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[Hurdity]

Hi Squibbins

 

So sorry to hear about all your menopausal woes.

I would suggest - get thee some HRT and vaginal oestrogen asap!! Don't worry about testosterone for the moment.

But first - have you had thyroid function checked and if so what were the results (although NHS are not good with thyroid as they don't test everything that needs testing...). There is an increased incidence in underactive thyroid  in menopausal women which can lead to exhaustion (feeling cold and unexplained weight gain are other tell-tale signs) - but can also interact with menopausal hormone changes such that it can be difficult to work out what's causing what. I'm not an expert on thyroid but there are forum members who are, if needed.....

If you are still having night sweats then HRT will help.

I will give a different recommendation than some of the others. As you have been so long without oestrogen I would recommend patches (this is what I use) because the dose is probably more consistent and you only change them twice a week, so you could start low - so a 25 mcg patch and gradually increase if necessary.

The other problem is the progesterone If you are exhausted already and fatigued then continuous progesterone may well make this worse, especially Utrogestan - because you need a high dose in order to protect the womb - without going into details, so initially I would suggest a cyclical progestogen so that you could see how you get on with just oestrogen. However, downside is having a monthly withdrawal bleed. Alternatively you could take utrogestan on a long cycle eg 6 weeks if you're only using a 25 mcg patch. This is very much off licence so ideally would need a specialist to oversee, but the products are all available on NHS.

Also you really do NOT need to see a menopause specialist to be prescribed HRT in the first instance! Just ask for it from your GP but do some research beforehand so that you know what type you want and why, and then insist. At the same time ask for a referral so that a specialist can advise on any tweaking but at least you can get started on the road to recovery. I am late 60's and have been on HRT for 16 years....

Vagifem or estriol cream will help with the vaginal problems. Really your docs have been remiss in not suggesting this earlier though I guess if you didn't get on with Evorel conti previously perhaps they/you are/were wary of going down this route again? Anyway as flossteacake said it can take several goes to find the right one.

Oh yes and rosacea. Not exactly sure about this but before I went onto HRT I started to get horrid red itchy blotches on my cheeks - which some refer to as menopausal acne. This completely disappeared when I started on HRT and only began to return when I stopped HRT once for 3 months, 12 years ago, and has never returned since remaining on HRT.

Hope this helps and if you want more specific advice please ask!

Hurdity x

[Tribbins]

Thanks Hurdity, what you have said about the progesterone is really interesting. I will take that information to the next appointment. Thyroid was tested recently, I don't know what the reading was but was just told all my bloods were fine. I do get very cold, but think that is because I just sit and stare at the wall a lot - once I start moving around I warm up. No particularly serious weight gain, just a spare tyre which usually reduces when the weather gets warmer. I have been told that I have slightly raised cholesterol in the past but they didn't even mention that last time. 

Also interesting what you say about rosacea -mine started when I stopped breastfeeding - I think the sudden drop in hormones triggered it, lots of awful flushing, terrible spots and also ocular rosacea. I was given antibiotics for many years to control the inflammation and now maintain it with finacea gel, which is brilliant. Strangely, it flares up every year in early spring. Yes I have been wary of using any form of hormones as I'm really worried about worsening the migraines again, which have probably been the most disabling part of menopause for me, although the fatigue and lack of interest in anything appear to have taken over.

I spoke to the GP yesterday and she was really helpful and agreed that I need some HRT and would prescribe after I had done blood pressure readings. So off I went to the health centre to use the blood pressure machine, but all the readings came back as quite high, between 130 and 148 systolic, although the diastolic pressure seemed ok. Anyway, after having handed them in at reception I received a text booking me in for a further telephone appointment in 10 days, so I called the docs as I was a bit concerned about the blood pressure thing, and they just said not to worry but GP probably just wants to discuss it and prescribe the HRT. Now I just feel a bit confused as I thought it would be sorted, but anyway, more of an opportunity to discuss the progesterone now that I have further info! I can also ask about the referral to the specialist as I didn't get that one in yesterday.

Julia, does your GP now prescribe the testosterone as CLKD has mentioned it is off-licence? I googled it and it sounds effective, but can raise blood pressure so that might count me out now.... also read something earlier about women's libido not usually disappearing for around 10 years post menopause - well I don't know where they got that from, mine went almost overnight within a couple of years.

I can't say how grateful I am for the supportive and knowledgeable responses, thank you :-)

[Julia Dizzy]

Hi Squibbins, yes, my Tostran is on repeat prescription since the Meno clinic prescribed it. It actually says "as per specialist". It does last a long time as I only use it Mondays and Thursdays. My Oestrogel also says "as directed by OPD" (guessing that may mean outpatients dept??) My HRT is conti, as I didn't want a bleed but as Hurdity says, there are other options.

Your symptoms in general seem to match most of mine!!

My libido disappeared also very quickly and despite lubricants, sex was very painful (razor blades have been mentioned by others-ouch). But over time with Vagifem and HRT this has been so much better for me, can't quite believe the difference, although I do have some episiotomy scarring at the entrance which can be tender, but nowhere near as bad as before.

Also, your blood pressure may be slightly higher when you are having it tested, if it's the dreaded "white coat syndrome". Mine always goes up when am at the Drs . I have a wrist monitor at home and find that useful for me to keep an eye on it.

Hope your next telephone appt goes well.

[Hurdity]

Hi again Squibbins - I would actually ask for the details of your thyroid reading because just saying all bloods are fine doesn;t really answer that specific query. For example what were the TSH and T4 readings? Were they near the bottom or top of the reference range? I'm not saying it is an issue but you want to rule it out.

Re Tesosterone - if I haven't said already, I also get mine on repeat thought NHS doctor now - since 2015.

All the best

Hurdity x