to find out to see if the pain is from an ovarian cyst.  The pain could be something else so a scan is probably a good idea before any more hormonal treatment. I don't know whether using HRT, which means adding oestrogen, will aggravate any cysts you may have but the fluctuating hormones of the peri meno stage can cause erratic bleeding, period cramps, headaches etc. Either ask for another appointment at the meno clinic or see your GP for a referral to a gynaecologist.

It's good to get clued up on the menopause so you understand what is going on and also find out about your options regarding HRT if you should decide you want to try it.
Here is an article that explains the peri menopause stage really well:
https://www.menopausematters.co.uk/magazine/pdf/Article%20-%20Perils%20of%20the%20Perimenopause.pdf

If you do experience cramps and erratic bleeding, then having a Mirena fitted can be a good option and you would then simply add oestrogen as pills, gel or patch to control flushes, night sweats etc.

Here is the section on you HRT options in peri menopause:
https://www.menopausematters.co.uk/perimeno.php

Get the pain checked out and let us know how you get on.  DG x

[kinola67]

Thanks very much for replying so quickly! yes I've had everthing checked out over the last year and a half, I've had numerous scans, a colonoscopy and an MRI just back in March so all is clear. It's just because I've come off the mini pill my 'cycle' if you could call it that seems to be kicking in again and my right ovary is growing it's cyst again (but no bleeding). It might burst and not come back or it might just continue to be a dull ache and then go away or stay. But it's not a pain I can manage properly for work or home life. I'm just not sure whether to go back on the mini pill. I'll make another doctors appointment but I know for certain they won't refer me again for any more scans! I could probably contact the menopause clinic again, I am signed off from there as at my late meeting we agreed my HRT options. I was feeling better though so I've not done anything about that. Thanks for the links, am reading them now!

[Dancinggirl]

Were you still on the BCP when the tests were done? Were you told after the scans and tests that the cyst was still present or were you actually told your cyst was regrowing? If the pain has emerged since you had all the tests, then another scan would be wise to see what's causing the pain - is it actually the cyst or is it period cramps due to your hormones fluctuating?  The progesterone only BCP you were using probably stopped the womb lining from building up and helped to control the cyst. Now off the BCP, your oestrogen levels will be fluctuating and you are unlikely to produce enough progesterone and your womb is now reacting and causing pain.
You could have a Mirena fitted that would do the same as the progesterone only BCP you were taking but deliver the progesterone more locally and then add in some oestrogen as gel or patch, as this might be less problematic. You need to go back to the clinic for further advice. DG x

[kinola67]

Yep all scans were done whilst on the cerazette, so i've had no cysts in recent years. I can feel it now so that's how I know it's arrived again. I used to have them and fibroids all thoughout my 30's and 40's until I found out what they were and started the cerazette - was such a saver at that time.
I will think about the mirena, I did go for a consult on that years ago but the consultant hassled me and told me he had to insert it when I was having a period  I was stressed out enough at that stage so thankfully a locum doctor suggested cerazette and I never looked back. Until peri menopause that is!! I suppose it's the fluctuating that's the nightmare, if oestrogen is dropping then you would think progesterone dropping would be OK, but perhaps not. I just didn't expect to have cysts again at this stage, with no bleeding, but until I am properly through menopause perhaps they will still keep forming. More local progesterone might be better, Ok I will email the clinic and see if they will see me again. Thanks for all your help! 

[Cassie]

I have had cysts since my early 30's I had surgery at the age of 38 to remove a cyst on each ovary and I am actually convinced that that is what caused my early menopause.  Went onto the pill at 38 but the cysts still returned. I then started with the rub on gel and Utrogestan when I turned 40. I am now well into my 50s and I still have cysts, I had a scan recently and have a fluid filled 3cm cyst on each ovary. They have been there since 2012 if not earlier and have never grown and blood tests are normal so the Dr has not bothered about them. I asked him why and he said some ladies are just more prone to cysts than others and perhaps you are also one of those. Mine do not cause pain though. There is no reason why you cannot use the pill as HRT if it helps with your cysts. The only reason I switched over to the gel was the pill caused a fibroid to start growing but when I started the gel it seemed to disappear. All the best.

[kinola67]

Thanks so much for your reply, its good to hear your story,sorry you've had such a time of it too with cysts and fibroids! yes I think we may just be more prone. I have 3 girls and I know my middle daughter already has a cyst on one of her ovaries, i know it's perfectly normal  too so just really hoping they don't have the problematic ones that I've had! I am waiting to see if I can get another appointment to ask about what to do, but if I can't see anyone soon I will go back on the mini pill and think about my options as whilst I feel as rubbish as this it's hard to be positive and think clearly. Currently blown up like a balloon! At least we are lucky to have options and fantastic forums where we can get advice, thanks again