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[GetStuffedPeri]

Which brand/type should I be asking the GP for?  Worst symptoms currently are rage, flushes, insomnia, itchy skin and tinnitus. Thanks!

[sheila99]

Transdermal is safer than oral so I would ask for a patch or gel. You can't tell which will suit you and which won't until you try  so not much picking really.

[Hurdity]

Some specialists may consent to trialling a continuous combined HRT if you are very late peri-menopause as you seem to be if you had no period for 10 months and then only one and have gone another 7 months without one.  Depends on your age too and how you were during menstruating years, whether you suffered severe pms and at what stage in the cycle? The advantage with starting with cyclical HRT is that you can see how well you tolerate the oestrogen separately from the progestogen component for a few months, and then if you're OK you could go onto continuous. If that is your aim then best to try one that has a conti version or at least with the same progestogen. If you start with conti then you can get too much breakthrough bleeding if you ovulate so then cyclical is advised.

In terms of transdermal there is only one conti version available at the moment, and supply is sporadic. This is Evorel conti, but with oestrogen and a progestogen taken separately there is much more choice. It is often a personal choice....

Can we advise further?

Hurdity x

[Hurdity]

Yes cyclical HRT involves a regualr monthly bleed although this is not a true period as such ( ie not as a result of ovulation) but in practice is the same thing, pms and all, due to starting and then stopping the progesterone, menstural cramps etc. Many find the bleeds not as bad as proper peridos but it depends on your body, the stage in menopause and also the dose of oestrogen too.

Not sure what you mean about holding off on HRT? Post menopause is for ever in terms of the loss of oestrogen and its effect on the body. Symptoms may or may not decline in the years following but you won't know until you try and then how long do you wait?

At you age I would say no contest ie if you are suffering then take the hRT. You are still young if you are late 40's and not yet at the natural average age of menopause of 51/52 so any extra oestrogen you take is bound to be of benefit as your periods are now very sporadic so oestrogen levels will be on the downward trajectory....

No not 40's, I went on HRT in my 50's but yes when periods were very sporadic. I was just under 54 when I started and still going in mid 60's!

Also I'm in SW and can get HRT no problem. Whereabouts are you?

Good luck

Hurdity x

[Hurdity]

Hi again

I don't think it's the case that the NICE Guidelines actively promote those herbal remedies?

The ones I looked up say this:

"Explain to women that there is some evidence that isoflavones or black cohosh may relieve vasomotor symptoms. However, explain that:

    multiple preparations are available and their safety is uncertain

    different preparations may vary

    interactions with other medicines have been reported."


Personally I wouldn't bother. However if you want to try then go ahead! Yes I used Black Cohosh when I was in the throes of peri.  Also phyto-oestrogen diet and cake!  At the time I thought it was brilliant because my flushes and sweats stopped. In reality it was my own cycle coming into play and the flushes etc stopped because my oestrogen levels rose and my periods came back.  After a while they stopped "working" once I got really far into menopause so I ditched the cohosh, stopped eating linseeds, and started hRT never to look back!

So - to clarify, you still have "HRT periods" in your 60s?!
x

Unfortunately yes horrible though this is! I am one of the few ( must be more around nowadays) who continue to take HRT, still have a womb so need progestogen, but do not like the effects of daily progesterone. I take mine on a long cycle about every 6 weeks and have to endure a withdrawal bleed and all that entails. Each cycle I swear it will be my last but then when I go back to oestrogen alone I forget and feel fine. There is no good solution to this so you have to toss up the pros and cons of each.

Stellajane was my fellow 60's bleeder but unfortunately she has now left the forum!

As an aside you won't believe the digs and comments made by some women on this forum in the past in response to the idea of bleeding in your 60's, because it is such an alien and yes unpleasant idea, as if it was something anyone would want to do! Need must though. Long cycle (under medical supervision) along with low to medium doses of oestrogen,  if you don't like the progesterone aspect and want to minimise bleeding episodes, are key to success

Hurdity x