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Ask a Menopause Nurse | Diane Porterfield-Bourne



  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Good afternoon. Thank you to writing in at Live Better With Menopause.

    It seems that you are showing signs of low oestrogen.

    I would make an appointment with you GP and see about increasing your Oestrogen. Have you had your testosterone levels checked? Many women who have had a hysterectomy experience low Testosterone too.

    Some GP's will do these, some won't so please talk to them. The most important thing is to get onto maximum Oestrogen then review your symptoms. Dry eyes is a symptoms I often see and ladies think they have eye infections but its often hormone related. You can discuss with the pharmacist who will sell you drops to help too.

    There is definitely room for manoeuvre.

    I hope my advice has helped you. Please contact me again if I can help.

    Best wishes

    Diane Porterfield Bourne.

  • Penny21Penny21 Posts: 1


    Does you know what the situation is with patches? (Evorel Sequi) Are they available locally atm (Stourport)? I feel great on them and really don’t want to swap. Heard that stock issues are better, but it’s a pain to request a prescription and then find out there is no stock at my online pharmacy. What do you recommend? Is it worth asking for a new prescription or should I ask for something else?

    Thanks 😊

  • Av222Av222 Posts: 4

    Hi Diane

    I wrote to you a few days ago you did not answer. I am 55 years old had period 2 and a half years ago.How much oestrogen does my body have and progestin can i get pregnant keep a pregnancy and ha ve a baby .

    Avril x

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Dear Penny,

    Thank you for writing to me at Live Better With Menopause.

    Unfortunately the shortages of patches doesn't seem to be resolving anytime soon...

    However according to the British Menopause Society Guidelines on shortages as from 30/4/20 it states

    Evorel Sequi will be available from Mid May. If there remains a supply issue you could ask your GP to prescribe the gel. There aren't any supply issues with the gel.

    I hope I have helped and that you get your patches!

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hello Avril,

    Thank you for writing to me and I must apologise for the delay.

    When we get into our 40's we produce less Oestrogen as our ovaries contain less eggs and our fertility is reduced.

    By the age of 55 it is virtually impossible to conceive. We stop prescribing any contraception at this point as its generally considered you are not gong to ovulate and conceive a baby.

    If you haven't had a period for over a year; you are post menopausal. Have you talked to your GP about menopause? HRT? It is well worth talking to them about it. For the majority of women the benefits of taking HRT out weigh any risks but you and your GP can talk this through.

    The amount of Oestrogen prescribed will depend on the severity of your symptoms and if you have a womb will need progesterone too. This is given at a standard dose.

    I hope I have helped clarify and few things for you and please write to me again if you need any other information on menopause.

    Best Wishes

    Diane Porterfield Bourne.

  • ChrissieKChrissieK Posts: 2

    Hi Diane, I wrote in to you on 26th April but still don’t appear to have had a reply just yet...I’d be grateful for any advice re the palpitations I’ve experienced for years now.

    Thank you


  • LoubobLoubob Posts: 1


    I'm 54 and for over a year have had muscle fatigue and exhaustion. I couldn't walk for more than 20 mins and day to day chores exhausted me giving me jelly legs and hand shakes. I was given hrt after 6 months and it eased after 3 months. I had a bleed recently and was advised to stop hrt after 6 months. I was using patches evoril conte. Exhaustion is coming back. I have been checked for neurological problem. Is this a usual symptom and what can I do?

    Many thanks.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    I am sorry for not replying soon. Please accept my apologies.

    Palpitations can be a very common feature during the menopause but you should always discuss them with your GP. Many women get them, it can be very normal. Often happening when you sit down or go to bed, they seem more noticeable when resting.

    Your GP will ensure your heart, blood pressure and maybe heart tracings are all OK, especially if palpitations are associated with dizziness, shortness of breath and or chest pains. Explaining your symptoms to them will reassure you and your GP will see if you need any further checks.

    I hope this has helped you.

    Please write in again if I can help you.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Good afternoon and thank you for writing into Live Better With Menopause.

    Having a vaginal bleed can be very common within the first 6 months of taking HRT, did your GP talk to you about this or did you need a scan?

    If the scan was clear, I think you could ask your GP about going back onto HRT. If you can't it would be good to know the exact reasons why.

    Muscle and joint pains are very common signs during menopause but your symptoms do sound more significant. Having jelly legs and shaking hands isn't something I often associate with low oestrogen. Have you told your GP? I would talk to them about it, they know your health better than anyone.

    Ensure you are eating regularly, drinking plenty of water and resting well.

    But do see what your GP says, they might be happy with your symptoms or do more checks and talk to them about HRT too. You can stay on HRT as long as its benefits outweigh any risks. It's a personal decision choice between you and your GP.

    I hope I have helped you and do keep in touch.

    Best Wishes

    Diane Porterfield Bourne.

  • GracelandGraceland Posts: 4

    Hi Diane,

    Just a quick question, with all these temperatures checks in relation to Covid-19 at airports and workplaces etc just wondering if at the time I was having a hot flush would my temperature on a thermometer reading be raised to an extent where perhaps I could be turned away?


  • Tracey1Tracey1 Posts: 2

    Hello I've been 1 year into the menopause and I don't get hot flushes that often, I do have joint pain, not a lot of energy, painful sex and also weight gain

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hello and thank you for writing in to Live Better With Menopause.

    An very topical question and one I have to say have not been asked before...

    But the reason of a hot flush is not a raised body temperature due to infection, rather that low oestrogen inducing the hot flush. I have never checked my temperature while having a flush but really can't see it would be elevated. So the answer I would imagine would be no you wouldn't be turned away.

    However if someone saw you were flushed and clammy it may alert them thinking you were unwell. You could say the reason was due to Menopause and once the flush passed would go.

    I hope I have helped answer your question.

    Keep safe and well and enjoy the Bank Holiday weekend.

    Best Wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hi Tracey and thank you for commenting.

    When you say you have been in the menopause for 1 year, do you mean having symptoms for a year or a year without a period?

    Not everyone gets hot flushes so sometimes women wonder if they are menopausal or not but joint aches and pains, lack of energy and vaginal dryness are very common signs of low oestrogen.

    Have you discussed this with your GP? Have you any thoughts how you want to manage your menopause symptoms?

    For most women HRT makes a significant improvement to their physical and emotional well being.

    You mentioned painful sex, so I assumed you had vaginal dryness. This can be managed well with vaginal oestrogen and some over the counter vaginal moisturisers. Only a very small amount of vaginal oestrogen is absorbed into the system, that small in fact, its barely traceable.

    If I can advice any more or you would like to chat further please contact me again or send me a private message on here.

    Have a good weekend.

    Best Wishes

    Diane Porterfield Bourne.

  • Tracey1Tracey1 Posts: 2

    Hello I started perimenopause at 41 and my doctor did tests every year and now I'm 49 and was told I'm going through menopause and getting symptoms tiredness and Insomaia, joint aches, verbal memory, loss of drive, headaches, dryness, painful sex and weight gain is there supplements I can take.

    Regards Tracey

  • srujulsrujul Posts: 1

    Hi Diane:lI recently turned 65. Up to recently, I had little or no menopause symptoms such as hot flushes, night sweats etc. So I naturally thought I was one of the luck ones. I exercise daily not too overweight (3 kilos above what I think is my ideal weight). Not a drinker and never smoked or taken drugs.

    Just before I turned 65 I started having strange symptoms such as stabbing pains randomly over my body (not crippling but like a short electrical shock). I also started having the feeling of hair touching my face and bugs crawling on my face and scalp (which I now know is formication). I do a lot of cardio and never get tired, my blood pressure is normally low average 110/60. However, suddenly at night, (in bed especially) my heart starts racing, and my blood pressure starts spiking and I get a slight twitching feeling, I am also urinating frequently at night (not dark urine thought).

    I have had an MRI scan to rule out MS or any nerve related issue (the result was totally normal), I also have a heart check up with Holter monitor (no problem on that front). The blood pressure spiking is getting quite frequent as is the formication. I have had several blood tests, fairly normal except for low vitamin D and a bit of anemia. I have spoken to my GP, who can't find any explanation for these symptoms. As I have been in menopause for 15 years, with no symptoms, it never occurred to me that it might be that.

    After researching heavily, I have reached the conclusion that lots of my symptoms coincide with those of menopause. I have discarded MS, Fibromyalgia, etc. as my muscles don't ache, my balance excellent and I am not tired or confused. I am getting desperate as I really do not know what is happening to my body. Is it possible that after so many years, I am starting to feel the results of a drop in oestrogen????

    Of course this is now affecting my sleep and I am getting a bit anxious.

    Thank your for your response.

    Desperate 65 year old

  • LilLil Posts: 6

    Hi Diane

    Is it right if you take hrt in tablet form that the amount of time Its taken for is prolonging the menopause even though it deals with a lot of the symptoms. I am not taking hrt now and the symptoms are terrible. I have taken it before for 6 years, but now i am 60 . Ive had cancer previously.My anxiety is very high, everytime i feel stressed I have a hot flush.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hi Tracey, I hope you are having a good Saturday.

    Unfortunately there isn't a supplement that will replace your Oestrogen. HRT would be the best treatment not only to help your symptoms but improve your long term health.

    If you do not want HRT, it is absolutely your choice. It might be advisable to talk to a qualified medical herbal practitioner. Think about your diet, the Mediterranean style diet is recommended, taking calcium and Vit D supplements, plenty of exercise, reducing alcohol will also improve your health.

    @Blanka_C can you advise Tracey on nutritional experts?

    I hope others can support and advise you too.

    Best Wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for posting on Live Better With Menopause.

    We are all different and therefore our bodies all react differently. 65 is quite late to first show symptoms of menopause but you said you have been going through the menopause for 15 years, I guess you mean you haven't had any periods for 15 years?

    Every women goes through menopause, whether you have lots of obvious symptoms or not. Oestrogen deficiency can have a significant effect on our bodies, primarily our cardio vascular system.

    It does like you are experiencing symptoms. Have you seen your GP? What has your GP advised?

    You sound very fit and have been looking after yourself, this maybe why you haven't had major symptoms. We are all different and react to low Oestrogen in different ways.

    If you haven't chatted to your GP I would suggest making an appointment. They can rule out any other issues too.

    Take care and please keep us updated.

    Best Wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for posting and you have highlighted a question I often hear. If taking HRT will prolong the inevitable.

    Oestrogen deficiency causes many symptoms, both physical and psychological. The inevitable has already happened. Your ovaries have stopped producing Oestrogen. By taking HRT you are supplementing with something your body is no longer making. There is no time limit with HRT. You take it as long as its benefits outweigh any risks. You can take for the rest of your life or take short term only. If you took it for maybe 2 years, once you stopped it your symptoms may return. We are all different. But HRT isn't something you have to stop. Most women take for many many years and enjoy the health benefits from it. I do know women in there 80's taking HRT.

    If you wanted to take it short term, talk to your GP, if you want to take it long term as long as you are healthy it is fine too. It's a personal choice and something you talk to your GP about.

    I hope I have answered your questions.If you want to discuss more please message me.

    Have a good weekend.

    Best Wishes

    Diane Porterfield Bourne.

  • Laura15Laura15 Posts: 1

    Hi Diane

    I am 53 and have been taking evorel conti for approx a year, the medication is superb and feel fantastic the patches gave me my life back. However over the last couple of weeks I have severe bloated tummy, tender breasts and what feels like period pain, nausea And headaches just very unwell. I was wondering my hormones could be out of balance. I removed the hrt patch a couple of days ago but don’t want to go back to the debilitating symptoms I had before I started taking Evorel conti. Thanks for listening and the wonderful website.

    kind regards Laura

  • amandaj1amandaj1 Posts: 4

    Hi Diane, I started my menopause journey in my early 40's then my periods naturally stopped when I was 45, I'm now 56 and the hot flushes are driving me insane during the day, nights are ok. I have been on HRT which I stopped for a while when I suddenly started bleeding (continuously for 6 months) I came off HRT but went on again. I stopped for back surgery and decided it was time to come off. Since I have been having awful hot flushes, I have tried Natural Supplements with Soya Isoflavines and Sage. My eyebrows stopped growing and are thin and my nails keep breaking and I feel exhausted. I'm at my wits end as trying to lose weight which I'm finding hard. Do you have any suggestions that may help please?😒

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Good afternoon Laura and thank you for writing into Live Better With Menopause.

    I am very pleased to hear you are feeling better on your HRT.

    However it does need reviewing from time to time.

    When did you last talk to your GP about your HRT?

    It maybe a few things, that you might need your Oestrogen altering- maybe increasing?

    Also that the type of progesterone in these patches may need to be altered too, by swapping to a capsule version of Progesterone.

    I would suggest calling your GP and having a chat. I often have to tweak my patient's HRT. So it isn't just you.

    Good Luck and do let me know how you get on.

    Best Wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hello Amanda and thank you for your message.

    It sounds like you have really been suffering, from symptoms to heavy prolonged bleeding, it isn't easy being a women is it.

    The bleeding you had was heavy and lasted a long time, did your GP refer you for scans? Were they all normal?

    How long have you stopped HRT for now? Did you GP ask you to stop or was this what you wanted to do?

    Sorry for the 20 questions... but as you started the menopause quite early, it's more important to think of the benefits of HRT, primarily protecting your heart and bones. The longer you take it, the more protection you get.

    You do sound like you are experiencing symptoms of low Oestrogen again and hair loss which is common with the fall in hormones and also a sign of other deficiencies. Has your GP checked your bloods?

    With your GP/health providers guidance you can discuss HRT and seeing if you can continue to use safely.

    Weight gain... is a nightmare too. As it is a sign of middle age/Menopause, not really the HRT.

    I would suggest talking to your GP. Taking HRT if it is safe and what you want to do. The right HRT improves your energy levels, helps you sleep and makes you feel normal again. If you have more energy, and eat better; exercising is easier to do, which may help your weight.

    @Blanka_C can you see if a nutritional advisor could help Amanda?

    The best of luck and please keep in touch.

    Best Wishes

    Diane Porterfield Bourne.

  • Blanka_CBlanka_C Posts: 406 Community Admin
    edited May 2020

    @amandaj1 @DianePorterfield-Bourne

    Thanks Diane for tagging me!

    Hi Amanda, further to Diane's advice, I just wanted to let you know we have a nutritionist on our site as well who might be able to give you more tips on vitamins & supplements to take. Feel free to contact her here.

    Many ladies on here take magnesium and maca for tiredness. Some say Omega 7 works for dealing with hair changes.

    In addition, I found the following resources for you to help with hair changes, brittle nails and fatigue:

    Hope this helps. Please do get back to me or start a new discussion if you need further assistance!


    Blanka x

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    I hope the above information is helpful to you.

    Let us know how it goes and please write in if there are other menopause/women's health things we can help with.

    Best Wishes

    Diane Porterfield Bourne.

  • Morning55Morning55 Posts: 13

    Hello Diane

    I am on the Patch 2 mg . I am wearing 2,patches and changing 2x a week for 5 months . I have no uterus and my estrogen was 27.12 and went up to 52 with the patch . I still don’t feel well mentally I have never had and depression prior to menopause and dealt with slight anxiety but never to this length before. I maybe feeling okay for 2 days then a sadness comes over me for no reason and begin to feel hopeless . The Mornings make me feel like I want to die but eases as the day goes on. I can’t remember anything even appointments for work and since working from home it’s worst. I get overwhelmed just paying bills and no motivation. I take magnesium, omega 3 , vitamins D3, vogel menopause support , vitamin B complex and probiotics. I feel these are a lot of supplements. I feel like I am slipping mentally and it scares me . Is this normal? My doctors prescribed me meds but not a fan so don’t take them. My like feels so lost. I have no friends going through this. Please help me understand.

    Thank You

  • 4:34PM

    hi there I spoke in the Facebook group regarding being very nervous about trying hrt after a bad experience with Femoston. I have many many symptoms of the perimenopause and I'm 51 with erratic periods. my problem is the side effects especially worsening off my low mood as I found with Femoston and weight gain. I had anorexia and bulimia in my teens and although I'm fully recovered weight and food wise I will always have an issue with gaining weight. I've already put weight on from aged 40 but the thought of gaining a lot more with hrt is scary and something I couldn't cope with. I already exercise and eat well so couldn't change much more if I gained a lot of weight. my choice of hrt would be evorel conti or the gel/utrogestan. any help would be great thank you

  • Barbie67Barbie67 Posts: 1

    Hi Diane,

    A year ago I had a Mirena coil fitted after having very heavy bleeding and ended up having a blood transfusion and being prescribed northisterone. Since last year I’ve had a bit of spotting but since March I’ve started to have a period on a monthly basis. Im very bloated and I’m in pain the whole time even between periods. The abdominal pain maybe down to IBS, not sure. This months period only started a couple of days ago but is very heavy and it’s waking me up in the night as the flow is very bad! Not sure my coil is still there as I can’t feel the strings! I can’t see the practice nurse due to the current restrictions!? help is this normal with the Mirena coil ? should I resume the northisterone?

    thanks in advance for any advice you maybe able to offer


  • JeskieJeskie Posts: 2

    Hi Diane

    Ive not had a period for over a year now therefore assuming I’m in the menopause. Only symptoms I seem to have at the moment are night sweats however I take menolieve which seems to be helping. Of late though I have had breast pain, right side below the nipple and a change in colour to the nipple and surrounding area. Would the menopause bring on these changes. I’m 49.

    thank you

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hello and thank you much for writing in. Please do not feel lost, that is what these forums are here for, making you realise you aren't alone and believe me menopause can be a very lonely place...

    Firstly you absolutely must make an appointment with your GP to discuss how you are feeling. Your GP has overall responsibility for your health, so please call tomorrow or 111 today if you need to.

    Your Oestrogen levels are very low, so something isn't right. Has your GP referred you to a menopause specialist?

    I would think maybe the route isn't suiting you and maybe the gel may work? It is definitely worth discussing with your GP. Low mood is very common in menopause and HRT is what is advised but I really think you need to talk to your GP again or ideally see them. Different routes and preparations suit some over another route. We are all different.

    If your friends are not experiencing the same then they will be soon enough, menopause affects every women.

    Please discuss with your GP and or 111 and of course anyone close to you. If your mood does worsen please call 111.

    Please keep in touch.

    Best Wishes

    Diane Porterfield Bourne.

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