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[somersetfi]

Hello. I hope everyone’s well.

I’m really hoping for some advice and reassurance.

I’m 48 and have been on systemic and localised HRT for about a year. My current routine is below, at the end of the message. Like many, I’ve struggled to find the right dose and it seems I also struggle to absorb oestrogen (tried one of the patches and it was a disaster).

My symptoms are wide ranging - primarily a lot of dryness issues from eyes to vagina (serious vaginal pain / recurrent UTIs / stress seems to be a big trigger).

Now a new one has raised its head - but it seems to have come on really suddenly (aligned with another oestrogen drop).

I’m having really serious “urgency” on, er, both ends.

Eating suddenly seems to be an issue as very quickly I feel like I need to do a poo but in fact there’s nothing there (though it can feel as though it’s sitting and could almost come out).

I feel really bloated. My tummy looks distended.

I can barely drink anything without needing to rush to do a wee.

My appetite is generally off and I’m not eating much beyond a smoothie for breakfast (dairy free) and gluten free pasta the rest of the time (I’m scared to eat anything that may trigger anything).

I’m also having heartburn type symptoms after eating (although this has only been an issue since I raised my oestrogen, as below).

In September my oestrogen suddenly plummeted again (extremely low) and I was advised to move up to the maximum dose. I’ve been on the max dose for about a week now.

I’m taking a good probiotic (Symprove), and have been for a while.

I’m sorry if this is too much info but I feel so desperately low about it all.

I’m not worried about my bowel as I was fortunate enough to have an all-over-body-MOT in July including a colonoscopy (best money I ever spent).

It feels like I have IBS or worse.

Would dearly appreciate tips / advice / personal stories. Thank you so much.

My routine:

I’m on local oestrogen (Vagifem and the cream).

Plus am now on x3 sachets Sandrena gel / 14 days progesterone orally / tiny amount testosterone for mood and sex drive.

[CLKD]

Nowt is too much info on here!   

YES IBS can be hormonal linked.

Lets begin with the dryness: as oestrogen levels drop the body may become dry: inside and out which includes the vaginal area.  Appropriate treatment will ease symptoms.  'Ovestin' or 'Vagifem' are usually prescribed: ladies use the latter internally as well as gently applying ovestin onto the outer labia if required.  Me, I use 'ovestin' inside and out.  The idea is that we insert for 3-4 weeks every night then as necessary; usually every 3/4th and 6/7th nights.  Some however require application nightly to keep symptoms under control.  So keep ups with the 'vagifem', nightly if you need it.

VA mimics repeated urine infection-type symptoms really really well and there is rarely an infection.  Have your urine samples been sent to a Lab. for testing?

As for bowel issues:  10 mins prior to a bleed I would get 'the runs' even if a period wasn't due.  So I suspect that your symptoms are hormonal related.  Giving your digestive system a rest is absolutely fine.  Are your symptoms every day/night or cyclical?

Hiatus hernia = heartburn/reflux - common in peri menopause as muscles may become lax = aches and pains.  This affects internal muscle groups as well as external, again an appropriate medication can ease symptoms.  I used Milk of Magnesia for years as necessary b4 developing an irritating clearing of throat caused by reflux. Omeprazolol helps that.

[Ayesha]

It's good that you have had a good check-up to rule things out.

I hadn't realised before I started to have back muscle pain that it can have a profound effect on your bowels, apparently back muscles share the same nerves. When I get a flare up of muscle pain, I need to use the loo a lot more and it also effects my stomach too with nausea.

Could it possibly be a muscle problem, so common as we age. Otherwise, it does sound like you have bad IBS, all guessing here of course!

[Ecl]

Hi Somersetfi,
I have been wondering how to ask a question on here about IBS too and trying to get my thoughts straight before I did. Yes, perimenopause can lead to IBS, in part due to the increase in cortisol with reduced oestrogen.
https://inspiredhealth.co.uk/blogs/the-menopause-blog/digestive-troubles-and-the-menopause-are-they-linked#:~:text=Oestrogen%20and%20progesterone%20imbalances%20can%20cause%20rhythmic%20muscular,to%20FSH%20known%20to%20promote%20feelings%20of%20nausea.
My problem started within a month of starting on HRT. I was too scared to go to the Dr in case they took the HRT away. however that was 16 months ago and it has progressively got worse so I now vomit with it too. I have finally gone to my Dr who is running tests but thinks it could be a side effect of the HRT and I may have to live with it.
i have therefore been wondering how I could change my hrt, (currently evorel 50 and utrogestan for 12 days) and am considering changes to my progesterone timings or type to see if it could make a difference, so perhaps taking utro daily instead of for two weeks so I have less fluctuations, and counter effect some of the oestrogen, or to go to a long cycle as my cycle was three monthly before HRT anyway and would reduce the progesterone. My other option would be to switch to a patch so no oral utro.
Sorry, probably rambling, but just wanted you to know you are not alone, and that while peri can cause IBS symptoms so can HRT. I have found when I do have the symptoms, that buscopan helps available off the shelf in Tesco, but I have to take the max for 2-3 days then gradually reduce over a week to keep symptoms at bay. If I cant stop it with adjusting my HRT I really dont know what I'll do.

[Joaniepat]

Would it help to use the Utrogestan vaginally do you think? At least you'd avoid the digestive tract that way. (I don't know much about IBS or utro, so speaking from a position of relative ignorance .)
JP x

[somersetfi]

Hi all. I’m away this weekend but wanted to say I’m so very grateful for these replies and support. I’ll reply properly asap. Thank you so very much. xxx