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[Tisiphone]

I  haven't posted before.  I'm 46 and probably perimenopausal (periods are still clockwork and I have ME, so hard to say what's going on)

Earlier in the year my GP recommended I start HRT.  I started with Lenzotto and oral utrogestan.  It gave me, among other bad things, very *very* bad depression.  After 3 months GP changed me to evorel patch and vaginal utrogestan.  I'm allergic to the adhesive on the patch and although less depressed, still felt awful and found it gave me the rage.  I stopped after 3 months. 

I've now been using oestrogel for 2 weeks and will start progesterone pessaries on day 14 of my cycle.  My energy level dropped immediately, I'm depressed again and - a lovely new one - my vulva has become dry and very uncomfortable.


At the first review my GP said I was probably sensitive to oestrogen.  I took the pill for less than a year in my 20s and it was terrible for me. I don't know if it's coincidence, given my age, but it feels as though the HRT has actually given me a lot of perimenopausal symptoms that I didn't have before.

I'm not sure what to do next and looking for advice.  I don't know anyone irl on HRT, I seem to be the first of my friends to start.  If anyone here has had a similar experience, I'd love hear from you.

[Flossieteacake]

Hello Tisiphone and a warm welcome to the forum.

Firstly, you likely have vaginal atrophy. This is were a lack of oestrogen causes soreness, dryness, UTI type symptoms. You will need localised oestrogen for it. Ovestin is a cream that can be inserted and applied to the outer area. Vagifem is a pessary that can be inserted. These are the two most common ones but there are other types. We have many threads on here about vaginal atrophy and sadly so many of us had no idea we had this until joining this forum. The good news is, the sooner you start treatment, the sooner you will feel better.

I have seen a few members who cannot tolerate oestrogen. I hope one of them replies to you soon.

[Hurdity]

Hi Tisiphone

 

Sorry to hear you're feeling rough.

One thing I am confused about is why you think you are peri-menopausal and why the doc has given you HRT? Because if your periods are like clockwork then you are not peri-menopausal according to the medical definition. Your hormones may be beginning to vary but your ovaries are most likely working normally.

Often what happens before peri-menopause is that the cycle length shortens and this is known as the late reproductive stage and then periods start going awry and once they start varying eg by a week or more between cycles - then this is the medical definition of peri-menopause.

Some women get worsening pms in this last stage - maybe that you are at - and can be difficult to treat but it is not necessarily the case that your oestrogen levels have dropped so please don't think that you can't take oestrogen! It may really work for you later on even if it is not helping much now.

Having said that though as flossie says - if you have dry vagina that IS a sign of low oestrogen - but as she says that can be treated locally until such time as you need systemic HRT. In fact that's what I started with in early peri-menopause (vaginal oestrogen) before I took proper HRT.

You mention the pill - the pills back then and some today, contain very strong synethic oestrogen and the progestogens were an older type. Nowadays there are newer pills and in particular there are a couple designed for peri-menopausal women because the oestrogen they contain is bio-identical, the same as in HRT ie estradiol. The advantage is that the pills suppress the cycle so shoould keep you more on an even keel oodwise once you're acclimatised to them, and one of them only has 2 days without oestrogen so you don't have that pill free week.

Might be worth a try? They are QLAIRA and ZOELY. There is some information here: https://www.menopausematters.co.uk/contra2.php The advantage is that it will also provide contraception.

Hope this helps

Hurdity x

[Tisiphone]

Thanks both for your replies.

I'm really not sure what to do for the best.  Hurdity, you asked why I think I'm peri menopausal - I was told that I am by a GP.  More background to that is that post Covid, I've had some urinary problems, pain mostly.  I was given topical oetrogen for it, which did nothing.  When I spoke to a urologist I was told to get a referral to a gynaecologist because of my age and because I'd once had a day of spotting mid cycle.  This wasn't long after my covid jab and I had Moderna which is now known to interfere with your cycle.

I didn't get the gynae referral I asked for because there's a GP in the practice with a special interest in menopause. She says all women over 40 are peri menopausal and it's never too soon to start HRT.  The thing is, I have ME and hEDS.  Joint pain, fatigue and brain fog have been my normal for a very long time.  I got Covid in the first wave and haven't fully recovered from that either.  I did suddenly develop paper dry skin and started having minor but regular night sweats about 8 years ago but nothing has changed since then.

Regarding the vaginal atrophy, I can't understand why that would suddenly start the day after I started the Oestrogel.  Literally overnight. 

I honestly don't know what to do with all this.  GP is opposed to testing hormones

[Flossieteacake]

I can understand why you are unsure of what to do. I do not think it is fair for you to be denied a referral because there is a GP who specialises in gyno as this if they think it is to do with menopause the best place is a menopause clinic. Perhaps it would be an idea to be asked to be referred to one?

It is odd the soreness seemed to happen overnight. I wonder if it was slowly building up and then became worse then. The reason I say this is, looking back I can see I have had VA for many years. I needed to empty my bladder so much and would have to go many times before I could get to sleep. I just assumed I had a small bladder but now I can see otherwise.

I understand ME can cause many similar peri symptoms so it is difficult for you to know if it is the ME or peri.

[Tisiphone]

I think that's a really good idea and that's what I'm going to do.  Apart from anything else, the menopause GP is holding fast to the idea that ME is a psychological thing and that can't help

[Flossieteacake]

I think that's a really good idea and that's what I'm going to do.  Apart from anything else, the menopause GP is holding fast to the idea that ME is a psychological thing and that can't help

How frustrating! For them not to be able to understand what ME is means they cannot understand you and what you are going through.