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[Jobo]

Not sure where to start really.

I am 46 and post meno and have been for 5 years. I have been battling all this time to get the right combination of HRT for all this time.  Off the top of my head I have had at least 8 different types but because I am progesterone intolerant couldn't find anything that agreed with me.  So after 3 extremely painful hysterscopies and several scans decided the last option was the mirena coil and Oestrogen patch, I completely objected to this regime a while ago but had run out of options so was willing to try.

All went really well and for the first time in  years I actually felt human again, hardly any side effects with the mirena, I thought I had cracked it! Oestrogen patch was .75mcg and at the time thought this was a bit high to start off with so have been cutting a tiny bit of off as I intended to build up rather than starting on a high dose if needed.  This all started in April 2016.

For a least the last few weeks I have been feeling pretty terrible and am wondering is it my regime.  It seems unlikely but I feel a little like I did when I took other progesterone's, lethargic, low mood, sore eyes, foggy head, lack of concentration and a banding headache all the time.   I know this may sound crazy but I have started to have really bad thoughts and feelings and some days wake up thinking its going to be my last for no reason at all.  I feel really anxious a lot of the time.  Is this normal or could there be something else going on?  I also appreciate the way I am feeling could be meno symptoms.

I am really frightened about increasing the oestrogen dose because a couple of years ago I had a terrible episode where I was shaking uncontrollably for 20 minutes and my poor husband had no idea what was happening so called an ambulance.  The only explanation for this was too much oestrogen as it was no coincidence I had just started a high dose at the time.
I am normally fit and healthy active, recently had sugar, cholesterol and heart checks at doctors and all came back great, so am baffled again.  Only other thing I have noticed is I have been having some discharge the past couple of months that I didn't have before.
I would really appreciate people's views and advice on what I should do next.
Thank you

[donnacrichton]

Don't want to just scroll past hope someone with more knowledge comes along soon x

[Menomale]

Hi Jobo,

I am no HRT expert and I'm sure some ladies will help you. Just want to ask you some basics in order to help me understand what might be going on...

When did you have the Mirena fitted? Could it be time to have another one? Anyway, the discharge should be checked!
If you have entered menopause at 41 this is quite premature, did you have any other problems then, what were you told by your docs about it?

All the weird emotional/physical symptoms points to a hormonal imbalance but  that does not exclude other possible causes.
I'm sorry I can't give you any other advice but to get an appointment asap.

XXX

[Annie0710]

I don't know what to advise but I can't tolerate high doses of oestrogen, I get all jittery and on edge

I'm a few years post meno with no uterus and disintegrated ovaries

Personally I felt better at 50mcg oestrogen

I'm now on Tibolone and feeling quite hormonally balanced x

[Jobo]

Hi Memomale

Thank you for the info, I had the mirena last April this is why I don't understand the change in my symptoms.  I am early memo and was really unwell for approx 12 months doctor just though I was depressed never occured to myself or doctor I was early meno, I haven't had a bleed for nearly 7 years. Didn't opt for HRT until I was 41 and have been on and off it since then. 

Am beginning to think there is something else wrong and not hormone.

I have an appointment next week at docs but tbh they have been pretty useless, if it wasn't for this site I don't know where I would be today!
Thank you for your reply

[Menomale]

Great that you have an appt soon. I know docs are sometimes more confusing than helping but only they can ask for exams so we don't have other option.
Don"t worry now, I think it may be just your adrenals producing sex hormones and messing with HRT.
Do let us know how the appt goes.
XXX

[Hurdity]

Hi Jobo

Sorry to hear about your problems and not feeling well still.

I doubt very much it is the Mirena suddenly causing problems after all this time if you haven't felt like this before - since the progestogen concentrations reach their highest values in the serum/blood after about two weeks and the release rate gradually falls over the next five years - so there should be a little less getting into your system by now. However this is a possibility I suppose.

I wondered how long you have been on the 75 mcg patch?

The symptoms you are describing don't sound like low oestrogen although low oestrogen can also cause low mood and lethargy. Unless you are also taking other meds that might suppress flushes, then the fact that these haven't returned indicates the level could be in the right region. However at your age your body would normally expect to have quite high oestrogen levels at certain points of the menstrual cycle ( but not all the time).

The other thing is I hope your doc will consider doing background blood tests to see if there is another explanation for your symptoms - low thyroid (especially if you have a tendency to put on weight and feel cold), low testosterone and some vitamin deficiencies can cause some similar symptoms.  Also this time of year many of us tend to feel a bit out of sorts with bugs going about and lack of sunshine so might be that? How is your diet generally? Do you get plenty of exercise and fresh air?

Which HRT types have you tried? One with a higher dose and maybe more suitable is the newer contraceptive pill QLAIRA which contains estradiol (like the patches) and only 2 tablet free days. You might get a bit of a bleed though each month, and you would need to be able to tolerate the synthetic progestogens it contains - but might be worth a try unless tablets do not agree with you?

Do let us know how you got on at the docs and  hope you manage to find a solution soon

[Jobo]

Thanks hurdity I am so glad you replied.  I too am thinking it can't be the merina because it's been 10 months and it's not really caused me any problems apart from the fact the threads can't be found!

I felt so bad again today and fell asleep when I got home from work.  My head has been throbbing all day. 

I have been on the 75 mcg patch for over a year am very active eat well and am always on the go so feeling like this is wearing me down.  I am beginning to think this could be thyroid as my mum had underactive and has for years I am also cold all the time and have gained weight despite having a good diet.

If no better tomorrow I am calling docs to bring my appointment forward.

[Menomale]

Hi again Jobo,

Hmmm, you didn't mention that the threads can't be found before... could mirena have been displaced and not be delivering the right amount of prog you need to balance oestrogen levels? That could also explain the discharge...

Just a thought. I hope you can have your appt soon!

XXX

[Hurdity]

Sounds like thyroid could be a possibility - make sure you get the actual results as well from the test and mention your feeling cold etc

Hurdity x