Different views of menopause with symptoms

[jacksfullofaces]

www.brooksidepress.org/Products/Military_OBGYN/Textbook/Menopause/menopause.htm#Serum%20Estradiol

[stumpy]

Thanks Jacks

Didnt like this bit:

Progesterone
Taken alone, estrogen replacement in standard doses is associated with an increased risk of uterine cancer. The addition of progesterone to the estrogen not only blocks the increased risk of uterine cancer, it reduces the risk to less than that of women who don't take any ERT at all. For this reason, progesterone has routinely been added to estrogen replacement regimens for women who have uteruses. Women who have undergone hysterectomy have no need for the progesterone addition.

Progesterone blunts, to some extent, some of the other estrogenic effects, and the best of the long term studies have not reported their results from estrogen-alone therapies. It is possible that some of the risks of ERT are actually a result of the progesterone.
Stumpy xx

[susan]

Just reading your post Stumpy. I know Bella is away and I may be getting this wrong. But the longer you take the progesterone component of HRT I think the higher your risk is.

That's why when you read the leaflets in the HRT boxes the risks are higher for those on combined HRT than they are for those just on ORT.

I remember having a conversation with the Silverlady about this. She only needed ORT as she had a hysterectomy years ago and intended to stay on her 25 mcg oestrogen patch forever.

As I think i want to be on HRT for ever due to the problems with osteoporosis in my family history, we were trying to think of ways to overcome the long term progesterone problem for me.

One of the plans was to cut a 25 mcg patch in half, so I was only getting 12.5 mcgs of estradiol & having a short course of progesterone every six months, just to shed any lining build up (might not have made any though with such a small dose of oestrogen.

We just weren't sure if 12.5 mcgs was enough for osteoporosis protection.

I would probably have to go to a menopause specialist like Studd for something like this.

In the US they have a patch called Menostar that is 17 mcgs of oestrogen that they let women stay on for life if they want along with a small course of progesterone every so often plus an annual scan. But that isn't available in the UK.

Goodness knows what i will do in 9 years time when I am 65. I don't want a hyster without a proper medical reason to have one, don't want to give up oestrogen supplementation, but don't want to be taking combined HRT into my doteage.

It's a bit of a conundrum really.

xxxx

[stumpy]

Susan

A man would only have to walk a day in our shoes to find a cure for lots of the things us ladies just have to put up with.

I hope that I can stay on HRT for ever too, but I will have to stop combined at some point?

Its all pretty scary stuff, as I am slowly feeling like me again. (think I would scratch someones eyes out if they tried to take it away from me now)

[susan]

I don't think they will cure it as such Stumpy, HRT really is the kind of cure if that makes sense.

I think what will happen is we will evolve over the years so that we carry on making our own hormones for a lot longer. As recently ago as 1910 the female life expectancy was age 50. in evolutionary terms 100 years is very little. I don't think then that they thought huge numbers of women would be living well beyond their childbearing years like they do now.

I have lost track of your age, but in real terms I'm not sure if there is that much problem in taking combined oestrogen & progesterone HRT at least up until age 60. If I am still well on it, I will push that to 65 and then maybe reassess it.

Hopefully there will be more science and research available by then for me to base my decisions on.

xxxx

[stumpy]

Hi

Am 49. So a while for me yet then, hopefully

I read an article once about women & meno back in 1900's. Lots ended up in asylums, bless them.

Stumpy xx

[susan]

Yes, and some a bit earlier than that has experiments done on them as women didn't have much voice in the days before Emily Pankhurst. Some went into asylums for ever.

Lots of menopausal women ended up on Laudanum to cope, ending up with an addiction to Opium to deal with it all. Puts women's worrys about a low dose oestrogen into perspective.

xxxx

[Robyn]

Sept 5, 2012 12:39:51 GMT susan said:

Goodness knows what i will do in 9 years time when I am 65. I don't want a hyster without a proper medical reason to have one, don't want to give up oestrogen supplementation, but don't want to be taking combined HRT into my doteage.

It's a bit of a conundrum really.

xxxx

That's my concern too. I'm fine about taking progesterone at the moment, but honestly do I really want to be pushing the Utrogestan into my nether regions when I'm 65? Even taking it orally, and having a period every so often, isn't all that appealing either. Perhaps the alternate day Utro is an option, but for me that didn't really work all that well, but I could give it another try I suppose.

I have a feeling that by the time I'm that age I will just say "bugger it" and just continue to take the oestrogen and let whatever happens to my lining happen. Hopefully by the time I'm 65 (in 12 years time) there will be a better solution.

[susan]

I hope so too Rambo. I am lucky as I'm on a combination patch so don't have to mess about with shoving utrogestan up thank goodness.

It's a real dilema for me though as I actually beleive that some sort of transdermal oestrogen, either oestrogel or estradot patch and utrogestan, is probably the saftest HRT of the lot with far more health benefits to it than risk.

Both are bioidentical, give virtually no risk of stroke & I have never been that convinced of the breast cancer risk at all, it's just something the British Tabloids like.

As you have said the breast cancer is never even mentioned in Australia and it's only mentioned in the US to spook them into buying their hormones from mega expensive compounding pharmacys as a shuge money spinner. I

It also dosen't seem to be a factor in Spain or France where most HRT can just be bought over the counter in a Pharmacy as it is deemed to be so safe. I bought a lot of stuff back from Spain there are no restrictions on it from what I can see.

In the UK the GP's treat it like we are asking for Crack Cocaine. They are a bunch of control and power freaks.

I might do something similar with just a low dose patch and prog twice a year and a scan when 65.

I think I might need to go and see a meno specialist though as over hear loads of our general Gyneacologists are not intrested in menopause.

Jacks was right as soon as they found out how much money there was to be made from IVF menopause and reasearch into it went straight out of the window.

xxxx

[Robyn]

Yes, hopefully by the time I'm in my 60s the worst of my meno will be over and I will also be able to be on a very low dose of oestrogen, so the risks of the lining build up won't be quite so great.

[susan]

We may not even need it especially if there is no history of oestoporosis and bone density has been maintained to 65.

[jacksfullofaces]

Sept 5, 2012 19:22:55 GMT susan said:

Yes, and some a bit earlier than that has experiments done on them as women didn't have much voice in the days before Emily Pankhurst. Some went into asylums for ever.

Lots of menopausal women ended up on Laudanum to cope, ending up with an addiction to Opium to deal with it all. Puts women's worrys about a low dose oestrogen into perspective.

xxxx

Susan
The era of Le Belle Epoque brought about the first inkling of HRT. The women in Paris breakfasted on raw sheep ovaries in brown bread forgoing their morning croissant. I prefer my boiled egg and oatmeal cracker and two arms smothered with oestrogel
Jacks

[susan]

Yuck, think I will stick to the tiny slice of fruit bread I have and a skinny latte.

Glad i can get my hands on some estradiol rather than having to resort to heroin.

I think Proff Studd has some stuff on his site about menopause in the Victorian Era, I'll see if I can find a link to it when I have more time.

xxxx

[jacksfullofaces]

well when my husband no longers requres his testosterone I guess I will no longer need estradiol or progesterone.
Jacks

[susan]

Actually I think this was what I was thinking of that is the history of female sexuality.

But it still makes for an interesting read for anyone that has a free five minutes or so.

www.studd.co.uk/sexuality.php

[jacksfullofaces]

Susan
I read this with interest but Professor Studd doesn't mention that until Victorian times attitudes to female sexuality were differfent. For reference I recommend the Earl of Rochester Signor Dildo - be warned it is explicit in content. Restoration London had a very relaxed attitude to female sexuality and this continued through to the Victorian era when things became puritanical despite Victoria's lust for Albert.
andromeda.rutgers.edu/~jlynch/Texts/dildo.html
Jacks

[susan]

I will give it a read later Jacks, but yes I am sure this is just the information that the Proff has chosen to put on his site and isn't fully comprehensive.

xxxx

[stumpy]

raw sheep ovaries....

[Robyn]

Sept 6, 2012 9:02:51 GMT susan said:

We may not even need it especially if there is no history of oestoporosis and bone density has been maintained to 65.

I think I will though, because I've already been diagnosed with osteopenia, and my father had osteoporosis. So I think I'm going to need to be on oestrogen as long as possible.

[lilangel1]

My main symptons are severe anxiety with frequent panic attacks, insomnia, crashing tiredness every other day, giddiness, the odd hot flash, bloating, nausea, dry skin and definite loss of libido.
Started having treatment through the australian menopause centre. Started on 75mg progesterone, increased to 100mg and did nothing.
So he increased dosage to 125mg and put me on a supplement called diindolmethane which is 100% natural made from the nutrients of broccoli, cauliflower, cabbage etc which helps the body utilise its own oestrogen as he says I dont need to be on it !! I researched it and apparently it is often used by cancer sufferers and those in high risk cancer groups as well as menopause.

Anyway I thought I would give it a go and yay I am feeling much better especially the anxiety and more energy so I dont know if its the increased progesterone or the supplement or a combination of both
I am having more hot flushes though and have started having to urinate every 5 minutes.
By listening to you ladies not sure if he is on the right track or if the other symptons are oestrogen related.Bit wary about stopping but dealing with these people is pretty expensive. I will go and see my GP again and see if he can prescribe the same thing only cheaper.
Any advice ??

[Robyn]

Hi lilangel - I don't have a very high opinion of the Aust Menopause Centre. They are one of those companies that is cashing in on the HRT scaremongering and trying to convince women that they need to use compounded hormones to get the bioidentical type, and you don't. I also didn't like the fact that I had to talk to the doctor on the phone. There was no face to face interaction.

When I made my enquiries through that centre quite a while ago they quoted me something like well over $100 per month, and there is no way HRT in Australia should cost that much. I've paid as low as $10 for 2 months supply for bioidentical hormones through my own GP, and it's regulated and PBS approved.

Definitely have a good talk with your GP and tell him/her all your symptoms. You should be able to get bioidentical hormones through your GP for much much cheaper than through AMC.

[lilangel1]

Yes I am planning on going back to my GP asap. I cant afford to keep paying the amount they charge but I was feeling so rotten at the time I would have paid anything to feel better.

[Robyn]

Yes, I certainly understand that feeling. That was why I made my enquiries with AMC, but I wasn't working at the time and there was no way I could afford it.

[susan]

Sept 12, 2012 4:03:46 GMT lilangel1 said:

My main symptoms are severe anxiety with frequent panic attacks, insomnia, crashing tiredness every other day, giddiness, the odd hot flash, bloating, nausea, dry skin and definite loss of libido.
Started having treatment through the Australian menopause centre. Started on 75mg progesterone, increased to 100mg and did nothing.
So he increased dosage to 125mg and put me on a supplement called diindolmethane which is 100% natural made from the nutrients of broccoli, cauliflower, cabbage etc which helps the body utilise its own oestrogen as he says I dont need to be on it !! I researched it and apparently it is often used by cancer sufferers and those in high risk cancer groups as well as menopause.

Anyway I thought I would give it a go and yay I am feeling much better especially the anxiety and more energy so I dont know if its the increased progesterone or the supplement or a combination of both
I am having more hot flushes though and have started having to urinate every 5 minutes.
By listening to you ladies not sure if he is on the right track or if the other symptons are oestrogen related.Bit wary about stopping but dealing with these people is pretty expensive. I will go and see my GP again and see if he can prescribe the same thing only cheaper.
Any advice ??

lilangel1

Your symptoms sound like they would be much more likely to respond to oestrogen.

My Doctor told me that basically a hot flash is your body yelling out 'give me oestrogen' rather than progesterone.

Although of course we need both. oestrogen is thought to be the uplifting hormone, and progesterone the calming hormone. That said a lot of women can find progesterone gives them something akin to PMT, so the amount that is needed must be weighed against how much you personally need as too much can have a negative effect.

Any woman with a womb who takes oestrogen must take a progesterone as well, to protect their womb lining from building up too much.

I honestly think you would benefit from taking oestrogen as well as progesterone. I

s there a way to buy oestrogen where you are as it is a very cheap product and is versatile in its delivery being available in tablet, patch and gel form?

This may save you the expense of going via what sounds like an expensive arrangement to just basically be told to go to a pharmacy and by some sandrena gel or a packet of oestrogen tablets/patches.

xxxx

[Robyn]

Yes, lilangel lives in Australia, so she can definitely get the same HRT that I get, which is as cheap as chips, through a regular GP and a regular pharmacy. I agree that she definitely sounds like she needs some oestrogen.

The company that she has been going through is an online place called Australian Menopause Centre. I'm not sure if they do saliva or blood tests (lilangel can probably tell us), but then they post the compounded hormones to you, but all that isn't necessary because every regular GP can prescribe bioidentical hormones here.

[lilangel1]

Yes after reading everybody elses posts im sure I would benefit from oestrogen as well so I will be heading back to the doctor.

Rambo the menopause centre just did blood tests but from what I hear they arent that reliable so will be having a word about that as well.

[susan]

I'm not sure how it is over there, but here they normal start women off on either a 1 mg oestrogen tablet, a 50 mcg oestrogen patch or two blobs of oestrogel which I think if you get Sandrena over there comes in little indvidual sachets.

You can normally work out what you need for yourself by monitoring your own symptom control over a three month period of time. If you are still getting flashes and sweats you need more oestrogen, if they go and you feel good in general you are probably getting the correct amount; however you can try less i.e. a 25 mcg patch or one blob of gel, and if you try that for two/three months & the flashes and sweats return then it isn't enough for you, so you put it back up.

Ignore any aching breasts you get on start of the treatment as that is just a reaction to reintroducing oestrogen back into an oestrogen starved body & should settle within three to four months.

Lots of women go for really expensive testing to establish what they need, but really you can work it out for yourself by being in tune with your own body & how it responds to different levels of hormones, then adjust accordingly.

xxxx

[Robyn]

Yeah, it's pretty much the same in Aust. I've only ever had one lot of blood tests done and that was right at the very beginning when I first started to experience insomnia. I'm not sure that I was even getting any hot flushes back then (can't remember).

Anyway, I can't speak for all doctors here, because I've only ever seen two for menopause (and one dickhead compounding GP - but he's not worth talking about...lol...), but I think most GPs usually just start you off on the lowest dose of HRT (usually tablets) and just monitor things over a period of a couple of months. If the symptoms settle then they leave you on it, but of course if you are still having problems then they will put up up on the next level, until things gets sorted out.

Everything with HRT is trial and error and it can take a while to get things sorted out, as we all know.

[susan]

Sounds very similar to here rambo, very unlikely to get blood tests unless you press for them. Although a lot of our doctors come across as knowing little about menopause, a couple I have seen have said that bloods are notoriously unreliable as a predictor during peri-menpause and they prefer to go by symptoms. (which a lot then ignore lol or tell you are natural ).

xxxx

[Robyn]

Yes, when I asked my GP recently about doing more blood tests to check my hormones she said no because it was too unreliable.

However, I've just had blood tests done for everything else and I'm as healthy as a horse. Absolutely nothing is wrong with me. Thyroid is perfect and even my cholesterol, which wasn't a problem anyway, has gone down a bit. The only slight issue is that my Vit D is on the lower end of the scale, but that's not uncommon in Australia because we're all too scared to go out in the sun because of cancer.....lol... I'm already taking Vit D3 supplements so I've just increased them a bit.