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[Mutley]

Hi there,

This is my first time on here.  In a bit of shock really.  I saw my Dr the last couple of weeks as I'd previously had a transient spell of hyperthyroidism early this year and thought it'd come back again as I was getting hot at night.  I was told my thyroid was fine but my LH and FSH were post-menopausal.  I'm 43 so not what I was expecting!! Dr said that I probably wouldn't want to start HRT so young and that we should repeat the bloods in 3 months, but also to go away and read up about it and I could come back to discuss what to do. I am getting hot flushes in the day and night and no period since I had 2, 2 weeks apart in July and August but it seems to have happened really suddenly.  There were probably changes in my periods before but never really taken too much notice. Maybe a bit irregular.

Anyway, I have read up a bit.  My husband is a Dr but not his field.  From our reading it seems that the advice is actually the opposite if this is the menopause and I should be starting HRT and continue taking it for a long time to protect against heart disease and osteoporosis.  I have phoned my Dr's surgery today and booked a phone appointment with a different woman Dr for Wednesday.

Any advice about what I should be saying to the Dr on Wednesday?  More bloods? Ask for a referral to a menopause centre (am in South Manchester)? 

Thanks in advance. And hope this makes sense. Head is a bit of a mush since getting the results!

[Dancinggirl]

Hi and welcome Mutley
I had a premature menopause - I was peri menopausal from my mid 30s.  I was advised to go on HRT to protect your heart and bones from oestrogen deficiency.
Do read up all the info under the headings to the left of this screen and get back to us with questions. 
Your GP seems to be rather ill informed!!!  Your research is absolutely right.
I would ask to referred to a meno clinic or a gynae for specialist support.
I'm sure others will be along with support.
DG x

[Limpy]

Hi Mutley



DG is right

Hope the different GP sees sense, stress the benefits for heart disease and osteoporosis.

Good luck on Wednesday.

[Mutley]

Thanks ladies,

I've had a bit of a read of the information up there but finding it rather overwhelming especially the different forms of HRT.  I've followed lots of info about coping with the hot flushes at night and seem to have slept better the past couple of nights.  Started taking EPO and sage tablets too.

IS there a certain type of HRT that is more suitable? Feel like I should be prepared in case this Dr is as good as the other! Hopefully not!!

[Mutley]

Right thanks. I was looking at the decision tree and couldn't decide whether I fitted in as peri or post as it's not 12 months with no periods but blood results for FSH/LH said post-menopause on them.

Will the Dr be doing bloods to check oestrogen (and testosterone?) before starting treatment?

Sorry for all the questions?  Just want to weigh up all the info especially since I come from a family where we seem to live to a good age.  Grandparents lived till late 80s and 90s and I don't want to be suffering from osteoporosis either!

[Mutley]

Thanks going to investigate further the pros and cons for different types ready for my appointment tomorrow

[Dancinggirl]

Hi Mutley
Re the different types of HRT:  It is often best to go for a lowish dose to start with then you can increase if need be. 

Many women continue with a sequential HRT beyond post meno as the side effects tend to be less.  Progesterone is often the problem and it can be trial and error before finding the ideal HRT. It may be a good idea to start on Sequential HRT so you can identify whether the progesterone is suiting you or not as you will only take this for part of the month. You can then move onto continuous if you are feel you want to. As you haven't had period for some time it may be strange for you to have a withdrawal bleed each month but hopefully you will get advice about this.

An alternative would be to have a Mirena fitted and then use oestrogen in patch or gel form which would result in no bleeding (after the first few weeks) but with the advantage of being able to adjust your oestrogen level to your needs.

Many women do very well on Femoston (it comes in both sequi and conti regimes) as the progesterone is kinder so better tolerated - so this one is good to start with. Don't let them put you on the old fashioned HRTs e.g. prempac, premique - they are the cheapest so the GPs tend to go for them first!!!!!

It is a minefield of info to get through - get back to us if you have any more questions.
DG x

[Mutley]

Thanks Dancing Girl, I did see your reply earlier but couldn't seem to reply on my phone.

Had my phone appointment.  Think I am happy with the plan.  She said she didn't want to prescribe me HRT just yet as she wants to do more bloods to get a better picture of what is going on and will look at all my pituitary hormones as I've had thyroid problems this year too.  She said she has seen people present like me go back to having periods again.  She has prescribed my Chlonidine (sp?) for the hot flushes.

She referred me back to this website and said if I experienced more symptoms in the meantime to get back in touch with her.

[Dancinggirl]

Hi Mutley
Oh dear! Another GP prescribing ADs for flushes.
In the peri stage the hormones will fluctuate so periods will come and go but this doesn't mean HRT is not a good idea.  Early menopause is also linked to thyroid problems I believe. I would have asked for a referral to a gynae.  If your oestrogen level is very low then no amount of ADs will protect your heart and bones!!! As someone said to you in this thread - "it is precisely because you are young that you need to take HRT."
If you are happy to wait for a couple of months that is fine - I personally wouldn't be happy to take ADs when it is actually HRT I need.  If you do decide to take the ADS I hope they help - they don't always work and they can bring some nasty side effects and take some time to actually work. Do read this page before taking them : http://www.menopausematters.co.uk/prescribed.php
ADs are usually prescribed for those who can't use HRT because of other health issues or need them alongside HRT to help with anxiety.
It is true that blood tests can be unreliable but your oestrogen level was actually very clear and diagnosed you as not just peri menopausal but post menopause!!!!
You mentioned your husband was in the medical profession - perhaps get him to go in with you for the next appointment to discuss things and maybe he will be able to get your GP to refer you.
Good luck  DG x

[Hurdity]

Heavens - not another one!

It makes us despair.

I would venture to suggest do not take the Clonidine - it is not the treatment you need.  You are 43 - peri-menopausal and you need oestrogen to protect your bones and heart.

OK if you start HRT your own cycle may kick back in - you may experience some bleeding at the "wrong" time and you may still get some mood swings as the hormones fluctuate (especially from the progesterone surges and falls) but at least your oestrogen levels will be maintained.

I agree with Dancinggirl - try  to get a referral to a menopause clinic if your doc refuses to discuss HRT or else try to find a sympathetic and knowledgeable GP in your practice. At your age you most definitely need to maintain oestrogen levels - there are all sorts of other health issues associated with early menopause.

Hurdity x

[Mutley]

Arg!! Meant to ask for a referral.  Spent 2 hours waiting for the phone call as their clinic was behind. I'd even got DH to stay off work so he was there for the phone call but it was so late he had to go in.  So by the time Dr did actually ring I forgot that bit! One of DHs colleagues recommended a gynae who specialised in menopause to him so maybe we'll able to go down that route. 

Will hold off the tablets and show this thread to him when he's back later. 

[Dancinggirl]

Hurdity has a science background and gives some very sound advice - so we are both singing from the same hymn sheet.
If your husband has a recommendation for a gynae then I would definitely get to see him\her a.s.a.p. before you take anything - maybe even go privately to get seen quickly.
Keep us posted.  DG x