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Ask a Menopause Nurse | Diane Porterfield-Bourne

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  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @peroxideblader93

    Thank you for your message. It came through as a private message and I replied on there.

    Hope I helped you!

    Best Wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Barbie67

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

    Heavy bleeding is common and can be very problematic. Your GP advised the coil and that does the trick for many women. The concern now is that you are bleeding heavily so what has changed? If you can't feel the strings it may not be in the right place. Whatever is happening you do need to speak to your GP practice.

    Most practices are seeing people, its just different at the moment. I know my local practices are doing smears. I would suggest calling them and explaining your problems.

    Please let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Jeskie

    Thank you for writing into Live Better With Menopause.

    Breasts do change during the menopause and not for the best! The skin becomes less elastic, so they can droop, size of the nipples and areola can shrink due to reduced Oestrogen.

    When we take HRT they can become swollen and sore too! But this is only temporary.

    I haven't heard of nipple colour changing, particularly as it has only affected your Right breast. Have you discussed this with your GP? How long have you had breast pain for ?

    Anything to do with the breasts, I do suggest seeing your GP, its always best to get them to check things out. If you need any investigations they can arrange and also in turn give you reassurances.

    Good luck and let us know how it goes.

    Best wishes

    Diane Porterfield Bourne.

  • sunny123sunny123 Posts: 5

    Hi I am new to all this HRt so am looking for some guidance if possible.


    I am 47 and peri. I have been so a consultant and she has recommended I go in 2 pumps of the gel and progesterone for 10 days. Since i started the gel , that's putting 2 pumps on my thighs in the morning I felt very drugged for a better word and slightly lightheaded. the tension i feel in my legs is awful. I am extremely irritable and snappy with everyone and at about 4 o clock im absolutely exhausted, an unnatural tiredness. I decided to put 1 pump instead of 2 at 6pm (doc said this was fine) to see if this made a difference but now when i go to bed i cant sleep like my head is racing, eventually when i do , i then cant wake up in the morning i'm so tired.

    I know that i am sensitive to drugs, with a paracetamol at night making me sleep the night through in a deep sleep haha.

    vit bs i can't take as they stimulate me and keep me awake also.

    about 6 months ago I suffered with nights sweats , waking at 4 every night, irregular periods, some months not coming at all. anxiety, moodiness and depression especially from ovulation till period hence this is why i sought help. flushes stopped about 2 months ago and early waking but i carried on and took the long awaited appointed with the specialist as i knew theyd come back. they haven't yet so i am wondering should i park the hrt until they do or will it help with the irregular periods, anxiety moods etc?

    sorry for long waffling emailing, slightly all over the place email . x

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @sunny123

    Thank you for writing in, I can only apologise for not getting back in touch sooner.

    How long have you been taking HRT for?

    How are you getting on with 1 pump of gel? Has your GP talked to you about your symptoms and why you can't feel better? Might be worth asking about the progesterone your taking. Some women are very sensitive to the progesterone. Many women consider the mirena coil as an alternative.... just a thought.

    Before you make any decisions about stopping HRT I would advice talking to your GP and discuss it together. As if you did stop your HRT more than likely your symptoms would return. But see what your GP says.

    I hope all goes well for you.

    Best wishes

    Diane Porterfield Bourne.

  • Blanka_CBlanka_C Posts: 406 Community Admin

    @DianePorterfield-Bourne, hope you don't mind me sharing the below information! :)


    Good afternoon ladies,

    Hope you're all doing well.

    Time and time again, we hear stories of women feeling isolated, confused and left to fend for themselves during this often very difficult journey.

    To answer some of your questions and shed some light on the menopause, we are organising a live Q&A session with @DianePorterfield-Bourne, our menopause nurse practitioner!


    We will be covering a range of topics, including:


     ✅ The stages and common symptoms of the menopause

     ✅ Anxiety, mood changes and feeling stressed

     ✅ HRT - facts, risks and benefits

     ✅ Lifestyle choices to live better with the menopause


    You will have the opportunity to listen in and ask questions live, using the chat function - don’t worry, you won’t need to use your camera or mic. 😏


    Date and time: 6pm - 6.30pm BST, Friday 26th June

    Where: Zoom

    How to join: Simply click on the following link at 6pm on the day: https://us02web.zoom.us/j/84236189200


    Hope to see you there! 👋


  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Blanka_C

    Ladies at Live Better With menopause, hello, I hope you are all well.

    At LBW menopause it's all about knowledge and support. Women support women, just as our best friends support us too.

    I'm Diane, a nurse practitioner specialising in Menopause and HRT. I have my own private clinic and support women all over the UK.

    When it comes to menopause, women generally experience the same symptoms, the same emotional rollercoasters and often feel they need more support.

    Tomorrow evening I will be talking all about menopause, symptoms, HRT, plus much more.

    Join us by clicking on the Zoom links above.




    See you tomorrow!

    Diane Porterfield Bourne.

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @DianePorterfield-Bourne

    Thank you for the live Q&A session on Friday it was nice a lot of great information that you shared with the group.

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @DianePorterfield-Bourne

    Hi Diane,I am taking progesterone, testerone and yuvafem. I have only been taking them for about 3 weeks. I was feeling fine at first but now I am not feeling well. I am going to contact my doctor. I have gained weight in a short period of time, I feel dizzy, breathing a little heavier, I feel bloated and constipated and now all of my allergy symptoms are back again. I really wanted to take this stuff to help me get through the night sweats, hot flushes and vaginal dryness but with these side effects hitting me not sure I can go on with the medicine. I am feeling like crap and it is annoying it just seems like if it isn’t one thing it is another. I just want some relief with everything and to be able to sleep through the night 😩😩😩😩

    I don’t know what to do anymore with all if this crap. I was only doing the hormones to get some kind of relief and try to have some type of intimacy in my marriage but feeling like this makes me want to stop it.

    Sorry ladies had to vent

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @MonicaM

    Thank you for the post.

    The HRT you have been prescribed is a strange combination. There appear to be symptoms of low Oestrogen and are taking progesterone, testosterone and vaginal oestrogen but not normal Oestrogen. I would talk to your GP about this. It's often more important to concentrate on increasing Oestrogen levels before using testosterone, however this is something you and your GP can discuss and understand. If your GP is unable to manage your symptoms/HRT there should be a GP with special interest in Menopause at your practice. Or your GP could refer you to a menopause specialist.

    I would get clarity of your HRT and see how this can be improved but your GP will advise you.

    Please let me know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @DianePorterfield-Bourne

    I will talk with her this week or next week. I was put on testerone because when she did my tests earlier this year before Covid, my bloodwork showed that my body had no testerone or it was such a small amount.

    I am definitely going to ask her about the oestrogen and I am concerned about all of these hormonal medications because she is supposed to be a menopause specialist.

    I don’t know what to do but thanks again fir your help

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @MonicaM

    If they are specialists in Menopause I would ask why you haven't been prescribed Oestrogen in a patch or gel too? Vaginal Oestrogen is beneficial when they is lack of Oestrogen to the vagina/vulva etc but it does not help with main symptoms such as flushes/sweats etc.

    I hope they can address your concerns and treat your symptoms.

    If you did want to discuss further you can always PM me too.

    Please keep in touch.

    Best wishes

    Diane Porterfield Bourne.

  • Melanie185Melanie185 Posts: 1

    Hi. I’m new to this page although I’ve been Menopausal for over 10 years.

    I’m 54 and have quite recently changed to hrt patches. Oestrogen patches with progesterone tablets. They are working much better to control my symptoms but my breasts are really tender and sore. It tends to be worse for a bit then eases off but I do have some discomfort most of the time.

    I had a clear mammogram in February so that has put my mind at ease a bit. Just wondering how long this could last for.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Melanie185

    Thank you for writing into Live Better With Menopause.

    It sounds like you are taking a good combination of HRT. Side effects from medication happen to most of us and normally pass in about 2 months. However I would suggest you talk to your GP and explain your symptoms. It is very important any health issue you have is discussed with your GP.

    We are all different. Some women no have side effects others have they really badly.

    I hope they pass soon and you get reassurance from your GP.


    Best wishes

    Diane Porterfield Bourne.

  • SophstermSophsterm Posts: 1

    I’m 51 and post menopausal due to breast cancer treatment. I’m looking for an estrogen free lubricant to use during sex. I already ordered some moisturizer with hyaluronic acid Is there a lubricant you can recommend? I’ve tried various with no luck.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Sophsterm

    Thank you for writing into Live Better With Menopause. Many women who have had breast cancer treatment experience vaginal dryness/soreness and itch. Having smears, wearing types of underwear and having sex can be very uncomfortable even impossible.

    You have mentioned about Oestrogen free vaginal creams etc but have you discussed with your GP/oncologist if you can have vaginal oestrogen? If you are taking Oestrogen blocking medication you probably won't be able to but if you are taking Tamoxifen you might be able to have vaginal Oestrogen.

    Non hormonal creams/gels there are a few...Sylk, Regelle, Yes are some of the products. Yes also has a lubricant which you can use when having sex etc.

    I do suggest talking to a health professional about vaginal oestrogen. The amount of oestrogen absorbed into your systemic circulation is incredibly small to zero, therefore some women can have it. Worth a conversation.

    Vaginal moisturisers- can be difficult to get one that suits you, trial and error but please DM me for more information.

    Best wishes

    Diane Porterfield Bourne.

  • SalelSalel Posts: 2

    Hi Diane

    I’m 57 and about 18 months into my menopause. 5 days ago I started oestrogel 2 pumps daily And Utrogestan 100mg daily. I’ve noticed this last couple of days that I have some lower abdominal discomfort.. almost like the feeling I used to get when I was ovulating.. kind of draggy feeling. Does this sound like a side effect of the Utrogestan and if so will it continue or do I just need to adjust to the medication?

    many thanks

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Salel

    Thank you for writing in and telling us about your experiences. When you first start on HRT you can get side effects. The most common abdominal discomfort is bloating and IBS type symptoms. As with all side effects they only last a few weeks. However it is essential you discuss any concerns with your GP as they know all about your health. I would give you GP a call and run it past them.

    Please let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • SalelSalel Posts: 2

    Thanks Diane 😊

  • ToniGToniG Posts: 7

    Hi Diane

    Apologies if you’ve received 2 messages from me, I couldn’t see if my first one went through, so I’m trying again.

    I’m worried because I am having very painful periods every 2 weeks while on continuous HRT. I started with a private doctor, which I can no longer afford, just over 2 years ago.

    She started me on sequential HRT, 1.5 mg Sandrena gel every day, 100 mg Utrogestan for 14 days.

    i was feeling really well for about 8 months, but then felt like I was suffering from PMT as soon as I restated Utrogestan, ie for @ 2 weeks of every month, with pain and low mood plus heavy painful Heavy periods also nausea in morning. This carried on for @ 4 months so I went to my GP. She was unable to help or advise because I was using a different type of HRT to what she normally prescribed. I did a phone consultation with private doctor and we agreed that continuous HRT could work so I started to take 100 mg Utrogestan every day with no break, no change to Sandrena gel. The trouble is that my periods now were every 2 weeks and quite painful. I gave it 7 months then went back to GP. Again she was unable to help so I asked to be referred for an ultra sound to rule out endometriosis or fibroids. She agreed, though “just to put my mind at rest“. I also asked to be referred to a menopause specialist.

    the scan was “all clear”, the lady who did it said that I was well past the age to worry about endometriosis anyway.

    i had an appointment with a gynaecologist rather than a menopause expert. She recommended the coil. I’m not keen to go this route, was left to think about it then lockdown happened.

    it has now been @ 1 year on continuous HRT. I have painful periods @ every 2 weeks. My moods are up and down, but of course everyone’s are at the moment. I really don’t know what to do. I am also suffering from groin/hip pain which started @ 18 months ago. I wonder if these are related to HRT? Certainly they are worse around period and whatever exercises I try (including visits to 2 different physios and an osteopath), it will start to get better then flare up again so I have to stop my regime.

    sorry for really long message, but I want to give you as much info as possible. I’m just in pain most of the time and really stressed that i can’t do anything about it and that I can’t get into a fitness routine due to pain. I really hope you can offer some advice.

    thank you.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @ToniG

    Thank you for writing in to Live Better With Menopause. To put your mind at rest, I have only received 1 message from you!

    I will try and break things down for you but firstly when you are taking cyclical progesterone it is a different dose but the private menopause doctor obviously had their reasons for this.

    Continous Progesterone is often tolerated better, especially when women are sensitive to Progesterone.

    Your heavy bleeding every 2 weeks I would imagine is getting you down. I immediately thought the coil might help. Can I ask why you haven't considered it? It suits many women and is long term ( 5 years) for contraception and helps with your uterus lining too. At least you have peace of mind all your investigations were OK.

    What has your GP said is causing your hip pains?

    I often hear women say they have hip pains... this is most likely due to lack of Oestrogen ( if your GP can't identify other reasons/investigations).

    Oestrogen gel via the skin is a great way of getting Oestrogen...I am wondering if you are applying it correctly, as it seems by your comments you may need more or a doctor review?

    I often talk to ladies who are not applying their gel in the right way, so just a thought. Please discuss all health concerns with your GP.

    I hope I have helped and please write back to us if you need more advice or guidance.

    Best wishes

    Diane Porterfield Bourne.

  • ToniGToniG Posts: 7

    Thank you for coming back to me so quickly.

    regarding dose of progesterone, I don’t really know - from what I have researched, 100mg Per day was quite low for sequential but about right for continuous.

    my GP has said that hip pain may be hormonal but offered no further explanation, and advised me to see a physio. After trying this, I later told her this hadn’t worked, nor did osteopathy she was disparaging about osteopathy and advised me stay active - I was regularly doing gym and Pilates plus some swimming. I have done that. I keep trying new things. To be honest, it Was only very recently that I really considered a link. Because everything I try in terms of exercise doesn’t work.

    with regards to applying Oestrogen, I apply at night to inner thigh or outer thigh.. I alternate legs and don’t rub too hard. It takes a long time to dry, I normally read in bed with legs bent for a while but it’s still tacky when I go to sleep. For that reason, for the last 2 weeks I have applied 1/2 Hour before bed time to allow to dry while watching TV. Is there another way I should be doing it?

    With regards to coil, I’m just afraid that I will still have same issues but that coil is more permanent (I know it can be removed, but less easily than stopping/changing dose of utrogestan). No one has explained why coil, delivering progesterone will not cause same issues as tablet delivering progesterone. Also, it would not be Mirena coil. I thought Mirena was the best one?

    Thank you so much for your help.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @ToniG

    Thank you for explaining more and I will see if I can answer your questions too.

    Normally cyclical Utrogestan is prescribed at 200mgs for 2 out of 4 weeks and continuously at 100mgs per night but I can't comment on your individual case. Your menopause specialist chose a different regime for you.

    Oestrogen gel does need to be rubbed in, well applied I normally say. Covering a really good surface area to get absorbency of the drug through your skin and into your blood stream.

    Always read the product information or discuss applying with the person who prescribed it to you. If you weren't applying it correctly that maybe the reason it is less effective?

    Just a thought..

    The Mirena delivers progesterone straight to the lining of your uterus and although a small amount will be absorbed and have an effect over the whole body, for most women its effects are so subtle it isn't noticed. Some women who are very sensitive have problems even with this route. Utrogestan suits most women and is an excellent form of progesterone.


    I hope I have helped you. Please discuss any issues/concerns with your GP too.

    Best wishes

    Diane Porterfield Bourne.

  • ToniGToniG Posts: 7

    Thanks, Diane, I’ll try rubbing in more and see if that helps.

    if not, I’ll rethink the coil.

    kindest wishes

    Toni

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @ToniG

    I hope you see a difference in the Oestrogen once you are absorbing it better. How many pumps/sachets are you using of the gel?

    If you aren't getting enough Oestrogen...maybe a conversation with your GP? Just a thought.

    I often talk to many women who are either afraid or their GP is reluctant to give them higher doses of Oestrogen. We are all different and it is about finding what HRT suits you and is safe.

    Good luck and please keep in touch.

    Best wishes

    Diane Porterfield Bourne.

  • ToniGToniG Posts: 7

    I’m using 1.5ml (1x 1.0 mg sachet & 1 x 0.5ml sachet) Sandrena gel. My GP is not willing to discuss dosage with me, as she says this is not a brand she is familiar with.

    I think I’ll monitor for a few more months with rubbing in more, and hopefully periods will become less frequent.

    thank you.

    Toni

  • MCG08MCG08 Posts: 3

    Hello Diane,

    I’m new to site , I’m 41yr old periods irregular for past 2 years had bloods checked 3 months ago and FSH was 55 so GP advised going on a low dose hrt, this has helped hot flushes and insomnia but I am still experiencing heart palpitations and acid reflux and extreme fatigue every 2weeks. GP unfortunately hasn’t been much help and was told just keep taking HRT but I feel it’s not helping any advice would be welcome as it is really impacting my daily life.

    I am on Femoston 1/10mg

    Many Thanks

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @MCG08

    Thank you for writing into Live Better With Menopause, we are here to listen, help and advise!

    You are very young to be experiencing these symptoms.Plus you have been having symptoms since you were 39..I am pleased they have prescribed you HRT but you are still having symptoms. Younger women often need more Oestrogen, the older we get the less we need ( mostly).

    I may suggest talking to your GP and getting on a higher dose of Oestrogen. You can have these in tablets, patches or gels.

    By increasing your Oestrogen your symptoms should improve. Also it is important ( when possible) to stay on HRT until at least you are 51. Most women go into menopause in there late 40's but as you were younger the low Oestrogen can impact on your bones and heart.

    I hope you get on OK talking to your GP. There is a network called "the daisy network" who support women in early menopause, as you started at 39, it won't do any harm looking them up and reading their information.

    Please keep us posted on your progress.

    Best wishes

    Diane Porterfield Bourne.

  • MCG08MCG08 Posts: 3

    Thank you Diane,

    I have spoke to GP this morning and he has agreed to changing HRT to Femonston 2/10mg on a months trial , he was a bit reluctant as he said it would increase risks associated with it , from my research I think if it works it’s worth the risk. Thank you again for your help , could I also ask is there a supplement I could take to help along with HRT

    MANY THANKS

    MCG08

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @MCG08

    Hello, I am glad you spoke with your GP. There are increased risks when prescribing tablet HRT but this often does not apply to younger women. Obviously if you had health problems your GP wouldn't prescribe this but for younger the effects of low oestrogen to the body can be harsh.

    There are many types of HRT... but good luck and I am glad you felt able to discuss your concerns with your GP.

    Best wishes

    Diane Porterfield Bourne.

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