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[foreignname]

Hi all

I'm nearly 45 and have several peri symptoms. A few night sweats, general anxiety, lethargy, occasional palpitations, some aches and pains in my joints in the mornings. On their own, I could probably manage these... However, I am really suffering with migraines and prolonged headaches that are triggered at the start of my cycle. They leave me unable to function for several days, affect my mood and are really getting me down. This is not helped by a stressful period of my life with very little consistency re: my job and having to travel quite far for work. I have two kids (one at secondary and one at primary) and generally a busy life with no support from family as they all live far away. My periods are still fairly regular (27-35 day cycle) but are lasting longer and my PMS symptoms are worse as I get older.

I went to the GP to discuss HRT as I believe low levels of oestrogen are contributing to the headaches. I came away with Evorel Sequi. I am scared to start taking them though even though I've read all the info on risks vs benefits. I always said I never would. My mum took HRT and has had both breast and ovarian cancer. She is now well at 74 but has had a terrible time of things having had surgery and chemo twice and radiotherapy once.

I just don't know what to do! I suppose I should try the patches so I have some idea whether they might help. Can people share their stories if you've experienced similar? I feel like I moan about this to my husband and predominantly younger friends who don't really understand. I feel like the migraines are ruining my life...

Thanks for reading!

[CarryWarry]

Hi there.  Firstly i just want to say my heart goes out to you when I read this because I have suffered almost daily with exhausting headaches for over 2 years (but I wasted time going down the wrong roads trying to sort it, eventually working out it was hormonal).  It's so tough for you as your Mum has had such a terrible experience and I can completely understand why you are balancing the pros and cons as to which route to take.  My own Mum was on HRT for 17 years and loved it and is still healthy and amazing at the age of 80 today.  Therefore it was an easy choice for me to start down the route of HRT.  Firstly if you have not had blood tests done yet, I think you should ask for them as many GPs just dish out HRT not even knowing what levels of oestrogen or progesterone we have in our bodies.  These levels play an enormous significance, once you know more about them you can work on the best route for you.  I'm so sorry not to be more helpful but I really do think having blood tests can save loads of time and help you get on to the right path faster.

Carry Warry

[foreignname]

Thanks so much for the reply and kind words. I suspect it's not NHS protocol to do blood tests until someone has tried HRT. I was not offered them and was told during a previous conversation they don't do them routinely. I agree that I would like some proof that it is indeed the hormone changes that cause the migraines. I suppose I know really that is the cause, having tracked them along with my cycle for several years. Plus, I suppose the peri symptoms will only get worse and evolve into the awful menopause symptoms my mum experienced that led her to take HRT twenty five years ago!

It's pretty shitty being a middle aged woman, eh?

[SueLW]

Hello

This is what happened to me when I was early 40's.  I had been prone to the odd 2 day migraine just before a period, but they were usually sharp and horrible but short.  As I got older my period pain grew much worse and my migraines were much worse too.  They lasted for more days and came more frequently.  I had a Mirena coil fitted.  I felt fat, tired and miserable for the first couple of months and then it all settled down and I was great and period free for the next 6 years.  When I had it removed I didn't know much about HRT otherwise I'd have had another straight away and started adding oestrogen. 

I am about to ask for another Mirena.  The HRT I've been using is no longer working out for me.  I'll use Estrogel or patches for the oestrogen with the coil.  I never had any issues with it once my body got used to having the progesterone in it's system again.

[Sid]

Hiya
My migraines restarted when I was about 43 after a break of many years. I asked my doctor if it was likely to be due to changing hormones and he just shrugged. I am sure it is hormonal: migraines started at puberty, stopped when I was about 20 (hormones stable)and started again in my forties. At one time I was getting 20 migraines a month and was feeling awful. I took various migraine prophylactics for 10 years, the latest being Topiramate, an anti-epileptic, which was very effective and reduced the number to 1 or 2 a month.  I recently stopped Topiramate as I have been diagnosed with severe osteopenia (genetic) and it is not known whether this drug, like other anti-epileptics, increases bone loss. I am now on HRT and, touch wood, my migraines have not increased.  I take Evorel 50 patches with Utrogestan 200mg on days 15 to 26. My doctor says that the patches are good for migraineurs as the oestrogen release is steady - no highs and lows - and does not go through the liver.

I am so sorry you are in a dilemma because of your mum's experience and hope you find a solution soon x

[Mary G]

foreignname, I don't know if this will help you at all but I started getting silent migraines (aura without headache) in the lead up to the menopause.  Long story short, mine are caused by low oestrogen (before period when menstruating) in conjunction with synthetic progesterone - I had a Mirena coil for contraception at the time they started.

The key is to know what your personal trigger is and I suspect your trigger is low oestrogen.  You say they start with a period so that would be day 1 or 2 of the cycle I assume? 

It took me a long time to work out what was going on but now I have to make sure that my oestrogen levels are constantly high and my intake of progesterone (all varieties) is very low.  I can do this because I have regular uterine scans to check the lining which is always well within the limits.

I would try the Evorel sequi patches but if you find that you get a migraine when on the progesterone part or when the period starts, then it would be a good idea to switch to Oestrogel and a separate progesterone.  I agree that a Mirena coil with Oestrogel could work very well because you would avoid the hormonal dips that you get with a cycle but if your migraines are caused by low oestrogen, you would need to keep your levels high and would need 3-4 pumps of Oestrogel every day - the beauty of Oestrogel is that it is very dose flexible.  Although the progesterone from the coil mainly stays confined to the womb, enough of it gets into your system to cause side effects so that is why it is important to keep your oestrogen levels high if you suffer with low oestrogen induced migraines.

I would try the Evorel patches first and see how they work.  At least if you feel much better during the oestrogen only phase, you will have something to work with.

[foreignname]

Thank you all for being enormously kind and helpful, it is really useful to hear your experiences. Sid, what you said really resonated with me. I had terrible migraines as a teen then none for many years. They got much worse after I'd finished having children.
I think I am going to give them a try. I'm pretty sure the trigger is a drop in oestrogen. When I was on the progesterone only pill some years ago I had really bad mood swings and irritability. But who knows what my natural progesterone levels are now...
I will report back.

[CarryWarry]

Hello

This is what happened to me when I was early 40's.  I had been prone to the odd 2 day migraine just before a period, but they were usually sharp and horrible but short.  As I got older my period pain grew much worse and my migraines were much worse too.  They lasted for more days and came more frequently.  I had a Mirena coil fitted.  I felt fat, tired and miserable for the first couple of months and then it all settled down and I was great and period free for the next 6 years.  When I had it removed I didn't know much about HRT otherwise I'd have had another straight away and started adding oestrogen.  etc.

Sue - I couldn't agree more about the Mirena story.  If I had known three years ago (tomorrow to the exact date) when I had my Mirena removed (after 17 year) what I've learnt since about it being used as a menopausal tool i would NEVER have had it removed and would have just added oestrogen back then!  Three years of going round in a big circle.  Now the Mirena is causing a rotten period (day 9) and I think if I only I knew what I knew back then I'd probably have had 2.5 years far happier than the nightmare I've been through with my head...and no bleeding at all just added hormones..  What a mess all because of lack of knowledge from the people we trust.  (Sorry don't mean to sound bitter, but it's a hard pill to swallow if you'll pardon the pun  )

Foreignname - I wish you well soon, as with all of us here....it's a good game played slowly. xx

[foreignname]

So a bit of an update from me... I will use my last patch from a box today and started a bleed properly yesterday after two days of spotting.

No headache or migraine as would be normal at this point in my cycle.
I've found my levels of anxiety to be increased though which is quite annoying - I'm hoping this will settle in a couple of cycles.
The first patches made me feel amazing.

So, we will see how I feel after three boxes!

[Jocy-66]

Sounds positive to me ! I'm also just starting the patches and feeling unsure about how anxious I feel but prepared to wait a while to see. However I'm really struggling with  the glue when I remove my patch I'm left with an area of the outline edge that has gathered particles of everything like threads from my clothes and I have these dreadful outlined squares on my skin Has anyone else found a solution to this what can I use to remove old glue ? Looks so bad !!!

[ali 61]

Jocy-66
I've just started the Evorel Conti patches. I find that baby oil removes the remaining glue really easily.
Hope this helps.

Foreignname.....Glad you havent had a migraine. I have suffered with 2 per week for 20 years.
My dr gave me patches, as that is best for migraine sufferers.
The 1st couple of patches gave me increased anxiety...but that has settled quite quickly.