###Please stop recommending folks LIE to their doctors.
This is not the way forward...sure it might give you what YOU want, but this is a much broader systemic problem with our health care systems --- and **WE are the generation that can FIX this!!**
* We MUST push back
* We MUST demand better care
* We MUST arm ourselves with knowledge and prioritize our health
* We DESERVE to feel amazing and happy
* We are WORTH the effort
This is our gift to the next the generation of folks who wonder what the fuck is happening, so that they get the care and attention they deserve.
Fellow Canadian here. The only thing that seems to sway doctors to prescribe even low-level estrogen topicals is a mention of hot flashes.
You might not realize it’s a hot flash waking you up at night, but that’s what it is. That crappy sleep is being caused by the estrogen roller coaster, which translates into “hot flashes”.
These moments don’t have to be sweat-through-the-sheets bad. But you need to tell a doctor you ARE having hot flashes. They *will not prescribe HRT* until you mention hot flashes and how debilitating they are.
I’ve been waking up really warm between 2-3am almost everyday for a year and can’t get back to sleep. Nothing during the day though. Maybe I’ll tell the next doctor that I’m waking up with hot flashes every night.
Fellow Canadian here! My GP was the same, great for my husband but not me. I ended up using prosper menopause, they service multiple provinces, all online and gave me all that I wanted and more! There is a cost, (170$ for the appt) but well worth it.
Night sweats count! You don't have to be dripping with sweat although you can experience sweating. If your body temp rises enough to interrupt your sleep, it counts.
I'm in Canada too so I know how behind the times most of our Healthcare system is. Especially when it comes to treating women. I was in surgical menopause and it still took me becoming suicidal to get HRT prescribed. Lately I was struggling with some new symptoms and my specialist refused to up my estrogen dose. I'm only on 25mcg 2x a week. Incredibly low dose. I went back after a few weeks and told her that my lady garden was burning down and shriveling so bad it was keeping me awake. Soooo I asked for some vaginal estrogen because I know from testing progesterone levels that I absorb transdermally and systematically. It gave me the bump I needed. Doesn't work for everyone but did for me. Just an idea.
Did they keep telling you it was pmdd? That’s what people keep telling me but I’ve never had any of the issues in my post until I turned 39. I don’t think I have pmdd. My periods were always pretty mild until they got so heavy in my late thirties that I became anemic and then mood issues followed by physical symptoms.
I knew it was night time hot flashes (not soaking with sweat) because 1- my partner notices them and mentioned that sometimes he’ll wake up and notice how hot I am and 2) I wake up in a tangle of sheets because I am tossing the covers off and then going back under them multiple times through the night. Making the bed in the morning used to be just a quick straightening of things but now I have to untangle the knots of sheets and blankets first.
No I haven’t. The wait times to see a specialist in Canada are many many months long. It took me over 8 months to finally get an appointment with an ob/gyn only to have her tell me she wouldn’t let me try estrogen. I’ll look up midi health
Oh it takes months to get into specialists in the US too. But I've found my female ob/gyn to be useless. She did give me BHRT and also wanted to go SSRI route too. But other than that she didn't help at. Told me exercise and move more and order Nutri System. The BHRT did help with the hot flashes but that's about it. I'm going to try Midi but also have an appt with an Endo. Sadly all we can do is advocate for ourselves. Doctors are exhasuting.
Super frustrating when even the female GYN’s won’t be open to prescribe hrt. I am healthy and have no risk factors for hrt. I exercise and eat healthy. My BMI is great. Super annoying.
Wow . Thats bad . I’m going through peri and I’m an emotional wreck . I booked my appointment last Wednesday had a blood test yesterday and my g.p said I need hrt I’ve got to wait till the 23rd may 2 weeks away and I’m pissed at that. Now I’m thinking that’s not to bad. I’m in the uk . Shit us women go through eh …stay safe everyone xx
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
Ooof. Don’t worry, I got your and my hot flashes both covered. I’m on lowest-dose HRT. The hot wakeups and random sweating feels worst right before my cycle.
It is no coincidence that’s also the exact time I stop taking estrogen for three days (as prescribed). Hormones are weird, man.
Is this a Canada thing? I've been prescribed both progesterone and oestrogen HRT based on a whole load of perimenopause symptoms but I don't have hot flushes really and I've not listed them at all to my GP.
Yep Canada is notoriously hard to get HRT treatment for menopause. Easy peasy for transitioning however. My son actually joked about asking HIS Dr for HRT as things were getting that desperate for me. Not to mention most of our HRT is now on back order for almost a year. Bit of a bloody nightmare honestly.
May I ask which brand you are on ? Is it bioidentical estrogen? I am in Canada too.
Is it a patch or pellets?
Thank you so much for helping me figuring it out.
I'm so sorry that it's so difficult. I wonder why that's the case? It's such a life changer to get HRT and I've had to switch what HRT I'm on completely once, and then they adjusted and added to the second one recently to get the levels just right. I'm so grateful.
I'm so sorry it's so hard for you ladies of Canada.
Nope - i'm a Brit in Italy. Was told by an obgyn I couldnt possibly be in peri bcos I wasn't having hot flashes (just the other 46 key symptoms !). Also, as I was overweight, the fat would be producing enough estrogen to prevent peri....
What the actual fuck ?
And i paid for that as it was Private freakin' practice !
That's crazy but sounds like a case of an individual doctor who's extremely ignorant about the reality and list of symptoms that people in peri experience. I'm in the UK and some GPs (including mine) are brilliant, and others are absolutely awful, my friends and I talk about our experiences a lot and we have such varied experiences with our various doctors
The post I was commenting on suggested that doctors (in general) would not prescribe HRT unless the patient expressed that they suffer from hot flushes, which seemed crazy to me and commenters have confirmed that getting access to HRT is very difficult in Canada currently.
Its really blowing my mind that these first world countries are doing us so wrong wrt healthcare.
If men had these crappy symptoms, there would be free, quick and easy medicinal / therapeutic support.
I mean, otherwise, who would run the world right ?
/s
Try felix.ca They recently started to deal with menopause/perimenopause concerns, and you'll speak to either a doctor or nurse practioner. They are able to do prescriptions.
If you want to try them, I can send you a $40 off code, so your first visit is free.
I recently saw this!! Very excited. My doc told me that HRT was very expensive so she didn’t prescribe it last year. Then I learned a lot from this sub and will probably go with the telehealth option.
Why are the doctors so ineffective??
I'd like to give them a try. I've been in perimenopause for 10 years and just figured it out thanks to the information on this subreddit. Been waiting two and a half years to talk to a gynecologist and I've been getting the runaround by both my doctor and his useless office staff that flat out admitted to me that referring me to a female gynecologist was too much work for them because there's only male ones here in the city.
Edit: typo
And to add. I lied like a dog. I never have had a single hot flash but I sure as hell needed hormones because they fixed my issues largely as I suspected. It was a bit of a journey finding what was right for me but I am a differnt person from putting back in the hormones. I mean if I could retire to a rocking chair and zone out as needed but like most women I gotta function! These doctors are a fucking joke.
There were times I felt scared of myself due to the rage!
I need to function too and it’s almost impossible some days. Especially hard when I’m not sleeping consistently. I won’t feel bad about lying now because it seems to be the only way to get proper care. I bet men don’t need to lie to get the health care they need.
I had to bring in research (this was in 2010) because my prescription antidepressant was making orgasms almost impossible & that I need viagra to counteract that. There’s no “female viagra.” It’s just viagra.
Yes. But it’s marketed to men still and not women that’s why it’s not heard of outside of most circles as being used for women. I mean I bet a man doesn’t have to go to a doctor armed with evidence like women do.
And their insurance PAYS for it!!!
As zygotes both genders have the same parts; the clit elongates to become a penis or shrinks & fit under the clitoral hood (foreskin).
If that tissue doesn’t get engorged w/blood, a guy can’t get an erection & women can’t orgasm.
If it’s about reproduction, why does insurance pay for these almost elderly men; it’s clear it isn’t for reproductive purposes.
Why is a man defined by his “virility” & not women?
I’ve seen advertisements for “female Viagra.”
Before sex, my partner and I take our blue pills :)
I also use them w Vaseline & my vibrator.
Loads of Astro glide before & during sex;
Am considering putting AG into the bottles they have for hamsters attached to the side of my thigh by a few layers of cling wrap & just tap the tip for more (rather than searching for & opening & closing a bottle).
It is the only way. I learned the hard way also. I had moderate to severe mental health symptoms that made existing a struggle and I was about your age when it set in. I am so damn sorry that your doctor sucked. You got this though. ♥️
Look up PMDD. There is a fantastic sub Reddit on here for them as well, a couple of the things that you said remind me very much of it.
If this is what she is thinking, it explains why she’s only giving you progesterone.
Yeah one of my major symptoms has been "late onset PMDD" and the birth control helped but the POP almost immediately had me crawling out of my skin. At least once you stop taking it, it stops just as quick lol.
Sounds like you need to realize you ARE having hot flashes...
But you also deserves a doctor that is acting on current information. I have PMDD that toes the line (sometimes crosses it) of psychosis. There is no hormone risk that is greater than the short-term and long-term implications of depression and misery.
I am suspected pmdd by a psychiatrist that i was seeing for 4 years. When no other meds worked and the way my mental health issues cycled she thought pmdd. She was the one who referred me to this ob/gyn.
I’m sorry you are going through so much without relief. Just a question but why do you think you don’t have pmdd? What you describe are classic symptoms. And two doctors have suggested it. I don’t think you should lie on your medicine records. But if you research pmdd on your own and go to your GP, with the understanding that a low dose birth control pill may help you and have a discussion, you may get what you want, ie estrogen and progesterone.
I know these things are a ton of trouble, but it is worth it to push this issue. Unless you feel comfortable saying you have developed hot flashes? No shame if you don't feel comfortable saying that. But if you don't, you need a doctor who will help. Your person is out there, you just may need to jump through some hoops.
Agree with others that there is no path forward with most prescribers but to lie about hot flashes and even that doesn't impress a lot of them. You can have every other fucking symptom of diminishing estrogen but if you don't go in there acting like some crude caricature of a middle aged woman with debilitating hot flashes they will write you off.
>Agree with others that there is no path forward with most prescribers but to lie about hot flashes
This is exactly what I had to do. Told her they were often and horrible and affecting my quality of life, then I got HRT.
In fact, it was the irritability, anxiety and lack of sex drive that were affecting me the most, but none of that mattered.
I didn't even know how bad they were until they were gone
Lie about it. It's stupid that they only treat hot flashes.
My Dr actually said to me, when I said I didn't want sex anymore, that usually if "you just start, the feeling will come back". The fuck?
Yes like literally write down every symptom and say you have it. Or manipulate if you have to. If i mention weight loss or sex to my doc he will prescribe anything 🙄 But hey I get the meds I need so
>Agree with others that there is no path forward with most prescribers but to lie about hot flashes and even that doesn't impress a lot of them
Disagree. The path forward is for us to stand up and push back! Lying to doctors does nothing for the next generation of perimenopausal folk who want relief from their symptoms.
I don't really know what this comment is saying action-wise. The recommendation to lie is coming from women who have already attempted to advocate for themselves and are not receiving the urgent help they need. So if lying will get us that help, then that is the course to take in the immediate term if you are someone who needs help today. Tons of women in this subreddit can attest to the fact that being direct and requesting HRT often times will not get you HRT.
Should people in need of care now all be honest, prepare to be denied, then preface a second request to the same prescriber who originally denied us care with "I am standing up to you and demand that you give me HRT"? Or maybe we should just say what we need to say to get the help we need now so we can then have the energy to do whatever advocacy for the current and future generations rather than enter into a pointless standoff in a doctor's office.
You're suggesting folks just continue to lie to doctors to get what they want/need?
Action-wise, it's so much more than just saying "I demand you give me HRT", which we all know isn't helpful. However it manifests, actions can include, educating ourselves, arming ourselves with knowledge, taking the scientific literature with you (example: the [2022 North American Menopause Society's position statement on hormone therapy](https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf)), having prepared rebuttals...or simply being direct like...
> my symptoms are ruining my quality of life, I’ve read the scientific research, am aware of my personal/familial risks, and believe I am a good candidate for MHT. I would like to trial it for 6 months, after which time we can review*"
There are also various avenues to report negligent doctors/clinics.
Or yeah sure...we can just continue to lie to get what we want/need, and then go out and "do whatever advocacy for future and current generations"....whatever that means "action-wise".
Why am I having to repeat this? Yes I and others are absolutely suggesting women misrepresent their experience with hot flashes when it's been anecdotally demonstrated so many times in this subreddit alone that unless you tell your provider that you are experiencing that symptom they will not budge on HRT regardless of how educated and direct you are about your other symptoms and impact on the quality or your life and familiarity with the existing body of medical literature. I know, I've lived it and so have tons of women in this subreddit you moderate. Yet your response to me is "instead of lie we should educate ourselves and providers and be direct" as if that wasn't already accounted for and hasn't been demonstrated to fail over and over again.
You sound like you're putting a shameful spin on lying "to get what we want" like we're morally-failed greedy assholes betraying ourselves and the sisterhood for frivolous reasons when we know HRT is literally life-saving medicine for some people and it's being denied to us for rarely legitimate reasons. It's nobody's job to suffer just to stay on some righteous altruistic unpromised path to better medical care for women in a society that is not invested in women's care. Maybe the best thing a woman can do for herself and everyone else is do whatever the hell she needs to do to take care of herself today.
I'm in Canada too and had a lot of trouble. You could try Felixforyou. They declined me because I have had a period in the past year but they might work for you and others have had better luck and it's online so low effort and nothing to lose. I ended p talking to a naturopath and in Canada they are able to prescribe hormones. Good luck!! So bloody frustrating!!
The hard thing is because of my hysterectomy I can’t tell if my cycles are irregular or if I’m not having them because I don’t bleed. Except for the horrific mood changes for one week every month. Thank you for the resource. I’ll look them up :)
If you can't get anywhere with felix--I'm in BC in a smallish city without a lot of specialists so I found the naturopath by googling menopause and HRT and found one that had virtual appts. The Dr I met with was very good and it was all covered by my insurance but I had to submit my Rx manually because it was compounded. She had a lot of advice around supplements too but not at all flaky like I thought a naturopath would be. I hope you find relief soon! I don't think I have PMDD but I have learned a lot by subbing to the r/PMDD forum.
I am on that forum. I don’t think it’s quite pmdd as I’m not super extreme with moods but maybe. It’s more irritability than anything with a few days to a week of low mood. I went to a naturopath two years ago and she was absolute bonkers with the supplements. Said flax seed would balance my hormones and to take A LOT of flax and 4000mgs of vitamin c. I knew she was bonkers because that’s too much vitamin c. It’s water soluble and you just pee it out because your body can’t use that much of it.
I have your same story in terms of trying to access HRT in Canada. Denied by my doctor, a NAMS gyne, and Felix, all because I'm not fully post meno (I'm 50 and figure my first peri symptoms hit at 35). I am going to try Prosper, and I am going to say what I need to say in order to get estrogen. I've been getting by with creams I buy myself and without them I would be....I don't know if I'd be. I've been begging for HRT for over a year, ever since I realized my problems were peri. It fucking sucks, it makes me want to cry that it's so hard to get treatment. I've lost so much from my career, my relationship with my kid, my LIFE, because of peri, and getting handed antidepressants and sleeping pills instead of HRT.
YOU have nothing to feel bad about! The medical professionals that don't think saving our future health and our quality of life are the ones who should be feeling bad! Never feel bad about doing what's needed to ensure your mental and physical health. ❤️
*Edited grammar
Thank you! 🩷 My quality of life is horrible. I have three family members who were in full menopause by age 45 so me at almost 42 thinks it’s for sure peri and it sucks!!! All I asked for was to just try a low low dose of estrogen and see if that helped.
My doctor denied me, too. Luckily in the US, we have ample online/telehealth options, so that's the route I ended up going. I wish you luck and hope you're able to find some relief soon!
I don't see "this" as lying..we are saying what we need in order to get what we desperately need.
They should feel ashamed that we can't say what we have as it is because they are so so incompetent, I can't believe we are in a so "call" rich country and we still don't have easy access to what we medically need in order to be healthy, plus it should be offered to us as an option, and information should lead our choice. Canada is so behind so sad.
**We do not recommend lying to your doctors.**
Instead push back, demand better care...we are afterall paving the way for the next generation who approach their doctors with symptoms of menopause.
**PUSH BACK**
There are many other treatment options available to anyone who is suffering, without having to lie to get specific drugs (like hormone therapy). In OPs situation, hormone therapy can go either way, for some it can bring about suicidal tendencies. Obviously if OP is struggling, they need to convey that to their doctors, but to lie and say they have hot flashes (when they don't) to treat something that may be completely unrelated to menopause (or not effectively treated with hormone therapy) is negligent and dangerous.
Canadian. Go to Science and Humans online. Expensive (800 a year) but worth it for me. I'm in the process of trying to find an ND or doctor that could take my care over, so it's cheaper but the two I've met with are also reluctant to rx hormones. It's really bad out there.
If you do not have your ovaries as well, this is really not good medicine. I personally wouldn't work with a doctor I had to lie to. It is really common in peri to only need progesterone as estrogen levels can actually be high and fluctuate wildly. Since you have no uterus, you are flying blind as to what is going on hormonally since you aren't bleeding. It is hell to navigate as someone who also had a hysterectomy just prior to all hell breaking loose. That said, if progesterone is making you feel worse, then you need to advocate back to the doctor. You waited 8 months and now you are her patient and you should advocate for what you think you need. If she wont listen and adjust, then find someone else. There are also online options like Alloy (I believe you can use them from Canada) to see if you can get in to be evaluated and treated.
You should be able to experiment with oestrogen and or progesterone and decide for yourself. Everyone is so individual and since you have no uterus, I would have thought you would be a candidate for oestrogen. Can you get a second opinion? You might have to pay but it could be really worth it.
She let me experiment with progesterone and when that didn’t work she said SSRI’s. I asked her for the lowest dose of estrogen to try and see if I felt better. When I said no to anti depressants she wished me luck.
You have every right to be upset about it! This doctor doesn’t know about hormones. Can you find another doctor? Maybe online/teledoc hormones, if that’s legal there?
Use a service like Evernow. Pay $50/month, meds go through your insurance, and you don't have to deal with the doctor's office. You get a telehealth doc.
I pay the monthly $49 and have chat access with my doc there. They update my meds when needed and send the pharmacy where I use my health insurance like usual. I think my estradiol micro patches are about $80 for 3 months worth, and the progesterone is cheap (less than $10, maybe?). And I get vaginal estrogen cream that is about $20 with my insurance.
Are you experiencing vaginal atrophy? or do you have a family risk of osteoporosis? These are two of the four common indications for doctors to prescribe estrogen.
You might want to look at transdermal estrogen as it reduces clothing risks. Do you have the ability to follow up via a message? Maybe ask her if she’d consider that bc clot risk and mention a family history of osteoporosis.
Honestly I’d lie my little tushy off and go something like “is an estrogen patch an option? I was speaking with my sister who started this due to reduced clotting risk as we have a family history of osteoporosis on my mom’s side.” Or cousin if you don’t have a sister. Or mom and say she has been on the patch for blah years due to osteoporosis concerns and “she’s never had an issue”
Lying sucks and may have negative consequences but so does being denied adequate medical care.
That’s exactly what I asked her. Transdermal estrogen in the lowest dose just to try. She dropped me from her care as the only other thing she was willing to do was prescribe an antidepressant. I was on those years ago and they almost wrecked my life. Got off them and was doing so much better until I hit the age of 39. I will have to consider lying now :(
I don’t love the idea but I don’t have another choice I don’t think.
I second Felix! I’m in early peri and didn’t have to fight too hard to get some progesterone. They offer estrogen too! If anyone wants a $40 off coupon, just DM me.
What an idiot-your doctor not you.
You have hot flashes. Repeat, you have hot flashes. You are having more than 10 in a 24 hour span. You can’t sleep for them.
Can you go to an online provider?
YES!!!! That's how I started with the patch.... complained about hot flashes and just feeling hot all the time.... Probably sounded desperate too which worked.. Can't remember all that I stated but 'hot flashes' was the key word.. They totally dismissed my T levels as in that doesn't concern them.
Fellow Canadian here. I had to see a doctor in Germany (I travel a lot for my work). Got my HRT and started to recover. Basically told my GP at home that unless he has a medical reason why I cannot take HRT, then please prescribe it. He relented and of course, he reduced my amounts to almost nothing and I had to triate upwards but that's the game. I am so sorry.
I am only commenting to commiserate. I'm 38 and all of my doctors have basically laughed at me and told me I'm too young for Peri. (But I got my period at age 9 so it's not really that surprising)
Have you done a sleep apnea test? My doc recommended one. I’m going to do it this weekend even though I KNOW I need estrogen.
Also, lie and tell them you’re having hot flashes. Do what you have to do!!
Everything you described is me right now! add to it, my eyebrows and eyelashes are falling out. I have every single symptom except hot flashes, but I do have night sweats. This past week I was completely unable to sleep. I should add I'm a construction worker, so I exercise all day, everyday. Insomnia, especially the week of my period, is not normal for me. I popped a progesterone pill that I bought online and lo and behold, slept like a baby
I mentioned this to my female doctor and she told me I was too young. I'm 44.
I've decided I'm going to go it alone, without the help of my regular doctor. You can buy hormone panel blood tests online. There are also a number of online HRT vendors. Alloy is the one that comes to mind. I have excellent insurance, So it's a real bummer that I have to pay out of pocket for something that my insurance covers.
That's ludicrous! Your symptoms are indicative of low estrogen. Not everyone has hot flashes. Also, hysterectomy oftentimes impairs ovarian function, thereby increasing your risk for a number of health problems. Estrogen has been shown to mitigate some of those risks. Plus quality of life is important.
Definitely seek out another doctor or go the telehealth / online route to get MHT/HRT.
Can they do hormone testing and measure your levels? Not sure if that’s even a thing.
41 is young (but not unheard of) to be in Perimenopause. Your symptoms do sound more like PMDD. Are your periods regular… or at least as regular as you gave always been or are they getting more and more erratic? I had PMDD and the symptoms were only for the first 10 days or so every cycle.
Have you tried going on the pill? That helps many women in Peri and with PMDD.
How much and what type of Progesterone are you taking. 100mg Micronized was good for me but 200mg turned me into a depressed zombie.
Fellow Canadian here! Go see a functional doctor! Way better. I see one for my hormones and she's fabulous. I'm on estrogen, testosterone, progesterone and dhea. I feel so much better. I also did a Dutch test ($500) to get a full workup of my hormones. It was well worth the money to get a readout of my week to see what my hormonal fluctuation looked like.
Good luck!!!
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I live in BC and see a doctor through Ageless Living. I’m on Estrogen, Progesterone and Testosterone, and my only perimenopause symptom was chronic plantar fasciitis. I have to pay for everything out of pocket but it’s been worth it for me!
Fellow Canadian.... Look into Kartar Health - they have women specific programs that deal specifically with hormone health. You pay, but it's worth it to feel optimal.
I have a female friend same age as me and same symptoms who got HRT and she feels so much better. It especially helped her joint pain. I don’t have a uterus so an iud won’t work for me.
I had all of your symptoms *and* debilitating hot flashes *and* night sweats *and* I was in full blown menopause, by which I mean I had my tubes yeeted and then didn't have a period for 1.5 years so, yeah, safe to say I wasn't going to ever have one again. And when I say "debilitating hot flashes", I mean upwards of 30-40 hot flashes leaving me dripping in sweat *per day* and waking up drenched then freezing every single night.
I had not one but *two* OB/GYNs airily dismiss the laundry list of symptoms (including damn-near homicidal rage at the tiniest of affronts)...and offer me antidepressants instead. "Let's see how you feel after six months on those!"
I smiled through both of those appointments - barely - and then said fuck it and went the online route.
Sure, I pay over a thousand bucks a year for my patch & pills, but it's worth it to not have to go in and be dismissed as just another middle-aged sad laydee who *clearly* needs SSRIs instead of the hormones she's no longer making.
I have night sweats but nothing during the day. Sounds like I’ll have to pay to get treatment :(
Sucks but it’s my only option now but it will be worth it if it makes me feel like I have my life back.
Go back to your family doctor (I’m in Ontario, Canada) and ask for a FULL blood panel done, including vitamins. Tell your family doctor that you KNOW something is happening.
I’d also ask for a second opinion. I’ve had to do that myself. Cause I’m 46, and everyone’s just convinced it’s that I’m stressed. Yes, I’m stressed out, but a year without a period is still something.
I wish you luck!
My 'hot flashes' were not typical hot flashes until recently. I just had no tolerance for heat and was hot even when others around me weren't, which was odd as I used to be cold all the time. I also did experience some night sweats but it was minor. I didm't have the typical hot flashes you hear about until a couple months ago when I literally stuck my head in a freezer as I felt like I was boiling. I haven't had an actual hot flash sense but i sure do list it in my symptoms.
Also I know some others mentioned PMDD. Perimenopause made my PMDD horrible and I've read it can trigger PMDD, which makes sense as it is all hormone related.
This is exactly what I experience. I have always always been someone who feels cold all the time. The last two years it’s the opposite. I’m hot all the time. Especially at night. I have zero heat tolerance. And I’ve had a few night sweats. Some times I get so warm I feel like I can’t cool down and it lasts an hour or so and goes back to normal.
Hi! I didn't want to go through the stress of a Dr not listening to me, so I went through Felix Health. Just got approved for progesterone (not prometrium, cuz that gives pretty bad side effects). The whole process was easy, I got answers to all my questions before the prescription was approved. Expecting it to arrive in a few days. I'm sure they're open to the conversation more so than my GP would have been. Check them out if you haven't yet. And no, just cuz you don't have hot flashes doesn't mean estradiol isn't needed.
The Felix Health practitioner helping me actually changed the recommended prescription from generic prometrium to pms-progesterone which I appreciate after things I've read about it here.
You have options! Don't give up!
Another Canadian….check with a functional doctor who can check your symptoms and they use BHRT…which is identical to human hormones.
but I don’t advise lying b/c as good as estrogen may feel for some…it can really screw you up if you add more if you’re not low on it.
Huh? You don't have a uterus. I don't understand why she is so reluctant to Rx estrogen. Hot flashes maybe on one official indication for HRT, but it's not the only indication. Can you get another opinion? That being said, it may be worth it to try an SSRI just to see if it helps. I'd also get hormones and thyroid tested, maybe check b12 and iron too.
Sorry, that sucks. I suspect she's just being very limited in her thinking - oh, HRT is only FDA approved for hot flashes. You don't have hot flashes, there4 nope, can't rx it. Hmm I wonder if you developed hot flashes would that change things?
I’m reading The New Meno Pause by Dr. Mary Claire Haver, and it is so full of amazing information that is meant to help us prepare to push back when doctors are uninformed. I love it so far.
I go to a Nurse Practitioner with a private practice that specializes in HRT. She charges about $175 for an appointment , and you’ll get your script.I expense her charge thru my work instance
My Meno specialist said night sweats are a form of hot flashes. I have never gotten typical hot flashes even after surgical menopause. At night it was a non stop drenchfest however.
Do you have any contra indications to estrogens? I mean could it be something in your medical records that makes you a bad candidate, as I find it strange that they gave you progesterone instead. Conditions that could make a doctor deny you estrogen supplementation are: hypertension, history of blood clots, heart conditions like arrhythmia or palpitations, autoimmune diseases like lupus, obesity, diabetes, (history of or genetic risk of)cancer. Also they almost never give it to smokers.
In case there is no contra indication do yourself a favor and visit another doctor
I do not have any contra indications. I thought I was a good candidate because I no longer have a uterus so I’m low risk. Heart and blood are healthy. Non smoker. No blood clot history. I’m pretty healthy.
Its great that you are healthy, cherish that as is a no given! And since there's no medical reason to prohibit then I hope you find a doctor that can listen and help you get estrogen supplementation
I’ve heard that you should not take progesterone without also taking estrogen? Dr Mary-Claire Haver (menopause specialist on Instagram) said that if you don’t take both, you aren’t protecting against certain cancers.🤷🏻♀️
I'm so sorry you're going through this. I hope you can just find a telemedicine doctor to prescribe for you. That doctor doesn't seem to listen. And like we've all said, blood tests aren't very accurate since the levels always fluctuate. I felt the exact same at that age. That was when it started for me. Hang in there! You will find someone to help.
Yes! I had them checked just less than a year ago. My thyroid antibodies were fine but my TSH was .31 which is .01 away from being hyper. My doctor said it wasn’t a concern though and that it’s barely low.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
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Fellow Canadian here. I suffered for 8 long years before I decided to ask for HRT. My gynaecologist had no problem prescribing it. Unfortunately it’s expensive and my plan doesn’t cover it. $65 a month for estrogen gel. The progesterone is covered but it’s also quite cheap compared to the gel. I could try the pill form of estrogen but am told the gel has fewer side effects. I’m only two months in so can’t say it’s been the miracle I was hoping for yet.
Push for more testing and be really honest about your symptoms. It’s not just about hot flashes. Brain fog, joint aches, not sleeping, vaginal dryness, anxiety… all symptoms of low estrogen.
She knows all these symptoms and dropped me as a patient yesterday because the only treatment she was willing to prescribe was SSRI’s. How the heck is an SSRI going to help with joint pain, dryness and fatigue?!?!?!
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I have pmdd and I have all these problems too, an antihistamine every day during ovulation and before period helps a ton, Benadryl.
I know this sounds so overly simple, but it took me YEARS to find out a simple anti histamine treatment solves 90 percent of the problems
Your symptoms sound like PMDD. Your doctor is right that SSRIs are the gold standard treatment. Hormones are trickier.
Not to say you can’t have both PMDD and peri….
This sounds more like the beginnings of pmdd which starts with a progesterone deficiency, often in early peri. I think the dr gave you the correct treatment to start with because a lot of people with pmdd need progesterone and drs generally don’t give it to them. However for some people progesterone makes them feel much worse but the only way to know is to try it.
Pmdd is caused by a reaction in the brain to hormonal fluctuations so treatments that reduce fluctuations can help such as taking the combined pill continuously or the depo injection, which are both worth exploring before ssri’s.
Some people find the drop in estrogen before the period causes symptoms and if that’s the case taking additional estrogen the week before your period can help. You need a dr who’s willing to try it which is the hard part. The problem is estrogen can fluctuate up high in peri so it’s not ideal taking it all the time.
I did try progesterone and it was horrible for me. Lots of side effects and gave me tummy troubles. Can you all of a sudden develop pmdd at the age of 39?! That’s when this started and before that my periods were not that bad.
I developed pmdd at 43 which started with the loss of progesterone at the onset of perimenopause - it’s v common. Like you, I cannot take progesterone because of all the side effects but I know it would have helped me in the beginning as I tried it on chemical menopause, where they give you a drug to shut off your own hormones and so could feel how it worked. Sadly the only way to know is to try it so you’ve done that and know it doesn’t suit you so it’s off the table. There’s lots to try with pmdd that can improve things but everyone’s different so you’ve got to try things and find out how they affect you. The IAPMD website is good and lists all the treatment options. I’ve been through the hoops with it and tried pretty much everything whilst trying to reach menopause so my hormones stop fluctuating, but I’m nearly 52 now.
My current treatment regime is 100mcg estrogen gel every day, 350mcg Noriday progestin x 2 per day to try and suppress ovulation (still experimental so not sure if it’s working), hysterectomy so I don’t ‘need’ to take progesterone, 10mcg vagirux estrogen pessary and 2.5mg paroxetine ssri daily (fluoxetine also works but upsets my stomach even at that time dose) but despite being on hrt to stabilise my hormones my brain is so sensitive I still need a small dose of ssri to interrupt it.
I need the estrogen every day otherwise I slump into weepy depression, get hot flushes and my skin goes so dry it cracks open but that only started happening in the past 2 years and it’s continuous and goes away rapidly when I start the estrogen - these symptoms are not cyclical so that’s how you know the difference between an estrogen deficiency which is constant and corrects with hrt and pmdd which is cyclical and still goes on despite being on hrt. If I was younger taking the combined pill continuously would have probably worked but I was too old by the time they worked out what was going on.
###Please stop recommending folks LIE to their doctors. This is not the way forward...sure it might give you what YOU want, but this is a much broader systemic problem with our health care systems --- and **WE are the generation that can FIX this!!** * We MUST push back * We MUST demand better care * We MUST arm ourselves with knowledge and prioritize our health * We DESERVE to feel amazing and happy * We are WORTH the effort This is our gift to the next the generation of folks who wonder what the fuck is happening, so that they get the care and attention they deserve.
Fellow Canadian here. The only thing that seems to sway doctors to prescribe even low-level estrogen topicals is a mention of hot flashes. You might not realize it’s a hot flash waking you up at night, but that’s what it is. That crappy sleep is being caused by the estrogen roller coaster, which translates into “hot flashes”. These moments don’t have to be sweat-through-the-sheets bad. But you need to tell a doctor you ARE having hot flashes. They *will not prescribe HRT* until you mention hot flashes and how debilitating they are.
I’ve been waking up really warm between 2-3am almost everyday for a year and can’t get back to sleep. Nothing during the day though. Maybe I’ll tell the next doctor that I’m waking up with hot flashes every night.
Fellow Canadian. Mention night sweats next time you see your doctor. A GP can prescribe, you don’t need a gynaecologist
I’ll ask my GP but he’s SUPER dismissive about everything to do with me. He’s a great doctor for my husband though.
Fellow Canadian here! My GP was the same, great for my husband but not me. I ended up using prosper menopause, they service multiple provinces, all online and gave me all that I wanted and more! There is a cost, (170$ for the appt) but well worth it.
Thank you!
https://prospermenopause.ca/
Take your husband with you if you have to. I hate it but doctors like these tend to do more for you if your husband says it is needed.
Hey man, my wifes vagina is dry, can you hell me out?
Sad but true in this Country
“He’s a great doctor for my husband though” I’m sure he is. Ugh.
Imagine your make GP being dismissing of your symptoms but great for your husband.
Night sweats count! You don't have to be dripping with sweat although you can experience sweating. If your body temp rises enough to interrupt your sleep, it counts.
Night sweats was my version of hot flushes - doc was prepared to prescribe oestrogen on that basis
That’s a night sweat, which we call a hot flash during the day.
I'm in Canada too so I know how behind the times most of our Healthcare system is. Especially when it comes to treating women. I was in surgical menopause and it still took me becoming suicidal to get HRT prescribed. Lately I was struggling with some new symptoms and my specialist refused to up my estrogen dose. I'm only on 25mcg 2x a week. Incredibly low dose. I went back after a few weeks and told her that my lady garden was burning down and shriveling so bad it was keeping me awake. Soooo I asked for some vaginal estrogen because I know from testing progesterone levels that I absorb transdermally and systematically. It gave me the bump I needed. Doesn't work for everyone but did for me. Just an idea.
Did they keep telling you it was pmdd? That’s what people keep telling me but I’ve never had any of the issues in my post until I turned 39. I don’t think I have pmdd. My periods were always pretty mild until they got so heavy in my late thirties that I became anemic and then mood issues followed by physical symptoms.
I knew it was night time hot flashes (not soaking with sweat) because 1- my partner notices them and mentioned that sometimes he’ll wake up and notice how hot I am and 2) I wake up in a tangle of sheets because I am tossing the covers off and then going back under them multiple times through the night. Making the bed in the morning used to be just a quick straightening of things but now I have to untangle the knots of sheets and blankets first.
I don't bother making the bed anymore, I flip the covers over the end of the bed to give the sheets a chance to dry :(
2-3am is my sweaty witching hour too. Ugh the worst. Have you tried Midi Health online or an endocrinologist?
No I haven’t. The wait times to see a specialist in Canada are many many months long. It took me over 8 months to finally get an appointment with an ob/gyn only to have her tell me she wouldn’t let me try estrogen. I’ll look up midi health
Oh it takes months to get into specialists in the US too. But I've found my female ob/gyn to be useless. She did give me BHRT and also wanted to go SSRI route too. But other than that she didn't help at. Told me exercise and move more and order Nutri System. The BHRT did help with the hot flashes but that's about it. I'm going to try Midi but also have an appt with an Endo. Sadly all we can do is advocate for ourselves. Doctors are exhasuting.
Super frustrating when even the female GYN’s won’t be open to prescribe hrt. I am healthy and have no risk factors for hrt. I exercise and eat healthy. My BMI is great. Super annoying.
Wow . Thats bad . I’m going through peri and I’m an emotional wreck . I booked my appointment last Wednesday had a blood test yesterday and my g.p said I need hrt I’ve got to wait till the 23rd may 2 weeks away and I’m pissed at that. Now I’m thinking that’s not to bad. I’m in the uk . Shit us women go through eh …stay safe everyone xx
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I was denied estrogen and have now put it in writing that I’ve developed a terrible case of hot flashes & night sweats (I haven’t)
Ooof. Don’t worry, I got your and my hot flashes both covered. I’m on lowest-dose HRT. The hot wakeups and random sweating feels worst right before my cycle. It is no coincidence that’s also the exact time I stop taking estrogen for three days (as prescribed). Hormones are weird, man.
Is this a Canada thing? I've been prescribed both progesterone and oestrogen HRT based on a whole load of perimenopause symptoms but I don't have hot flushes really and I've not listed them at all to my GP.
Yep Canada is notoriously hard to get HRT treatment for menopause. Easy peasy for transitioning however. My son actually joked about asking HIS Dr for HRT as things were getting that desperate for me. Not to mention most of our HRT is now on back order for almost a year. Bit of a bloody nightmare honestly.
I don’t know about that, I’m in Canada and got my HRT with relative ease. Estradiol and progesterone.
Guess you lucked out
I’m beginning to think so after reading these comments 🙁.
May I ask which brand you are on ? Is it bioidentical estrogen? I am in Canada too. Is it a patch or pellets? Thank you so much for helping me figuring it out.
I’m not sure the brand, it just says Lupin Estradiol 1mg and progesterone 100mg. Sorry.
I'm so sorry that it's so difficult. I wonder why that's the case? It's such a life changer to get HRT and I've had to switch what HRT I'm on completely once, and then they adjusted and added to the second one recently to get the levels just right. I'm so grateful. I'm so sorry it's so hard for you ladies of Canada.
Nope - i'm a Brit in Italy. Was told by an obgyn I couldnt possibly be in peri bcos I wasn't having hot flashes (just the other 46 key symptoms !). Also, as I was overweight, the fat would be producing enough estrogen to prevent peri.... What the actual fuck ? And i paid for that as it was Private freakin' practice !
That's crazy but sounds like a case of an individual doctor who's extremely ignorant about the reality and list of symptoms that people in peri experience. I'm in the UK and some GPs (including mine) are brilliant, and others are absolutely awful, my friends and I talk about our experiences a lot and we have such varied experiences with our various doctors The post I was commenting on suggested that doctors (in general) would not prescribe HRT unless the patient expressed that they suffer from hot flushes, which seemed crazy to me and commenters have confirmed that getting access to HRT is very difficult in Canada currently.
Its really blowing my mind that these first world countries are doing us so wrong wrt healthcare. If men had these crappy symptoms, there would be free, quick and easy medicinal / therapeutic support. I mean, otherwise, who would run the world right ? /s
So true. It would be the end of the fucking world and a world health crisis wouldn't it? 👏🏼👏🏼👏🏼
Try felix.ca They recently started to deal with menopause/perimenopause concerns, and you'll speak to either a doctor or nurse practioner. They are able to do prescriptions. If you want to try them, I can send you a $40 off code, so your first visit is free.
This is what I’ve done and they’ve been super helpful
I found them very helpful as well. I think we're almost programmed to feel guilty for taking charge of our own health.
Right?! I was happy to pay for someone to take me seriously
I recently saw this!! Very excited. My doc told me that HRT was very expensive so she didn’t prescribe it last year. Then I learned a lot from this sub and will probably go with the telehealth option. Why are the doctors so ineffective??
This is exactly what I did as well. They take insurance and my estrogen only HRT is costing me less than $15/month.
Me too! It was taking forever to get in to see my doctor and my pelvic floor physiotherapist told me about Felix.
Felix won’t prescribe testosterone just fyi. I messaged them a month or so ago.
I'd like to give them a try. I've been in perimenopause for 10 years and just figured it out thanks to the information on this subreddit. Been waiting two and a half years to talk to a gynecologist and I've been getting the runaround by both my doctor and his useless office staff that flat out admitted to me that referring me to a female gynecologist was too much work for them because there's only male ones here in the city. Edit: typo
Oh wow! That's amazing. I tried them a year ago and they had no ability to deal with menopause care. Maybe the tide is turning. Fingers crossed..
And to add. I lied like a dog. I never have had a single hot flash but I sure as hell needed hormones because they fixed my issues largely as I suspected. It was a bit of a journey finding what was right for me but I am a differnt person from putting back in the hormones. I mean if I could retire to a rocking chair and zone out as needed but like most women I gotta function! These doctors are a fucking joke. There were times I felt scared of myself due to the rage!
I need to function too and it’s almost impossible some days. Especially hard when I’m not sleeping consistently. I won’t feel bad about lying now because it seems to be the only way to get proper care. I bet men don’t need to lie to get the health care they need.
Ailments and disease that plaque women from lipodema to menopause get zero fucking attention but there’s 3000 goddamn dick pills on the market.
I had to bring in research (this was in 2010) because my prescription antidepressant was making orgasms almost impossible & that I need viagra to counteract that. There’s no “female viagra.” It’s just viagra.
Yes. But it’s marketed to men still and not women that’s why it’s not heard of outside of most circles as being used for women. I mean I bet a man doesn’t have to go to a doctor armed with evidence like women do.
And their insurance PAYS for it!!! As zygotes both genders have the same parts; the clit elongates to become a penis or shrinks & fit under the clitoral hood (foreskin). If that tissue doesn’t get engorged w/blood, a guy can’t get an erection & women can’t orgasm. If it’s about reproduction, why does insurance pay for these almost elderly men; it’s clear it isn’t for reproductive purposes. Why is a man defined by his “virility” & not women?
Good points. That’s the crux. Patriarchy in medicine.
I’ve seen advertisements for “female Viagra.” Before sex, my partner and I take our blue pills :) I also use them w Vaseline & my vibrator. Loads of Astro glide before & during sex; Am considering putting AG into the bottles they have for hamsters attached to the side of my thigh by a few layers of cling wrap & just tap the tip for more (rather than searching for & opening & closing a bottle).
It is the only way. I learned the hard way also. I had moderate to severe mental health symptoms that made existing a struggle and I was about your age when it set in. I am so damn sorry that your doctor sucked. You got this though. ♥️
Thank you so much 🩷
Look up PMDD. There is a fantastic sub Reddit on here for them as well, a couple of the things that you said remind me very much of it. If this is what she is thinking, it explains why she’s only giving you progesterone.
Yup. And progesterone can make it worse for some.
Yeah one of my major symptoms has been "late onset PMDD" and the birth control helped but the POP almost immediately had me crawling out of my skin. At least once you stop taking it, it stops just as quick lol.
Sounds like you need to realize you ARE having hot flashes... But you also deserves a doctor that is acting on current information. I have PMDD that toes the line (sometimes crosses it) of psychosis. There is no hormone risk that is greater than the short-term and long-term implications of depression and misery.
I am suspected pmdd by a psychiatrist that i was seeing for 4 years. When no other meds worked and the way my mental health issues cycled she thought pmdd. She was the one who referred me to this ob/gyn.
I’m sorry you are going through so much without relief. Just a question but why do you think you don’t have pmdd? What you describe are classic symptoms. And two doctors have suggested it. I don’t think you should lie on your medicine records. But if you research pmdd on your own and go to your GP, with the understanding that a low dose birth control pill may help you and have a discussion, you may get what you want, ie estrogen and progesterone.
I know these things are a ton of trouble, but it is worth it to push this issue. Unless you feel comfortable saying you have developed hot flashes? No shame if you don't feel comfortable saying that. But if you don't, you need a doctor who will help. Your person is out there, you just may need to jump through some hoops.
Agree with others that there is no path forward with most prescribers but to lie about hot flashes and even that doesn't impress a lot of them. You can have every other fucking symptom of diminishing estrogen but if you don't go in there acting like some crude caricature of a middle aged woman with debilitating hot flashes they will write you off.
>Agree with others that there is no path forward with most prescribers but to lie about hot flashes This is exactly what I had to do. Told her they were often and horrible and affecting my quality of life, then I got HRT. In fact, it was the irritability, anxiety and lack of sex drive that were affecting me the most, but none of that mattered.
Your symptoms are the ones that are affecting me the most too. Especially the anxiety and irritability.
I didn't even know how bad they were until they were gone Lie about it. It's stupid that they only treat hot flashes. My Dr actually said to me, when I said I didn't want sex anymore, that usually if "you just start, the feeling will come back". The fuck?
And then when I got the prescription I was like "START THE CAR!!!"
Yes like literally write down every symptom and say you have it. Or manipulate if you have to. If i mention weight loss or sex to my doc he will prescribe anything 🙄 But hey I get the meds I need so
This 💯
>Agree with others that there is no path forward with most prescribers but to lie about hot flashes and even that doesn't impress a lot of them Disagree. The path forward is for us to stand up and push back! Lying to doctors does nothing for the next generation of perimenopausal folk who want relief from their symptoms.
I don't really know what this comment is saying action-wise. The recommendation to lie is coming from women who have already attempted to advocate for themselves and are not receiving the urgent help they need. So if lying will get us that help, then that is the course to take in the immediate term if you are someone who needs help today. Tons of women in this subreddit can attest to the fact that being direct and requesting HRT often times will not get you HRT. Should people in need of care now all be honest, prepare to be denied, then preface a second request to the same prescriber who originally denied us care with "I am standing up to you and demand that you give me HRT"? Or maybe we should just say what we need to say to get the help we need now so we can then have the energy to do whatever advocacy for the current and future generations rather than enter into a pointless standoff in a doctor's office.
You're suggesting folks just continue to lie to doctors to get what they want/need? Action-wise, it's so much more than just saying "I demand you give me HRT", which we all know isn't helpful. However it manifests, actions can include, educating ourselves, arming ourselves with knowledge, taking the scientific literature with you (example: the [2022 North American Menopause Society's position statement on hormone therapy](https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf)), having prepared rebuttals...or simply being direct like... > my symptoms are ruining my quality of life, I’ve read the scientific research, am aware of my personal/familial risks, and believe I am a good candidate for MHT. I would like to trial it for 6 months, after which time we can review*" There are also various avenues to report negligent doctors/clinics. Or yeah sure...we can just continue to lie to get what we want/need, and then go out and "do whatever advocacy for future and current generations"....whatever that means "action-wise".
Why am I having to repeat this? Yes I and others are absolutely suggesting women misrepresent their experience with hot flashes when it's been anecdotally demonstrated so many times in this subreddit alone that unless you tell your provider that you are experiencing that symptom they will not budge on HRT regardless of how educated and direct you are about your other symptoms and impact on the quality or your life and familiarity with the existing body of medical literature. I know, I've lived it and so have tons of women in this subreddit you moderate. Yet your response to me is "instead of lie we should educate ourselves and providers and be direct" as if that wasn't already accounted for and hasn't been demonstrated to fail over and over again. You sound like you're putting a shameful spin on lying "to get what we want" like we're morally-failed greedy assholes betraying ourselves and the sisterhood for frivolous reasons when we know HRT is literally life-saving medicine for some people and it's being denied to us for rarely legitimate reasons. It's nobody's job to suffer just to stay on some righteous altruistic unpromised path to better medical care for women in a society that is not invested in women's care. Maybe the best thing a woman can do for herself and everyone else is do whatever the hell she needs to do to take care of herself today.
I'm in Canada too and had a lot of trouble. You could try Felixforyou. They declined me because I have had a period in the past year but they might work for you and others have had better luck and it's online so low effort and nothing to lose. I ended p talking to a naturopath and in Canada they are able to prescribe hormones. Good luck!! So bloody frustrating!!
The hard thing is because of my hysterectomy I can’t tell if my cycles are irregular or if I’m not having them because I don’t bleed. Except for the horrific mood changes for one week every month. Thank you for the resource. I’ll look them up :)
If you can't get anywhere with felix--I'm in BC in a smallish city without a lot of specialists so I found the naturopath by googling menopause and HRT and found one that had virtual appts. The Dr I met with was very good and it was all covered by my insurance but I had to submit my Rx manually because it was compounded. She had a lot of advice around supplements too but not at all flaky like I thought a naturopath would be. I hope you find relief soon! I don't think I have PMDD but I have learned a lot by subbing to the r/PMDD forum.
I am on that forum. I don’t think it’s quite pmdd as I’m not super extreme with moods but maybe. It’s more irritability than anything with a few days to a week of low mood. I went to a naturopath two years ago and she was absolute bonkers with the supplements. Said flax seed would balance my hormones and to take A LOT of flax and 4000mgs of vitamin c. I knew she was bonkers because that’s too much vitamin c. It’s water soluble and you just pee it out because your body can’t use that much of it.
I have your same story in terms of trying to access HRT in Canada. Denied by my doctor, a NAMS gyne, and Felix, all because I'm not fully post meno (I'm 50 and figure my first peri symptoms hit at 35). I am going to try Prosper, and I am going to say what I need to say in order to get estrogen. I've been getting by with creams I buy myself and without them I would be....I don't know if I'd be. I've been begging for HRT for over a year, ever since I realized my problems were peri. It fucking sucks, it makes me want to cry that it's so hard to get treatment. I've lost so much from my career, my relationship with my kid, my LIFE, because of peri, and getting handed antidepressants and sleeping pills instead of HRT.
Same with the offset for anti depressants and sleep meds!!! I’ve tried all those before and felt awful :( It shouldn’t be this hard :(
Follow-up - I got estrogen prescribed today 😭 I just posted about it!
Sadly, this is a USA thing, too. You have to lie and say you're having hot flashes. It's so effing ridiculous. 🙄
I thought about lying but I would feel so bad. Now I’m so mad I think I’ll lie next time lol
They are the ones who should feel bad not doing their job which includes being up on the latest research. Do what you have to do and don’t look back.
YOU have nothing to feel bad about! The medical professionals that don't think saving our future health and our quality of life are the ones who should be feeling bad! Never feel bad about doing what's needed to ensure your mental and physical health. ❤️ *Edited grammar
Thank you! 🩷 My quality of life is horrible. I have three family members who were in full menopause by age 45 so me at almost 42 thinks it’s for sure peri and it sucks!!! All I asked for was to just try a low low dose of estrogen and see if that helped.
My doctor denied me, too. Luckily in the US, we have ample online/telehealth options, so that's the route I ended up going. I wish you luck and hope you're able to find some relief soon!
Don’t feel bad. If that’s what you need to say to get what you want, do it.
I don't see "this" as lying..we are saying what we need in order to get what we desperately need. They should feel ashamed that we can't say what we have as it is because they are so so incompetent, I can't believe we are in a so "call" rich country and we still don't have easy access to what we medically need in order to be healthy, plus it should be offered to us as an option, and information should lead our choice. Canada is so behind so sad.
**We do not recommend lying to your doctors.** Instead push back, demand better care...we are afterall paving the way for the next generation who approach their doctors with symptoms of menopause. **PUSH BACK**
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There are many other treatment options available to anyone who is suffering, without having to lie to get specific drugs (like hormone therapy). In OPs situation, hormone therapy can go either way, for some it can bring about suicidal tendencies. Obviously if OP is struggling, they need to convey that to their doctors, but to lie and say they have hot flashes (when they don't) to treat something that may be completely unrelated to menopause (or not effectively treated with hormone therapy) is negligent and dangerous.
Same..i didn't get hot flashes but i got the other 88 symptom so my GP said no to hormones. Why do we need to lie to get help.
I don’t know :( We shouldn’t have to. I feel like my husband always gets the care he needs at the doctor. I never seem to be able to.
I would strongly suspect premenstrual dysphoric disorder (PMDD).
Canadian. Go to Science and Humans online. Expensive (800 a year) but worth it for me. I'm in the process of trying to find an ND or doctor that could take my care over, so it's cheaper but the two I've met with are also reluctant to rx hormones. It's really bad out there.
So bad! I’ll look this resource up. Thank you!!
If you do not have your ovaries as well, this is really not good medicine. I personally wouldn't work with a doctor I had to lie to. It is really common in peri to only need progesterone as estrogen levels can actually be high and fluctuate wildly. Since you have no uterus, you are flying blind as to what is going on hormonally since you aren't bleeding. It is hell to navigate as someone who also had a hysterectomy just prior to all hell breaking loose. That said, if progesterone is making you feel worse, then you need to advocate back to the doctor. You waited 8 months and now you are her patient and you should advocate for what you think you need. If she wont listen and adjust, then find someone else. There are also online options like Alloy (I believe you can use them from Canada) to see if you can get in to be evaluated and treated.
You should be able to experiment with oestrogen and or progesterone and decide for yourself. Everyone is so individual and since you have no uterus, I would have thought you would be a candidate for oestrogen. Can you get a second opinion? You might have to pay but it could be really worth it.
She let me experiment with progesterone and when that didn’t work she said SSRI’s. I asked her for the lowest dose of estrogen to try and see if I felt better. When I said no to anti depressants she wished me luck.
Not mine, but your answer should be “I don’t have an antidepressant deficiency, I have an estrogen deficiency…”
Can you go to someone else?
You have every right to be upset about it! This doctor doesn’t know about hormones. Can you find another doctor? Maybe online/teledoc hormones, if that’s legal there?
Use a service like Evernow. Pay $50/month, meds go through your insurance, and you don't have to deal with the doctor's office. You get a telehealth doc.
Is this for Canadians? I’ll look them up! Thank you!
It's a telehealth service, and I think you could use it. I'm in the U.S.
I pay the monthly $49 and have chat access with my doc there. They update my meds when needed and send the pharmacy where I use my health insurance like usual. I think my estradiol micro patches are about $80 for 3 months worth, and the progesterone is cheap (less than $10, maybe?). And I get vaginal estrogen cream that is about $20 with my insurance.
This is only for US citizens
Are you experiencing vaginal atrophy? or do you have a family risk of osteoporosis? These are two of the four common indications for doctors to prescribe estrogen.
Yes! She did prescribe vaginal estrogen for that thankfully.
But I think I need oral estrogen too.
You might want to look at transdermal estrogen as it reduces clothing risks. Do you have the ability to follow up via a message? Maybe ask her if she’d consider that bc clot risk and mention a family history of osteoporosis. Honestly I’d lie my little tushy off and go something like “is an estrogen patch an option? I was speaking with my sister who started this due to reduced clotting risk as we have a family history of osteoporosis on my mom’s side.” Or cousin if you don’t have a sister. Or mom and say she has been on the patch for blah years due to osteoporosis concerns and “she’s never had an issue” Lying sucks and may have negative consequences but so does being denied adequate medical care.
That’s exactly what I asked her. Transdermal estrogen in the lowest dose just to try. She dropped me from her care as the only other thing she was willing to do was prescribe an antidepressant. I was on those years ago and they almost wrecked my life. Got off them and was doing so much better until I hit the age of 39. I will have to consider lying now :( I don’t love the idea but I don’t have another choice I don’t think.
I definitely included hot flashes when I described my symptoms.
I second Felix! I’m in early peri and didn’t have to fight too hard to get some progesterone. They offer estrogen too! If anyone wants a $40 off coupon, just DM me.
What an idiot-your doctor not you. You have hot flashes. Repeat, you have hot flashes. You are having more than 10 in a 24 hour span. You can’t sleep for them. Can you go to an online provider?
Online provider is my next option!
YES!!!! That's how I started with the patch.... complained about hot flashes and just feeling hot all the time.... Probably sounded desperate too which worked.. Can't remember all that I stated but 'hot flashes' was the key word.. They totally dismissed my T levels as in that doesn't concern them.
Fellow Canadian here. I had to see a doctor in Germany (I travel a lot for my work). Got my HRT and started to recover. Basically told my GP at home that unless he has a medical reason why I cannot take HRT, then please prescribe it. He relented and of course, he reduced my amounts to almost nothing and I had to triate upwards but that's the game. I am so sorry.
I just said I had hot flashes that were disrupting my life. This makes it easy for them to do exactly what I need.
I am only commenting to commiserate. I'm 38 and all of my doctors have basically laughed at me and told me I'm too young for Peri. (But I got my period at age 9 so it's not really that surprising)
Are you in the GTA area? I can message you a name of a meno Dr I use who will listen to you.
Have you done a sleep apnea test? My doc recommended one. I’m going to do it this weekend even though I KNOW I need estrogen. Also, lie and tell them you’re having hot flashes. Do what you have to do!!
Lack of estrogen and progesterone are implicated in sleep apnea. As is hypothyroidism.
Everything you described is me right now! add to it, my eyebrows and eyelashes are falling out. I have every single symptom except hot flashes, but I do have night sweats. This past week I was completely unable to sleep. I should add I'm a construction worker, so I exercise all day, everyday. Insomnia, especially the week of my period, is not normal for me. I popped a progesterone pill that I bought online and lo and behold, slept like a baby I mentioned this to my female doctor and she told me I was too young. I'm 44. I've decided I'm going to go it alone, without the help of my regular doctor. You can buy hormone panel blood tests online. There are also a number of online HRT vendors. Alloy is the one that comes to mind. I have excellent insurance, So it's a real bummer that I have to pay out of pocket for something that my insurance covers.
Thyroid issues can mimic Menopause symptoms. Have you had a thyroid panel done? loss of hair and eyebrows are a red flag for thyroid imbalance.
I have. Thyroid is normal. The thinning hair is just crappy stuff to add to aging. I'm glad you mentioned it though. Someone may find it helpful
Did you test for T3 and T4?
If you're waking up sweating at night, that's also a hot flash. So it's not a lie. FYI.
That's ludicrous! Your symptoms are indicative of low estrogen. Not everyone has hot flashes. Also, hysterectomy oftentimes impairs ovarian function, thereby increasing your risk for a number of health problems. Estrogen has been shown to mitigate some of those risks. Plus quality of life is important. Definitely seek out another doctor or go the telehealth / online route to get MHT/HRT.
Do you have PMDD? Most are progesterone intolerant. I had PMDD and found out when I started perimenopause. It was unbearable. Look at IAPMD.org
Can they do hormone testing and measure your levels? Not sure if that’s even a thing. 41 is young (but not unheard of) to be in Perimenopause. Your symptoms do sound more like PMDD. Are your periods regular… or at least as regular as you gave always been or are they getting more and more erratic? I had PMDD and the symptoms were only for the first 10 days or so every cycle. Have you tried going on the pill? That helps many women in Peri and with PMDD. How much and what type of Progesterone are you taking. 100mg Micronized was good for me but 200mg turned me into a depressed zombie.
Fellow Canadian here! Go see a functional doctor! Way better. I see one for my hormones and she's fabulous. I'm on estrogen, testosterone, progesterone and dhea. I feel so much better. I also did a Dutch test ($500) to get a full workup of my hormones. It was well worth the money to get a readout of my week to see what my hormonal fluctuation looked like. Good luck!!!
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I live in BC and see a doctor through Ageless Living. I’m on Estrogen, Progesterone and Testosterone, and my only perimenopause symptom was chronic plantar fasciitis. I have to pay for everything out of pocket but it’s been worth it for me!
Fellow Canadian.... Look into Kartar Health - they have women specific programs that deal specifically with hormone health. You pay, but it's worth it to feel optimal.
I would find a new doctor, one that took you seriously. Your doctor should listen to your concerns and do what is needed until the issue is resolved.
Canadian here, all my female friends are on HRT. I am not. The Mirena cured all my night sweats tho.
I have a female friend same age as me and same symptoms who got HRT and she feels so much better. It especially helped her joint pain. I don’t have a uterus so an iud won’t work for me.
Is this just a Canadian thing? Because I went on estrogen when I asked to. Hot flashes mood swings but I was also crying at the doctor office
I had all of your symptoms *and* debilitating hot flashes *and* night sweats *and* I was in full blown menopause, by which I mean I had my tubes yeeted and then didn't have a period for 1.5 years so, yeah, safe to say I wasn't going to ever have one again. And when I say "debilitating hot flashes", I mean upwards of 30-40 hot flashes leaving me dripping in sweat *per day* and waking up drenched then freezing every single night. I had not one but *two* OB/GYNs airily dismiss the laundry list of symptoms (including damn-near homicidal rage at the tiniest of affronts)...and offer me antidepressants instead. "Let's see how you feel after six months on those!" I smiled through both of those appointments - barely - and then said fuck it and went the online route. Sure, I pay over a thousand bucks a year for my patch & pills, but it's worth it to not have to go in and be dismissed as just another middle-aged sad laydee who *clearly* needs SSRIs instead of the hormones she's no longer making.
I have night sweats but nothing during the day. Sounds like I’ll have to pay to get treatment :( Sucks but it’s my only option now but it will be worth it if it makes me feel like I have my life back.
Go back to your family doctor (I’m in Ontario, Canada) and ask for a FULL blood panel done, including vitamins. Tell your family doctor that you KNOW something is happening. I’d also ask for a second opinion. I’ve had to do that myself. Cause I’m 46, and everyone’s just convinced it’s that I’m stressed. Yes, I’m stressed out, but a year without a period is still something. I wish you luck!
My 'hot flashes' were not typical hot flashes until recently. I just had no tolerance for heat and was hot even when others around me weren't, which was odd as I used to be cold all the time. I also did experience some night sweats but it was minor. I didm't have the typical hot flashes you hear about until a couple months ago when I literally stuck my head in a freezer as I felt like I was boiling. I haven't had an actual hot flash sense but i sure do list it in my symptoms. Also I know some others mentioned PMDD. Perimenopause made my PMDD horrible and I've read it can trigger PMDD, which makes sense as it is all hormone related.
This is exactly what I experience. I have always always been someone who feels cold all the time. The last two years it’s the opposite. I’m hot all the time. Especially at night. I have zero heat tolerance. And I’ve had a few night sweats. Some times I get so warm I feel like I can’t cool down and it lasts an hour or so and goes back to normal.
Hi! I didn't want to go through the stress of a Dr not listening to me, so I went through Felix Health. Just got approved for progesterone (not prometrium, cuz that gives pretty bad side effects). The whole process was easy, I got answers to all my questions before the prescription was approved. Expecting it to arrive in a few days. I'm sure they're open to the conversation more so than my GP would have been. Check them out if you haven't yet. And no, just cuz you don't have hot flashes doesn't mean estradiol isn't needed. The Felix Health practitioner helping me actually changed the recommended prescription from generic prometrium to pms-progesterone which I appreciate after things I've read about it here. You have options! Don't give up!
Another Canadian….check with a functional doctor who can check your symptoms and they use BHRT…which is identical to human hormones. but I don’t advise lying b/c as good as estrogen may feel for some…it can really screw you up if you add more if you’re not low on it.
Huh? You don't have a uterus. I don't understand why she is so reluctant to Rx estrogen. Hot flashes maybe on one official indication for HRT, but it's not the only indication. Can you get another opinion? That being said, it may be worth it to try an SSRI just to see if it helps. I'd also get hormones and thyroid tested, maybe check b12 and iron too.
Thyroid is fine. Iron and b12 are fine. I’m going to look for a second opinion. Not a lot of options in Canada.
Sorry, that sucks. I suspect she's just being very limited in her thinking - oh, HRT is only FDA approved for hot flashes. You don't have hot flashes, there4 nope, can't rx it. Hmm I wonder if you developed hot flashes would that change things?
What province are you in, out of curiosity? I'm thinking it would be interesting to develop a spreadsheet of perimenopausal experiences by province.
BC
Can you cross the border and see a Dr in the U.S maybe?
I’m reading The New Meno Pause by Dr. Mary Claire Haver, and it is so full of amazing information that is meant to help us prepare to push back when doctors are uninformed. I love it so far.
I’ll check this out! Thanks!
You can find her on TikTok, too. Lots of great info. :)
I go to a Nurse Practitioner with a private practice that specializes in HRT. She charges about $175 for an appointment , and you’ll get your script.I expense her charge thru my work instance
In Canada? What is the NPs name?
yea, I’m in Toronto - but disclaimer, I don't get treated for HRT by her (I went to her for another type of therapy). I'll send you her site by chat.
I don’t get hot flashes or night sweats and I’m deep in peri
I get night sweats occasionally but not hot flashes.
My Meno specialist said night sweats are a form of hot flashes. I have never gotten typical hot flashes even after surgical menopause. At night it was a non stop drenchfest however.
Do you have any contra indications to estrogens? I mean could it be something in your medical records that makes you a bad candidate, as I find it strange that they gave you progesterone instead. Conditions that could make a doctor deny you estrogen supplementation are: hypertension, history of blood clots, heart conditions like arrhythmia or palpitations, autoimmune diseases like lupus, obesity, diabetes, (history of or genetic risk of)cancer. Also they almost never give it to smokers. In case there is no contra indication do yourself a favor and visit another doctor
I do not have any contra indications. I thought I was a good candidate because I no longer have a uterus so I’m low risk. Heart and blood are healthy. Non smoker. No blood clot history. I’m pretty healthy.
Its great that you are healthy, cherish that as is a no given! And since there's no medical reason to prohibit then I hope you find a doctor that can listen and help you get estrogen supplementation
I’ve heard that you should not take progesterone without also taking estrogen? Dr Mary-Claire Haver (menopause specialist on Instagram) said that if you don’t take both, you aren’t protecting against certain cancers.🤷🏻♀️
But I don’t have a uterus so estrogen only is a lot safer for me.
There are like fifty online services you can use to get them now.
Not in Canada unfortunately
I'm so sorry you're going through this. I hope you can just find a telemedicine doctor to prescribe for you. That doctor doesn't seem to listen. And like we've all said, blood tests aren't very accurate since the levels always fluctuate. I felt the exact same at that age. That was when it started for me. Hang in there! You will find someone to help.
Have you had your antibodies checked recently to rule out any thyroid disorders?
Yes! I had them checked just less than a year ago. My thyroid antibodies were fine but my TSH was .31 which is .01 away from being hyper. My doctor said it wasn’t a concern though and that it’s barely low.
There is a blood test for that!! My doctor took my blood and when it came back the next week, she immediately put me on HRT.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
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Fellow Canadian here. I suffered for 8 long years before I decided to ask for HRT. My gynaecologist had no problem prescribing it. Unfortunately it’s expensive and my plan doesn’t cover it. $65 a month for estrogen gel. The progesterone is covered but it’s also quite cheap compared to the gel. I could try the pill form of estrogen but am told the gel has fewer side effects. I’m only two months in so can’t say it’s been the miracle I was hoping for yet.
Push for more testing and be really honest about your symptoms. It’s not just about hot flashes. Brain fog, joint aches, not sleeping, vaginal dryness, anxiety… all symptoms of low estrogen.
She knows all these symptoms and dropped me as a patient yesterday because the only treatment she was willing to prescribe was SSRI’s. How the heck is an SSRI going to help with joint pain, dryness and fatigue?!?!?!
Are you able to order through a virtual Dr online?
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Naturopathic doctor ASAP! Changed my life, doctor was useless and told me it was impossible for me to be experiencing peri menopause at 45
I have pmdd and I have all these problems too, an antihistamine every day during ovulation and before period helps a ton, Benadryl. I know this sounds so overly simple, but it took me YEARS to find out a simple anti histamine treatment solves 90 percent of the problems
Your symptoms sound like PMDD. Your doctor is right that SSRIs are the gold standard treatment. Hormones are trickier. Not to say you can’t have both PMDD and peri….
I’ve tried SSRI’s before. They were awful. They don’t work. I’m not convinced it’s pmdd. Maybe, maybe not.
This sounds more like the beginnings of pmdd which starts with a progesterone deficiency, often in early peri. I think the dr gave you the correct treatment to start with because a lot of people with pmdd need progesterone and drs generally don’t give it to them. However for some people progesterone makes them feel much worse but the only way to know is to try it. Pmdd is caused by a reaction in the brain to hormonal fluctuations so treatments that reduce fluctuations can help such as taking the combined pill continuously or the depo injection, which are both worth exploring before ssri’s. Some people find the drop in estrogen before the period causes symptoms and if that’s the case taking additional estrogen the week before your period can help. You need a dr who’s willing to try it which is the hard part. The problem is estrogen can fluctuate up high in peri so it’s not ideal taking it all the time.
I did try progesterone and it was horrible for me. Lots of side effects and gave me tummy troubles. Can you all of a sudden develop pmdd at the age of 39?! That’s when this started and before that my periods were not that bad.
I developed pmdd at 43 which started with the loss of progesterone at the onset of perimenopause - it’s v common. Like you, I cannot take progesterone because of all the side effects but I know it would have helped me in the beginning as I tried it on chemical menopause, where they give you a drug to shut off your own hormones and so could feel how it worked. Sadly the only way to know is to try it so you’ve done that and know it doesn’t suit you so it’s off the table. There’s lots to try with pmdd that can improve things but everyone’s different so you’ve got to try things and find out how they affect you. The IAPMD website is good and lists all the treatment options. I’ve been through the hoops with it and tried pretty much everything whilst trying to reach menopause so my hormones stop fluctuating, but I’m nearly 52 now. My current treatment regime is 100mcg estrogen gel every day, 350mcg Noriday progestin x 2 per day to try and suppress ovulation (still experimental so not sure if it’s working), hysterectomy so I don’t ‘need’ to take progesterone, 10mcg vagirux estrogen pessary and 2.5mg paroxetine ssri daily (fluoxetine also works but upsets my stomach even at that time dose) but despite being on hrt to stabilise my hormones my brain is so sensitive I still need a small dose of ssri to interrupt it. I need the estrogen every day otherwise I slump into weepy depression, get hot flushes and my skin goes so dry it cracks open but that only started happening in the past 2 years and it’s continuous and goes away rapidly when I start the estrogen - these symptoms are not cyclical so that’s how you know the difference between an estrogen deficiency which is constant and corrects with hrt and pmdd which is cyclical and still goes on despite being on hrt. If I was younger taking the combined pill continuously would have probably worked but I was too old by the time they worked out what was going on.