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[Focus]

I'm new to all this. And even newer to starting to learn about it all.

Here's where I'm at: GP has been very dismissive and useless. So I'm bypassing her totally now and educating myself.

Age 48 (almost 49).
Almost 9 odd months of increasingly heavy periods, larger and larger clots, increasing flooding.

From mid October: period 8 days long with all of the above. Still 3 weeks before next period.
Went to GP. Blood tests, low ferretin, given iron tablets and Transexemic Acid. GP dismissed perimenopause.

From November: 8 day long, very, very heavy, very clotty period.
Went to GP. Given Cerelle, which I took for one packet. One week break. Another 8 day longvery, very heavy, very clotty period.

Called NHS24. Referred to hospital. Given Norethistone. Doctor said I was 'the right age' for menopause
Went to GP. Asked for combined pill (which I was on for years and which worked really well).
Became ill with stress of preceding x months.

December. First packet of mini pill, some breakthrough bleeding but felt OK

January. Second packet of mini pill, heavy and long period mid packet with large clots and flooding.

Where am I at now?

The best I have ever felt was when I was on the Norethisterone. I actually felt like myself. Not talking about the endless bleeding having finally stopped, but I was my old self again.

Which leads me to wonder if I'm low on progesterone? My mood is a total roller coaster, but most of the time I'm feeling super panicky, really stressed out, very depressed. A bit like when I used to get regular, normal periods and it was the week before my period. I used to feel very, very tearful and vulnerable, and feel 'picked on' and paranoid.

Now, I knew those symptoms so well, that it happened so regularly, that if I just managed to get through the day/that week, then my perspective would change. And it always did. As soon as I got my period, I started feeling much better, mentally. And then on the second day of my period, I'd feel better physically. Then back to my normal self.

And now? It's like that panicky, stressy, vulnerable, paranoid feeling but never ending. And multiplied a bajillion times. It's been going on for months and months now.

The stress of it all, and also the stress of dealing with my GP (including her manner) has triggered the PTSD I suffered with for a good few years from 2007. I need to feel in control, and I need to feel in control of the decisions that are being made in regards to my body - or at least made to feel that I am being listened to and have equal input. The lack of all of this has also subsequently triggered my eating disorder from my late teens/early 20s.

Now, I'm very, very familiar with this feeling of extreme stress, and this fight or flight state I'm currently in - all because of my experience with PTSD. I need to try and deal with this asap.

So, should I be on the combined mini pill? I'm wondering if I shouldn't be on the POP? The Cerelle I was originally given. And also trying to raise my progesterone levels as well?

How do I do this? What do I take to try to raise my progesterone levels?

[jaypo]

Have you had the clots/flooding investigated? I had exactly the same & it was fibroids & they need their own separate treatment,might not be that of course,just wondered if you'd had any scans etc

[Focus]

Thank you. I haven't.

But I have an appointment with a sexual health/contraception clinic next week, so I will mention it then.

They've been brilliant so far. The nurse I made the appointment with spent ages talking to me over the phone and said she would get me a referral for their menopause clinic as well.

My appointment is on Wednesday morning. Just less than a week.

[Hurdity]

Hi Focus

Sorry to hear about your heavy bleeding - yes this is typical of peri-menopause or just before it starts, if you are still ovulating regularly. Have you had cyclical irregularity ie has you cycle started lengthening yet to longer than 28 days and is this variable?

I'm not sure what the combined mini pill is - the mini pill is progestogens only and the combined pill contains oestrogen as well. As you are still under 50 and depending on any risk factors you have for cardio-vascular problems, you may still be able to take the CCP in one form or another. There are a couple designed for peri-menopausal women called QLAIRA and ZOELY. They contains high doses of progestogens which help stem the bleeding as well as prevent conception and also estradiol - our own (body-identical) oestrogen. A pill like this would suppress your cycle and prevent the hormonal turmoil, and hopefully heavy bleeding that you are experiencing.

nevretheless in view of the fact that treatments suggested by the odcotr have had no effect on the bleeding i would ask for a referral as jaypo says just to check for fibroids etc in case these might be contributing to the problem.

The other alternative is the Mirena coil - which will definitely control the bleeding and then you can add in oestrogen when your own levels fall as you enter the peri-menopausal transition - starting with a low dose as a top-up and then increasing if you need to.

Here is an article on peri-menopause and the website section on bleeding which might help:
https://www.menopausematters.co.uk/magazine/pdf/Article%20-%20Perils%20of%20the%20Perimenopause.pdf
https://www.menopausematters.co.uk/heavyperiods.php
https://www.menopausematters.co.uk/periodtreatments.php

Hope this helps

Hurdity x

[Focus]

Thank you.

I can't do anything invasive (PTSD). So the coil is an absolute no way for me. I can barely go to the dentist. So triggering to have someone invade my space like that. Couldn't. Deal. It's in my medical notes.

Cycles really short now.

Night sweats, insomnia, dermatitis noticeably worse, tinnitus worse. And you're saying it's not even started yet? How can it be worse than this? Seriously, I'm feeling like I've had enough of everything. I can't cope any more with this. How does it get worse?

[BlueButterfly]

I use a natural progesterone cream. You can get it off Amazon. (It's the alternative section anyways right? )
It has controlled my anxiety better than I expected. If I miss using it for over half a day, I get the internal shakes and heart palpitations. They go away about a half hour after I use it. It still amazed me. I think my body absorbs it well.

I was having 10 day long periods ever 20-24 days. This last one was 5 days long and 27 days, still 1 heavy day. It's taken a few months to get here but every month I'd see little improvements. The best was when I had a scan that showed it was reversing an "odd growth" on my ovary...most likely endometriosis. (No I didn't have the surgery to check it out because I can't stand the idea of it unless it was absolutely necessary. We already know I have it, no reason to go through all that unless it was growing like cancer or something).

I've heard the POP can also take a few months to settle down as far as break through bleeding and everything, but after you get past that, you could possibly not have periods anymore. Really might be worth trying again and giving it a few months to settle.


For me, yes I have a small fibroid but I have always had heavy, clotty 7 day long periods before I ever had the fibroid. (and the hormones changing things) The endometriosis made my periods bad and the extra estrogen my body produced.

[Focus]

Thank you so, so much!

Yes, alternative suggestions please

I've never really gotten on well with the medical profession as a whole. There have been exceptions, of course...but they have been very much the exception.

My way of dealing with stuff has been to find out as much as I can for myself (intellectualise). That helps calm down the feelings a lot and give them some sort of framework. I've ended up finding out a heck ton of about how the brain processes memories, cortisol, adrenaline etc, through being until with PTSD. And then I've been able to use that info to give other people a hand as well.

From what I'm starting to understand with all of this, stress hormones are not good for the liver? They put a huge strain on it? And that also knocks the progesterone out of kilter? Even more that what's going on in this part of perimenopause? I'm still only scratching the surface of this and don't really understand much at the moment.

Would you be able to give me a link to the cream from Amazon please?

[BlueButterfly]

I'll message you the link for what I get. I'm in the US but I'll see if I can find a UK link for it for you.

From what I've read, our body will use progesterone (or at least the precursor for progesterone) to make cortisol.

[Focus]

Thank you.

Totally random question, I know, but do you know why my mood improved a ton while I was taking the Norethisterone back at the end of November? I was back to my totally normal self for the time I was taking it. And I felt my mood drop slowly after I stopped taking it. I actually felt like myself again. It was brilliant, like my old self was still there.

[BlueButterfly]

I really don't know. I'm still learning about all this hormone fun. I would think it's just because it was something your body needed? Not sure. I know I had the same thing with the progesterone cream. I really didn't expect that, especially after reading about how so many people don't get along with progesterone-some feel absolutely awful. Then I just waited for the better mood to go away, that it was temporary...but it's still helping with the anxiety...so maybe there's a few of us out there that just really need that progesterone?? I do get moody (read b*tchy) if I use too much though. So I just listen to my body (and complaints from the family  )

[Focus]

This is amazing, thank you so much!

Going to check it out now...

If I can get the cream irrespective of what the medical profession say what is up with me and what they are willing to give me, then I'll educate myself and go along with my own knowledge. I'm extremely stubborn like that. 

Do you know how the dose compares to Norethisterone offhand?

[BlueButterfly]

Honestly I'm not sure if you can compare the 2. You only absorb a small about of the Norethisterone because it is taking internally. And it is also a synthetic progestin.

The bio-indentical progesterone is just like what your body makes and it's a cream. And what you get out of the dose depends on how your body absorbs it. My doctor said he couldn't tell me a dose to use (because I asked what I should be using) because it really is dependent on your body. I just needed to go with how my body felt. If I get too high, I'm moody...too low and I get anxiety problems again.

Also, the POP is supposed to (sort-of) prevent ovulation. The cream is just more to help your body work as it should so you will most likely ovulate still (at least sometimes...depending on if your body is still ovulating sometimes..I know mine is just every few months now it seems). It is often used to help pregnancy happen.

[Hurdity]

Hi again Focus

Please do not use progesterone cream for your bleeding problems. It will not have any effect as no OTC creams have enough progesterone in them to do anything much. There is no alternative treatment (as far as I know) that can help your bleeding - so please for the sake of your health continue with your investigations. I quite understand why you might not want a coil - but if you get on well with norethisterone, provided that you have no underlying problems - then it sounds like you could continue with this?

We are not supposed to promote commercial brands of stuff on here, so please don't think this is the answer to your medical problems. It's a great idea to educate yourself - that's what most of us are doing - so if you read the scienc about prog cream you would find out that it is not for bleeding/endometrial protection. Do please look at the links to the info on this website that I gace you - and here also is what it sayd about prog cream:

"PROGESTERONE CREAM "Natural" progesterone cream is available on private prescription in varying strengths. Studies have shown inconsistent results on effect on menopausal symptoms. Claims for a protective effect on bones have not been confirmed. Women who take systemic estrogen for menopausal symptoms must also take progestogen to protect the womb lining from being stimulated by the estrogen. Progesterone cream is not suitable for giving protection to the womb lining and should not be relied on for this purpose."

There is no comparison with norethisterone dose because the prog is infinitessimally small by comparison. If you want to use natural protesterone then your best bet is to get a properly regulated dose of a product available on NHS "Utrogestan" which can be used vaginally. It is listed here: https://www.menopausematters.co.uk/to_progestogens.php Some doctors may well prescribe it for bleeding problems if you say you would prefer the body-identical progesterone rather than the synthetic norethisterone.

If you want to try a progesterone cream then go ahead - but to reiterate - it has barely any active ingredient in it though (as it is OTC) and so will not help your bleeding.

If you are getting sweats too then combined HRT sounds like the best way forward - so you could use a body identical oestrogen (estradiol) in the form of patch or gel - which is the most natural way to replace hormones in your body if you feel this is what you would like to do.

Hope this helps.

Hurdity x

[BlueButterfly]

I know there's been very little research but I can't agree that progesterone cream can't be helpful or effective...it has so little it will do anything. It has helped me tremendously and yes, I bleed less as well. It has also helped to reduce endometriosis issues (shown on a vaginal ultrasound) and pain.

I know there is a lack of studies but can't deny that it has helped me is ways that you are saying it can't.