2022 – A year of HRT – Part 1: January to March
On Wednesday 12 January, I saw some highlights
of Dr Louise Newson and Lisa Snowden's interview on This Morning and then watched the 16-minute interview the following morning. There were some
really good points raised about the menopause, perimenopause, and HRT.
It got me thinking. Lisa Snowden stated that she started having symptoms
at the age of 42 and she had no knowledge of menopause or perimenopause.
I was completely different. In my late 20's and early 30's I was a
stay-at-home mum. Anyone who knew me then would laugh at the 'timetable' that
was my life. One thing that I did do, at a certain point, was exercise on a
rebounder for an hour a day. Not anything like the Bounce™ classes that I have
been to in the last couple of years, just gentle rebounding and I generally
used that time to watch Oprah!
Oprah is 68 years old, so back when I was watching her in the early
2000's she would have been in her mid-40's so perimenopause and menopause would
have been on her radar. I remember watching a programme where I was first
introduced to the term perimenopause. Unlike Lisa Snowden who had no knowledge
of this or really of the menopause, I was fully aware that I could be
perimenopausal for possibly a decade before I then became menopausal. I even
bought a book that Oprah suggested should be read. The idea was good, but the
book remains unread, even to this day! In the following 20+ years I have bought
several books on menopause always with the intention of reading them but guess
what (?!) they have remained unread! I will come back to this
in Part 3!
The difference that I faced was a general belief that I couldn’t ask for
HRT and that if I did, I would be sent packing. Also, it took me a number of
years to realise that some of the ‘flags’ were perimenopause symptoms. I am not
someone who goes to see a doctor regularly. Over the past nine months I have
seen healthcare professionals more than I have in the previous 5 years!
So, let’s get back to HRT; as I stated in A moment in time I started HRT on 12
November 2021. My NHS GP advised that the Gold standard in HRT was an
oestrogen gel (Sandrena) and as I still have my uterus I would need progesterone
too and that this should be supplied through the Mirena coil. I’d not
heard anything from my practice two weeks after my physical appointment. I called
and established that there was a waiting list of around three months to have
the coil fitted! Having made the decision to start HRT, I wasn’t satisfied with
waiting that long. After a phone consultation with the GP, she prescribed the
progesterone in tablet form (100mg of Utrogestan) and 1mg of Sandrena. As I
have previously said, within five days I noticed an almost immediate difference;
muscle aches and pains disappeared, my mood was better and my attitude towards
certain things was improved.
The Sandrena
gel comes in a little silver sachet. I was squeezing this into my hand then
putting it onto my outer thigh, alternating each night onto a different leg (if
I could remember which leg I’d done the night before!). You should not rub the
gel in as you do a moisturiser so as soon as I’d put it on, I was then washing
my hands, so as not to transfer it onto anything or my husband! I saw a post on
Instagram where someone suggested using a spatula. I found some fantastic small
spatulas on Amazon. So, squeeze the sachet onto the spatula and then apply to
my thigh. Easy, clean and trouble free! Although it would take about 30 minutes
for the gel to ‘dry’.
When I
started taking the progesterone tablet and applying the gel, I was two weeks
off not having a ‘bleed’ for a year. The GP and I agreed that I should be on
‘continuous HRT’ as I was so close to the ‘magic’ year. At no point did I have
any breakthrough bleeding, which I had been advised might happen, and the only
adverse reaction was that I noticed that about 30 minutes after taking the
Utrogestan, I got stomach cramps; nothing too severe, just like a mild period
pain. Also, not a huge issue as I had been advised to take the pill and apply
the gel at night-time, so I was falling asleep fairly quickly after taking it.
Some
of the issues that surround perimenopause and menopause are about sharing
experience and details. I am using this blog to share details, some of which
might not make for pleasant reading; it’s my experience but does need to be
shared.
On 24
January I had the Mirena coil fitted and stopped taking the Utrogestan. I
expected to have some bleeding, due to how it is fitted. I’ve heard lots of
negative comments about having a coil fitted. I can’t say that it was a
pleasant experience, but it could have been worse! I do think that if I was a
younger woman and had not had children this would have been completely
different. When you have children you just tend to take ‘painful’ things in
your stride. I had niggle bleeding for the first week and then a ‘proper’ bleed
for at least 4 weeks. Bear in mind that I hadn’t had a bleed for 14 months to
this point, so this was a little bit of a shock. I continued to bleed for
approximately 16 weeks; not enough to worry about but enough that I did have to
use a panty liner every day. I had a couple of chats with the GP and was told
that it could take around six months for my hormones to settle down. I was
reaching a point where I was going to ask to have the coil removed when it did settle down.
The
breakthrough bleeding that I’d been warned about when starting HRT hadn’t materialised
but change to the coil and naively, I’d expected that to still be the case; how
wrong was I!
Four
weeks after having the coil fitted, I had an appointment, with a nurse, to check
its status. There were a couple of questions that I had which required a GP’s
input. I had a telephone call and discussed that some of my symptoms had
re-appeared; I was grumpier than I had been, to name just one. The GP increased
my dose of Sandrena to 1.5mg.
As I’m
over 50 I now have 3-yearly breast screening. This took place at the end of
March and no issues were raised at this screening.
I follow several menopause specialists on Instagram as well as being part of forums/pages on Facebook. All of these I find really useful. You get an understanding that you are not the only one going through what you are plus hints and tips. Dr Louise Newson, @menopause_doctor, and the Balance app that she set up are amazing tools. I would advise everyone to download it. You can track your symptoms, and the articles on the app/website www.balance-menopause.com are invaluable plus the YouTube channel, balance Menopause. I also follow Dr Naomi Potter, @drmenopausecare, and also find everything that she has to say really informative. Dr Potter does a mid-week live Instagram with Lisa Snowden and they have recently created a YouTube channel called Menopause Madness. Davina McCall's new book, Menopausing, has also been written with Dr Naomi Potter.
As I
approached the end of March, having been on HRT for just over four months, I
still didn’t feel quite right. I knew that it wouldn’t be a magic fix and I
also think that the daily bleed, though only slight, was getting me down. One
of the biggest problems that we as women have is that we really don’t talk
about this kind of thing. We start our monthly cycle and it’s something that we
accept/put up with, along with all the pains and issues that go with them. I am
of a generation where it just wasn’t really talked about. One thing that is
happening is that prominent women, Davina McCall, Lisa Snowden, to name just
two, are bringing perimenopause and menopause into the open. To be discussed.
As the mother of boys, I didn’t have to have the ‘period’ conversation, but I
have been very vocal about perimenopause with them. Mainly because at some
point they may have a woman in their life who would go through it! I wanted
them to have some understanding and to be supportive of their partner when that
time comes.
If you
want to continue reading how my year has gone, please read Part 2:
April to June, Part 3: July to September and finally Part 4: October to
December. Depending on when you are reading this they may or may not have been
posted!
