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Ask a Menopause Nurse | Diane Porterfield-Bourne

Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

Get practical advice on symptoms, treatments and living with the menopause. Post your questions below and Diane will be in touch with you within 72 hours!


About Diane 👩‍🏫

Diane is a Nurse Practitioner, having been nursing for over 30 years all over the world. She is committed to raising menopause awareness and teaching people how the menopause can impact everyday life.

Her mission is to improve the lives of women during and after the menopause, and to ensure the menopause is explained by qualified health professionals.


"It's time to take control and start living again", says Diane.


Diane is the founder of Bourne2Care. She has her own private menopause clinic where she prescribes HRT, and has helped other professionals deliver menopause education around the UK, giving menopause awareness talks to many organisations.

Diane has always been motivated in health education and health promotion and has written health articles for government magazines, written and implemented government policies around health and led many organisations on improving health in the community. She wrote a play to demonstrate the inequalities teenagers experienced and performed the play in many educational settings. In 2005, she was nominated for an award and was a finalist in The Nursing Times Award for Promoting Health in the Community.

Diane understands the menopause affects every woman differently and with her warm, gentle approach she has received excellent feedback from the many women she has advised over the years. She feels very passionately about women's health and believes helping ladies when they are often at their lowest is very rewarding.


💬 Post your questions below and Diane will be in touch within 72 hours! 💬

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Comments

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    Good evening ladies.

    I hope you are all keeping safe during the lock down. Being in such close proximity and spending all day with family can be challenging under normal situations but add lockdown and menopause together and it can be very difficult.

    Hormones, mood swings and anxiety can really affect us.

    I am a nurse practitioner and provide menopause advice and support. Please message me if you need to talk....

  • Joyjoy67Joyjoy67 Posts: 2

    Hi Diane

    I went into surgical menopause after a hysterectomy 3 years ago. Initially I was allowed to go on HRT but had to come off it due to a medical condition. I’ve coped with the anxiety and hot flushes well over time and these are less bothersome for me now but what I really struggle with is sleep. I can wake up 3 or 4 times a night and be wide awake. It’s been like this for years now, and I’ve tried lots of natural solutions but nothing really works. What would you suggest to help me get a really good nights sleep?

  • 77marie7777marie77 Posts: 1
    edited April 18

    Hi Joyjoy67 , just like you I was constantly waking up in the night sometimes for 2 or 3 hours at a time.the next morning I would feel like I had a hangover and it affected my mood so much. I went to my GP and she just said you have to accept your a bad sleeper this didn’t help me at all .i was arguing with my husband all the time I blamed him for everything which was very unfair, my daughter pointed out to me that I did not speak to them I snapped at them this upset me so much.when I saw a friend who is a nurse I told her while I was crying that I just can’t sleep & it’s affecting me so badly...she recommended Phenergan 25 mg tablets a full dose is 50 mg ... I took the first full dose and slept so well for the first time in months.. I took the full dose for a further 2 nights & slept great.After 3 or 4 nights I reduced the dose to 25mg I did this for about 2 weeks & then I took it down to half a tablet .i don’t know if the half is actually doing anything or if it’s just my safety blanket all I know is phenergan changed my life for the better.

  • Sol1Sol1 Posts: 6

    Hi Diane . I've been on HRT for 6 years . I was wondering why my symptoms have been worse the last 2 years, now that I'm Post menopausal . Thank you , Sorrel x

  • ElleMElleM Posts: 3

    Hi Diane,

    I've suffered with PMDD for years during my fertile years. About a year or so ago, I tried HRT because the peri-menopause symptoms were pretty bad. I was told because I was still occasionally having a period that I had to take a combination pill of oestrogen and progesterone. I questioned if the progesterone would exacerbate the PMDD. The doctor prescribing (supposedly the expert in my GP surgery) said they didn't know until I tried it. As I suspected, it did. Not to mention, it caused me to have one of the most painful periods in my life. At the follow up, the doctor seemed unsympathetic and said I could try the patch but it was likely to have the same effect. In other words, there's no help for me because I can't take progesterone and I'm still occasionally having a cycle. Is this really the case? Is there no way I could take HRT or some other remedy without causing PMDD to rear its ugly head?

  • GEI69GEI69 Posts: 2

    Hi Diane

    I am 51 and I was diagnosed with Premature ovarian failure at 38 and started HRT at 40. HRT for me was my "miracle pill" and I had fantastic results with it and all my symptoms cleared quickly. I couldn't believe it, I was delighted I felt normal again! After 8 successful years on HRT apart from a few tweaks, mainly due to painfull and increased heavey monthly/quarterly bleed and terrible headaches I started to get lots of symptoms back. Terrible brain fog, mood swings, tirdeness, chills, anxiety, constant flushing. I went to my GP and she advised to stop immediately as she said I was showing signs of being sensitive to progesterone. So I stopped. Thankfully with not alot of problems. A year on I started getting really bad and frequent flushes and the dreaded brain fog was back so went back to GP. She precsribed Tibalone. I picked up my prescription and read about them and was put off as it said it was a steroid. I went back to my GP to discuss but she didnt really know much about Tibalone and just said it was another kind of HRT. As i had to previously had to come off HRT I was confused and I didnt take them. I still have my symptoms, I am lucky that they are not too bad but more importantly I'm worried about the lack of hormones my body has been missing and the effect this will have in the future. I've been off HRT now for 2 years. Any advice on this would be greatly appreciated.

    Many thanks

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner
    edited April 18

    Dear @GEI69,

    Thank you for sending your message. Firstly it was great your Premature Ovarian Insufficiency was picked up and treated, as you said this really helped you.

    Tibolone can be prescribed as an alternative to traditional types of HRT. As your GP said, it is a synthetic steroid. Once taken it's structure changes and it produces mild hormone effects. I obviously do not know the medical reasons you had to stop HRT but I do know many ladies are advised to stop when in fact they did not have too. I would advise asking your GP to clarify the reasons and ask for the evidence to show this; at least then you would know.

    It seems by what you have said that you are displaying symptoms of low oestrogen. Hormone imbalance can really affect quality of life. Therefore I would suggest talking to your GP.

    I hope my advice has helped you and contact me again if you need further advice.

    BW

    Diane Porterfield-Bourne.

  • MelGuerMelGuer Posts: 2

    Hi ,

    Just need some advice please,

    I had a hysterectomy in July 2019 due to Endometriosis and fibroids previous to having the hysterectomy I was on prostap injections for 18 months which I hated. I was also put on to evorel conti patches as well to ease the induced menopause.

    Once I had the hysterectomy I was put on to tibolone tablets, I was told because I had Endometriosis previously I couldnt just have estrogen.

    I carried on with the tablets for 6 weeks and felt terriable headaches and aching joints.

    I came of the tablets and was put on tablets of progesterone and a patches of estrogen.

    Still felt ill, so then I was put on evorel conti patches again which where fine but then they went out of stock. So I was put back on tablets and now gel sachets 1mg.

    I stuck on this till Feb on this year but still felt tired and aching joints. Evorel conti patches came back into stock so went back on to them in March. Been on them now for over a month. I feel so tired on a morning and eyes sore again. Do you think it is progesterone that making me feel like this? I have asked my doctor can I just take estrogen and was told I had to wait a year after hysterectomy because of Endometriosis

    I definitely think I would just be better on estrogen only.



    Any advice would be greatly appreciated thank you.

  • KazHowKazHow Posts: 2

    Hello, I am over 2 years post menopause & although I don’t have many hot flushes any more, I still get very tired, achy & not a lot of energy. Is this quite common in post menopause & is there any supplements I can take?

    Many thanks

    Karen Howard

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    Hello @KazHow, thank you for getting in touch.

    Your symptoms are very common in menopause and post menopausal women. The lack of Oestrogen can really affect your physical and emotional health.

    Rather than thinking about supplements have to thought about HRT? This is first line treatment for symptoms. Your GP should advise you and its clearly written in NICE guidelines. I would advise a phone call first and see what they say.

    Good luck and please post again if you need advice.

    Best Wishes

    Diane Porterfield-Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    Hi @MelGuer

    Good to hear from you.

    When women have had hysterectomies, most do not need progesterone, only oestrogen. Occasionally if still have endometrial tissue this can be problematic and you can be prescribed progesterone.

    There are different types of progesterone and some suit you better than others.

    However I would talk to your GP about your oestrogen and ensure you are taking a good amount to improve your symptoms and long term health.

    Let me now how you get on and I am hear if you need to talk again.

    Best wishes

    Diane Porterfield-Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @Joyjoy67

    Hello, I hope you are keeping safe and well.

    Thank you for your message.

    When you go through surgical hysterectomy your symptoms can be quite dramatic, not for everyone but most women.

    HRT is advised to primarily protect your heart and bones and help with symptoms.

    There are many reasons why women are taken off HRT when on occasions they don't have too.

    I obviously do not want to discuss your reasons on here but would suggest asking your GP for more information about why you had to stop.

    If you can't have HRT then such measures as wearing light clothing in bed, not eating too late as your stomach will be digesting food and not aiding sleep, switching electrical devises off a few hours before bed and establish a good healthy bedtime routine.

    Reducing caffeine and alcohol will definitely aid sleep too.

    I don't advise on herbs or supplements but would suggest contacting a qualified medical herbal practitioner.


    I hope this has helped but I would talk to your GP about this.

    Best wishes and please keep in touch.

    Diane Porterfield-Bourne.

  • GEI69GEI69 Posts: 2

    Hi Diane Thank you very much for your quick response. It's so good to speak to an expert. I live in the north of Scotland and unfotunatley we dont have many Meno Experts near. I have a wonderful GP but like so many they are lacking in the expertise in this area. Some great advice, I feel as though I've been in limbo this last year, not really knowing what to do next. As you say im definately showing signs of lack of oestergone. My GP said that with my menopausal symptoms and headaches coming back whilst being on HRT, this was a sign of over sensitivity to progesterone and I would have to stop HRT immediately. There was no tests or any other medical reason, she just made the decision after our chat. TBH i sailed through HRT and only saw her once a year for my review until the symptoms all started again. I have a keen interest in menopause as I started early and know how important our hormones are in so many different ways. So I want to make sure I'm doing the right thing, physically and mentally. Do you think I should just start taking the Tibalone or make another appointment to see GP? Thanks again for your help. G X

  • BeviePBevieP Posts: 2

    Hi Diane, I went through surgical menopause about 17 years ago and have been on HRT ever since. I’m now 61. I’m on patches, a very low dose of 25mg. I’ve tried to come off it several times believing that at some point I will have actually gone through the menopause. The last recent time I came off it I lasted about 6 months. My symptoms are unbearable, I’m a total mess. I have about 30 hot flushes day and night. I get no sleep. I lose all my confidence, spend a lot of time crying. I have tried cutting down to come off it and going cold turkey. Neither way makes a difference to how I end up. Am I ever going to be able to come off it? Do you still go through the menopause while you are on HRT or does it just delay it? The patches don’t stop my symptoms altogether but they make life bearable. Am I ok staying on it?

    Thanks Bev

  • KirstywirstyKirstywirsty Posts: 1

    Hello, my family has a history of ovarian cancer) ore cancerous cells ( both me my mum and grandmother) so I've been told I can't take HRT? I have not had. Period for over a year and im 50. Any suggestions?

    Thankyou

    Kirsty

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @Kirstywirsty

    Hi Kirsty,

    Thank you for sending a message to me.

    If you, your mom and grandmother have all had a hormone related cancer that you are obviously concerned. Firstly I would clarify with your GP that you are unable to have HRT and ask why. Just so you understand. Some cancers feed on oestrogen others don't, so worth talking to your GP more.

    If you definitely can't have it, depending what your menopause symptoms are and how severe they are will determine what treatments you can have.

    It might be that you can have HRT or prescribed medications, ensuring a healthy diet, low alcohol, normal weight and plenty of exercise will help, yoga, mindfulness and a good positive mental outlook.

    Talk to your GP first and good luck.

    Best wishes

    Diane Porterfield-Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @BevieP

    It's lovely to hear from you.

    You have mentioned some really interesting things and something many women ask... is HRT delaying the menopause?

    The answer is no. Oestrogen deficiency occurs natural as we hit middle age except when women have hysterectomies or take medication that brings them into menopause. HRT helps replace our bodies with the oestrogen and other hormones we lack. Our ovaries will not start working again so for most ladies HRT will improve their symptoms and replace the Oestrogen their ovaries no longer make.

    Does that make sense?

    It seems by what you have written you probably need more oestrogen. I would discuss with your GP as I think you might benefit from more Oestrogen not less.

    I hope I have helped with your concerns.

    Please contact me again if you need more advice on menopause.

    Good luck.

    Best Wishes

    Diane Porterfield-Bourne.

  • BeviePBevieP Posts: 2

    Hi Diane,

    Many thanks for your response. How do you feel about me being on HRT at 61? Should I worry? And do you think I should try to come off it every now and again too see if I am through the menopause?

    thanks

    Again

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @77marie77

    Good afternoon Marie and thank you for your message and support for others on Live Better With Menopause.

    Phenergan Is an older anti histamine, the active ingredience passes the blood brain barrier and can make you sleepy. The newer ones don't do this so are safe to take daily for hay fever/allergy symptoms.

    Insomnia is a very common symptom during menopause, so maybe it might be worth your while talking to a health professional about your symptoms and asking if it's menopause.

    Low oestrogen occurs during menopause, so well worth looking into. Also think if there are other factors affecting your sleep, too hot/cold, feeling anxious about life or things on your mind?

    But do have a read about menopause and see if you think this is the reason.

    I hope I have helped you and please contact me again if you would like to talk more.

    Take care

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @Sol1

    Hello and thank you for writing in. Many women ask me this question...why doesn't my HRT seems to be working anymore?

    Firstly, this often happens. We start HRT feel better then we seem to have a blip. Our symptoms return and we can feel rather despondent.

    HRT just as with other medications needs reviewing. Obviously if we feel great and your GP is happy with your route and dose thats fine but when things alter, I would definitely talk to your GP.

    You may need more oestrogen? or the route you are having it may need changing? Oestrogen in patches or gels are the safest way of having your oestrogen but tablets do help some women too.

    I would recommend a chat with your GP or health professional and seek their advice.

    Could you please let me know what they say?

    Have a good afternoon.

    Best wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @BevieP

    Hello, I hope it is sunny wherever you are!

    The guidelines on HRT are that you may continue taking it as long as it's benefits outweigh any risk factors. If you are of normal weight, stop smoking, drink in moderation, eat a healthy well balanced diet, take plenty of exercise and have no significant risk factors like cancer then there would be no obvious reason to stop it.

    As we get older we generally need less oestrogen but can still use HRT into our 70's and 80's.

    Some people stop after a few years, it really is a personal choice but you do not have stop it now you are in your 60's. I personally know women in there 80's on it!

    I hope I have answered your question and if I can help please get in touch.

    Best wishes

    Diane Porterfield Bourne.

  • JoJoPrincess21JoJoPrincess21 Posts: 1

    Hello and thank you for giving the opportunity to ask some questions as with the current situation I haven't contacted my local surgery as was going to get a blood test to see, I think I am in peri stage, periods been irratic for the last 3 years now not had anything for 5 months, but really suffering from hot flushes and lack of sleep and more face hair! I don't want to go on hrt is there something you can recommend, I am 52 any help would be appreciated Kind regards Jo

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @ElleM

    Good afternoon and thank you so much for writing in.PMDD or premenstrual dysphoric disorder is a complex thing. In easy to understand terms it is a really severe form on PMS /PMT. No one really understands the causes or treatments and it can be difficult to treat the fluctuations in your hormones. I bet you know that more about your imbalances than most...

    It can be difficult to treat, hormones for many women make symptoms worse, others it can help. There is no easy answer. You have already identified that hormones trigger it and as most women with PMDD you understand how you feel more than most.

    I have prescribed HRT to women with PMDD and it has helped some, not all.

    The best HRT is oestrogen that is absorbed through the skin, in patches or gels and progesterone

    ( normally biggest culprit with PMDD) can be taken as Utrogestan or in the coil. Utrogestan is a newer regulated body identical progesterone, so should be better for you. But offers no contraception!

    I hope I have helped you. I would suggest talking to your GP again or asking to see a gynaecologist.

    Please keep in touch and good luck.

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @JoJoPrincess21

    Thank you for messaging me about your symptoms and of course due to the crisis, it's more difficulty seeing your GP.

    Firstly I'd like to say you have mentioned something I hear many women say ''I don't want to go onto HRT". Many women say this to me but I always ask why? What are your main fears when you think of HRT?

    Most women say it gives you breast cancer, so I think its important to address this worrying thought.

    There is a risk, a very small but yes a risk of cancer when taking HRT. But I like to put his into perspective. Being over weight dramatically increases your risks of breast cancer far more than HRT.

    Breast cancer affects a very small proportion of the population and oestrogen can increase it's growth, not all breast cancers but some. However those who have had a hysterectomy and only need oestrogen there risks are very much lower!

    I always explain menopause as oestrogen deficiency, what HRT does is replace the oestrogen you are no longer producing. HRT isn't what everyone wants and most importantly its about personal choice but really understanding Oestrogen deficiency is key.

    Your GP could prescribe you other medications that may help your symptoms, some women say they help, others not. Exercise, maintaining a healthy weight, eating well and doing things like yoga and meditation do help many women!

    When you are over 45 you do not need a blood test to say if you are in the menopause, it is based on your symptoms and you have those.

    I hope I have answered some of your concerns and if I can help again please message me.

    Best Wishes

    Diane.

  • LouETLouET Posts: 3

    Hi Diane,

    I have been on transdermal hrt for over a year and still experiencing menopausal symptoms. Blood tests are showing that I am unfortunately not absorbing effectively. I have used gel and am currently once month into 2 x 100 patches after my latest blood test on 150 patch was 127 pmol/l.

    Is oral hrt the only alternative available to me in these circumstances? If so, what are the negatives to taking in this way and are there some tablets which are considered better than others (aside from those derived from mare urine).

    Many thanks for your time.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 262 Menopause Nurse Practitioner

    @LouET

    Good morning and thank you for posting on LBW Menopause.

    I am glad to hear that you have been prescribed transdermal HRT. Oestrogen taken in patches or gels

    ( transdermal- via the skin) is the safest way to take Oestrogen. Sometimes it can take a while to get the dose right for you. If you are younger than 45 yrs, women often need more oestrogen. As we get older less.

    I am pleased your GP is checking your Oestrogen levels. Women can have oestrogen in different routes such as patches and gels. There is room for improvement.

    Oral oestrogen isn't the a route I would normally advise however; if you are you, healthy, have low risk factors and normal body weight it could be an option. The negatives are that tablet forms of oestrogen may make your blood stickier and could increase your risks of strokes. This is judged against your risk factors and state of health. Premarin ( oral) oestrogen, yes is made using pregnant horses urine. This is still available but there are many newer better ones to have.


    Stay in there, discuss with your GP and I hope they get your HRT right for you.

    Good luck and please write to me again if I can help.

    Best Wishes

    Diane Porterfield Bourne.

  • mucket1971mucket1971 Posts: 5

    Hi. I'm 48 years old and struggling with hot flushes at night making it impossible to get a good night's sleep. On top of that I can't lose the weight that has crept on over the last couple of years so nothing fits which, on top of the lack of sleep, is really getting me down. I walk for an hour a day, do Pilates and eat well (mainly a plant based diet) so don't know what else to do. I tried bio-identical HRT a while ago which did nothing for me at all and have tried Sage and MacaPause which also didn't seem to make much difference. Any help or advice would be great. Thank you

  • ClareKerr73ClareKerr73 Posts: 3

    Hi Diane, I would very much appreciate your advise in bloating in Perimenopause. I am 46 & have been experiencing symptoms of Perimenopause for around 3 years. In February I attended a clinic in London which specialises in Bio-Identical HRT. After having a blood test, it was revealed that I was heavily Estrogen dominant and I prescribed a Progesterone Lozenge (75mg). Almost immediately I started to feel better & I had a period, the first in 7 months. Approximately a month later I started to get really bloated & upon my six week follow up appointment I mentioned this to the doctor & she upped my progesterone to 100mg. My symptoms are now worse, irritable, exhausted & the bloating is so severe & a real worry. I exercise 5 days a week & eat fresh healthy food. I am very concerned by these symptoms & don’t know whether to stop taking & I have read that these bio-identical hormones are unlicensed. Are you able to offer any advice on this & the bloating as it is really worrying me.

    Kindest regards,

    Clare

  • Dane48Dane48 Posts: 2

    Hi I am in the full menopause due to having breast cancer and having my ovaries removed. I’m taking tamoxifen. I have hot flushes a lot day and night amongst other things. I can’t take s lot of things due to it conflicting with Tamoxifen. I take magnesium, vitamin d and stsrflower oil plus I wear the ladycare magnet. A friend who is menopausal started taking Clarityn for hay fever symptoms since this she hadn’t had hot flushes. Do you know if these work and if so am i able to take with Tamoxifen?

  • URSSYURSSY Posts: 5
    edited April 25

    Hi Diane

    I'm 49 and had a test for menopause about 4 years ago which was negative, as I was getting hot in the night. Not extremely hot...just feeling uncomfortable, this has continued throughout.

    I think the reason I'm posting is that over the last couple of years I've been finding my periods lare really really really heavy for a couple of days near the start this 'gushing' is something I had after my children were born (many many years ago lol all adults now) but last couple of years it's that gush again when standing or getting up from sitting...

    Not good. Its only recently I realised on reading online about periods etc. that my periods thoughout my life, must have been what is known as heavy...super tampons and big night time pads always. Now I'm wearing the thick huge nappy pads for the couple of heavy days :/ not sure how I reached this stage...hoping my periods would ease off if I was honest.

    Another issue is they are very watery with small clots. Still the usual 4 weeks apart there has been no change on that. But I wondered is this part of the perimenopause? My mother had no symptoms of menopause so feeling a bit like I have no one to ask.

    Thank you

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