Perimenopause HRT - update in comments

[lavenderblue]

I went to my Gyn earlier this year after having a 22+ day period. They did a uterine biopsy to rule out Cancer, which was fortunately negative. I then followed up and had my annual exam and it was all, everything looks great, see you in a year. I had of course mentioned my concerns with my cycles and other issues, but was basically told, see you next year. I've been doing a lot of research on Dr Google and am currently reading The Menopause by Dr Mary Clare Haver and really think that I would benefit from starting HRT now instead of waiting until my symptoms get worse. 

I'm wondering, would I be better off waiting another 8 or so months to just follow up with my Gyn and then pushing for it, or just taking the plunge now with one of the online providers like Winona? Wondering what others in my situation have done. 

[charlatti]

Does your gyn have a nurse line you could call to ask if they’d prescribe something? Mine would definitely be responsive to that if I called.

[mcsangel2]

The first thing I would do is join the Menopause subreddit. They have been a WEALTH of information. There are several online providers - I'm at the beginning of this journey myself, I'm currently working with my PCP on getting vaginal estrogen. We talked about HRT but she is sending me to talk to a hematologist first because I have a dicey personal and family history.

Do you still get your period regularly? It may be difficult to find someone who will prescribe HRT. You'd be at risk of more frequent and longer bleeding like you just experienced.

[mrsukyankee]

Aug 20, 2024 12:12:08 GMT -5 mcsangel2 said:

The first thing I would do is join the Menopause subreddit. They have been a WEALTH of information. There are several online providers - I'm at the beginning of this journey myself, I'm currently working with my PCP on getting vaginal estrogen. We talked about HRT but she is sending me to talk to a hematologist first because I have a dicey personal and family history.

Do you still get your period regularly? It may be difficult to find someone who will prescribe HRT. You'd be at risk of more frequent and longer bleeding like you just experienced.

I'm still bleeding and on HRT (for 4 years) and I haven't ever had more frequent or longer bleeding.

[mrsukyankee]

lavenderblue, did they look for anything other than cancer, like polyps? I'd push back if I was bleeding that long and they just said, see you next year. There has to be more to talk about.

[mofongo]

Did they check your hormone levels? I was told this yesterday that bc I'm still having periods, regularly, that hrt is not recommended. They do prescribe it and are open to it, but I'm just not there yet.

[mrsukyankee]

Aug 20, 2024 12:17:15 GMT -5 mofongo said:

Did they check your hormone levels? I was told this yesterday that bc I'm still having periods, regularly, that hrt is not recommended. They do prescribe it and are open to it, but I'm just not there yet.

Push back - it's all about the symptoms. And checking hormone levels may show nothing. You should be able to get it in perimenopause and not just menopause, as some of us have horrific symptoms before we stop bleeding and being regular.

[Susie]

I agree that I wouldn't be content to just see ya next year, with unexplained 22 day periods as an ongoing issue.  I would think you'd likely wind up anemic pretty quickly if you're regularly bleeding for that long, not to mention that's just a really annoying way to live.  If your gyn isn't taking your concerns seriously, can you find another one who will?  I'd try to do that way before seeking advice or prescription of anything online.

[mofongo]

Aug 20, 2024 12:19:43 GMT -5 mrsukyankee said:

Aug 20, 2024 12:17:15 GMT -5 mofongo said:

Did they check your hormone levels? I was told this yesterday that bc I'm still having periods, regularly, that hrt is not recommended. They do prescribe it and are open to it, but I'm just not there yet.

Push back - it's all about the symptoms. And checking hormone levels may show nothing. You should be able to get it in perimenopause and not just menopause, as some of us have horrific symptoms before we stop bleeding and being regular.

I agree! I'm there too, just saying what I was told by my doctor.

ETA: I am praying to menopause daily over here! 😅

[wanderingback]

I think you should follow up with your gyn. An annual exam unfortunately isn’t always the best time to bring up a very specific concern and get the full answer when we’re trying to review and get through if someone is up to date on all their preventive screening.

I would make a follow up "concern" visit to talk about your symptoms and let them know you want to know the treatment options.

[wanderingback]

Aug 20, 2024 12:17:15 GMT -5 mofongo said:

Did they check your hormone levels? I was told this yesterday that bc I'm still having periods, regularly, that hrt is not recommended. They do prescribe it and are open to it, but I'm just not there yet.

Ugh that’s annoying. It’s hard to advocate for yourself. There are different treatment options for perimenopause symptoms. If you’re up for it you should push back and discuss what symptoms bother you and ask for treatment options.

[mofongo]

Aug 20, 2024 12:49:17 GMT -5 wanderingback said:

Aug 20, 2024 12:17:15 GMT -5 mofongo said:

Did they check your hormone levels? I was told this yesterday that bc I'm still having periods, regularly, that hrt is not recommended. They do prescribe it and are open to it, but I'm just not there yet.

Ugh that’s annoying. It’s hard to advocate for yourself. There are different treatment options for perimenopause symptoms. If you’re up for it you should push back and discuss what symptoms bother you and ask for treatment options.

I go back in 6 months this time. I will see how I'm doing then. I think my symptoms are mostly related to endo and adeno, and not peri. The mirena has helped some!

Although I did wake up sweating profusely last night, only to find H had a snafu with the thermostat app and see it to 82. 🤦🏼‍♀️

[litskispeciality]

OP I encourage you to schedule another apt for the ongoing periods. Long story short I had a nightmare time and eventually had to switch GYN providers to get someone to take me seriously, but I couldn't continue to bleed for over 2 months straight. At least rule out other potential problems like cysts, fibroids, potentially endo or andeo (I've read conflicting reports if that can be diagnosed without a hyster. Mine was only diagnosed via a hyster). Plus you just don't want to bleed all the time, the anemia and other issues just aren't worth it.

It's much easier said than done, but feel empowered to try to switch providers if you don't feel your concerns are heard or that you're not getting that you need for your own health.

[mrsukyankee]

Aug 20, 2024 12:46:44 GMT -5 mofongo said:

Aug 20, 2024 12:19:43 GMT -5 mrsukyankee said:

Push back - it's all about the symptoms. And checking hormone levels may show nothing. You should be able to get it in perimenopause and not just menopause, as some of us have horrific symptoms before we stop bleeding and being regular.

I agree! I'm there too, just saying what I was told by my doctor.

ETA: I am praying to menopause daily over here! 😅

Your doctor is behind the times! And yes, at 55-1/2, I'm praying for menopause like mad. I'm too old for this shit.

[doctoranda]

I don't know if this is helpful because it is not about HRT but I had unusual bleeding and they did the uterine biopsy and then an ultra vaginal ultra sound about a month later to check for polyps etc. The doctor then suggested another consult a couple of months out. My gyn is not fantastic either but this seems like really minimal kind of care. A "concern" visit and bring up menopause. If dismissive I would seek another doc. I am so tired of docs not knowing proper women's healthcare (I understand their training is often not sufficient because women's issues are often ignored etc. so I don't blame the individual).

[moreace01]

My anecdote - I have an IUD and am on HRT. I have no idea if I am still getting a period because of the IUD (haven't had a period since I got my first one 8 years ago). Anyway - my point is that we don't know right now if I'm in peri or actual menopause and I was able to get HRT prescribed based on my symptoms alone (hot flashes, night sweats, etc) and the the treatment has thus far relieved my symptoms.

[lavenderblue]

The update that no one asked for LOL

I was able to get in with my Gyn and had my appointment yesterday. We discussed my symptoms and she said that she doesn't even need bloodwork, that based on my symptoms I'm clearly in Perimenopause. She prescribed me HRT in the form of the patch that delivers both Estrogen and Progestin. I will follow up with her in another 8 weeks, but man was that appointment a relief. I've heard so many horror stories about going to the doctor about their Perimenopause symptoms and basically being told too bad, so sad. I'm feeling hopeful, so fingers crossed that this helps to alleviate my symptoms.

[underwaterrhymes]

lavenderblue - I’m so glad you got a prescription. My doctor was willing, but needed approval from my specialists since I have two gene mutations in cancer suppression genes. But, I’ve had a double mastectomy and a hysterectomy so they gave me the thumbs up and I am so happy. I’m hoping the estrogen alone helps with my sleep issues because my doctor won’t prescribe progesterone since I don’t have a uterus.

[litskispeciality]

lavenderblue, so proud of you for advocating, and happy you're getting some help. Prayers and good vibes it starts working really soon. ((( underwaterrhymes,))) I hope you get relief too.

[stemmie]

I'm so happy you were listened to.

[onetruething]

I have been on the pellets for about 5 years and I have never felt or looked better. I really hope your HRT makes you feel the same way! Good for you for advocating for yourself!

[wanderlustmom]

So glad you got a positive update! Hope the HRT works its magic

[wanderingback]

Lovely! I know some doctors are assholes but most aren’t
It’s not great that the system is the way it is but it’s def best to make a separate problem visit outside of a routine wellness check so that the doctor has time to really focus on the concern. Hope your symptoms improve with treatment!

[mrsukyankee]

I'm glad it worked out!

[kath16]

can i latch onto this thread?

i am having some early perimenopause symptoms -- my cycle is less regular than it used ot be (honestly not too bad, just different), insomnia, weight gain for no reason, oh! and my freaking boobs hurt before my period like crazy. i actually started to worry that I was pregnant (i wasn't!) and increased anxiety.

my provider offered birth control or lexapro. i declined birth control because it made me an absolute lunatic when i was on it in college and I can't do that to my husband and family lol. but i am considering the lexapro in the hopes that it chills me out and helps me sleep better? those are the two symptoms with the biggest impact for me. the weight gain too, but i'm starting to come to terms with it.

anyone have any experience with that?

[wanderlustmom]

Sept 26, 2024 8:01:05 GMT -5 kath16 said:

can i latch onto this thread?

i am having some early perimenopause symptoms -- my cycle is less regular than it used ot be (honestly not too bad, just different), insomnia, weight gain for no reason, oh! and my freaking boobs hurt before my period like crazy. i actually started to worry that I was pregnant (i wasn't!) and increased anxiety.

my provider offered birth control or lexapro. i declined birth control because it made me an absolute lunatic when i was on it in college and I can't do that to my husband and family lol. but i am considering the lexapro in the hopes that it chills me out and helps me sleep better? those are the two symptoms with the biggest impact for me. the weight gain too, but i'm starting to come to terms with it.

anyone have any experience with that?

I do!  At 47 I started to experience some perimenopause symptoms and I've always had anxiety and my mom had just died. My OB told me that lexapro treats anxiety and perimenopause.  I'm almost 50 now and I was on the the lexapro for one year.  My symptoms had been weight gain (ten pounds up from my previous weight that I was okay with, I'm short so those ten pounds were a stunner) worse PMS symptoms, worsening anxiety (I was used to some with my generalized anxiety disorder but this was worse, feeling hot all the time, brain fog, tenderness in my breast, alcohol intolerance.  My period was normal and like clockwork and I slept fine.  No hot flashes. Everything got better with the lexapro except the weight.  But then when I went off of it my weight didn't come down either. My regular doctor told me the lexapro doesn't add weight for many people and it didn't for me but it did make it hard to lose. So I now take magnesium citrate at night since GI issues started, magnesium glycinate for the brain fog also at night and I am mostly okay.  My periods have just started to be a little off schedule. If I watch my diet pretty carefully, I can weigh five pounds up from my pre menopause weight but the last five pounds and what I used to like to weigh I don't think will ever come back unless I diet and I don't want to.  My body has changed a lot, more curves and all of my clothes fit differently. I will go back on the lexapro if my anxiety worsens as I get more into perimenopause. I also will consider HRT. I also drink just a tiny bit now after taking seven months of no drinking and that helps too.  But even with the things I've tried I still have some symptoms. 

[underwaterrhymes]

kath16 - did your doctor tell you why they won’t consider HRT?

[kath16]

Sept 26, 2024 8:20:59 GMT -5 underwaterrhymes said:

kath16 - did your doctor tell you why they won’t consider HRT?

so it may have been dumb of me, but i got the impression during our conversation that the birth control pills would have been their offering of like, HRT for dummies (me)? it sounds like i have fully misunderstood... but that's why i didn't specifically ask.

[kath16]

Sept 26, 2024 8:18:03 GMT -5 wanderlustmom said:

Sept 26, 2024 8:01:05 GMT -5 kath16 said:

can i latch onto this thread?

i am having some early perimenopause symptoms -- my cycle is less regular than it used ot be (honestly not too bad, just different), insomnia, weight gain for no reason, oh! and my freaking boobs hurt before my period like crazy. i actually started to worry that I was pregnant (i wasn't!) and increased anxiety.

my provider offered birth control or lexapro. i declined birth control because it made me an absolute lunatic when i was on it in college and I can't do that to my husband and family lol. but i am considering the lexapro in the hopes that it chills me out and helps me sleep better? those are the two symptoms with the biggest impact for me. the weight gain too, but i'm starting to come to terms with it.

anyone have any experience with that?

I do!  At 47 I started to experience some perimenopause symptoms and I've always had anxiety and my mom had just died. My OB told me that lexapro treats anxiety and perimenopause.  I'm almost 50 now and I was on the the lexapro for one year.  My symptoms had been weight gain (ten pounds up from my previous weight that I was okay with, I'm short so those ten pounds were a stunner) worse PMS symptoms, worsening anxiety (I was used to some with my generalized anxiety disorder but this was worse, feeling hot all the time, brain fog, tenderness in my breast, alcohol intolerance.  My period was normal and like clockwork and I slept fine.  No hot flashes. Everything got better with the lexapro except the weight.  But then when I went off of it my weight didn't come down either. My regular doctor told me the lexapro doesn't add weight for many people and it didn't for me but it did make it hard to lose. So I now take magnesium citrate at night since GI issues started, magnesium glycinate for the brain fog also at night and I am mostly okay.  My periods have just started to be a little off schedule. If I watch my diet pretty carefully, I can weigh five pounds up from my pre menopause weight but the last five pounds and what I used to like to weigh I don't think will ever come back unless I diet and I don't want to.  My body has changed a lot, more curves and all of my clothes fit differently. I will go back on the lexapro if my anxiety worsens as I get more into perimenopause. I also will consider HRT. I also drink just a tiny bit now after taking seven months of no drinking and that helps too.  But even with the things I've tried I still have some symptoms. 

thank you SO MUCH for this. truly. 

i'm also wondering if it may help with my IBS/anxiety cycle. my main hesitation is that i had a not-great experience on a completely different type of anti-depressant i tried for the IBS and i have some PTSD from it. i just have to keep telling myself that it's very different.

[sequins]

Sept 26, 2024 8:01:05 GMT -5 kath16 said:

can i latch onto this thread?

i am having some early perimenopause symptoms -- my cycle is less regular than it used ot be (honestly not too bad, just different), insomnia, weight gain for no reason, oh! and my freaking boobs hurt before my period like crazy. i actually started to worry that I was pregnant (i wasn't!) and increased anxiety.

my provider offered birth control or lexapro. i declined birth control because it made me an absolute lunatic when i was on it in college and I can't do that to my husband and family lol. but i am considering the lexapro in the hopes that it chills me out and helps me sleep better? those are the two symptoms with the biggest impact for me. the weight gain too, but i'm starting to come to terms with it.

anyone have any experience with that?

I have the exact same symptoms. Severe breast pain, and a sickly feeling before period. And sooooo much anxiety. 

I was on both birth control and lexapro last year. One or the other caused a 10lb weight gain over the year and I couldn't afford that, I'm already prediabetic even at normal weight. 

I'm thinking about going back to my PCP to ask for a lexapro alternative and also test my insulin resistance and thyroid. It's been so hard to find the right doctor. I found a menopause expert in my area and she was super dismissive. I'm only 38 and I'd think its more concerning rather than less that I already have these symptoms? 

Anyway commiseration. I started drinking raspberry leaf tea last month and I think my breast pain was a little bit better?? Oh also, I take ashwagandha drops which seems to chill me out somewhat. Being a woman sucks.