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[rosie17]

Hello, ladies. I've been eavesdropping on you for quite a while and find myself needing to reach out for some help and advice.

A little about me: I'm a 62-year-old woman in the U.S. who hasn't had a period for 9-10 years. I did okay until maybe 4-5 years ago when I started having cyclic PMS-like symptoms, but WAY worse than anything I had when I was younger, even during perimenopause. These episodes seem to come monthly and are completely debilitating. They usually last 4-5 days, then everything goes back to normal.

During these episodes, I have extreme anxiety and cry almost constantly. I can't eat because my stomach is tied in knots …just the thought of any type of food makes me cringe. My usual muscle aches and pains are magnified, I get a slight headache, have mild hot flushes (which I normally don't have), I'm overwhelmed by fear, and feel as if an alien has taken control of my body. I basically exist on Xanax and Pepto-Bismol. I get to the point where I don't want to live anymore, then things gradually get better and I can eat anything I want without problems, the muscle pain settles down a little and I feel pretty good…until the next episode.

I've done some searching on the Internet and actually found posts on other forums by women around my age and older who have the same symptoms – they call them phantom or silent periods, but I haven't seen any research or studies of this phenomenon. I've considered the fact that these episodes may have nothing to do with menopause or hormones, but then why the cyclic nature of them? I've had all sorts of tests and my doctor says I'm the picture of health.

At the present moment, I'm coming out the other end of one of these episodes. This one hit me especially hard and I actually ended up in the emergency department this past Sunday because my stomach hurt so bad and my anxiety was through the roof. I had a CAT scan of my abdomen which showed everything was normal, which was a great relief. I felt pretty good for a couple of days when I had another panic attack and had to resort to taking Xanax. I don't like taking it, but I'm sure glad I have it on hand.

I've tried estrogen and progesterone half-heartedly in the past, but didn't stick with it because the fear of cancer was always in the back of my mind, even though I have no risk factors. The only health issues I have are hypothyroidism, which is being treated, and osteoporosis. I still have all my lady parts. Is it possible that these episodes could be caused by an estrogen surge or an estrogen dip after all these years? Am I going through menopause a second time? My doctor is very open to me using hormones if I want, but I'm afraid that estrogen may make my symptoms worse.

My last serum hormone test in May 2017 showed (postmenopausal reference ranges in parentheses):

Progesterone 0.2 (0.0 - 0.1)
Total Estrogens 142 (<40)
Estradiol 40.2 (<6.0 - 54.7)
Total Testosterone 13 (3 – 41)
Free Testosterone 1.2 (0.0 – 4.2)

I don't put much stock in reference ranges because I realize they are the normal levels in postmenopausal women, not what is optimal. Do you think estrogen would help even out these highs and lows?

I've searched this forum and most of the posts about phantom periods have to do with perimenopause, not 10 years down the road! I just don't get it and wonder if anyone here  has gone or is going through this, and what you're doing for it. Thanks in advance from across the pond!

[Daisydot]

Hi Rosie  :welcomemm:sorry I can't help with any answers just wanted to say welcome.one of our more knowledgeable ladies will come along shortly I'm sure and give you some advice xx

[Annie0710]

Your thread title got me reading but now realise our stories are different

I was told a few years ago by a gynae  that I am going through a 2nd menopause, and they are usually more aggressive.  I first had symptoms when I was 32 after my hysterectomy, my ovaries failed so I started and have ever since been on oestrogen with all symptoms sorted.  Then at 45 I came crashing down with different symptoms, which led to the diagnosis of 2nd menopause.  A couple of years ago a scan revealed my ovaries had disintegrated so I think my ‘crash' was my body's realisation the ovaries weren't even chugging along any more, they were gone.  I thought through my experiences I may be able to help you but unfortunately I can't x

[Dancinggirl]

Hi and welcome to MM Rosie17
I'm wondering if there is something else going on as it seems to be related to you digestive system - it doesn't seem to be hormonal. You see, it's not just our hormones that can be cyclical, there can be other things that occur regularly and in fact because something happens once or twice, one can then expect it to happen and these episodes become a pattern?  Do you think you are reacting to particular foods?  Are there any triggers generally for when these episodes happen?  Have you discussed all this with a doctor?

I would suggest you keep a diary of what you eat to see if there is a correlation. You clearly have issues around anxiety and acid reflux and perhaps something to calm all this down may be of help?

You need to some specialist advice from a professional who can look at what is happening in a holistic way.  DG x

[rosie17]

Thank you so much, ladies!

Annie, I hope you got your problem sorted out and are feeling better.

Dancinggirl, I think you might be onto something. I've always had a nervous stomach and it's the first place stress hits me. And maybe the fear of another attack, even though I'm not consciously thinking about it, triggers it. Maybe more of a psychological thing? I was under a tremendous amount of stress when these episodes started. It's the cyclic nature of it that stumps me, which is why hormone imbalance seemed so obvious to me.

I'm retired and don't have anything going on that I would consider stress. I have discussed this with my doctor, a naturopath, and she has mentioned that she thinks I may be holding onto a lot of unresolved grief. Counseling may be in order here, though I've tried that and antidepressants in the past many times and it didn't seem to help much. I came across the list of menopause symptoms and I have about 31 of them. I even added a few of my own, dry eyes being one of them. I just wonder if HRT might be beneficial to me psychologically?? I guess I could give it a shot and see what happens. Your thoughts?

[Dancinggirl]

As you are very Post menopause, HRT may not be sensible. I think you need to start HRT within 5 years of your last period and it could possibly make your health trickier.
I really think you need to keep a diary. Really look at your diet to see if you could adjust a few things. I assume you eat small highly nutritious meals regularly and avoid caffiene, fruit juices and alcohol ? Drinking enough water is vital. Maybe try practising mindfulness and take more exercise? DG x

[Joaniepat]

rosie17, I can't say if HRT would help psychologically, but you may not be too old to start at 62 if you want to.

I was prescribed oestrogen after a hysterectomy and oophorectomy at the age of 48, but it was withdrawn by my GP when I reached 54 (average menopause age) due to the health scares resulting from the flawed millennial studies on women's health and HRT. This was in 2004. I resumed hormone supplementation last year at the age of 67, and now use transdermal estradiol and testosterone, as well as local oestrogen for urogenital issues.

If you have osteoporosis, then taking oestrogen would probably prevent it worsening and may even improve your bone health. It would also be beneficial for other tissues besides your bones.

DG, why do you believe one needs to start HRT within 5 years of the last period? I agree it would much be better for overall health to do so, but do you know of any research which indicates that it would be inadvisable to start later in life?

JP x

[Dancinggirl]

Joanne pat - I believe there are increased risks of stroke and other problems if more than 5 years post meno though with specialist supervision I think some women( like yourself) do try HRT when very post meno. If Rosie was getting flushes and night sweats then it might well be worth trying HRT but from what she is telling us I'm not convinced the HRT would help her. The difference for you was that you only needed oestrogen - it tends to be progesterone that causes the problems with HRT - and I expect your are being closely monitored.
I found that my body simply wouldn't tolerate progesterone the older I got and so I abandoned HRT at 60 - if I had had a hyster I'd still be using oestrogen. I do use Vagifem regularly though and will do for the rest of my life. DG x

[rosie17]

Thank you so much for the encouragement, joaniepat! It's nice to hear of other women starting HRT later in life. I would love to have started years ago when the symptoms first started and feel a little cheated.

I have very low-dose estrogen, progesterone and testosterone staring at me from my bathroom counter until I get up the nerve to use it. I think I'll just jump in and do it! One at a time.

Dancinggirl, your suggestions are spot on and we should all be doing them, whether on HRT or not. However, from what I understand, it was the synthetic progesterone that caused the most problems. I refuse to use anything synthetic in the way of hormones and will only use topicals, either patch or gel.

I have almost every known menopausal symptom and the thought of maybe living 20 more years like this, especially with osteoporosis, is very depressing. If it doesn't help psychologically, then it doesn't. But maybe, just maybe, it will.

[Dancinggirl]

Good luck Rosie - if you have the HRT there to try, then go for it. Do a sequential regime first to see if the oestrogen helps before adding it the progesterone.  I'd also add in the testosterone later once the oestrogen has settled.  Many women love the bio identical progesterone but sadly for me, when I tried it, it was more problematic than all the synthetic progesterones - we are all different and for me it didn't work. Let us now how you get on.  DG x

[rosie17]

Thanks for the tips, Dancinggirl.  I will post an update at some point, good or bad.  Take care.

[Hurdity]

Hi rosie17

 

The actual recommendations now are that if you start HRT aged under 60 or within 10 years of menopause, the benefits are likely to outweigh the risks, and may actually confer benefits for the cardio-vascular system, and reduce cornonary heart disease. Here is the consensus staetement from the British Menopause Society:

https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/

Taken from the summary points:

HRT prescribed before the age of 60 or within 10 years of the menopause has a favourable benefit /risk profile and is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

If HRT is used in women over 60 years of age, low doses should be started, preferably with a transdermal estradiol preparation.

There is also further information here:

https://thebms.org.uk/2012/10/hrt-and-cardiovascular-prevention/

There will be something similar for the North American (and International ) Menopause Societies. Yes just found it:
https://www.menopause.org/docs/default-source/2017/nams-2017-hormone-therapy-position-statement.pdf

"For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the
benefit-risk ratio is most favorable for treatment of botherso
me VMS and for those at elevated risk for bone loss or fracture.
For women who initiate HT more than 10 or 20 years from menop
ause onset or are aged 60 years or older, the benefit-risk
ratio appears less favorable because of the
greater absolute risks of coronary heart d
isease, stroke, venous thromboembolism,
and dementia. Longer durations of therapy should be for docum
ented indications such as pers
istent VMS or bone loss, with
shared decision making and periodic reevaluation. "

I hope this gives you enough information to help you and good luck with your treatment!

Hurdity x

[Dancinggirl]

Thank you Hurdity. I didn't know this.

Rosie17 - Hurdity knows her stuff so it is apparently ok for you to try HRT.  If you don't try, you'll never know if it would help. DG x

[rosie17]

Thank you, Hurdity! Very interesting. I'm going to give it a shot and see what happens. Quality of life is what I'm shooting for.

This is also interesting, even though it was published in 2001. It's quite long, but you can scroll down to the Summary.

http://www.bcmj.org/article/hrt-older-women-it-ever-too-late

(Apparently I don't know how to paste a link to this site - it works for me everywhere but here. But copy and paste will do. Is there a special trick I don't know about?)

[rosie17]

Never mind...I see that the link is correct after submitting the post, just looks wonky when the post is open. Never too old to learn!