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Ask a Menopause Nurse | Diane Porterfield-Bourne

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  • Maggie11Maggie11 Posts: 5

    Thank you Diane .

    What is the.highest dose of divigel ?

    I am having my.estradiol levels checked soon . Will that tell me my oestrogen levels ?

    Another doctor said I might need bisoprolol ?

  • TraceyH67TraceyH67 Posts: 1

    Hi Diane, I have been on HRT now for about 6 weeks. After three weeks I started to bleed lightly (not had period for 18 months prior to this). I’ve been bleeding now for 3 weeks although only spotting now. My GP wants me to stop taking the HRT (Evorel Conti 50 patches) for 6 weeks to see if the bleeding stops then I may be allowed to go back on them. I was just hoping for your take on this

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Maggie11

    Dear Maggie.

    `Divigel is not a name I know well but its a type of Oestrogen gel. I think the highest dose is 1mg, other parts of the world have different strengths. They commonly prescribe this in Ireland.

    Please ensure you are applying the oestrogen gel as your GP advised as many women aren't. Your Oestrogen levels will see if you are absorbing it correctly.

    Bisoprolol is a beta blockers with quite a few uses too. It's best to talk to your GP why they want to prescribe this medication.

    Hopefully you'll get your answers.

    Please let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @TraceyH67.

    Hi Tracey. You have vaginal bleeding when you first start HRT. You have only just started taking it so can be completely normal. When I prescribe HRT I always explain this can happen and be aware. You need to talk to your GP and ask their advice.

    If your bleeding is heavier than normal your GP can discuss this with you.

    Good luck and please let us know how it all goes.


    Best wishes

    Diane Porterfield Bourne.

  • Maggie11Maggie11 Posts: 5

    Thank you Diane .

    I put the gel on my thigh or bum . In what ways can it be applied incorrectly ?

    What is the favoured oestrogen gel in England ?

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Maggie11

    Hello Maggie.

    I am not able to advise you on how to use prescribed medications as this is what you must discuss with the GP or your pharmacist. I hope you understand. Also there should be product literature within the box that should explain it too.

    A popular gel we use in the the UK is Oestrogel but there are few different types.

    Best wishes

    Diane Porterfield Bourne.

  • MCG08MCG08 Posts: 3

    Hi Diane, I’m 41 and have been having symptoms for few years my gp said perimenopause and put me on HRT Femonston 1/10 in April due the symptoms he upped the dose to 2/10 in July and I was doing well up until last week, on day 10 of cycle I woke up in morning trembling and dizzy and awful heart burn and acid reflux which were some of my symptoms before starting hrt I’m in day 14 of cycle and still barely able to function with light head and acid reflux. Not sure what to do as have had tests n everything is clear

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @MCG08

    Thank you for writing in.

    Have you gone back to talk to your GP about your new symptoms?

    I would, get some advice and reassurance.


    Let me know how it goes.

    Best wishes

    Diane Porterfield Bourne.

  • debbie201debbie201 Posts: 2

    Hi Diane,

    I am 56 and went through the menopause about three years ago. I have the usual hot flushes, mood swings, anxiety, aching joints; but manage my symptoms OK. I am not on HRT. Since last year I have had recurrent urinary tract infections, having rarely suffered from them before. Antibiotics clear them up quickly, but I feel vey unwell with them for about a week - exhaustion, stomach ache, nausea. I was sent for an ultrasound which showed nothing abnormal. My doctor has suggested a course of oestrogen cream, initially for three months, then possibly up to a year. He says the risks are minimal compared to HRT, which I have always been reluctant to take. What is your experience of oestrogen cream for UTIs? Is it likely to help? Are there other things I could be doing?

    Many thanks

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @debbie201

    Thank you for writing into me at LBW. It seems you haven't had many symptoms until fairly recently. Have you talked about HRT with your GP before? We have choices what we do or don't do but HRT is the preferred treatment for menopausal symptoms. I actually presented on an NHS webinar yesterday talking about HRT.

    Lack of Oestrogen can have a real effect on the body producing symptoms and long term effects on the body. Frequent urine infections are are often a sign of Oestrogen deficiency. Antibiotics are needed within health but as we all know carry quite unwanted side effects too.

    If you have been getting recurrent UTI's I guess your GP sent your urine off to the lab to be tested, not just dipped in the surgery?

    Vaginal Oestrogen is very good if the symptoms you are experiencing are relating to menopause and no other urine infections. Are you experiencing any vaginal dryness, sore, itch, painful sex? These are common signs of low Oestrogen.

    Vaginal Oestrogen can be prescribed long term; I am unclear why your GP is suggesting shorter terms. I often prescribe for vaginal symptoms in menopause.

    There are very few risks associated with HRT and for the majority of women can be taken long term too. There are many myths on HRT!


    I hope this helps. Please write back tome if you want to know anymore.

    Best wishes

    Diane Porterfield Bourne.

  • Mary78Mary78 Posts: 30 ✭✭

    Hi Diane, I'm relatively new here. I'm looking for some advice on dealing with seasonal sadness / feeling low. I feel on edge most of the time but as it's getting darker outside, my anxiety gets worse. Is there anything natural I can try? I heard a lot about these weighted blankets and SAD lamps...do you think they could help? I'd appreciate any advice. Thank you so much in advance

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Mary78

    Good morning Mary and thank you for writing in. It's important to reach out when you are feeling low. How long have you been feeling like this? Does it happen every wintertime, or just this year?

    First of all it's really important to talk to your GP about this, they are there to support and help you.

    A few tips to help with seasonal affective disorder or SAD. I use to work in a basement clinic, no natural light at all, it wasn't pleasant but we bought some SAD lights and I personally think it helped a lot. It was like natural daylight in the room, so worth thinking about.

    It's important to get outside as much as possible, even if its cloudy but any bit of sun, get out and go for a walk. Exercise, getting out of breath makes our bodies produce feel good hormones which make us feel happier but even walking and appreciating the scenery around us can calm us down, ground us, like mindfulness.

    Make sure you are supplementing with multi vitamins and minerals and eating small regular meals.

    Are you experiencing any menopausal symptoms? such as increased anxiety? insomnia? mood swings?

    If so please write in and let me know and we can talk about that some more too.

    I look forward to hearing from you soon.

    Best wishes

    Diane Porterfield Bourne.

  • is dizziness a symptom

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Karen brisband

    Good morning Karen.

    Yes, dizziness can be a symptom of menopause but it's important to make sure there isn't another cause. Your GP can advise you on this.

    Please let us know how you get on; or for any more advice on menopause please write to us.

    Best wishes

    Diane Porterfield Bourne.

  • Mary78Mary78 Posts: 30 ✭✭

    Thank you Diane for your advice, I just got a SAD light. Waiting for it to be delivered now! I don't really have mood swings (yet haha) but I noticed I tend to get snappy for no reason. Is this also related? I also have headaches but not sure if that's a symptom either.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Mary78

    Good morning Mary. Let us know how you get on with your light. You can put being "snappy" down to many reasons, I suppose its if its related to your hormones, you think it's menopause or are you feeling low generally due to the season/covid etc?

    Headaches- there are many reasons, if they are intense or prolonged you must discuss them with your GP. It maybe menopause, your eye sight, your blood pressure, poor sleep/diet or other reasons.

    It's always best to chat to your GP and put your mind at rest.

    Please let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @Mary78

    I have had seasonal ups and downs before, I haven't heard of the SAD lamps. Let us know if you try them or not. I would like to know if they help or not. I don't experience a lot of mood swings but I am very impatient still working on it. When I feel there is something that I am not interested or I feel like someone is saying something stupid I just ignore it not a good thing to do but that is an area that I need to work on because I am very inpatient in a lot of areas LOL

  • I was diagnosed perimenopausal in May but was told by the female doctor she didn’t recommend I take any HRT due to my age and the risk of breast cancer (I’m 44. I will be 45 during Christmas week). I’ve had perimenopausal symptoms of periods growing closer together, hot flushes, night sweats and mood swings since I turned 40. I have had gaps in my periods of up to 5 months. None of these symptoms worry me and I cope well with them

    I can cope with the sweats and moods but my neck problem is debilitating and brings on strong anxiety and fear of dying (problems I have never suffered from. I’m the strong member of the family).

    my neck feels like I am being strangled constantly. My larynx feels swollen to me and regularly feels very painful (as though I have been punched int there throat). My throat is often dry too. My doctor originally suspected goitre (it isn’t) and then throat cancer. After ENT clinic and camera investigation I was told there is nothing wrong. My throat isn’t swollen and there are no lumps (despite it feeling like that to me when I touch it). She suspected reflux and I’m on omeprozole and gaviscon advance (no change in neck). Another doctor now is trying me on higher thyroid medication incase my thyroid needs a boost (blood test due before Christmas but I still feel no better after 3 months on new strength).

    Any advise would be great.

    I am a musical instrument teacher. I also teach singing which is impossible now. 

    I don’t drink, smoke, vape, eat fatty foods or red meat or chicken. I take sea buckthorn oil and multivitamins. I eat yogurt with dried fruit and grain/nuts to help with estrogen levels daily.

  • puppy3puppy3 Posts: 24 ✭✭

    Hi Diane, my legs have been really aching in the past weeks. I can't think what it could be - I haven't done any vigorous exercise or hurt myself or anything. Could it be hormonal?

  • puppy3puppy3 Posts: 24 ✭✭

    Sorry, I should add that sometimes it is in my arms too, but mainly legs, and the backs of my feet where the heels are

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Sara Swift-Stafford

    Hello sara, I can only apologise for not getting in touch sooner.

    Firstly about being young and risks associated with HRT...I would strongly suggest discussing this with other GP's who specialise in menopause/women's health at your GP surgery.

    Age is an important factor but if you are having symptoms this needs to be addressed. I frequently prescribe HRT to women in their early 40's.

    As for your neck swelling, reassurance is that your GP has investigated this and so far all is normal. Is isn't a strain to the mastoid/neck muscles is it?

    The fact it is impacting on your quality of life is significant so please ensure you get sorted or the discomfort you are experiencing can be improved.

    Please let us know what the problem is and how you have got on.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @puppy3

    Hello and thank you for contacting me on Live Better With.

    Aching legs are common during menopause and the most common reason I have found is Magnesium deficiency or in the lower range of normal. It might be worth reading more about magnesium supplements and seeing if you think its the cause?

    You may have strained muscles, or have other health problems; so your GP should be the first port of call.

    Please let us know how you get on with your GP and what they suggest to improve your symptoms.

    Best wishes

    Diane Porterfield Bourne.

  • KrisKris Posts: 3

    Hello, I almost 49 and 2 years ago I woke up with extreme thirst one morning, pretty bad dizziness, brain fog and a headache. I thought I was coming down with something because my throat was dry and I kept coughing but I never did get a cold. A month later the hot flushes started. I am not one to visit the doctor but that summer and fall I must have gone to 10 walk in clinics bc my own doctor totally dismissed my thirst issues. I went back later in the year and managed to get her to refer me to an internal specialist. I'm not diabetic or even close to it. My vasopressin levels were also fine. ENT also cleared me.The specialist couldn't figure it out, my family doctor had no clue, my first naturopath couldn't help and my current naturopath didn't hear about thirst problems either. I'm at a loss, after nearly 2 years I'm still thirsty and no one knows why! At my last dental checkup I was told I now have gum disease and pockets. I never had gum disease or any dental issues. Other than this of course I have a myriad of other symptoms like joint aches (again never had anything like this before), trigger finger, muscle spasms, electrical shock-like feeling in one leg from time to time, extremely tight hipflexers, carpal tunnel flare-ups, dryness and poor quality sleep. Luckily brain fog is gone. This has been going on for nearly 2 years and I'm sick of it, but most of all the dry mouth/ thirst is the worst. I tried omega 7 capsules and they barely do anything even at 4 capsules a day. How can I get rid of the thirst? I'm taking all kinds of supplements to try to manage all these symptoms but clearly they aren't working too well. I'm scared of the hrt side effects including a huge weight gain which happened to my grandma. Please tell me there is something I can take before this dry mouth ends up ruining my teeth and gums. If you have a suggestion for any of my other symptoms I'd welcome any input. I'm so over this and just want my body back. Thank you for reading my rant. Kris

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @Kris

    Hi Kris,

    Thank you for sharing with us and I am so sorry that you are experiencing all of thesesymptoms and that you haven’t found any relief or really what is causing it.

    Our professionals maybe able to give you more insight on what is going on.

    @Diane Porterfield-Bourne and @Giada Frontino

    I have found an article for you that you can take a look at and hopefully it will help.


  • KrisKris Posts: 3

    Hi, thanks for your note. How do I connect with the medical professionals on the site? Thanks for sending the article, I came across a couple of times. That's where I read about the omega 7.


    Thanks. Kris

  • MonicaMMonicaM Posts: 337 ✭✭✭


    @Kris

    Hi Kris,

    I am sure one of them will answer soon or you can go to the discussions and post the questions under ask an expert and they will get back to you

    I am glad the article helped some

  • KrisKris Posts: 3

    Thanks.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @Kris

    Thank you for giving more information about your health.

    Thirst isn't a symptom of menopause I have heard of but dry membranes in the nose, eyes and vagina is. However dental issues, gum problems are more prevalent during menopause.

    Lack of Oestrogen during menopause has many effects; it affects every women but all experience and deal with it differently. I can see you are concerned about side effects of HRT. For the majority of women there are very few side effects and side effects are often short lived. I prescribe HRT and advise most women side effects often pass within 6 weeks. Weight gain is related more to being menopausal rather than HRT.

    I would suggest talking to your GP about menopause and HRT or getting information from the British Menopause Society and understanding how HRT works and why many women take it.

    I hope this helps.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 431 Menopause Nurse Practitioner

    @MonicaM Thank you for posting this information for Kris. There are many resources on here! I'm sure they will help.


    Best wishes

    Diane Porterfield Bourne.

  • Giada FrontinoGiada Frontino Posts: 73 Consultant Gynaecologist
    edited March 21

    Dear @Kris

    I'm very sorry to hear about your struggles. I do feel all your symptoms and your wellbeing benefit from trying a low dose HRT patch. Please discuss this with your GP and let us know your thoughts and how you do.


    Best wishes,

    Giada Frontino

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

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