Perimenopausal and should I take hrt?

[Auntbessy]

Hello, I am trying to assess whether I am perimenopausal or if I just have the usual under active thyroid symptoms. I'm 42 and struggle with the following symptoms...no sex drive and loss of ongoing dryness, headaches on one side of my head with constant tinnitus on this same side, tiredness and mood fluctuations. I know people can't diagnose me on here but I'm interested to know if anyone else has had similar symptoms and found something that helps. My GP knows about all of this and did a FSH test which came back as 11.

[radd]

Auntbessy,

FSH raises as oestrogen falls in an effort to encourage further. Even without the ranges (numbers in brackets) an FSH of 11 doesn't look high, and progesterone will fall first during perimenopause anyway. This can create unopposed oestrogen that could be the cause of your symptoms.

Your previous posts indicate a fluctuating TSH and elevated antibodies which can influence sex hormone levels greatly (via the HPT-HPA-HPGonads axis). Some members have found introducing an OTC Wellsprings progesterone cream helps but it was never enough for me, and to be sure of sex hormone levels you will need both oestrogen and progesterone measuring.

[Auntbessy in reply to radd]

Thank you for your reply, do you mind me asking how and where you got your progesterone and oestrogen measured? I do think my oestrogen has been falling for some time actually. For 8 years I've had lots of fibroids and heavy menses which I believe indicates this. Now in the past year my menses have shortened and gotten much lighter. Also do you mind me asking if your have ever tested your testosterone levels?

[Auntbessy in reply to Auntbessy]

I should also add that my go will possibly offer me progesterone tablets and estrogen gel. I'm not sure if it's a good idea to use this if I'm only at the start of perimenopause?

[radd in reply to Auntbessy]

Auntbessy,

Good your GP is onboard. If you are symptomatic, and as the benefits of HRT outweigh the risks for most women, the advice being given by the NHS and The British Menopause Society now very clearly states to start replacing sex hormones as soon as possible, even without testing.

However, your over-all risk would need assessing and the main uncertainties remain which are whether the symptoms are solely natural perimenopause advance or being influenced by thyroid issues in which case topping up O & P is not addressing the root cause. Fibroids and period troubles are closely associated with hypothyroidism.

I have had huge hormonal issues and had everything tested numerous times including testosterone mainly privately. If I was you I would not start HRT until thyroid issues are stable and all nutrients deficiencies addressed. You can also help mange symptoms through diet and life style choices, for instance I had to stop drinking wine and eating hot curries which instigates hot flushes at night. I'm post menopausal and now take O, P & T.

nhs.uk/medicines/hormone-re....

[TiggerMe in reply to radd]

mange symptoms... 😏 really Radd?

[radd in reply to TiggerMe]

Yeh, canine scabies E. What's wrong with that? 🤦‍♀️

Almost as good as the 'eyesore' 🤣🤣🤣

[CoeliacMum1]

I would at least give it a try unless you have any other underlying conditions that haven’t been addressed.

What you describe sounds more like perimenopausal and good your GP is onboard I would go on her advice as she has all your medical records to make a better informed choice and you’re best to start hrt when perimenopausal as it has most its benefits, but never too late to go on it to help symptoms.

Guidelines will state under 45 to be tested via blood test but after this age its predominantly based on symptoms, and benefits of hrt out weigh risks theres very few that cannot go on hrt … good book to read is oestrogen matters … menopause balance app/website for all hrt and menopause related topics.

I found hrt to almost have over night benefits and recently upped them under guidance of my GP. I definitely found progesterone to be of benefit I’m on oestrogel and Utrogestan which is deemed the safest option.

Before diagnosed with Hashimoto’s/hypothyroidism I had and still do have hormonal ovarian cysts and mid cycle bleed it’s gone on for decades along with in my 40s heavy periods …I was told this was probably something to do my thyroid too although when was diagnosed and “in range” it has still happened, apart from musculoskeletal & constipation I don’t suffer other hypothyroid symptoms really. I have had a few gynaecological issues found I have adenomyosis possibly endometriosis and my pain which isn’t continuous is pelvic region with back, top of thigh hip sij musculoskeletal issues, which is why went on hrt and it helped somewhat but along with complications and just wanting this to end I’m 57 and still perimenopausal 🤦🏻‍♀️ I’m definitely no worse for having hrt and reluctant to be without now… I have had to go off and on hrt to have scans.

[jrbarnes]

I'm 43 and the issues I've been having with my thyroid/thyroid meds have made me feel like I'm going through menopause since I was 36! I even went to a reproductive endocrinologist at 38 where they did a follicle antral count during my cycle with a vaginal ultrasound, which proved that I was not going through meno. In addition with regular cycles and good hormone labs. Basically it was all thyroid related. There's nothing that kills sex drive like out of wack thyroid hormone levels because they affect your other hormones. I started on Levo when I was 30 and within the year I had developed a fibroid which caused excruciating labor like pain for a week, every month, for 7 years until I had it treated with radiofrequency ablation. I don't think it's coincidence I developed that fibroid right after I started Levo. Being poorly treated on Levo has also caused heavier cycles.

[Regenallotment]

Just for the purposes of balance and seeing all sides, at 45 I was encouraged by the GP to start HRT a combined oestrogen and progesterone pill. I was exhausted, light periods, hot flushes, night sweats awful memory loss and brain fog, aches and my regular running was becoming tough due to aches and pains and slow recovery.

I felt a bit better for about 18 months but then I started having 2 periods a month, flooding blood loss at night, very slow recovery from Covid. I felt like walking through treacle, couldn’t stay awake in the afternoons at work, had to stop driving to work as I couldn’t stay awake on the road, it hurt to just be, then it was lockdown but managed to get a phone appointment said to random phone GP, HRT not working need a higher dose, GP said hmmmm please stop HRT immediately and sent me for blood tests, found it was wrong diagnosis 2 years before and should have been tested for thyroid.

Now I’m 49 with thyroid hormones when I’m optimal it feels absolutely brilliant, I literally bounce around these days, but it’s been a long road getting there. I had developed fibroids (possibly as a result of too much oestrogen). I’m told they should shrink in the next couple of years.

I do wonder when I’ll perhaps need to revisit HRT, I feel reluctant after my last experience, in the coming years/months ill have to consider the options.

having not had a single blood test for sex hormones I’d say definitely ask for that before making any decisions and be willing to reverse ferret if it doesn’t suit you. Don’t stick at it like I did, thinking it must be me that’s the problem. Oh and I didn’t realise the whole time I was taking it it contained lactose… I was burpy and gurgly for 2 YEARS and didn’t question it, just settled for this is peri-menopause…it’s taken over a year to restore gut health and I’m not 100% there yet.

let us know what you decide and how it goes I will read with interest 🤗🌱