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[Menopausal Mona]

Hi all

First of all I want to say thank you for the wealth of knowledge I've already discovered whilst I have been lurking in the shadows, building up the courage to say hello and ask any questions.

I am 41 and just started HRT at the end of May. I had been experiencing symptoms for around 4-5 years, but without really realising it.  The only symptoms I was really aware of was the hot flushes, having come from a family where we don't really talk about that sort of thing....  Two years ago I went to the GP as I had already had 2 years of hot flushes and sleepless nights, only to get laughed out the surgery (by a female doctor) as I was 1) too young and 2) on the progesterone only contraceptive pill, so she said any bloods done would throw a low result so wasn't worth doing.

Back in April/May I went to GP again, having gone off sick from work, feeling completely unable to cope with my workload (a job I have been in for over 10 years and very capable at!), crying, like, all the time, memory function starting to slip... I thought I had genuinely lost the plot, especially having just spent the last 5 years watching 3 loved ones deteriorate with forms of dementia.  I wondered if early onset was my thing.  Doctor listened to my symptoms, prescribed me some anti-depressants (which I didn't want but sold them to me as would help with night sweats too)  sent me for blood tests, expecting a  low score because of my pill, but had said "even if it's below 30, we'll still repeat them a second time, just in case".  Had my results come in at 75!!!!  I was shocked, I kind of knew I was, but still, I'm only 41.  I was kinda relieved I guess, as it answered so many questions, once I started my own research and discovering what menopause really meant. 

Anyway, at this point he prescribed me an oestrogen gel, for every night, and utrogestan, to be used for days 14-28.  Thanks to you guys I worked out HRT would create me a new cycle, as I didn't know when my cycle was, as being on POP I haven't had a period in 10 years, so I started oestrogen straight away.  After the first 2 weeks I started to feel more myself and started the progesterone..... which is where troubles began.  I also decided to stop the Sertraline the doctor had prescribed, having read that antidepressants should not be prescribed for hormonal induced anxieties.  By around day 6 of utrogestan (and no sertraline) I was starting to get "reactive" again, snapping over nothing.  By day 9 of utrogestan, I wanted to talk to nobody, do nothing and just be left alone to sleep or cry.  Every muscle and bone in my body hurts and I'm so tired, I feel like I could sleep on a washing line.  Last night would have been day 10 of utrogestan, but I didn't take it, thinking this is about all I can take of feeling like this.  This morning I woke up very tired and emotional again but after some food now, I'm not sooo bad. I'm just wondering, is this normal for the progesterone part of a cycle (as I had terrible PMT back when I did have periods before the POP) or should I start back on the sertraline that I gave up on so easily??  I stopped the Sertaline as it just made me sleep.  I have to go back to work at some point (got less than 2 weeks left on note), bills wont pay themselves, and I can't function on anti-depressants.  However, if I return to work in the state I've been in since the weekend I might not keep a job very long anyway.  I have been the most miserable, tired mess I can imagine.  If I'm not crying or feeling generally sorry for myself, I'm super angry and/or paranoid, everybody hates me and nobody loves me and I should just go eat a can of worms lol!!!

I'm struggling still trying to keep up the "everythings fine" act.  I can't dwell in feeling like poop, cause I'll keep feeling like poop, but how do you deal with this?  It's super exhausting.  I have no female family members to talk to about menopause, we don't talk like that.  I have very few female friends anyway, but I don't feel I can talk to them at the moment as they have their own dramas going on.  My partner is superb, but I don't want to keep going on and being down around him as I know it becomes a drain on both people.  Feel so alone and don't know what I'm supposed to be doing/feeling/reacting. 

You know some days you just wish the earth would open up and swallow you whole?  Thats how I feel.  Not so bad that I'd do anything stupid.... I don't know, life is just hard.

Sorry this has become bleak, it wasn't meant to be!!  Was just exploring symptoms with fellow sufferers, seeing if this is normal.  It has to be.....  Will it settle.  Should I have kept going with utrogestan even though I felt so low, or was I right to stop it, and try again next month? I know I've read somewhere about the ability to play with our HRT/cycles and know every person is different, but would 9 days of progesterone do what its meant to?  I'm still on the progesterone only pill too (Noriday) as the GP told me to keep taking for now so don't know if I'm potentially taking too much progesterone which was why I'd felt so low, or if I should stop that too.  I have an appointmnt with Doctor tomorrow so will ask again about if I should stop it.  Am also debating asking for the oral utrogestan as he has me on pessary form and I didn't like feeling so akky "down there" from pessary chalk!


Menopausal Mona

Thanks guys, sorry for the waffle - my brain is a bit hectic at the moment and struggle to contain a trail of thought lol.... Menopause Brain 

[CLKD]

Hi!  you waffle away.  Getting it out of the brain on2 paper can make a huge difference to logic.

No one is too young for perimenopause.  Wish GPs would get on board with the fact that some girls have a few periods then no more, some never menstruate.  Rare but it happens.  Then moving through the age range, peri can begin at any time, often as 'early' as mid-30s.  So your GP needs to put her head down a loo etc., etc., etc..

Progesterone part of an HRT regime can cause problems but there are several ways of delivering HRT.  This part of a menstrual cycle can be hard work too.  U may not require the progesterone part if you are using another form of delivery, your GP should know that.  Hopefully some1 will be along with. more info for you.

Do print off 'hints for husbands' for your partner. 

'pessary chalk' - love it!   You'll fit right in ;-).

Let us know how you get on, do make a list of concerns to discuss.

[Menopausal Mona]

Hi!  you waffle away.  Getting it out of the brain on2 paper can make a huge difference to logic.

No one is too young for perimenopause.  Wish GPs would get on board with the fact that some girls have a few periods then no more, some never menstruate.  Rare but it happens.  Then moving through the age range, peri can begin at any time, often as 'early' as mid-30s.  So your GP needs to put her head down a loo etc., etc., etc..

Progesterone part of an HRT regime can cause problems but there are several ways of delivering HRT.  This part of a menstrual cycle can be hard work too.  U may not require the progesterone part if you are using another form of delivery, your GP should know that.  Hopefully some1 will be along with. more info for you.

Do print off 'hints for husbands' for your partner. 

'pessary chalk' - love it!   You'll fit right in ;-).

Let us know how you get on, do make a list of concerns to discuss.

Thank you CLKD.  I didn't know that I may not need the progesterone.  I had wondered about the POP being necessary, but hadn't thought about it the other way.... Hopefully someone will know, as the GP I'm booked with is the same who prescribed me the muddle of meds.  I spoke with a metal health nurse when I stopped the Sertraline and she said GP shouldn't have prescribed anti-depressants for hormone related anxiety anyway, should have waited for my bloods to come in first, and the one he prescribed me under the sell of helping with hot flushes wasn't one they would use for flushes anyway. 

Hopefully we'll get it right eventually, before I end up completely crackers 

[CLKD]

However: if some1 is depressed or if anxiety is overwhelming, there is no reason not to prescribe appropriate medications to get the lady settled.  Then HRT can be discussed and considered as it can take months to sort out ...........

I would ask for a referral to an NHS dedicated Menopause Clinic as many GPs don't understand the impact of peri symptoms.  Let us know how you get on.

[Flossieteacake]

Hello Mona and welcome to the forum. I am so pleased you feel able to post and ask questions. That was very brave of you when you were feeling nervous.

I can relate to you being laughed at when you tried to talk to your GP. I had the same experience. I first realised I was in peri when I was 38 and the GP burst out laughing and said I have another 13 years to go. It is so sad how some GPs can be so dismissive.

It sounds to me like the ultrogestan is causing you to feel unwell. I know you are on the POP. You can actually take two Desogestrel as the progesterone part of HRT so maybe that would be a better option for you.

Like you, I have nobody I can talk about this with so it is great you have found the forum. You will find lots of support on here and you are no longer alone. The emotional side of peri is very challenging. I think it may improve for you when you find the right HRT as I suspect you are feeling so low due to the ultrogestan. Just a thought, if you wanted to keep on it then you may find it more tolerable to take vaginally.

I tried stopping the POP to see what would happen for myself and I regret it. I felt unwell and after a 3 month break I went back on it. If you wish to stop it then you will still need contraception so that is something to bare in mind.

Just to say, are you aware of vaginal atrophy because you can take localised oestrogen to help with that. That has been my worst peri symptom so I just thought I would mention it.

I think you did the right thing in stopping the sertraline and the nurse was right to say they should not have been prescribed. I am also unsure if that helps with hot flushes. I know Venlafaxine does.

[Cassie]

I started the meno journey @ 38 and finally went onto the Gel and the Utrogestan at 40. Have been on it ever since and nearly 60. I dont enjoy the Utrogestan part so I only use 100mg vaginally every other month, I just cannot tolerate it more often. I only use a low dose of 1 pump of gel and have regular bleeds and am due a gynae check up soon to see how my lining is looking. I also tried other options but this protocol seems to be the most "user friendly" & is considered bio identical. I hope you can maintain it perhaps try every other month but do see if you can get a scan of your uterus every other year or so just to see its working as I am not sure what dosage you are on. It can be very daunting but I am so greatful for the HRT or I would have by now am sure ended up with  osteoporosis if not other issues from going through it so very young. All the best.

[CLKD]

Tnx for the update Cassie.  It shows that as long as we have regular scans, once we find a regime that works, we should stick to it ;-)

[Menopausal Mona]

Hello Mona and welcome to the forum. I am so pleased you feel able to post and ask questions. That was very brave of you when you were feeling nervous.

I can relate to you being laughed at when you tried to talk to your GP. I had the same experience. I first realised I was in peri when I was 38 and the GP burst out laughing and said I have another 13 years to go. It is so sad how some GPs can be so dismissive.

It sounds to me like the ultrogestan is causing you to feel unwell. I know you are on the POP. You can actually take two Desogestrel as the progesterone part of HRT so maybe that would be a better option for you.

Like you, I have nobody I can talk about this with so it is great you have found the forum. You will find lots of support on here and you are no longer alone. The emotional side of peri is very challenging. I think it may improve for you when you find the right HRT as I suspect you are feeling so low due to the ultrogestan. Just a thought, if you wanted to keep on it then you may find it more tolerable to take vaginally.

I tried stopping the POP to see what would happen for myself and I regret it. I felt unwell and after a 3 month break I went back on it. If you wish to stop it then you will still need contraception so that is something to bare in mind.

Just to say, are you aware of vaginal atrophy because you can take localised oestrogen to help with that. That has been my worst peri symptom so I just thought I would mention it.

I think you did the right thing in stopping the sertraline and the nurse was right to say they should not have been prescribed. I am also unsure if that helps with hot flushes. I know Venlafaxine does.

Hi Flossieteacake

Thank you for your reply 

Sorry you had such a hard time getting a diagnosis too.  It's a shame that a disorder affecting at least half of the population isn't more known about isn't it.  Hopefully we're getting there as it does seem like we've moved forwards since I got laughed out of surgery 2 years ago.  I'm hearing about menopause groups and the such like more now.  Maybe thats just because I'm living it now too though I guess.

I am aware of vaginal atrophy, I discovered that waaay before I started having any inkling about menopausal symptoms.  I'd spotted things had gone, shall we say, a little grey down that way and it scared the poop out of me.  Google led down many rabbit holes (had to be careful googling grey vaginas lol) but never found it was menopause related until more recently!  That must have been a good 7-8 years ago when I first noticed that.  When I began the HRT conversation this year with the doc I explained that down there had a no entry sign and had for a good few years, we discussed a localised oestrogen to relieve that symptom, and I ended up leaving with a prescription for an oestrogen gel for thigh application and utrogestan 200mg for vaginal use.  I'm not sure how we ended up there, I don't know if the doctor really knows either, as I collected from pharmacy 3 months of oestrogen and 3 weeks of progesterone, so who knows lol! 

I will have a word about menopause clinics as CLKD mentioned above too, as I do feel for the GP too really - He is only trained in general medicine, he isn't going to know the exact ins and outs of menopause if womens health wasn't one of his specialties.  I will see tomorrow what he suggests as I really didn't like how I've felt the last few days.

[Menopausal Mona]

I started the meno journey @ 38 and finally went onto the Gel and the Utrogestan at 40. Have been on it ever since and nearly 60. I dont enjoy the Utrogestan part so I only use 100mg vaginally every other month, I just cannot tolerate it more often. I only use a low dose of 1 pump of gel and have regular bleeds and am due a gynae check up soon to see how my lining is looking. I also tried other options but this protocol seems to be the most "user friendly" & is considered bio identical. I hope you can maintain it perhaps try every other month but do see if you can get a scan of your uterus every other year or so just to see its working as I am not sure what dosage you are on. It can be very daunting but I am so greatful for the HRT or I would have by now am sure ended up with  osteoporosis if not other issues from going through it so very young. All the best.

Thanks Cassie! I take the utrogestan vaginally already, but on 200mg for days 14-28.  I think this time I managed day 16-25 but had to stop at day 26.  Felt awful.  I am going to speak to the GP about switching to the oral utrogestan as I understand that is a lower dose, then I could always use that vaginally if symptoms remain.... It was horrible though, felt like a train wreck!  I too, like you am grateful for being able to start HRT as I do worry about the other implications for health with it starting young.

However: if some1 is depressed or if anxiety is overwhelming, there is no reason not to prescribe appropriate medications to get the lady settled.  Then HRT can be discussed and considered as it can take months to sort out ...........

I would ask for a referral to an NHS dedicated Menopause Clinic as many GPs don't understand the impact of peri symptoms.  Let us know how you get on.

Thanks CLKD, always good to have another perspective, perhaps the mental health state does need the help.  Will see what is said tomorrow.  Will certainly ask about menopause clinics, many thanks for this advice 

[Flossieteacake]

Hello Mona and welcome to the forum. I am so pleased you feel able to post and ask questions. That was very brave of you when you were feeling nervous.

I can relate to you being laughed at when you tried to talk to your GP. I had the same experience. I first realised I was in peri when I was 38 and the GP burst out laughing and said I have another 13 years to go. It is so sad how some GPs can be so dismissive.

It sounds to me like the ultrogestan is causing you to feel unwell. I know you are on the POP. You can actually take two Desogestrel as the progesterone part of HRT so maybe that would be a better option for you.

Like you, I have nobody I can talk about this with so it is great you have found the forum. You will find lots of support on here and you are no longer alone. The emotional side of peri is very challenging. I think it may improve for you when you find the right HRT as I suspect you are feeling so low due to the ultrogestan. Just a thought, if you wanted to keep on it then you may find it more tolerable to take vaginally.

I tried stopping the POP to see what would happen for myself and I regret it. I felt unwell and after a 3 month break I went back on it. If you wish to stop it then you will still need contraception so that is something to bare in mind.

Just to say, are you aware of vaginal atrophy because you can take localised oestrogen to help with that. That has been my worst peri symptom so I just thought I would mention it.

I think you did the right thing in stopping the sertraline and the nurse was right to say they should not have been prescribed. I am also unsure if that helps with hot flushes. I know Venlafaxine does.

Hi Flossieteacake

Thank you for your reply 

Sorry you had such a hard time getting a diagnosis too.  It's a shame that a disorder affecting at least half of the population isn't more known about isn't it.  Hopefully we're getting there as it does seem like we've moved forwards since I got laughed out of surgery 2 years ago.  I'm hearing about menopause groups and the such like more now.  Maybe thats just because I'm living it now too though I guess.

I am aware of vaginal atrophy, I discovered that waaay before I started having any inkling about menopausal symptoms.  I'd spotted things had gone, shall we say, a little grey down that way and it scared the poop out of me.  Google led down many rabbit holes (had to be careful googling grey vaginas lol) but never found it was menopause related until more recently!  That must have been a good 7-8 years ago when I first noticed that.  When I began the HRT conversation this year with the doc I explained that down there had a no entry sign and had for a good few years, we discussed a localised oestrogen to relieve that symptom, and I ended up leaving with a prescription for an oestrogen gel for thigh application and utrogestan 200mg for vaginal use.  I'm not sure how we ended up there, I don't know if the doctor really knows either, as I collected from pharmacy 3 months of oestrogen and 3 weeks of progesterone, so who knows lol! 

I will have a word about menopause clinics as CLKD mentioned above too, as I do feel for the GP too really - He is only trained in general medicine, he isn't going to know the exact ins and outs of menopause if womens health wasn't one of his specialties.  I will see tomorrow what he suggests as I really didn't like how I've felt the last few days.

Perhaps you could request Vagifem or Ovestin as they are going to be the best things for the vaginal atrophy. It is a great idea to ask to see a menopause clinic. I hope you appointment goes well.

[Menopausal Mona]

Perhaps you could request Vagifem or Ovestin as they are going to be the best things for the vaginal atrophy. It is a great idea to ask to see a menopause clinic. I hope you appointment goes well.

Thank you for the advice, I will certainly ask. 

Just a too much information kind of question - do the vagifem or Ovestin leave you with that chalky residue feeling, like I said the utrogestan does, or is it more of a gel, and does that leave a residue?  Only I am a little bit grossed out by utrogestan at the moment - Isn't being a woman fabulous fun 

[Flossieteacake]

Perhaps you could request Vagifem or Ovestin as they are going to be the best things for the vaginal atrophy. It is a great idea to ask to see a menopause clinic. I hope you appointment goes well.

Thank you for the advice, I will certainly ask. 

Just a too much information kind of question - do the vagifem or Ovestin leave you with that chalky residue feeling, like I said the utrogestan does, or is it more of a gel, and does that leave a residue?  Only I am a little bit grossed out by utrogestan at the moment - Isn't being a woman fabulous fun 

Ovestin is a cream and does not leave a residue for me. You may find some comes out when you wipe after going to the bathroom.

Nothing is too much information on here so ask away.

[Cassie]

HI MM the Utrogestan 100mg is what I use vaginally for 12 days a month could not tolerate the 200mg the dosage is no lower whether you use it orally or vaginally.

[Menopausal Mona]

Thank you everyone for advice.

Doctor has halved my utrogestan to 100mg, but advised for daily use too as per post menopausal routine, as my bloods are showing so high on fsh.  I might play with that a bit myself having just,had such a terrible time on it. He did mention a scan if I had any bleeds,  which I haven't yet so hoping it'll stay that way., Also struggling to find a pharmacy to full my prescription anyway right now! Dr was all for me stopping the hrt and told me off for still using the oestrogen gel if I'm not taking the utrogestan, even though I did 200mg for 9 days and am on POP too. I had to put him right as it's not like I'm getting zero prog is it.

Crikey!  Anyway, he said he'll see me again in a month and up the dosage of oestrogen too if I'm still suffering symptoms (brain fog, hot flushes, sleepless nights from night sweats and anxiety) as I'm only on a low dosage of that right now (0.5mg) . He's also seeking advice re menopause clinics and what to actually do with me as I'm apparently not a straightforward case and bloods appear to indicate post meno rather than peri.

He did also give me a prescription for vagifem, thanks to flossieteacake for the suggestion of some localised oestrogen. However, he's prescribed that for daily for 2 weeks, then twice a week after. I've read other ladies elsewhere on the forum stating their GP has done the same but it appears advice should be to continue daily to prevent further atrophy? This is getting so confusing.

Hoping I can find a pharmacy with some 100s of utro now though, I so do not want to go back to those 200s, they were vile!!

Thank you kind ladies for all your support and advice x

[Flossieteacake]

Sounds like your appointment went well.

Although the vagifem leaflet suggests using it twice a week after the loading dose, many find that is not enough. I would use it daily until your symptoms improve then you can reduce it if you wish to.