Menopause and endometriosis

[harryhonda25]

Good Afternoon

Hope you are all well

I am 50 years old and going through the menopause

I have not had an hysterectomy so still have everything in tact

My doctor has put me on oestrogel 2 pumps one on each arm. She also gaveme Utrogestan 100 mg tablet I also have an implant in my arm for contraception and this stops my periods which is what they wanted so my endometriosis does not grow

My friend thinks it is too much for my body and thinks with all 3 things my endometriosis will come back

Any advice or experiences with any of you please

Many thanks for your help with this greatly appreciated

Kindest regards

Janet

[Bethleah]

oestrogen can reactivate the endo. You need the progesterone but the lowest dose of estrogen possible. I started with progesterone pill and oestrogen patch 25mg evorol. Im now on evorol conti patch which is progesterone with 50mg oestrogen which was too much so I cut it in half. You can take hrt in Different forms. If you are on the implant it’s increasing the hormone levels. Maybe see a gp who has an interest in menopause or see a menopause clinic but this would be a long wait. Look at everything you are taking in detail and add up how much progesterone and oestrogen you are on. Also what symptoms are you taking it for?

[harryhonda25 in reply to Bethleah]

Good Evening

Hope you are well

Thank you so much for your kind reply with all the help and advice greatly appreciated

I had all the blood tests and they came back saying I was definitely in the menopause

I have been having night sweats, hot sweats during the day, brain fog, feeling down, tired all the time. Insomnia. No energy

The doctor put me on the progesterone and said keep the implant in until it is due out in January 2025 so the hrt gel would not thicken the lining of my womb making my endo grow back

The progesterone pill gave me extreme tummy pain, breast pain in fact endometriosis pain

Not many doctors are experienced in endometriosis and menopause together

Thank you so much for taking the time to reply to me so appreciate it

Take care and enjoy the rest of your weekend

Kindest regards

Janet

[BloomingMarvellous]

Huuuummmm. I hear your concern and your friend’s . It’s unusual to be on the implant as well as the rest to be honest if you are naturally menopausal rather than peri menopausal. However, there is plenty of usage of suppressants treatment and put back hrt levels of hormones which is far, far weaker than the body’s natural output in many cases of endometriosis treatments in younger women. You may want to go back to your medical provider and discuss it. You can but try it as there must have been good reason for your provider to choose with you to put HRT in and see perhaps tracking things regularly using the tracking suggestions here on this website.

For advice on menopause and endometriosis there is some good resources available on Dr Louise Newson’s Balance App . For many women including those with endometriosis menopause brings deficiency of essential hormones that without we can go onto develop serious illnesses without. These range from heart disease, osteoporosis and severe mental health concerns so HRT correctly administered can be a godsend. Likewise there are some alternatives but choose carefully with proper advice. The variety you have been given are low dose and body identical so are better than other formats for many women. The Utagestan is frequently more regulating for endo and less prone to bringing emotional lows than the progestins of pill or implants. If you have been on suppressant implants for a while there is some concerns that these non body identical hormones act as a menopause early and there might be long term increase in post menopause issues with them . There needs to be more information with this but it just outlines that there are unanswered questions around that quite honestly we need more data on. So putting some body identical hormones in to counterbalance this may not be a bad thing after all ! It goes both ways. Sometimes it’s between the devil and the deep blue sea with health care choices . Weighing up risks is just that and none of us have crystal balls 🔮 but we can use probability and data to help us on our initial decision process. If you’re looking for certainty then am not sure anyone can give you that.

Endometriosis while partly fuelled by hormone imbalance and productive of its own tissue hormone is not only the product of hormones alone. Research is indicating inflammation and probably autoimmune involved so looking to ways to overall reduce your inflammation levels might be a useful route to explore whatever you choose to do. For exploring I would suggest a few fellow warriors own journeys such as @heal-endo and @leahbrueg as well as a lecture given by Dr Angie Muller of @corerecoverypt looking at the importance of pelvic floor for hormone balance ( and frankly super important as we age balance and strength wise ) all on Instagram . Sharing with your friend might be helpful but in the end trust yourself, discuss with your medics and do what’s best for you. There is a lot of misunderstanding around HRT full stop and endometriosis and there are many different forms of endometriosis. We aren’t all the same and ergo there isn’t a magic formula to manage the chronic condition.

[harryhonda25 in reply to BloomingMarvellous]

Good Evening

Hope you are well

Thank you so much for your kind reply with all the help and advice greatly appreciated

I had all the blood tests and they came back saying I was definitely in the menopause

I have been having night sweats, hot sweats during the day, brain fog, feeling down, tired all the time. Insomnia. No energy

The doctor put me on the progesterone and said keep the implant in until it is due out in January 2025 so the hrt gel would not thicken the lining of my womb making my endo grow back

The progesterone pill gave me extreme tummy pain, breast pain in fact endometriosis pain

I will definitely check out the sites you shared with me my lovely 🙂

Not many doctors are experienced in endometriosis and menopause together

Thank you so much for taking the time to reply to me so appreciate it

Take care and enjoy the rest of your weekend

Kindest regards

Janet

[BloomingMarvellous in reply to harryhonda25]

You’re very welcome , it can take a while for HRT to settle down and dosage or variety can be a bit of a luck of the draw too. Full menopause occurs 12 months after last bleed officially which is why it’s classed as peri - if you still are bleeding. Sometimes tough to establish if there’s endo or adenomyosis of course. Loved my GP’s comment when he said “ it’s a bit of a dark art” 🤣. Tolerance of the progesterone can be a bit of an issue but I found swopping taking the Utrogestan to vaginally every other night rather than orally every night has really worked for me. I’ve also had Testosterone added on a private script ( the Australian cream that’s actually designed for womens use rather than the NHS offering ) has been essential for bladder and flushes management. Both of those you can research on Louise Newson’s Balance site about. Sometimes it’s not so much the endo re inflammation but adhesions stretching and being bothersome as the tissue changes at menopause.

[Maybelline2022 in reply to BloomingMarvellous]

Hello, that’s good to hear the utrogestan is helping you. I’m thinking of also trying the utrogestan vaginally, please could you let me know if you are also taking it with a form of oestrogen if so did you start both together or the utrogestan first then add in the oestrogen gel later, ( gel is what I have). I have also read on Louise Newson’s balance app that every other night is ok vaginally.

[BloomingMarvellous in reply to Maybelline2022]

Mine was taken together. Vaginally some recommend taking one progesterone every other night rather than each night. I find it’s just fine at that.

[Maybelline2022 in reply to BloomingMarvellous]

Thank you so much for your reply. I’m new to this site only just joined today. I have been suffering with Adeynomyosis and thought the pain would disappear once periods stopped over a year ago but not the case for me, not as bad as having periods but it’s like my body is still on a cycle and with all the menopause symptoms too now. I did try the utrogestan orally but left me so groggy. Mirena really helped with the pain and heavy feeling but my periods restarted which was why I had it removed now feel everything has flared up again, so now wondering if I should have stuck with mirena a bit longer as i didn’t have the hot flushes or headaches when I had it and I felt a lot calmer.

Thanks for all the info you have posted really interesting to read it all.

Take care

Maybelline

[Maybelline2022 in reply to BloomingMarvellous]

Hello again sorry I forgot to ask you in my reply are you using the oestrogen gel and if so how much? I’ve been told to start really low at just half a pump and to see how it goes, Still paranoid about adding oestrogen as always thought it would feed the adeynomyosis/endo.

[BloomingMarvellous in reply to Maybelline2022]

I think you have to go with the doses and intro as you and your team have worked out. Everyone is different! Good luck 🤞 and try not to be too anxious ( I know it’s hard hope and fear all jumbled together)

[harryhonda25 in reply to BloomingMarvellous]

Good morning blooming marvellous hope you are well. Thank you so much for your reply. Only just seen it at the bottom of my messages. My gynaecologist has taken me off all HRT now as it was making me worse rather than better. I have bad joint pain, fatigue, hot sweats, low mood, insomnia but trying to cope with nothing. I had a transvaginal scan yesterday and she said there was a thickening in my cervix which looked like blood. I said is is endometriosis and she said she couldn't tell. Sending a report to my gynaecologist to see what she thinks. How are you doing. I am going to look at natural medicine to help my menopause symptoms. Take care your help is greatly appreciated. Have a lovely day x

[BloomingMarvellous in reply to harryhonda25]

Might be worth discussing the anti prolactin route with them ?

[harryhonda25 in reply to BloomingMarvellous]

Good morning blooming marvellous hope you are well today. What is the anti prolactin route not heard of that before. Thank you so much for your help greatly appreciated x

[BloomingMarvellous in reply to harryhonda25]

There’s a reasonable amount of research as to the appearance of raised prolactin levels with endo. Again there’s limited additional knowledge as to the extent of prolactin’s role beyond milk production but it can be raised because of either an issue with benign pituitary adenomas, thyroid dysfunction or seems to be an indication of inflammation, autoimmune issues and increasingly, prevalent with endo. The whys and wherefores also a bit of a mystery. Some suggest that it may be helpful as a bio marker for staging the endo. Background aside. Standard treatments for diminishing prolactin levels, such as cabergolin medication, have shown to reduce endo lesions. This does have unwelcome side effects for some but better tolerated than bromocryptine. Another newer route has been trialled - not extensively- and found to be highly effective with significant lesion reduction by using auto prolactin antibody’s . Dig around with Dr Google and am sure you’ll find it.

[JulesUK]

I’m also 50, in menopause and unsure what to do. I started using 50mg patches last year however my stomach pains returned so I stopped. They have since given me the 25mg (which I’ve not started) but I’ve been told (anecdotally) that it is such a low dose I won’t see the benefits of HRT. I don’t have any of the usual symptoms like flushes, sweats etc but I developed terrible neck pain last year and my joints are cracking and I worry given that I’ve had two induced menopause before whether it’s affected my bones. It seems a bit of a minefield for many people let alone having the added complication of endo.

How do you feel on the treatment they’ve given you? Do you feel it’s helping ? I knew within about a month that my endo pains had come back.

[BloomingMarvellous in reply to JulesUK]

Everyone is so different aren’t they ??? It’s such a juggle isn’t it. I prefer the gel so it means I can tinker with the dose very slightly to suit my needs. Eventually I’ve ended up on 2 pumps instead of the 4 but endo wise that’s not been so much of the issue but the side issues of inflammation overall. To be fair that was fluctuating really badly with menopause anyway. It’s led me to deal with the inflammation side itself and realise that’s it’s not so much been the endo that’s been at issue but the chronic side kicks of the condition like lactase intolerance ( caused by klebiesella UTI infection that can trigger lactase issues 😬😬😬😳common in endometriosis sufferers ) fibrosing tissue, dehydration, poor pelvic core strength and lack of proper absorption from a sore gut needing extra supplements that’s been the key to recovery along with finding the right kind and level of HRT. My mental health was seriously compromised by my lack of oestrogen so it’s been a real lifesaver along with much better sleep. The stress itself is enough of a trigger to set my endo off at the deep end so finding balance has been key.