Diaries from a peri-menopausal nutritionist: Taking HRT
Hello and welcome, my name is Jo Leccacorvi and I’m a Registered Nutritional Therapist. I’m 44 (soon to be 45), I’m perimenopausal and I have started this blog to share my personal experience with the aim to help others who unsure if they are perimenopausal and those who know they are but are not sure what to do. This is my second update, if you would like to read the first, please click here to have a read.
Why I started taking HRT
I always thought taking HRT was a ‘bad’ thing. If I’m being honest, I’m not actually sure where I got this idea from, maybe it was from seeing headlines from a younger age about the risks associated with taking HRT. I was actually very ignorant about it and was completely unaware about the different types of HRT that are available. However, after Davina McCall made her first documentary, I started to look into it and realised the many benefits it can do for women’s health and the scary cancer risks associated with taking HRT aren’t that scary and the risks are quite small due to how HRT is now made and how it is prescribed.
As a Registered Nutritional Therapist, I genuinely believe and have seen with my own health and working with my clients how lifestyle changes around your everyday diet can have a positive impact on your health symptoms. In terms of making changes to my lifestyle to help with my perimenopause symptoms, there was not much to change. I honestly do practice what I preach and my everyday diet is pretty good, I exercise regularly (I love running and Pilates), I see a therapist every two weeks to help me manage my anxiety and support my mental health and have focused on improving my sleep hygiene to stop my regular 3am wake ups.
As there was not much scope to improve on what I was already doing I decided that HRT would be right for me. Having looked at the various options I decided to opt for body identical HRT as I felt this would give me the most benefit and relief from my symptoms. Particularly the heavy periods as this was getting me down and having a big impact on my life and I didn’t think supplements were going to improve my heavy periods.
What happened after I started taking HRT
Having heard from other women that taking HRT was life changing for them, I was expecting big things when I started to take it! However, I am going to be completely honest and say this was not the case for me. My improvements were gradual and not all of my symptoms have been relieved by HRT and some still persist.
The first symptom that was dramatically improved was my sleep, after taking the HRT I slept through the night and did not wake up at 3am for the first time in about three years. I put this down to taking progesterone as low progesterone can linked to poor sleep and I suspected my progesterone was low due to my terrible sleep and heavy periods. I also noticed after three months of taking HRT my night sweats and body odour were much better. Another thing I realised that had improved was my red flushed face, I no longer looked like I’d had too much sherry at Christmas time.
Sadly, the progesterone HRT made no difference to my heavy periods and in fact they got worse and was getting blood clots that were the size of a golf ball. The pain in my breasts increased, I felt like I was breast feeding again as they felt so full, heavy, and painful like they do when your baby is due a feed. My mood swings didn’t change, I was still on that emotional rollercoaster and the rage was out of this world! There was no improvement to my poor memory, I couldn’t remember names of food, kept forgetting dates, double-booking events, and sending my son to school in school uniform on PE day. I found this really distressing I just felt so unorganised and if you know me, I’m an organised person. This had an impact on my mood swings as I’d have an emotional reaction when I realised, yet again, I’d forgotten another date. It also had an impact on my mental health as it amplified the negative voice in my head telling me I’m not good enough.
The most concerning issues for me were the increased breast pain, passing large golf ball sized clots, spotting between periods and not being able to take a break from the progesterone due to the length of my cycle. I was advised by my GP to take the progesterone from 1 day of my cycle to day 25. However, my cycle was varying form 21/24 days, so I wasn’t making it to day 25 and was therefore taking the progesterone continuously. There was also a new symptom that had developed, I had zero sex drive. I just didn’t (and still don’t) fancy having sex, I’m shattered, and the painful boobs make me feel like I don’t want to be touched.
Follow up appointment
If you read my previous post will know about my experience with my GP, it was not positive and an unpleasant experience. Therefore, the prospect of a follow up appointment with the same GP triggered my anxiety and I was very worried about it. I did try to make an appointment with another GP but there wasn’t one available, so I had to see the same doctor. I did my usual and prepared for the appointment by making a note of the things I wanted to discuss and tried to mentally prepare myself for another battle. I was so anxious that my husband actually came with me and sat and in the waiting room. However, I’m really pleased to say that the follow up appointment was a completely different experience and the GP sat and listened to me rather than talking over me, her tone was kinder, and she was more supportive. She could see I had my notes and made sure I had discussed all the points with her. She listened to me, made notes, and asked further questions about my concerns.
My GP recommended I take the progesterone for 14 days and said the easiest way to remember this was to take it for 14 days from the 1st of every month. She agreed with me that it was a good idea to change my oestrogen from tablet form to gel. The GP also arranged for me to have blood tests as fatigue and poor memory can be associated with other health problems and she wanted to rule these out. The GP also referred me the community gynae so that I can discuss my symptoms with a menopause trained doctor as she felt my remaining symptoms should have improved with the HRT.
So overall, I feel I’m in a better place with my symptoms compared to where I was earlier this year before I started taking HRT. My sleep has improved, and this has had a dramatic improvement on my day-to-day life and mental health. However, I do still feel tired after a decent night of sleep. Since taking the progesterone for 14 days I’ve started to notice an improvement to my heavy periods, they still aren’t there yet but they are moving in the right direction. I would say if you are considering taking HRT to do your research before you see your GP and have your notes ready and also manage your expectations. It is not going to magically relieve your symptoms overnight and it can take three to six months for your symptoms to settle once you have started taking HRT. So just be aware of this if you do start to take it.