Hi jo1488jo
![welcomemm :welcomemm:](https://www.menopausematters.co.uk/forum/Smileys/extended/welcomemm.gif)
Sorry to hear about your woes
The thing is - going to a shorter cycle as you described is precisely the classic pattern of PRE-perimenopause and is known as the late reproductive stage. This is not peri-menopause as such because cycle length does not vary (early peri-menopause is defined medically as beginning approx when cycle length varies by more than 7 days each cycle).
This late repro phase - you are still ovulating each month, I understand, but hormones are beginning to go awry, and hence pms symptoms often get worse. Depending on your own natural oestrogen levels - maybe they are not dropping too far yet - maybe they plunge down low at the end of the cycle?
For some women - a low dose HRT at this stage can work - just to top up (I have read quite a few cases of standard patches Like Evorel or Femseven sequi or tablets like low/medium dose Femoston - doing the trick until peri-menopause really sets in), but for many HRT, at least high dose HRT, is not the answer AT THIS STAGE and I can't understand why the Newson clinic seems to think it always is.
So it is not that HRT is not right - with the right product, it should be able to find the right dose and type to suit most women (all except the most extremely sensitive) - it's just that the standrad regime of high dose gel and going on increasing - may not be right.
This is again where I disagree with private medicine - not only are you paying for it, and this is beyond the reach of most women in UK, especially now, but it does seem that there is some overprescribing going on - and I wonder if this happens at NHS menopause clinics?
I haven't read Dr Annice Mukherjee but there is plenty of evidence showing the long term health benefits of HRT - the British Menopause Society ( and the International Menopause Society) regularly trawl the scientific journals and review/update their evidence-based consensus views and statements. There is also evidence from what I recall of adverse effects of early menopause on various health measures - possibly even longevity (through association studies I think) but I'm a bit hazy here as I haven't looked anything up for ages.
In your position - being only 44 and pre-peri-menopause (at least when you started HRT), some menopuase specialoists prescribe one of the newer combined COC pills which contain estradiol - which is bio-identical and the same as in HRT. These tablets are not like the stronger synthetic pills. These have almost no tablet free days and will regulate the cycle and hopefully eliminate or at least minimise the dramatic hormonal fluctuations that are beginning to occur. This could then take you through the early stages of peri-menopause when you could possibly then transfer to a more conventional HRT.
Stopping HRT for several months will tell you what your cycle is doing - if you could cope with this - but you don't need to do this, nor have blood tests to measure anything, as these tests will not be helpful at this stage and wouldn't be offered on NHS except under special circumstances.
Hope this helps and all the best
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Hurdity x