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Ask a Menopause Nurse | Diane Porterfield-Bourne



  • MazzleMazzle Posts: 6

    Hey Diane, I haven't had a period for about 5 years since Ive had the Merina coil in.

    FSH was 106 with merina last year.


  • Loujay01Loujay01 Posts: 5


    I’ve recently changed my HRT regime from Evorel conti patch (with top up 1pump if gel) & testosterone. It had worked well for a while, but some of my symptoms started coming back, wasn’t sleeping well, itchy skin, muscle cramps, & just felt tired and achy all the time & skin started to react to new manufacturers’ patch! I’m now on 2 oestrogel gel pumps a day & 1 utrogestan tablet (vaginally) & testosterone. I am now sleeping really well (I could go 9-10 hours if left to sleep!) but I feel really groggy & tired / brain fog . Sex drive has got worse & my aches & pains seem worse and feeling more emotional too! I have always been very sensitive to hormone changes; in particular progesterone changes mirena coil, didn’t work, (bad side effects, got periods!), bad pmt in past & PCOS. And hormonal migraines really kicked in when perI-menopause started. I’ve had an endometrial ablation & no longer get periods. I Can’t seem to find a good balance of HRT, is there another way / type of progesterone I can take; is it that that’s just turned me into a sleeping zombie?! Sorry for long explanation, but it’s a bit complicated & 10 minute appointment with my GP just not helping!!

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for getting back to me.

    When you have the Mirena, you rarely get any bleeding/periods so menopause can't be determined by absence of periods. Having an FSH taken really isn't needed. As the NICE guidelines state taking an FSH if you are over 45 will not tell you anything....a health professional needs to take a full comprehensive history. This is far more useful in determining if you are menopausal.

    I hope you can get the advice and support from your GP to help with your menopause symptoms.

    Let me know how it goes.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thanks for writing in to me.

    Who has prescribed you this HRT regime? Have you seen someone privately or has a gynaecologist addressed your HRT?

    Your symptoms seem like you are low in Oestrogen. You didn't say how much your patch was. 2 pumps is a standard dose. I would call the person who prescribed your gel and ask if you can increase or discuss at you are applying it correctly. In my experience many women aren't and this can cause symptoms.

    What type of testosterone are you taking? Your sex drive should have improved, so the question is why hasn't it? When did you last have your testosterone and Oestrogen levels checked?

    You are taking progesterone vaginally so it will give you far less effects. I normally prescribe vaginal progesterone if women continue to feel groggy on the oral version. If you are still having these effects I would suggest discussing your regime with your prescriber.

    Please keep in touch and let me know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • Blanka_CBlanka_C Posts: 406 Community Admin

    Thank you @DianePorterfield-Bourne for tagging me in the discussion.

    Morning ladies, nice to "meet" you all, I'm Blanka, the Community Manager at Live Better With! :)

    @Mazzle@Djdros52 just wanted to share last week's very informative webinar on HRT, the NICE guidelines and the menopause. You can watch the entire session on Youtube at the following link:

    This was a fantastic afternoon and we hope to do more in the future! If there's any particular topic you'd like to hear more about, please let us know.

    @Mazzle I hope you don't mind me getting involved in the discussion, I saw your question on the stages of menopause and I thought this article might help explain more in detail what Diane has mentioned:

    Have a fab day,


  • MazzleMazzle Posts: 6

    Thanks so much for reaching out to me, very much appreciated.


  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    If you need any more information please message me. I am hear to advise you and other women experiencing menopause.

    Best wishes

    Diane Porterfield Bourne.

  • Jus21Jus21 Posts: 1

    I have had a Mirena coil for almost 14 years for dysmenorrhoea and menorrhagia, due to be changed next year. I am 50 this year, the same age my mother went through the menopause, and have been having symptoms of perimenopause for about 2 years now, but they are mild mostly - mood swings, fatigue, problems with sleep, warm face after eating, dizziness, memory issues and blanks (very rare but I do occasionally lose what I'm talking about mid sentence).

    I don't know where to start with being tested to see where I am in the menopause because of the mirena (hormones and no periods at all), and don't know what the best options will be for me for treatment now and when my mirena runs out.

  • LesjewLesjew Posts: 1

    I am being treated for anxiety and depression. I have had a rough year but probably no worse than anyone else. I really am not convinced it is , I think it’s the menopause. Symptoms are the same if not worse. I am 49 and my mother had an early menopause. Please help I really feel I am going mad and losing my mind . Thank you

  • Djdros52Djdros52 Posts: 29 ✭✭

    Thank you very much the webinar was very informative. I will definitely discuss HRT with my GP at my next visit.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for writing in. Your Mirena is good way of getting progesterone, controlling bleeding and for contraception. It can also be used as the progesterone part of HRT.

    You mentioned a good point, what tests do you need....

    The good news is for menopause none at all. The NICE guidelines state that over the age of 45 you do not need a blood test to identify menopause. A diagnosis is based on your age and symptoms. If you are still menstruating we can look at your period history too but with the coil you rarely get bleeding.

    So the good news is that your menopause symptoms are mild; however the Oestrogen deficiency will most likely be causing your symptoms. If the Mirena is being used for HRT protection, it can be changed every 5 years, or you can leave it in and have other types of progesterone, it is up to you and your GP to discuss.

    It is the lack of Oestrogen that will be causing your subtle symptoms. Remember the bigger picture; Oestrogen deficiency affects your heart, blood and bones. The long term benefits of HRT for many women outweigh the risks. This is something to think about and talk to your GP for guidance.

    Taking HRT or not is your choice and when you have all the information you can make informed choices.

    Please keep in touch and let me know how it goes and what you decide to do.

    If I can help please message me.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for writing to us at Live Better with.

    You are being treated for anxiety and depression; is this a new problem or have you had this on/off for some years?

    What has your GP done to help? advise? Are you on medication?

    Have you discussed how you are feeling with your GP? If you are feeling lower than normal, you must talk to them or call 111.

    You are 49 so menopause has to be at the forefront of your mind. There is no escaping it! Anxiety and low mood are very common signs. Are you getting any other symptoms, hot flushes, night sweats, aching joints, poor sleep?

    Some GP's will understand that low mood happens in menopause, others won't and give you anti depressants. HRT is first line treatment for low mood in menopause. Please listen to my webinars I have done on LBW. Talk to your GP and If I can help anymore please let me know.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you. I'm glad I could help. At least it gives you some guidance on what to expect from your GP.

    If I or anyone else at LBW can help please write in to us.

    Best wishes

    Diane Porterfield Bourne.

  • AnnmarieAnnmarie Posts: 3

    Hi I'm always feeling tired & bloated...is there any vitamins that i can take...

  • ScoobyScooby Posts: 1

    How do I know if I'm peri menopausal?

  • BirdiebBirdieb Posts: 1

    Hi Diane

    I am about to turn 60 and had my last period 8 years ago . Apart from the hot flushes I had been relatively symptom free until a few months ago . I now seem to have more mood swings and although prone to some anxiety in the past , this seems to have ramped up for no apparent reason . I am experiencing some nausea and occasional heartburn which I’m not sure is related . Can symptoms kick in after all this time or are they likely not to be menopause related ?

  • MonicaMMonicaM Posts: 337 ✭✭✭
  • MonicaMMonicaM Posts: 337 ✭✭✭


    Good morning, I experience quit a lot of blaring myself as a matter if fact I am experiencing it right now and it can be so uncomfortable and so annoying. I was taking probiotics fir a few months but now I am trying to watch what I eat. My biggest problem I think is eating late which I need to stop doing.

    I have gone to a specialist and they say I have an over acidic stomach and I have IBS. I have had these problems before menopause but I think menopause has made it worse along with all of the weight gain.

    I found a couple of articles that hopefully can help you.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you @MonicaM for the link explaining the stages of menopause.

    Peri- is the stage leading up to the first day of your last period. This can last for years and normally when you start to get symptoms....

    Menopause- this is the first day of your very last period. A year later if you haven't had any bleeding/loss you have completed the menopause.

    Post- 1 year without a period means you are post menopausal.

    If I can help and explain please message me.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hello and thank you for talking about how you feel.

    Some good links have been put up for you. I wouldn't immediately think that vitamins would help, I would want to know the possible cause of your bloating. How long have you had it for? What has your GP said/advised?

    Have you discussed menopause with your GP? @MonicaM has put some great articles up to help.

    If you would like more information on Vitamins please write back in and we'll see what links we can provide you.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Yes symptoms can kick in anytime, the fact you haven't had a period for 8 years means you are post menopausal so your Oestrogen will be low regardless.

    Some still get menopause related symptoms in their 70-80's... we are all different. Firstly its best to talk to your GP about this. You may want to talk about HRT and see if it would benefit you. As age isn't a reason not to have it.

    Please watch the webinar I did a few weeks ago on HRT and NICE guidelines. Once you know the facts you can make a choice if you would like HRT or not.

    Please let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • Knibbsy69Knibbsy69 Posts: 1

    Hi i have been given evorel sequi 50 for menopause. I put the patch on my right thigh today at 5pm.by 5.30pm my right leg felt weird kind of weak and wobbly.then my right side of my face felt the same.i rang the pharmacist and he told me to remove the patch.

    Im wondering if anyone else has had the same feeling

  • karenrowdonkarenrowdon Posts: 2
    edited September 2020

    I am 51 years old. My GP has prescribed 2.5 Tibelone. For about 3 weeks I am fine, but for about a week a month I get terrible brain fog and fatigue. It debilitates me so much I cannot work. I walk around in a daze, and feel terrible. I have a healthy diet, but am putting on weight. I have recently had blood tests and everything was fine. I am at the end of my tether! I take multivitamins, magnesium, and am also on 20mg Citalopram. What else can I do to clear this twrrible brain fog, and ease the fatigue please?

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for your message.

    Interesting....it appears you had some sort of reaction to either the HRT or something within the patch itself. However after only 30 mins? I can't say for sure how long it takes for the hormones to reach your blood supply via a patch and the symptoms are quite significant. You did the only thing you could do and removed the patch. How long later did the symptoms lift? what did your GP say about this reaction?

    Are you OK now? Have you gone back on it or tried something else?

    Sorry for 20 questions!

    Please let me know what the outcome is and we can discuss this more.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Hello Karen.

    Have you gone back to your GP? What have they said? Will they increase your Tibilone? Is there a medical reason you're taking this and not normal HRT?

    The symptoms you have listed are most likely Oestrogen deficiency.

    I hope your GP can help you and please keep in touch and let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • I think to begin with they swapped me to Tibolone because of a negative reaction to the Progesterone tablets I was given with the Eostrogen Gel. Also I wanted a little help with my sex drive, so she said Tibolone may help. But I've felt rubbish for 5 days now. Have called GP, just waiting for a call back. Would you suggest normal HRT? Or can I add a little extra Eostrogen Gel with the Tibolone I am taking? Just don't know what to do. And its so difficult to get an appt with a GP.

  • Maggie11Maggie11 Posts: 5

    Hi Diane , I am.on hrt since the 1 ,st of July. I am on divigel 1mg and utrogestan 100mg . I only went on divigel since 2 nd of sept .

    I wake up hearing my.heart beating and my tummy.rises and falls to my heart beat . My pulse is.a.bit fast too .

    I wondered about increasing the dose of divigel ?

    Thank you .

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner


    Thank you for your message. How long have you been taking HRT for?

    It can take a few weeks before some women notice the difference. Whatever HRT has been prescribed it's very important to take the amount they say. If it isn't helping or you're wondering about your dose they will advise you to increase or remain the same etc.

    If you are having fast heart beat and possible palpitations is vital to discuss this with your GP. It can be quite normal in menopause but until you see your GP you won't know for sure.

    Please keep us posted how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • Maggie11Maggie11 Posts: 5

    Hi Diane , I have been on hrt since the 1st of July . I started off on femoston conti ., then I went to estradot and since the 2nd. Of sep on divigel 1mg and utrogestan 100mg .

    Thank you so much for.your reply -',,Margaret.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    Hi @Maggie11

    It sounds like you have been chopping and changing your HRT a lot!!

    Your body doesn't like change, so please give it time...

    1mg of Oestrogen is the lower dose so do talk to your GP and observe your symptoms. If you are concerned discuss them with your GP. It personally took me 6 weeks to notice improvements but we are all different.

    Best wishes

    Diane Porterfield Bourne.

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