I have alot of questions as to the use of hormones in peri and/or meno. After visiting my gyno with
a litany of symptoms, dizziness, anxiety, depression, fatigue, PMS, she suggested that at the age of
47, I go on BCPs for the first time in my life. She said they provide a smooth transition into menopause
(her words). I have read numerous posts from women who have taken BCPs for years. There are those
who went off them and were thrown into hell. I understand this as the steady dose of hormones was withdrawn. However, there are other women who are on BCPs, who are still taking them, yet
are experiencing symptoms as they enter this period of life.

Question - Why would this happen if a woman remains on the pill? Do her receptors become less sensitive
to the hormone or something like that?


Also- I have read alot of women say they want to avoid all hormones, synthetic or natural, as it is just
"postponing the inevitable". Is that true?

For example, if you take any kind of hormone therapy and it works for your symptoms to the degree that you go through meno without "knowing it" so to speak, why would you have symptoms if you went off the hormones once you were clearly menopausal -(your FSH is elevated to menopause).

Must your body go through an adjustment period (i.e. reduction of estrogen receptors) no matter what at some time? Does this apply if you use the smaller doses of NHRT? Are there any women who have
used NHRT for peri symptoms, gotten relief, then discontinued when they were clearly in meno?

What about those who took BCP in peri?

Any responses much appreciated. I

HIya Idge

At the moment (after a year in hell before I understood what was happening to me) I see menopause as a natural process - my body knows what it is doing - I am giving it the tools to rebalance itself.

For me - I do believe that artificial hormones of whatever kind are postponing the inevitable - but I also think this is an individual decision - my issue is that women do not have the information to make these decisions at a time in their lives when they are dealing with uberemotions and insomnia and all this horrid body crud - how can I make really rational long term decsions now - I dont even know what I want to feel like - I cant even remember normal???

This is the kind of thing we need to plan from puberty onwards - how do we want to manage our reproductive lives - if we need to manage them that is......all this is now kneejerk at my Drs surgery - get blood test result - OMG you need HRT - OMG your tests are normal - OMG you dont need HRT....I mean.......this is no way to manage a transition - blimey if I had done project plans like that at work I woudl have been sacked.

Begin with the end in mind they say - well I think all hormones therapy throughout our lives whenever it is should be part of a longer term plan - as far as I can see this does not happen

Hey ho - all I can say is body be quick about it!!!

Mele

Hi there Lidge!

I can answer some on your questions on long-term BCP use and my experience with peri/meno symptoms.
I've been on bcps since 20; I'm now 52, so thats 32 years. Most of that time its been a low dose bcp (35mg estrogen steady all month, with progesterone progressively going up).

Peri: At around 37 I began having very sporadic, mildly moist night sweats & mild digestive problems
At around 40, night sweats became cyclical and more frequent. I would awaken with wet clothing, which I had to change to dry clothing. (Not so bad that sheets were wet.)
At around 40 I began having pre and post period migraines that were lessened with asprin, but not stopped.
At 45 I began having serious insomnia, requiring melatonin or valarian root nightly.
At 47, I began having terrible flatulence, and frequent digestive problems; pronounced ringing in ears.
At 48, had my first UTI in my life time; raising heart periods.
At 50, my joints began to ache constantly, my muscles became smooth despite hard heavy weight workouts; my weight began to creep up a few pounds; intestinal bloat became more common; urge incontinence became a HUGE problem; lost my libido, severe dry eye.
At 51, More joint pain, overwheming fatigue, suicidal depression, major intestinal disruption (diarrhea, intestinal cramping, bloating, food allergies galore, dry vagina, mild hair thinning. (Went of the pill for 2 months and experienced 2 mild warm flushes...got back on pill PRONTO!
Now 52, Gyno says I should come off bcp and go to HRT. My symptoms continue same as age 51.

So you see, Lidge, I didn't avoid all peri/meno symptoms just by being on lo-dose bcp pill. I admit that I have had no hot flashes, though. Maybe the avoidance of hot flashes is what they mean by smooth transition.

The reason I think I have peri/meno problems even though I've been on the pill is because [from what I've read/research] the bcp is administered at a high enough dosage to REPRESS the body's production of estrogen/progesterone so that the body thinks it is pregnant. This dosage is usually 3 (or more) times stronger than what is need/used in hormone supplementation, after the body moves into peri/meno. So, even though I am on a steady of dose of bcp hormones, my own hormonal levels are rising and falling and that is affecting the amount of hormones in my body at any given time. Confused yet?

In other words, my base line level of hormones is changing (as my symptoms indicate). So the added hormones I'm taking in from the bcps will be erratic too. In 20s and early 30s my hormones were steady, so the bcp's affect was steady. Now, I am low in progesterone and using Pro-gest with some minor relief.
I am also exhibiting physical symptoms of low estrogen. You would think that a steady of dose of hormones from bcps would keep everything steady, but I believe that my problem is HORMONAL BALANCE, or the LAC of it. What I'm saying is, EVEN ON THE PILL, you can experience being estrogen dominant.

I believe I am estrogen dominant and that is why the pill is not able to control my many symptoms. That's why I've come to believe that I should go on bioidenticals and get off the pill. Just getting a steady dose of hormones from the pill will not balance out your hormones if one is dominant and the other is completely depleted (progesterone).

My MAJOR frustration right now is that there is little information for women who have beenon the pill for their entire adulthood. We don't know whether to treat our symptoms as women who are in peri-meno or full meno. I downright PERTIFIED to go off the pill and find myself in WORSE shape than I am already.
I don't know what to expect, whether I will fall apart, or when I can expect everything to fall apart. I merely coping with life right now. I'm scared that when I go off the pill, I won't even be able to cope anymore!

I don't know the answers to your other questions. I'm especially curious about the "postponing the inevitable" question. Hey, here's a thought: With the way I feel today, if I can postpone worse symptoms long enough, maybe they won't happen until after I'm dead!!! I'm all for postponing!

Gosh, Lidge, I just want to feel better! Oh and don't let anyone tell you that exercise will automatically make you feel better. While it HELPS, I have been an athlete ALL my adult life, and continue every day to weight train and do elliptical (45-1hr). I remain suicidally depressed and [sometimes] overwelmingly fatigued. But, it I don't work out, I feel worse. I think getting those fews endorphins must help a tiny bit.

Take care,
Urcyn

Lidge,

This is only anecdotal, and therefore, not real proof one way or the other. But a few years ago, my FIL passed away and my MIL came to live with us. She was 84 at the time. She lived with us for a couple years and during that time, I would pick up her meds from the pharmacy. She took a lot of different meds, for one thing or the other, but the most unusual thing to me was that at the age of 84 she was still taking Premarin.

I was really puzzled by that and asked her to check with her doctor, and see why she was taking hormones at her age. She informed me she didn't need to ask her doctor, because she knew the reason she took them. She said everytime she went off the Premarin, she had hot flashes, and hated them, so she chose to stay on the Premarin, and was on it till the day she died (actually she entered hospice about a month before she died and they did take her off Premarin, and were as amazed as I that she was still on it.)

Whether she was "really" experieincing hot flashes, or just psychologically "addicted" to it, and thought she was having hot flashes when the Premarin was withdrawn really doesn't matter, I guess. The fact that her doctor was still willing to prescribe it to a woman her age is still a puzzlement to me (btw, she started on it when she had a hysterectomy in her mid 40's and had been on it all those years...and her health was pretty good, so I don't think it "hurt" her health by taking it.)

Thanks for the posts-

Dawn - While anecdotal, your story is informative. I wouldn't mind living and dying like your MIL!
I think the pendulum swings too far one way or another from era to era. Once the pill was put out,
it was a money maker, convenient and gave women relief and contraception. The health effects were not of concern and women could stay on it forever. Then, as studies were done and it was found that
estrogen could cause problems for some re cancer, etc. the pendulum swung all the way back -
take away the hormones so we doctors won't be sued if you get breast cancer. We are all products of the time we live in. Thanks for the story.

Urcyn-

Thanks for touching on some of the points. I was under the misconception that bcp "turned off" your
hormones and "replaced" them with the "nice steady dose" in the pill. If in fact, it doesn't "turn off"
our hormones" but merely adds more hormones on top of what you already have, it would be
useless for women in peri as a major problem is the fluctuations. I am still confused as you use
the word "repressed". If your hormones are repressed, how would the fluctuations matter? If your body thinks its pregnant, wouldn't your own baseline be irrelevant. So confusing.

I need to do some more research -this seems like a fairly simple question to answer, why is it so hard to find this addressed? Did you ever question your gyno about this subject? The devil really is in the details here. It matters big time. I can understand your frustration - who wants to voluntarily go back to hell?

One of the reasons I'm doing this monthlong test is to get a snapshot or as you say "baseline" of what
my body is doing now. How can anyone make a decision without knowing your hormonal status -
even if it does fluctuate, you can get some idea. This might be something you want to do, however, not sure if it tells you anything if you are on BCPs. I'm looking at the sheet that came with test and it asks,
have you used bcp in last 12 months? Also asks, about any other hormones in past 3 months.
Maybe call Pete at Bellevue Pharamacy (he's on this site) and ask him whether you need to go off BCP to do test.

Urcyn, my doctor is insisting on this month-long misery test, but others I sw tell me that bioidenticals can be prescribed just by symptoms.

About postponing the inevitable, I guess I'll have to research that more too. I have a young son and if I can postpone this 10 years till he is a young man, that would be better than him living with this shell of a mom.
For those with responsibility for others, I don't see too many options.

Thanks for trying to answer my post "on point'. I really appreciate it.

Mele-

As always, appreciate your input. Yes, I agree, we need information. Without it, we are just blind pigs
hoping to stumble on that acorn.

Also curious about your belief that hormones 'postpone the inevitable"

That is a question I would like someone to explain with facts. I believed that meno was a few hot flashes and night sweats. I listened to the wisdom of my body my whole life -never took birth control, hormones etc. Now at this stage of life, the wisdom of my body has brought me a year of nonstop misery. I'm a mother. This is just too destablizing to merely wait out.

Is there a physiological reason that our bodies would have symptoms if one was on hormones through the transition and then came off? Must we have our estrogen receptors decrease or something like that? Is there a doctor in the house?

[quote name='lidge26' date='Jun 18 2006, 12:33 PM' post='128390']

useless for women in peri as a major problem is the fluctuations. I am still confused as you use
the word "repressed". If your hormones are repressed, how would the fluctuations matter? If your body thinks its pregnant, wouldn't your own baseline be irrelevant. So confusing.>

Lidge, everything I've read states that bcps "repress" your hormone production. To be literal, repress is defined in the dictionary as "to check or restrain an action...". BCPs don't turn off your hormones. They fool the body into thinking it is pregnant, and you know that pregnancy can't occur without PLENTY of hormonal activity. That's why some women have so many problems when they are on the pill, and quickly come off of it. Thank God, my body could adjust to it!

Now, I believe our hormones begin to fluctuate despite being on bcps because Mother Nature is a fierce adversary to man-made synthetic hormones, i.e., at a certain age, the body attempts to begin its transition to menopause despite taking synthetic hormones.



Girrrrlll, don't get me started on my gyno! Grrrr! I can now see that he is NOT the fine doctor that I thought he was all these years. So many of his past actions are clearly negligent now that I've done so much research on my own! Despite symptoms of peri over the years, that I complained to him about, he never even brought of the subject that I might be in peri or nearing meno! The first UTI, the constant vaginal burning, w/o having an infection; dry vagina, repeated infections. One year, I asked him if the dry vagina during sex could be the start of menopause! I was 49, I think and he told me I was too young to be in menopause!!!!! The bastard!!!!! If he had dealt with the issue at 49 yrs old, maybe I could have avoided the worseing and increasing of my symtoms during 48-52 years old! The only reason he brought up HRT last Oct [during my annual exam] was becaue of my biological age...not my symptoms over the years! MOST SUSPECT is that a couple of years ago, he gave me a big sample pack of a new line of natural products he was marketing for women with PMS and Meno symptoms. He wanted me to see if I could get the company I was doing some educational TV shows with to feature his products. Can you believe the nerve? I tried the products by they did nothing for me. Now more educated, I can see why. None of them had any USP ingredients in them!

Recently, I called his office and asked if he prescribed bioidenticals. I didn't want to waste my $150 for office visit if he didn't. The receptionist didn't even know what the hell I was talking about! I waited all day for his return call, which finally came at 8:00pm that night. He said he didn't approve of them because there was no proof that bios were any more safe than synethtic HRT. So, come October [time for annual] I will NOT be going back to him. I've found a woman dr. who specializes in meno. She's on vacation right now, but I will make sure she prescribes bios before keeping my appointment. I'm determined to try bios first. If they don't work, then I'll consider synthetic.

Maybe call Pete at Bellevue Pharamacy (he's on this site) and ask him whether you need to go off BCP to do test. I have spoken to Paul at Bellevue (last week). A saliva test would not produce accurate results for me without going off bcps for TWO MONTHS! Aiiiiiggggghhhhh! I do not want to do that, and he didn't recommend that. He said the other option is to make an educated, informed recommendation based on how much synthetic hormone I'm on now and what my symptoms are, then that dose a shot. While this seemed like "hit or miss" to me, thats what all of us have to do to fine tune our treatments whether we get tests or not, isn't it? Then you have to test in 3 months, even if you started with a saliva test! Right? Gosh I just seem expensive medicine and tests in my life forever!

About postponing the inevitable, I guess I'll have to research that more too. I have a young son and if I can postpone this 10 years till he is a young man, that would be better than him living with this shell of a mom.
For those with responsibility for others, I don't see too many options.

Lidge, you wonderful, brave women who are going through peri/meno with young children are truly warrior goddesses! I have great sympathy and admiration for all of you. I say do what you have to do to get through it.

Thanks for trying to answer my post "on point'. I really appreciate it. [i]I may err on the side of giving too much information sometimes, but I appreciate it when people give specific answers to my specific questions. It helps me understand so much better!

Take care,
Urcyn