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[Donna-paul]

Hi
It's been 3 weeks since stopping the hrt as the consultant said I may be at high risk of a stroke. I'm am really struggling and feeling awful the night sweats are all night and no sleep and the Adrenalin racing heart has started again. I feel so low and tearful and don't know where to go from here. I saw my gp this week who is really being helpful and said the consultant did say I could take just 1 pump of estrogel and try 100mg ultrogetan everyday but know the risks. Does anyone else get migraines with flashing lights and weak right arm when they took hrt, as this was what I was getting. I've ordered some phytosoya and St. John's wort to try but so tempted to try the hrt again. I saw mr Warren private and thinking I may need to see him again does anyone know if follow up appointments are cheaper? It's so wrong you have to pay to get good proper advice. Sorry if a bit long but no one else to talk to and understand.

[Mary G]

Donna-paul, sorry to hear you are struggling but I really do understand how difficult it is.  Why are you at high risk of a stroke?

Transdermal HRT does not put you at an even greater risk of a stroke and if you are really struggling I would say go for it. 

I suffer with silent migraines (visual disturbance for 25 minutes without headache) which are caused by low oestrogen levels in conjunction with all types of progesterone used in HRT preparations, nothing else.  Do you know what causes your migraines and have you always had them?  If you are the same as me and your migraines are caused by progesterone then the regime your consultant mentioned would not work because it involves taking Utrogestan every day but if your migraines are caused by hormonal fluctuations then it would be OK but you need to know what your trigger is before you start taking HRT again. 

What type of HRT were you taking before and how was that linked to your migraines?

It's taken me a long time to get there but I now have to take high levels of oestrogen all the time with a super low dose of Utrogestan every 5-6 weeks but I do have regular uterine scans to make sure I get adequate womb lining clearance.  So depending on what your particular migraine trigger is, this is something you could consider. 

I hope that helps.

[Donna-paul]

I only got the migraines as soon as I started the hrt didn't have them before. I use to get them when I took the pill years ago when it was the pill free week so had to stop them. The consultant said as I'm getting them on hrt with aura and weekness I'm at high risk of a stroke and my Nannie died of a stroke and she had migraines! I got them when just on the oestrogen as well so not sure if specific hormone. Since being of I am getting headaches everyday and but of flashing but not so bad and arm and pins and needles gone. It got worse when the pharmasis gave me oesdrdose not oestrogel and I tried to take more.

[Mary G]

If your migraines started with HRT and you also had them with the pill, it sounds like they are linked to hormones but you need to know which hormones. 

You say you had migraines on the oestrogen only part of HRT but if it was at the beginning of the oestrogen only phase it could still be linked to the progesterone because it stays in your system for a long time.  If you can remember when in the oestrogen only phase you had the migraine that would help to establish the cause. 

I think you will get there in the end but you need to find out if your migraines are caused by progesterone or hormone fluctuations.  If they are caused by hormone fluctuations then you need to be on continuous combined HRT and if they are caused by progesterone, you need to seriously limit the amount of progesterone you take. 

Perhaps you need to experiment for a while to find out?

[Dancinggirl]

Donna-paul - if you are seeing Mr Warren in Norwich - do go back to see him,  I think follow up appointments are £180  - you can call or email his lovely secretary to find out. 

You are obviously getting headaches wither withdrawal fo the progesterone and this is quite common. Are these headaches just for a day or so? Are you still getting them even without the HRT? You may be better with a Mirena, which give less systemic absorbtion and stops the fluctuations of the sequi HRt.

Quote about Mirena from this site:
Progestogenic absorption throughout the body is minimal so reducing progestogenic side effects. The effect of Mirena on the womb lining can significantly reduce bleeding and when used as part of an HRT regimen, in time, 30 to 60% of women have no bleeding at all. Although Mirena used for contraception is licensed for 5 years, the license for use for the progestogen part of HRT is currently 4 years.

Have you been diagnosed as suffering from migraines or are these more general headaches?  I got headaches when I tried the more modern BCPs after having my first baby - the older BCPs had suited me fine.  I also found I got a lot of headaches in the peri meno stage.

Keep a diary of when your get headaches - eat small meals regularly, reduce sugar as much as possible.  Drink plenty of water but avoid caffeine, fruit juices and alcohol.

Personally I would try the sequi version of Oestrogel with Utrogestan - so start really low with one pump of Oestrogel each day for 3 weeks and then do 12 days of Utrogestan. Mr Warren explained that taking progesterone for at least 10 days each month was very important, so, unless you can afford to have regular scans, using Utro for fewer days may cause problematic bleeding (as happened too me).

The alternative is to try an SRRI but, if you are under 50, then this is not the best option for you and SRRIs are not without side effects.   DG x

[Donna-paul]

Thank you all for your great advice. The bad headaches which I think are migraines as had awful flashing lights ,problems with my sight in one eye and heavy arm and pins and needles. Also felt like tight band on my head and couldn't deal with flashing lights or noise. I do now think it maybe the flatuactions of the hormones I had it all the time on oestrogel got worse when tried to go up to 2 pumps but got better when I started the progerstone. Both the private and nhs consultants have recommended progestrone all the time! What do I do I feel my body desperately needs oestrogen as I felt better in that tearfulness went days flushes went, felt able to cope better even ibs was better, it didn't take aniexty away or night flushes completely away. I like to see Mr Warren again but he only does private now and a 20 min follow up is £150! I don't know where I am they think now post menopausable but I feel like I've got pmt all the time with greasy skin and hair but no period!

[paisley]

It is horrible coming off HRT as your body is in shock because you have done it suddenly. I stopped my HRT last May suddenly & it does gradually get better. I had all the same things as you. The anxiety is awful & the weepiness. It depends if you can put up with the symptoms from stopping. There has been so many times in the last 9 months when I have just been tempted to go back on the HRT. At the moment I take Menopause Support by A. Vogel & Valerina for the anxiety. Only you know if you can cope without or not.

[Donna-paul]

Much needed update and advice from you lovely ladies going through this awful menopause journey. It's been nearly 4 months since I stop the hrt as consultant frightened me about side effects. Well I'm physically and mentally exhausted and really can't cope with hot flushes day and night and my body running on Adrenalin all the time do anyone else get this? Had discussion with Gp today and considering the minimum the consultant recommend I can have 1 pump of estrogel and 100mg Utrogestan every day to stop hormones fluctuations and hopefully no migraines is anyone else doing this? Aniexty has gone through the roof with hot flushes and no sleep tried alternatives but no good.

[Dancinggirl]

Donna - it's worth giving this low dose a try - nothing ventured, nothing gained. Good luck. DG x

[Donna-paul]

Thank you dancing girl do you know what causes the Adrenalin my dr says it's to do with the hot flushes? Also he did say some women just take a couple of pumps of oestrogen a week I assume without progerstone? Another question if you know can you take k2 with hrt as I'm on Vit d with k2 for definencey?

[Dancinggirl]

Yes, I think the surges are to do with the flushes. I get these through my legs at night.
I do not think a couple of pumps of Oestrogel per week would do much good for you but one pump per day might be helpful.
If you have your uterus(womb) then you must still use progesterone if using oestrogen, even at very low doses, but you might get away with using Utrogestan vaginally for about 10 days every 4-5 weeks if you are just using one pump of Oestrogel per day but it should be under medical  supervision.
 Vitamins will not effect HRT. It's imortant you keep your vitamins D and K levels up. DG x

[Tempest]

Something you could try Donna-Paul is Clonidine. This is a blood pressure medication that is used to help hot flushes and is ocasionally used as a migraine preventative. Maybe do a little research to see if you might like to try it and go ask your GP? It also partly blocks the release of adrenaline too, you'll be pleased to know! This is why it is also sometimes used to treat anxiety.

The adrenaline is real - before a flush we release stress hormones such as cortisol and epinephrine and our heart rate speeds up and blood pressure drops slightly. It's part of the whole hot flush process! Very, very nasty and disturbing I know as when I have mine I get this very intensely. I can sympathise completely!

I hope this gives you another option to think about, and reassures you that what you're experiencing is truly horrid but normal!
xxxx

[Mary G]

Donna-paul, I would definitely go for it.  You will probably be able to adjust the doses slightly later on if you need to.

[Tempest]

Oh and btw - I've had aura too and have a congenital heart aneurysm that slightly raises my stroke risk that was discovered just last year and my neuro. and cardio. are fine with HRT as long as it's transdermal. Is there any chance you could get a more professional opinion on the cause of yours before you have to give up on HRT? xxxx