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Ask a Menopause Nurse | Diane Porterfield-Bourne

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  • Djdros52Djdros52 Posts: 29 ✭✭

    Hi @Diane Porterfield-Bourne

    I have a question that may or may not be menopause related. Lately I have been bothered with hemorrhoids. I am never constapated because I eat plenty of fiber in my diet but yet I get flare ups. Swelling pain and itching. I've tried preparation H, tucks pads. I seem to get it worst after intercourse even using a lubricant. Is there anything else that might help. The hemroids don't bleed but very swollen and painful. I don't want to have to have surgery to remove them. Any advice will be very helpful.

    Djdros52

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Djdros52 Thank you for contacting us. I'm sorry to hear about your haemorrhoids. They can be problematic and often reoccur. If you can't identify the reason and over the counter treatments aren't working you could discuss this with a pharmacist. They may advice other over the counter treatments but do always take to your family doctor. Your doctor can examine them, make sure they are OK and may prescribe more medication. If they worsen after sexual intercourse I would advise talking to your doctor about this.

    I really on advise on menopause but your GP can help you with this.

    Hope they can help you.

    Best wishes

    Diane Porterfield Bourne.

  • Hi

    this may be a silly question... however I have been prescribed Evorel Sequi. My anxiety has been terrible lately along with a whole host of other symptoms that I got to the point that I definitely needed to give HRT a go and see if it will improve. I’m so desperate to get started but it says I need to start it within 5 days of bleeding if you still have a regular period. I’m on day 6 and already had a meltdown that I may now have to wait. Will it make a difference if I’m a day over the recommended starting point.

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @Lesley-Anne Lupton

    Hi Lesley,

    Thank you for posting in our group.

    I am going to tag our nurse expert @Diane Porterfield-Bourne and the GYN @Giada Frontino to help speak to you about what you are experiencing.

  • Djdros52Djdros52 Posts: 29 ✭✭

    @ Diane porterfield-Bourne,

    Thanks for the response and advice, I really appreciate it. I am going to see what my GP says and I will give an update soon as I get a chance.

    Djdros52

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner
    edited March 28

    @Djdros52

    Thank you @Monica for tagging me in.

    Good morning.

    Thank you for posting. Have you spoken to your GP yet?

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Lesley-Anne Lupton

    Thank you for tagging me in @MonicaM.

    Anxiety can be really significant during the menopause and HRT can make a huge difference.

    I'm not able to comment or advice on taking prescribed medications differently to how you have been prescribed/advised....but do talk to your pharmacist or contact your GP/family doctor for clarification. If they say its's OK to take then you will know.

    Please let us know what they say.


    Best wishes

    Diane Porterfield Bourne.

  • Giada FrontinoGiada Frontino Posts: 73 Consultant Gynaecologist

    Dear @Lesley-Anne Lupton

    You can start later but this might cause some spotting this month, which should not worry you.

    With regards to the anxiety, have you asked your GP to test your vitamin D? Low levels of vitamin D can often cause anxiety and mood disorders.

    Kind regards,

    Giada Frontino

    GMC Full Specialist Registration # 7468911 

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

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Lesley-Anne Lupton

    This is excellent advise from @Giada Frontino. Many people are low in Vitamin D and lots of people have anxiety. With the warmer days and getting outside more will help lift all our moods and increase Vitamin D but many people need to get it checked with their GP.


    We hope all goes well.

    Best wishes

    Diane Porterfield Bourne.

  • PAULA MILHAMPAULA MILHAM Posts: 2

    Good afternoon. I have just joined this site. I have been on HRT Femoston 1/10 since November and after one month of taking started experiencing increase in reflux and excess phlegm. Feel like constant lump in throat. Have tried all the usual nasal sprays, antibiotics etc but nothing works. Could the HRT/menopause be causing this. Off and on during the day I feel nauseous. Feel low mood and lack energy. Seriously thinking of putting up with the symptoms rather than taking the tablets. GP says experiencing possible post nasal drip but it just continues. This surely has nothing to do with low moods etc.

    Would appreciate some advice please.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @PAULA MILHAM

    Hello Paula and thank you for writing into Live Better With Menopause. Acid reflux can occur in anyone but often when you have higher levels of Oestrogen; when you are pregnant and start HRT. It relaxes the muscle at the top of the stomach and acid can move up the food tube more easily.

    With tablet HRT, it is advisable to take it with food and see if this improves. Like all side effects they should last a max of 3 month but if you have concerns do talk to your GP.

    I'm not sure if the post nasal drip is related or if its related to the acid reflux too. Your GP can advice you on this.

    It is early days and everyone responds differently to HRT, some women notice improvements in a week, others 6 weeks..It does sound that your side effects are significant so I would advice chatting to your GP.

    Dose of 1mg is low but often a good place to start as you can always increase the dose or talk to your GP about the route, from tablet to patch/gel and possibly increasing the dose? But it is early days. Low mood, and tiredness are common signs of low Oestrogen but of course can be many things too.

    Good luck talking to your GP and let us know how it goes.

    Best wishes

    Diane Porterfield Bourne.

  • Sam woodsSam woods Posts: 1

    Hi Diane I have a high BMI of 38 and want to go on hrt. I’ve gained weight since the menopause and I am struggling to shift it. I do 3 hour long HIiT training each week and walk with my dog. I also eat quite healthily. Will I be able too or not. My symptoms are really getting me down. Thank you

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Sam woods

    Hi Sam, thank you for getting in touch. Weight gain during the menopause is really common; believe me you are not a lone. We all know being over weight can affect our health in many ways. When I consult with women about weight I always ask about the types of food they eat. Many women consider fruit healthy and of course it is but it also contains lots of sugar which makes us put weight on. Also watching the amount of carbs- bread, rice, pasta, cakes, sweets, potatoes we eat are important. There maybe hidden sugars in drinks- soft drinks and in teas/coffees too. Reducing the amount we eat by half and bulking more on vegetables rather than fruit can help. Your GP should advise you too.

    For your menopause symptoms; have you discussed them with your GP? Is HRT something you'd like to know more about? I prescribe HRT every day and understand how it work in the body. It is safe and effective for most women. It's about assessing the risks and benefits with your GP.

    Feeling low is common during menopause but when we put weight on it makes this worse.

    @Blanka_C can you help Sam with information on the site?

    Keep in touch with us.

    Best wishes

    Diane Porterfield Bourne.

  • MonicaMMonicaM Posts: 337 ✭✭✭

    @Sam woods

    I totally understand how feel you keep gaining weight after you try to eat healthy. I have tried for many years to loose weight since I have been post menopausal and it is quit the challenge. I agree with @Diane Porterfield-Bourne for me lowering my carbs and sugar has helped me a lot but it isn't easy because I still have cravings for sugar and sweets sometimes but I try to fight it but if I can't I eat it and then I make sure I drink plenty of water and then I try again the next day to try to eat only what I need to eat. Eating veggies, salads and proteins and walking has helped me. It is a struggle daily because I really want carbs and sweets but I know at my age I can't eat them like I used it. It really sucks but this gut of mine is telling me Monica please stop eating it so I won't keep getting so big LOL.

    I feel menopause fights you in your own body things you used to do and eat you just can't do anymore and I get mad about it sometimes with all of the issues that menopause can bring but I try to fight through it even thought it is very difficult at times.

    Good luck and I hope you are able to loose the weight that you want to loose.

  • JuehalfabrewJuehalfabrew Posts: 1

    I am 51 very shortly and i have been experiencing migraines for the past 2 years, not had a period for 17 weeks and now these migraines totally wipe me out for a day and a half every time. Absolutely blinding, i can take pain but not this it's unbearable. Please can you recommend something that will help relieve my symptoms. My doctor has not been very good in helping me, just told me to go to chemist and get Migraleve which made me feel very strange and i nearly fainted. Also getting hot sweats not sure how to cope with them. Please help

  • fizzy1967fizzy1967 Posts: 4

    Hi Diane - I started per-menopause when I was 40 (I think!) and then full on menopause just after I turned 50. The main difference was the full on hot flushes and worsened insomnia, as opposed to intermittent insomnia and night sweats. I started taking red clover and black cohosh root as natural supplements and they seemed to start working really effectively after about 2 weeks. However, I forgot to take them on holiday with me and within another fortnight was back to the old symptoms. Since then their effectiveness has been intermittent. I'm currently taking red clover, omega 7 Buckthorn and black cohosh - I'm not getting many hot flushes in the day but oh boy, on a night time I'm literally laying there having one constant hot flush! I have tried to manage my insomnia by doing Sleepstation, which I would say has improved my sleep by 20% - albeit far from perfect or what I'd like it to be (and it was a really touch programme). My question is - should I persist with the supplements I'm taking - even though they're not really that effective, or should I change and try something different. My fear is that my symptoms will get much worse if I try a change?

    Thanks, Fiona

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Juehalfabrew

    Thank you for posting and I'm really sorry to hear you are struggling....

    Migraines are very problematic. But we know in the menopause they can worsen. Have you noticed this?

    Have you spoken to your GP about this as you need to dismiss other causes like high blood pressure.

    You are experiencing other menopausal symptoms too, so you could discuss menopause and HRT with your GP. By replacing the hormones and calming the fluctuations can make a big difference.

    Addressing lifestyle- sleep, diet, exercise, drinking plenty of water and relaxing can really help. But knowing your triggers is key.

    Dehydration, heat, certain foods are my triggers but sometimes we just don't know.

    Replacing your hormones can certainly help so worth a conversation with your GP.

    Please keep us posted.

    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @fizzy1967

    Thank you for your post. I can see that you have tried a lot of over the counter herbal supplements but there is little evidence on their effectiveness.

    Loosing weight, reducing alcohol, healthy lifestyles can make a big difference to your menopause symptoms but also reducing stress and having a positive mental attitude help too.

    I'm a nurse practitioner who specialises in menopause and prescribes HRT, so I am an advocate of HRT.

    HRT not only relieves the symptoms of menopause but improves our long term health. Primarily our hearts, bones and there are good links that it helps prevent against Altzeimers too.

    I prescribe it several times each day, educate the NHS on it and take it myself. It's not what everyone wants to do but its worth doing your own reading around it and if it is something you'd like to know more on you can ask us but also talk to your GP.

    We all know sleep deprivation can impact our quality of life.

    Good luck and keep us posted on what happens etc.

    Best wishes

    Diane Porterfield Bourne.

  • fizzy1967fizzy1967 Posts: 4

    Hi Diane

    thanks for your response to my previous question. I watched the Davina MacCall programme the other night and am now thinking that HRT patches are the answer. However, my previous experience of visiting the GP and asking about it was that I as told there as a shortage of HRT and I was prescribed blood pressure tablets to try and regulate the hot flushes. I did not take them. I’ve also previously been prescribed anti depressants which I also decided not to take. Instead I’ve struggled on for 3 years spending a fortune on over the counter treatments. It’s frustrating. I did go on a diet and lost 2 stone and have managed to maintain that. However, I’ve been getting some symptoms that suggest I might have a thyroid issue which I’m going to get checked. I realised that some of the symptoms I thought were to do with menopause could be thyroid.

    thanks Fiona

  • CassidyCassidy Posts: 1

    Good morning i luckily havnt had a period forn3 years i did try some patches which caused bleeding and made all my symptoms worse i felt as bad as i did with severe pms.I ferl great on the estogen weeks then awful on progestorone and im scared to try anything else as it takes weeks to feel ok.What would you prescribe? I have nightsweats itchy skin anger very low self esteem terrible constipationand indegestion tiredness


    kind regards

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @fizzy1967

    Thank you for writing in and I can sense your frustration!

    Have you asked if there is a GP within your practice that specialises in women's health?

    That would be my first suggestion and see how you get on?

    Please let us know how you get on.

    Best wishes

    Diane Porterfield Bourne.

  • fizzy1967fizzy1967 Posts: 4

    Hi Diana

    they don’t have someone in the practise who specialises in women’s health but I did an eConsult last week and they have asked me to go in for blood tests and then a phone consultation with a Dr. I’m also going to ask them to check my blood pressure while I’m there. Hopefully I will start to get somewhere with it. Thanks for your comments and responses.

    best wishes, Fiona

  • Blanka_CBlanka_C Posts: 406 Community Admin

    Hi @Cassidy, thank you for your question! I'm going to tag @DianePorterfield-Bourne again in this discussion so she'll be able to see & advise further!

    Diane - please see Cassidy's question about HRT & symptoms above. :)

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @fizzy1967

    Thank you for updating us.

    Are they going to discuss HRT and menopause with you?

    Are the blood tests for menopause?

    I'm glad you've spoken to your GP and they will look into this for you.

    Do you have a home blood pressure monitor? I advise most women to buy one as it's always good to have at home!

    Let us know how you get on and please keep in touch.


    Best wishes

    Diane Porterfield Bourne.

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Cassidy

    Thank you @Blanka_C for your tag.

    Thank you for telling us how you've been feeling. I can say you aren't alone with these feelings. More often than not it is the Progesterone that causes these feelings of bloating and just feeling low...

    The itchy skin and night sweats etc are due to low Oestrogen. How long did you use the patches for? Did your GP review your symptoms and discuss this with you?

    If you would be interested in HRT I would suggest asking for a different type of Progesterone; rather than the one in the patch and see if this makes you feel better.

    Sometimes it's about tweaking HRT to get it right for you; rather than stopping.

    I read about HRT most days and I present to the NHS on menopause and how to treat it. Many women feel their symptoms are affecting their quality of life too. However with the right specialist support, advice and HRT many feel much better.

    Is it worth another conversation with your GP?

    Please let us know how you get on.

  • Dcaputo35Dcaputo35 Posts: 1

    I am 43, just had a mirena removed after 18 consecutive years of use(3 placements). I haven't gotten a period. I feel wacky. Headaches, mood swings, fatigue, hot flashes, and depression. Is it likely that I am in menopause? Is there anything I can do to feel better?

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @Dcaputo35

    Hello and thank you for getting in touch.

    The coil is very good. It does what it says it's going to do: No periods, great contraception, lasts years and it can be used as part as HRT. It gives us progesterone but it seems you are experiencing symptoms low Oestrogen. This is what happens when our ovaries produce less hormones.

    You are only young and it's vital you get an appointment with your doctor and discuss your symptoms.

    Are you in the US? Management of your symptoms might be different but you need to find the cause. Your doctor should do blood tests to see what else is going on; or likely cause anyway.

    Hormone therapy is really the best course of action but your doctor will talk to you about this and why it is important.

    Menopause symptoms are miserable, some women have loads others very few but getting the right professional advice is vital.

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

    Best wishes

    Diane Porterfield Bourne.

  • fizzy1967fizzy1967 Posts: 4

    Hi Diane - in answer to your previous questions - the blood tests are to check things like my thyroid firstly and I’m hoping they are going to check my hormone levels too with a view to getting HRT. I will be asking for that certainly. I’m also going to ask them to check my blood pressure. Can you buy menopause testing kits I’ve the counter and would you say they are accurate? I’ve heard that because our hormone levels fluctuate, you have to be tested regularly to get a good idea of what your hormone levels are. My GP has always put me off that for some reason?

    im going to discuss the HRT options with the GP after the blood test results via a telephone consultation. They are not doing face to face at the moment.

    thanks you, Fiona

  • MenopauseorjustmeMenopauseorjustme Posts: 433 Menopause Nurse Practitioner

    @fizzy1967

    Thank you for your message.

    It's worth your GP checking other things such as your thyroid to exclude other reasons for your symptoms but blood tests checking for your menopause hormones aren't very accurate and for many women are not needed. If you are younger than 45, they may be of benefit. But if you are older than 45 they are not required.

    Blood tests for hormone levels bought over the counter aren't something I advise.

    It's best to chat to your GP about your symptoms and see what they advise and prescribe for you.

    Best wishes

    Diane Porterfield Bourne.

  • JM1JM1 Posts: 1

    Hello . My sister is 55 and has been prescribed HRT for extreme depression and anxiety associated with the menopause. But, it doesn't seem to have helped and she still has days when she cuts herself off and withdraws as she feel she isn't coping. Should this be happening if she is on HRT ?

    Thank you

    Jane

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