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[AuntyBiz]

Hi All,

Long time no post    and I'm hoping this post will make sense.  Basically a couple of years ago (appx) I changed from Elleste to Cyclo-progynova 2mg.  At first everything seemed to be OK, I was having periods every month (these are cyclical HRT tablets) but then I started to feel really rough every month.  Headachey, tired, stomach aches, restless legs etc.  To cut a long story short, one month when I was trying to get my prescription, I was informed by the pharmacist that these tablets had been discontinued in the dose I used so I decided to stop taking them (this was back in March).  I didn't have any problem stopping them, I know tapering is advised, but everything was fine.

My questions are.......how do I know if I have finished the menopause?  I had periods when I was taking the HRT but as soon as I stopped taking them, I haven't had a period since.  I have asked two GP's, who have both said "well, it's very difficult to say"  and who are reluctant to do blood-tests as apparently they don't give an accurate response.

Secondly, if I have finished the menopause, would it be beneficial to take HRT for osteoporosis and tiredness/mood-swings?  I take anti-d's and have done for 17 years (don't get me started on that!) so my moods aren't attributable to depression. 

As my GP's are next to useless, would it be wise to see someone privately?
I'm 51 but feel about 151 

Any support or advice will be enormously appreciated.

Biz xx

[CLKD]

Menopause is literally, the last monthly period.  However.  Mine waxed and waned for 2/3 years so I had to start counting from 0 again.

Your GP can arrange a bone density scan of pelvis and hips to see if you are at risk of osteoporosis.  Brisk daily exercise can keep bones strong as can a diet with calcium and green veg. included.  Tiredness can be caused by low VitD levels, again a blood test will show if you need capsules to lift the levels.  I was so tired when my levels dropped that I sat, unable to function. 

Mood swings can be hormonal.

[AuntyBiz]

Thank you @CLKD for your very speedy reply.

I had a bone density scan last year as I have arthritis (I had a hip replacement at 46) and I have arthritis in both ankles.  The scan was OK and I take VitD and Calcium tablets (on prescription).  My iron levels have fluctuated in the past so I have taken iron tablets although iron levels seem to be back to normal now. 

Re the mood swings, would these still be hormonal even though I'm no longer having periods?  Just to mention I had a thyroidectomy in 2008 so I;m on thyroxin, but levels are OK as I had them tested before Xmas.

[Conolly]

Hello Biz,

Theoretically you will know if you're menopausal only next March. Of course you could go back to HRT, but you could wait until March to be sure you're are menopausal and then you could start it if you feel you're still having symptoms. I think you are just at the worse time of the roller coaster which is the turning point from late peri to menopause, things have calmed down for me soon after that.

Conolly X

[Hurdity]

Many of us do not know when we became menopausal because we started HRT before we reached that point (12 months after last natural period). I am one who would have gone throuygh it a long time ago somewhere mood 50's but still taking HRT in my mid 60's.

The two chief reasons women take HRT are symptom control during the menopausal transition (and beyond if necessary) and health protection ( of bones and heart/cardio-vascular system chiefly, amongst other things).

If you are taking anti-depressants then these may well be masking the obvious symptoms of flushes and sweats since ADs can be prescribed for women who cannot take HRT ( eg due to breast cancer) and some of them work for this purpose for some women - depending on which type you take.

If you are post-menopausal then mood swings are very unlikely to be due to hormonal fluctuations althought cyclical changes continue to some extent for some years following the last period - while oestrogen levels on average decline sharply. Any fluctuations would be only mild by comparison with the usual fluctuations of the menstrual cycle and especially leading up to menopause.

Taking HRT for several years beyond menopause is of course beneficial to bones as long as you continue taking them and your decision re this may be governed by genetic factors - do you have close relatives who have/had osteoporosis? Also it's worth taking into account how many years women live post-menopause on average - you could live to 90 - and by that time your bones may well be very weak. Taking HRT even low dose will help protect them - boradly speaking.

Re fatigue - there can be all sorts of reasons for this. However if you take thyroid medication - despite what your results actually say - maybe your medication needs tweaking especially if other symptoms such as feeling cold or weight gain are present? Otherwise vitamins deficiency, too much alcohol ( eg daily drinks), and lack of exercise can lead to fatig

I hope these few thoughts help you a little in trying to work things out!

Hurdity x

[Katejo]

Hi All,

Long time no post    and I'm hoping this post will make sense.  Basically a couple of years ago (appx) I changed from Elleste to Cyclo-progynova 2mg.  At first everything seemed to be OK, I was having periods every month (these are cyclical HRT tablets) but then I started to feel really rough every month.  Headachey, tired, stomach aches, restless legs etc.  To cut a long story short, one month when I was trying to get my prescription, I was informed by the pharmacist that these tablets had been discontinued in the dose I used so I decided to stop taking them (this was back in March).  I didn't have any problem stopping them, I know tapering is advised, but everything was fine.

My questions are.......how do I know if I have finished the menopause?  I had periods when I was taking the HRT but as soon as I stopped taking them, I haven't had a period since.  I have asked two GP's, who have both said "well, it's very difficult to say"  and who are reluctant to do blood-tests as apparently they don't give an accurate response.

Secondly, if I have finished the menopause, would it be beneficial to take HRT for osteoporosis and tiredness/mood-swings?  I take anti-d's and have done for 17 years (don't get me started on that!) so my moods aren't attributable to depression. 

As my GP's are next to useless, would it be wise to see someone privately?
I'm 51 but feel about 151 

Any support or advice will be enormously appreciated.

Biz xx

   I am considering starting systemic HRT now (5 years post menopause) after reading the recent book on the benefits of oestrogen and also to help my joints/improve bone density. I am waiting for an appt. to have a bone density scan done as a precaution. I last had one done 3 years ago and that was ok. I have also had a thyroidectomy (2005) due to a goitre. I was born with underactive thyroid. I didn't take them during peri because I had no probs with hot flushes. They were very mild.

[AuntyBiz]

Thank you so much ladies.  The anti d's I take are Venlafaxine, which are supposedly good for hot flushes (not convinced).  My thyroxin was tweaked before Xmas as I was taking slightly too much and I've had another blood test since which indicated all was OK.  I only drink occasionally, perhaps a glass of wine or two on a weekend, if that.  I take Vit D and calcium tabs, my Mum has osteoporosis but she's 89.

So, do you think it would be wise to ask for blood tests in March which would be 12 months after my last period? Would this then show that I was post menopause?
 There's been a lot going on for me the past few years, Dad died, I've had several operations, work issues culminating in me handing my notice in,  I've started studying again- p'raps I'm just getting old!  I have arthritis too which makes it difficult it exercise, so I do feel like a slug most of the time.

[Conolly]

Hello again Biz,

If your last period was March 2018 and you don't have any other until next March, theoretically, you will be postmenopause. Because you were on HRT this is not 100%. I would wait a bit longer for blood tests because they are not reliable to establish the menopause status.

I'm so sorry you've been through such distressful events, most of us have been there, so it's perfectly normal to feel rotten.

As a side note, you should take vitamin K2 along with vitamin D and calcium to make sure all calcium goes to your bones and not your blood causing atherosclerosis or kidney stones. I've been there myself, so have a word with your GP.

Conolly X

[Hurdity]

You absolutely do not need blood tests to establish menopausal status and in fact the tests currently used (FSH) cannot show this! The 12 months without a period when not on HRT or Mirena etc - is the only way to determine this at your age.

If you are taking Venlaxafene and not getting any flushes/sweats then this is the likely reason - these are prescribed for women who are medically unable to take HRT and I think are the most recommended type for hot flushes.

You don't need to see anyone privately but yes if you want to take HRT it will give you bone protection. It is all available on NHS provided you go to a doc at your practice that understand menopause and is up-to-date (there are still some dinosaurs about, and blinkered GPs, sadly!). I can't comment on mood effects because since you are taking ADs already this muddies the waters as to what is doing what, but if your mood is also low then the oestrogen part of HRT can help lift your mood. When you are post-menopause continuous combined HRT is usually recommended but the continuous progestogens can cause low grade pms-like side effects including low mood so some women opt to remain on a cycle.

Also tablet HRT and some anti-depressants can depress libido in some women so if this is an issue best to use patches and also consider reducing the ADs if you re-start HRT - unless the ADs were given for other reasons ie long standing depression unrelated to hormonal changes.

Hurdity x