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[Annie0710]

I think this lovely Specialist covers lots on menopause x

https://youtu.be/JMF4EwODch8

[Tempest]

She does indeed, Annie! Thank you for posting.

The only issue I have is that on her website, she states that when a woman stops HRT and if her menopause is 'over', then any withdrawal symptoms should only last a 'couple of weeks at the very most' (!) https://menopausedoctor.co.uk/what-is-the-menopause/myths-about-hrt/

I'm pretty sure from the many experiences I've read from women and the fact that HRT takes up to 3 months to work, that it would be rather longer than that for things to settle once stopping. I've only ever heard this as being her opinion - most authorities say that staying off for 3 to 6 months to see if symptoms settle is the norm. Surely it takes a while longer for the estrogen receptors to downregulate than a couple of weeks?

Does she know something that other specialists don't? It would be extremely interesting and helpful to know! xxxx

[Annie0710]

Ive no idea Tempest, I once forgot my elleste solo tablets whilst going on holiday and that's been the biggest break I've ever had, 11 long days hrt-free and I didn't notice an iota of a difference BUT saying that, apart from testosterone (which took a couple of weeks for the energy to kick in) I've always felt the benefits of oestrogen replacement within a few days x

[Tempest]

I remember you saying, Annie! 

I therefore wonder if in fact most changes can be felt after a few days and that waiting (as many women are asked to do) for up to 3 months for things to 'settle' whilst coming on or off HRT is in fact a bit cruel if a woman is clearly struggling. Many GP's insist on this as it's more or less the accepted 'guidelines' and so many women here struggle on for months after being made to wait. It all adds to the stress! xxxx

[Kathleen]

Hello ladies.

I haven't had time to listen to the interview but I'm reminded of a male  GP who confidently told me that the menopause is all over after three years!  I understand that several cycles need to be completed when beginning any HRT so surely the same must apply in the reverse?

Perhaps now that Louise Newson is running her own menopause clinic  she can start collecting  some research data which hopefully will take the guesswork out of this whole business in the future.

Tempest - I would be interested to know more about the workings of oestrogen receptors, for example do they remain on the cells and become dormant with declining oestrogen or do they stay active until that cell dies and is replaced by another cell minus a receptor? . They say every cell in our body is replaced over seven years so could this be why the transition can  take so long?  Puberty takes five years apparently and perhaps that is for similar reasons? I think I read a comment of yours stating that menopause is akin to oestrogen withdrawal and when my innards are quivering for no obvious reason, a chemical withdrawal is what it feels like lol. Incidentally I heard an endocrinologist say that puberty for boys feels like testosterone poisoning and that explains their behavior until things settle down!

Take care ladies.

K.

[Rosie63]

Thanks for posting this link Annie.  It makes very interesting listening and it has actually made me feel more positive about what I'm going through.  I just wish she was my GP !

Rosie x

[Rosie63]

I've just seen your post Tempest and I totally agree with what you say.  I was taking Prempak for years and whenever I took a break I would notice the difference within 3 or 4 days and again, when I started taking it again I would start to feel better within a couple of days. I'm quite lucky that my GP only expects me to give it 1 to 2 months but even that length of time can seem like an eternity when I'm feeling rubbish.

Rosie x

[Tempest]

Kathleen, I get that blessed quivering too! It is so, so unnerving! You raise some good questions and points here - I will try my hardest to fish out any research I can on the receptor/cell question!

It most certainly is withdrawal - and although I probably didn't frame it well in my previous thread, I was trying to illustrate the point that estrogen withdrawal shares so many characteristics of withdrawal from any substance on which the human body becomes chronically dependant.

I'm going to use - just for example - opiate dependency. Withdrawal includes sweating, nausea, shakes, restless legs, disturbed sleep, emotional instability, anxiety - these are acute withdrawal symptoms. And then symptoms progress into something called Post Acute Withdrawal Syndrome, which is what I also believe happens when periods stop and women are still symptomatic in post menopause. I also believe the faster and steeper (or more erratic) the withdrawal, the more severe the symptoms - just as in a 'cold turkey' withdrawal (for surgical meno) or in peri, like an 'addict' constantly abstaining and relapsing from any other substance.

The receptors then have to down regulate, and this is not a linear process. The receptors are active but not 'occupied', and this is what causes drug cravings or in our case, the horrible symptoms we still get post menopause.

I'm still not sure I've explained what im getting at too well - but hopefully you get the gist!

I've heard the theory that boys become 'drunk on testosterone' at puberty before - it certainly explains a lot! Puberty for me was pretty horrid as well - so I'm pretty sure that's why I'm hating this whole experience too!  xxxx

[Conolly]

Hello ladies,


This is a very good article on the subject. Don't be put off by the techy speech at the very beginning, just go on reading and it will make sense 😁
http://jci.me/27987-pdf
I'll post some more later on today 💕


Conolly X

[Tempest]

Brilliant, Conolly - thank you! This just goes to prove that this is a very complex issue indeed - and that there is a 'critical window' for HRT too.

I think this is why we need dedicated menopause clinics - especially for helping women who have early risk reducing surgery for BRCA mutation, surgical menopause for any reason prior to age of natural menopause and POF.

This is much too big of a responsibility to place in the hands of GP's!  xxxx

[Conolly]

This one's a recent review on androgens in postmenopause


https://www.sciencedirect.com/science/article/pii/S2050052118300465#bib115


Conolly X

[Annie0710]

Whenever I read on the forum that it's recommended for a woman to wait 3 months for hrt to settle my heart bleeds for them.  24/7 for 12 weeks is hell when you're feeling total crap.  Personally I'd not be wait that long apart from testosterone x

[Conolly]

Hello Annie,


That's exactly what has happened to me, 3 months in hell and I just collapsed and ditched the patches and the Utrogestan capsules, but not the testosterone sachets... I wonder why! 


Conolly X

[Kathleen]

Hello again ladies.

Tempest -  Yep the quivering is so unsettling,  it certainly contributes to my anxiety and I always feel so much better and calmer when it stops. I read a report on alcohol withdrawal and the sensations described are very similar to our experiences.

Conolly - excellent finds, thank you.. Obviously the development of targeted HRT is what's required for symptom relief and it seems Tamoxifen has some of these qualities. Ideally we would have oestrogen delivered to the brain, heart and joints etc but avoid the breasts and uterus. Such treatment would alleviate so much misery and reduce incidence of disease.

Take care ladies.

.

[Emerald2017]

Thanks for sharing Annie! 💐
 I find Dr. Louise Newson so sympathetic and kind! She makes me feel more secure about taking hrt!