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Ask a Menopause Nurse | Diane Porterfield-Bourne

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  • amandaj1amandaj1 Posts: 4

    Hi Diane, I started my menopause journey in my early 40's I'm now 56 and the hot flushes are driving me insane. I have been on HRT which I stopped for a while when I suddenly started bleeding (continously for 6 months) I came off HRT but went on again to treat symptoms of hot flushes and low mood. I stopped taking it before surgery in 2018. The hot flushes are back and I'm taking Sage and Menopace, which have decreased the amount only a few times a day but they are horrid and very uncomfortable. My eyebrows are thin and sparse also.

    How long will the hot flushes last and is there anything else besides HRT to manage them!!

    Thank you 🙂

  • JanoggyJanoggy Posts: 1

    Hi Diane, I am 55 and apart from some flushes which were resolved by a short course of HRT about 8 years ago, I think I have been relatively lucky with my menopause symptoms.

    I am suffering however with poor sleep and weight gain. My BMI has gone up to 29 over the last couple of years. I work shifts as a paramedic and find it extremely difficult to improve my diet due to shift work and short meal breaks. I can't afford to put on much more weight as I need to be physically fit for work. I have heard that weight gain is also linked to poor sleep. Any advice with how to try to tackle my weight would be appreciated, I am considering trying the 16 hour fasting diet.

    Many thanks

  • SarahbSarahb Posts: 1

    Hi Diane

    I am getting bad migraines and sickness from my hormone replacement and none of the migraine tablets the doctors and hospital work and they are debilertating and they wake me up so I’m tired .Ive been told I have to be on hormone replacement to stop myself getting osteoporosis. don’t know what to do I’m 44

  • CharlieCeeCharlieCee Posts: 1
    edited April 2020

    Hi Diane

    I was diagnosed with premature menopause when I was 38 and am now 47. For the last 7 years I have been using HRT in the form of oestrogen transdermal patches and the progesterone via a Mirena IUS. This has managed my symptoms very well. I have not had any periods in this time. However, following advice from the family breast cancer clinic (my mum and younger sister have both recently had stage 1 breast cancer, non genetic) I have now had the coil removed and replaced with utrogestan tablets to be taken every day. I am now into my second month of this and have had a slight return of night sweats/insomnia but not too problematic. However, I have just had a period which was heavier than when I used to have periods, and lasted longer than I was used to (about a week). Is this normal? And is this just a result of the change in my HRT? I had thought I was post menopausal but was this just because of the coil? I have also started to put weight on without changing my eating/exercise habits - is this another side effect of the utrogestan?

    many thanks

    Charlie

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @mucket1971

    Good afternoon. Thank you for writing into Live Better With Menopause.

    Menopause affects us all, every women will go through this.

    Hot flushes affect about 80% of women, they can be mild- just feeling a bit of heat, to full blown volcano feeling all over, does it sound familiar?

    The main reason why you are feeling like this is probably due to lack of Oestrogen. Your GP will be able to make sure there are no other causes. Poor sleep is very common too and there is nothing worse that not sleeping.

    Walking is a great form of exercise, brisk walking to really get some cardio vascular effect. Drinking lots of water, at least 2l a day a healthy well balanced diet and the most important thing is to think about HRT.

    Oestrogen absorbed through the skin is the safest way. You can have tablets but this isn't something I recommend. HRT helps many women. In fact I did some reviews yesterday on some ladies I prescribed HRT to 4 weeks ago. They all said they felt much like their old selves again.

    Please have a think and talk to your GP.

    I hope I have helped you.

    Please keep in touch.

    Best wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @URSSY


    Hello and thank you so much for posting... you have come to the right place.

    Periods... where do we start! For some women they aren't too problematic others are a nightmare from puberty.

    When you bleed heavily it can be embarrassing but also you can loose a lot of blood. Have you discussed this with your GP?

    After talking to your GP they may refer you to gynae and get an ultra sound scan done or discuss with you progesterone tablets or fitting a mirena coil and then reviewing you loss? Plus they may want to check your blood levels.

    Change in periods is very common in peri menopause. Your heavy bleeding isn't actually a sign of low oestrogen but rather that your cycles are just changing. Its more important to get he loss under control.

    Are you having other menopause symptoms? Whether your mom had symptoms or not she would still have gone through it.

    The Mirena is an excellent choice, for heavy bleeding, contraception and the progesterone part of HRT.

    So please talk to your GP.

    Keep in touch and let know how you got on.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @URSSY

    Also please talk to your GP about HRT.

    Oestrogen absorbed through the skin is the safest way.


    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @Dane48

    Hi Dane, thank you for your message.

    Managing menopause after breast cancer is always difficult.

    There are types of breast cancer, oestrogen receptor positive and oestrogen receptor negative.

    Having breast cancer often mean you can't have HRT however some women do. It depends on the type of cancer you have and discussing it with your consultant. I am not saying your choices would be easy but if you could have HRT and did take it, it does not necessarily mean you would get cancer again. However it is about personal choice, quality of life and some quite lengthy discussions with consultants.

    Your GP can prescribe medications to help with your symptoms, so please discuss your options. There is no evidence magnets or anti histamines work.

    Yoga, meditation and mindfullness do, plus they have no side effects except making you feel better.


    I hope I have helped advice you.

    Good luck and stay safe.

    Best Wishes

    Diane Porterfield Bourne.

  • Dane48Dane48 Posts: 2

    Thank you Diane. I cannot have HRT I have been strongly advised against this. My cancer was oestrogen positive. I have practiced mindfulness and go to yoga these don’t gelp the hot flushes unfortunately but make me feel calmer when I have bouts of anxiety. It’s the hot flushes I wanted to see if there was anything to help but looks like I will be struggling on.

  • ChrissieKChrissieK Posts: 2

    Hi Diane

    Thank you for this opportunity! I started having mild menopausal symptoms around the age of 48, but around my 50th Birthday they were full on - my periods had completely stopped, I started to gain weight all over, and hot flushes took over my life!

    I’ll be 57 this year and it’s still virtually as bad. Luckily I don’t suffer with mood swings or anxiety, but so many hot flushes day and night...My main concern is with every hot flush, just before the “creeping heat” starts, I get bad palpitations, and an increasing need to wee and have therefore had years of interrupted nights sleep - normally after about 5 minutes the hot flush and the palpitations go. I have never been to my GP about my symptoms..I assumed they were “normal”?!

    I often thought about HRT but like so many women, worry about the possible side effects as my Grandma and two Aunties all had breast cancer. My Mum took HRT for about 16 years but her GP advised her to come off it and she had a few breast cancer scares but luckily were all negative. However, after she stopped taking HRT, her hot flushes returned and she still had them in her 70’s.

    I have a healthy diet, rarely drink alcohol, never smoked, and exercise regularly. Is it common to experience palpitations just before and during a hot flush? I try to control it with Yoga breathing when it happens to try not to get panicky.

    Many thanks for your advice.

    Chrissie

  • URSSYURSSY Posts: 5

    Thank you so much Diane for your reply and help :)

    I have ever been to the GP for periods, even though they have always been heavy.

    However now they are even heavier I think I will take your advice and potter along after we get out of the lock down.

    I hadn't really thought they could do anything...but now reading posts i see that there are things like the marina.

    I dont know if I have another symptom, I still get the hot at night occasionally tender breasts but that's it...so maybe in for the long haul yet :/


    Thank you Diane, I have a lot to try out to ease this heavy flow :)

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @ClareKerr73

    Hi Clare,

    Thank you for getting in touch with me her on Live Better With Menopause.

    I am pleased you have talked about going to " clinics specialising in Bio Identical HRT".

    You are right these clinics are not licensed and as a health professional do not advocate the treatments they give. They are unregulated clinics.

    The best HRT and the safest is from your GP or a menopause clinic prescribing you the same HRT as your GP. Like your GP, I only prescribe regulated body identical HRT. They are pharmaceutical medications, researched and studies for many many years. I, like your GP follow NICE guidelines and best practice when it comes to safe prescribing in menopause.

    I would consider talking to your GP and ask to be prescribed HRT this way.

    Once you have your HRT dressed hopefully your bloating will become more infrequent but do discuss this with your GP.

    I hope I have helped you.

    Best wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @CharlieCee

    Good afternoon and thank you for posting on here.

    I am very pleased when you were diagnosed with Premature Ovarian Insufficeny (POI) or premature menopause you were started on HRT. This will have reduced your risks of heart disease and osteoporosis significantly.

    You say that the breast clinic have advised removing your mirena coil and you are now taking tablet progesterone, are you still on your oestrogen patches? As you are having symptoms commonly seen in low oestrogen. Why did they want you to remove the coil?

    They have said the breast cancer is not genetic? But do they think are you at risk?

    Any first degree relative over the age of 40 who develops breast cancer will not automatically pass this to you. If your relatives were over 40 when diagnosed with breast cancer you will be classed at population risk. I would clarify this with your GP or them.

    The mirena is very good at stopping periods, so now you are on progesterone tablets continuously you are bleeding.

    Bleeding can happen after the coil has been removed however please call your GP to discuss this. You are only young, it may also be that you need cyclical progesterone.

    I think I have highlighted the need for you to ask more questions...

    However I hope I have pointed you in the right direction.

    Best wishes

    Diane Porterfield Bourne.

  • MonicaMMonicaM Posts: 309 mod

    Hi Diane,


    I am still struggling with these symptoms pretty badly but I don't want to get on anymore hormones are their any options for relief that isn't hormones. The last time that I tried hormones it made me gain a lot of weight and I am working to hard trying to get off all the weight that I have now.


    Also, my libido is low, I have things to keep it slippery in the private area but I need something to bring my mojo back the desire to want to have sex.


    I have been going through this for about 7 years now.


    Hopefully I didn't get to personal but any suggestions that you have would be great.

  • LemonyLemony Posts: 32 ✭✭

    Hi Diane

    I have been prescribed Evorel Sequi but the pharmacy doesn’t have them in stock. She tells me the evorel 50 and evorel conti are the same just not combined in the same box. She said I would have to have my prescription amended for her to dispense them. So I called the doctors and spoke to the pharmacist there who quite frankly didn’t have a clue. He said one patch and one tablet I said why would you give me 2 different things when the pharmacist at the chemist said these patches were exactly the same. I ask him to speak with my doctor he said he would and also call the pharmacist at the chemist. Then the pharmacist at the chemist calls me and basically said he didn’t like been told what was best. Anyway long story short he’s just handed it over to the doctor who is now calling me back Monday. The pharmacist said she spoke to him 2 weeks ago on the same subject.

    A brief history the doctors prescribed me the wrong HRT patches for 8 months they gave me a 12 months supply with no checks. I ended up hospital having to have polyps removed from this. So obviously I’m very nervous at going back on hrt to start with.

    thank you for your help.

    Lemmony

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @Sarahb

    Thank you for writing into Live Better With Menopause and apologies for not answering sooner.

    Many women get increased migraines when they first start HRT, as hormone levels suddenly increase. But having they frequently where you need to take anti sickness tablets is not fun.

    Nausea and migraines are common in the early weeks due to stabilising of your hormone levels. Please ensure you are taking enough Oestrogen as its the drops your body doesn't like. For the majority of women once their levels stabilise this goes.

    Please ensure you are taking oestrogen in a patch or gel rather than a tablet as for most women you will get less side effects. Progesterone can be taken as a capsule or coil or in a patch.

    Making sure you eat when you are taking your HRT and looking at other triggers too. Are you drinking enough water, getting enough sleep, any stress contributing to this?

    Please discuss this with your GP as if the anti sickness/migraine medication is not working this needs to be reviewed. Do ensure you are on higher doses of Oestrogen as younger women often need more.

    I hope I have helped you and please message me again if I can advise.

    Good luck.

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @amandaj1

    Good evening Amanda and thank you for writing to me on Live Better With Menopause.

    I am sorry I couldn't answer sooner.

    Heavy bleeding can have a severe impact on your quality of life. How did they control the bleeding? Did you have a hysterectomy? Heavy bleeding isn't often a reason to stop HRT, the cause of the bleeding is the most important thing.

    You mentioned you went on HRT then stopped it. During menopause the most important thing is looking into replacing hormones you are now deficient in; such as Oestrogen and testosterone.

    There are many over the counter tablets/creams/herbs that " claim" to help but as it stands there is no concrete proof they do. Some people will always find they help but for the majority of women the don't. They can also interact with prescribed medications, so I only advise women to take herbal medications through advice from a qualified medical herbal practitioner.

    Your symptoms would probably be reduced by HRT and there are very few reasons why you can't have HRT but if you do not want to take please discuss alternatives with your GP.

    Triggers for hot flushes are warm hot drinks, spicy foods or warm foods and alcohol .

    I hope I have helped answer your questions. If I can help more please get in touch.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @Janoggy

    Good evening. I am sorry I haven't got back to you sooner. I will help answer your concerns.

    Weight gain is common in menopause its the " Middle Age Spread". Unfortunately it happens to most women where we deposit fat around our midriff. This is mainly linked to low oestrogen.

    Menopause makes most women put weight on, HRT is neutral. This means some women when they take HRT loose, others remain the same, some ladies put weight on. It is a very individual thing.

    The fact you aren't sleeping will only make it worse, shift patterns too.

    I would be looking at your symptoms more holistically. Poor sleep, means we feel tired more, less motivated to want to eat better, less likely to want to exercise... and so it goes on.

    I'm glad your menopause symptoms have passed but poor sleep is very common with low oestrogen too.

    If nothing else has changed in your life, do think about HRT. HRT has many benefits but a few side effects. It's choosing what's right for you.

    The Mediterranean diet is the best, also reducing carbohydrates too. Eating vegetables more than fruit as they contain less sugars and thinking about fluids too. Water and no sugar drinks. Alcohol contains a lot of calories we don't think about, so watching what you are drinking may help. There are nutritional advisors on here so please message them to.

    I hope I have pointed you in the right direction and good luck.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @Lemony

    Good evening and thank you for your message.

    I am glad you messaged me. You are obviously anxious as you've had problems with your HRT prescriptions before. It's always best to double check these things, just to settle your mind.

    The 50 relates to the mg/dose/strength of the patch.

    But Evorel Contin, you apply twice a week, these give you a continuous supply of Oestrogen and Progesterone. This is normally prescribed for post menopausal women.

    Evorel Sequi isn't. You have different patches for different weeks, some patches just contain Oestrogen, the other patches contain both Oestrogen and progesterone. You normally apply the combined patches the last 2 weeks of your cycle. This is normally prescribed to menstruating women.

    So these 2 products are not the same.

    If there is a shortage of patches, ask your GP about gel and progesterone separately.

    I hope I have helped you and good luck. Any further questions please contact me.

    Best Wishes

    Diane Porterfield Bourne.

  • LemonyLemony Posts: 32 ✭✭

    Thank you Diane for the reply

  • LockieLockie Posts: 4

    Hello Diane

    I am 52 and although have not been tested to see if I am in the menopause I am sure I am. I have been in the pill since I was 17 and the went into the mini pill in my 40’s but came off this in February. I have not had a period since October. I am suffering from night sweats and am not sleeping very well. I have really achy joints, I have no energy. I am feeling really quite low and depressed, I cannot be bothered to do anything at the moment and don’t feel like the normal me at the moment. I have felt like this for about a year now but this year I have felt worse. Would HRT be good for me? I am worried about the side effects from it and do not want to put weight on as I am stuggling to keep it off as it is. I am worried I need anti-depressants, but would HRT work instead if these.

  • SEC_2003SEC_2003 Posts: 2

    Hi, I have a question about sudden joint pain. I am 54, menopausal and have had no period for over 12 months. My symptoms so far have been mild compared to some. I keep myself reasonably fit with running, Cycling, HIIT and weights. In the last few weeks my thumb joint that joins my hand and the topmost joint of my thumb has become at times painful and what I can only describe as “sticky” and is painful to move. This happens mainly in the evening and during the night. Any thoughts as to why and what might help please? Thank you Sue

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @Lockie

    Hello there and thank you for writing in.

    The symptoms you have talked about are really common signs of menopause. The fact you are 52 is signifying you are in the menopause too. Periods can be all over the place but you haven't had one since October, so you heading towards the 1 year with out a period. After that year you are post menopausal.

    You should consider HRT. Replacing the hormones you are now low in makes perfect sense. Many people fear HRT but its about understanding why it is important to have. No medication is without risks and side effects but side effects but for the majority women are very low and do not really affect them.

    HRT is first line treatment for menopause and is recommended by NICE for relieving symptoms of menopause. Anti depressants are not first line treatment for menopause. I have been advising and prescribing HRT to many women who find it really helps them. I am more concerned about the effects of NOT having HRT on your long term physical health.

    If you want to talk to your GP about HRT please ask to have oestrogen in a patch or gel as this safer.

    I hope I have answered your questions and please et me know how you get on with your GP.


    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @SEC_2003

    Good afternoon Sue,

    Thank you for getting in touch with me.

    Do you have any other joint pains or just in your thumb? Have you talked to your GP about this?

    If its just in your thumb I would doubt its due to menopause however you are post menopausal so will be having low oestrogen effects. Low oestrogen can affect our physical and emotional health, so don't under estimate its impact. Replacing these hormones with HRT would be recommended.

    Your joint pain, are they in your dominant hand? any injury? have you had problems before? have you taken any over the counter medications for your thumb?

    If its a concern its well worth talking to your GP.

    I am also a nurse practitioner in urgent care/minor injuries and illness so I can certainly advice on other areas too!

    I hope your thumb improves soon, please keep in touch and let me know how you get on with your GP.

    Best Wishes

    Diane Porterfield Bourne.

  • SEC_2003SEC_2003 Posts: 2

    Thank you very much for the reply.

    it’s only started in the last 3 weeks so haven’t ventured to the doctor as yet. Yes it’s my dominant hand and don’t take any medication as I’m not sure what would help. What about glucosamine? I’ll see about a doctors visit if it doesn’t improve

    thanks again Sue

  • LockieLockie Posts: 4

    Thank you Diane, that is really helpful. I will contact my GP to try and get some patches.

    kind regards

    Lisa (Lockie)

  • JackiJacki Posts: 10

    Hi 

    I’ve been perimenopausal for some years. I’ve been given so many different types of hrt and most work for me for the first few weeks. Then as my cycle carries on I become more depressed, lethargic, anxious, over processing, constantly thinking of my past relationship and comparing my old life, tearful, Hot sweats. ive also tried many supplements and not sure what I really should be taking with what. I suffered Cronic acid reflux last time. Which I kept being treated for for possible heart problems.

    im reluctant to go on antidepressants as I’ve heard many doctors just prescribe these but aren’t the solution. 

    my doctor is lovely but says that we have exhausted hrt and they aren’t working for me??? And referred me to hormone specialist but with the current situation, my appointment got cancelled due to covid. 

    any advise is welcome. 

    ive tried combination patches. Tablets etc. From my own log, I notice that I’m good on estrogen but when I’m on progesterone is when I really dip. But I have to have progesterone as I have a womb. I had an ovary and tune removed a few years ago as they weren’t healthy.

  • Av222Av222 Posts: 4

    Hi Diane

    I am 55 years old 2 and half years since no periods. Do i have low oestrogen . Could i get pregnant or am i pregnant . Taking pregecare pre conception tabs for the last 30 days. How often would i ovulate i am very healthy.

    Please answer Diane

    Avril Patel

  • Kathleen1310Kathleen1310 Posts: 1

    Hi Diane,

    I’m 55 and had a hysterectomy about 5 years ago. I’m on currently HRT Elleste Solo 80mg patches but I am suffering from burning mouth syndrome, dry eyes and nasal passages, headaches, nausea and intermittent ear ache.   Please advise if I am on to high a dose of HRT not enough or any vitamin supplements I can take to alleviate these symptoms.

    I did change the HRT briefly to Everol 75mg as I had read Elleste is soya based and Everol is yam based and I wondered if I had a soya intolerance but after a week my headache was a lot worse so I changed back to the Elleste solo but at least my acne spots on my forehead disappeared.

    Kind Regards

    Kathleen

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 382 Menopause Nurse Practitioner

    @SEC_2003

    Good morning.

    Thank you for getting back to me. I would just buy over the counter medications and take them as directed. More complex supplements and herbal medications are not something the health profession advise on or understand. We judge pain levels by your history, if any injury and what over the counter (OTC) medications you have taken. If you haven't taken any OTC medications then we would advice you to start there. Then when you see your GP they can evaluate how effective they have been.


    Please keep in touch.

    Best Wishes

    Diane Porterfield Bourne.

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