Category Archives: menopause

What Is It Like To Have A Hysteroscopy?

My appointment for my NHS hysteroscopy was set for 10:00am. I arrived in the hospital waiting room at about 9:50am but then had to wait until 10:30am before I was finally called into a side room. It was a terrifying delay of half an hour as I was already scared about the possible pain and the possible sinister findings, but somehow I got through it although at one point I did have to get up and pace.

I was weighed and measured and then shown into an operating room where two nurses were busy gathering equipment, wiping trolleys, and moving paper towels etc. I sat with a specialist nurse at a desk (I think that was how she described herself, I was so petrified I could barely process anything anyone said to me) who took my gynae history, previous operations details, and explained what was going to happen. I signed my name under the list of awful side effects, dangers, and warnings of dire consequences they always give you before a procedure that scares you half to death, then, behind a curtain screening off a corner of the room I undressed from the waist down.

As directed, I lay on one of those horrible beds with the high leg stirrups, a sheet just about covering my nether regions, while one of the nurses raised the table so that my private parts would be exactly eye height to anyone sitting in the chair placed directly between my legs. At this point all dignity is gone, so the dazzlingly bright lamp next to the chair is just one more hilariously awful fact to endure. The specialist came and sat in the chair and put a local anaesthetic into my cervix because I’m sensitive there (it’s not routinely given!) and then the first thing she did was a cervical smear test. I was due anyway and it made sense since she was already right there. We’d discussed whether I was due for a test during the talk beforehand.

So far I felt no pain or discomfort because of the local anaesthetic, even as she inserted a camera into my womb to have a look round. For some reason I remember a lot of water being involved at some point – which subsequently had to drain out of me. That was a weird feeling. There was an impulse to cover (pointless), to cross my legs (impossible) and to wipe (unnecessary) but since none of those options were available I just had to let it gush out into the poor nurse’s face (well, not actually splashing I hope).

I was still feeling no pain at all, but that changed dramatically when she did the biopsy. This gave me some uncomfortable cramping but I chatted to one of the nurses about pet insurance(?!) to distract myself, which actually worked.

Then everything was finished. I lay on the bed for a few minutes with the cramping getting worse and sat up only when I felt brave enough. I was leaking a bit of blood but not too much to be uncontrollable by the usual methods. I’d already taken paracetamol before coming to the hospital (as advised) but that didn’t seem to be helping. I needed ibuprofen as well, and soon after, an anti-sickness tablet.

After I got dressed and had a debrief with the specialist nurse, I was able to walk away from the room, albeit bent over like an old woman, and my lovely friend who’d been waiting for me in the hospital all this time accompanied me to her car and drove me home. But by now the cramping was absolute agony and I was strongly nauseous.

As soon as I got home I clamped a hot water bottle to my abdomen, made myself a cup of tea, and nibbled a couple of ginger biscuits. Thankfully, within an hour the pain had faded and I was able to watch Netflix without having to brace against it. I didn’t need pain killers again that day, and the morning after there was no increase in cramping or bleeding.

With regards the findings, she specialist nurse said she saw two small fibroids (10mm and 5mm) in my uterine muscle wall which she left in place. Apparently they can’t be removed unless by hysterectomy, which is obviously too extreme at the moment as they’re very small. The uterine lining was 7mm I think she said?? But at that time the cramping was so painful I could barely concentrate on anything.

Apparently they will write me a letter with the results of the biopsy which I should get within the next couple of weeks. So now it’s back to the waiting game.

The Doctor Phoned & It’s Not Good News

SIGH.

And SIGH again.

A few days ago I had an ultrasound on my womb and it showed some fibroids and a thickened lining. I don’t know by how much, but this is not good news. I get the feeling that it’s quite likely to be cancer. It was such a horrible shock to get the phone call. You can tell when a doctor knows something is serious by the words they use and their tone of voice. This was serious. She wasn’t making me any promises. My world reeled about my head and my breathing became shallow. I knew what she was going to say before she said it. I had a sense of a gulf opening up, a crossing over into another world, the world of medical problems, appointments, treatments and severe anxiety.

In a few days’ time I will go for a hysteroscopy where they will investigate further and possibly take a biopsy. For the last 24 hours I’ve been in a horrible state of terror. I have no appetite. My mind has gone into overdrive catastrophising all sorts of painful suffering, early death, and grief-ridden, orphaned children. Last night I couldn’t stop the thoughts coming, wave after wave of them, frightening me ever more and more.

I didn’t sleep a wink. The demons crept all over me until 5:00am. I went to the loo four times, ate a yoghurt, went on social media, read the news, did Wordle, drank water, tossed and turned in my bed… It was horrible.

I’ve now had 24 hours to let it sink in, so although I’m still very, very anxious, I’m not completely overcome by the fear as I was last night.

For any women reading this, wanting to know my symptoms, this is my timeline so far:

18/05/2018    Started HRT patches for first time

10/01/2021    Stopped HRT patches

14/04/2021    Cervical screening showed HPV virus

18/06/2021    Hot flushes so severe I restarted HRT

15/09/2021    Coil removed, stared using ‘Utrogestan 100’ progesterone tablets instead

08/12/2021 – 14/12/202    BLEEDING

17/12/2021     Doctor’s appointment to discuss bleeding, presumed to be menstrual cycle breakthrough bleeding, told me to have monthly 3 days off progesterone, and she’d refer me for a scan but it wasn’t urgent (not two week pathway)

07/03/2022    Ultrasound of womb showed thickened uterine lining and a couple of fibroids

09/03/2022    Referred to hospital gynae team

15/03/2022    Hysteroscopy and biopsy(?)

Goodbye Mirena Coil IUS

And for me at least, it is good riddance. After six years, it was definitely time for us to part ways. I’m 52 and single so it’s not needed for birth control, and I’m on HRT and take progesterone tablets, so it’s not needed as the progesterone part of HRT either.

The Mirena coil is used as effective birth control for about four years so it was even, by now, out of date. So although the nurse I saw six months ago persuaded me to keep it in (against my instincts) I decided I’d had enough of there being a sizeable piece of plastic in my womb for no reason at all, and asked the doctor to take it out today this morning. She agreed.

I stripped off the bottom half of my clothes and lay on the bed. The (female) doctor then switched on the lamp and aimed it between my legs. Awkward… but necessary! Then she inserted the speculum and dilating instrument and cranked it up to widen the cervix to about 5cm. I tried to relax and she told me to take deep breaths, but it was pretty uncomfortable (although not exactly painful). Then she inserted a grabber thing, like a miniature litter picker, and a few seconds later told me to cough… in the same instant I obliged she pulled the strings of the coil and it pinged out onto the bed. That part didn’t hurt at all, and I was delighted. I’d given birth to a t-shaped piece of polyethylene! Straight away I started feeling cramps, and these continued for several hours along with light bleeding, but by late afternoon the bleeding had slowed right down and the cramping had become mild.

So that’s it. I am free of the implant in my womb. Just got to get these large silicone breast implants out now. Five days until the big op….

Back on HRT – Evorel Oestrogen Patches & Utrogestan Progesterone Capsules

Well I tried. I have been six months completely free of any kind of HRT. I started weaning off my oestrogen gel and progesterone capsules in October 2020 and by January 2021 I reduced my dose to nothing. I was delighted to be dealing with the menopause the way my mum dealt with hers: stoically accepting the natural process. Not interfering with my body’s natural hormonal cycles.

And then came the hot flushes. Although that’s not really a fair way to describe what happens. They’re more like Intense Sweating Attacks.

These happen multiple times per day, starting at the neck, where I feel a sudden mushroom of heat that rapidly expands to my ears, face, whole head, and then the rest of my body. Sweat runs off my forehead and seeps out of my neck. Sweat gathers and trickles down my chest, my hair sticks to the skin on my forehead and the back of my neck, sweat pours out of my arms, back, thighs, behind my knees, elbows, shins… EVERY bit of skin on my body suddenly, within seconds, goes from a completely normal temperature to an INTENSELY sweating, deeply uncomfortable hot mess. Why? Why, body, why? What is the point of this unpleasantness? How does it serve me?

The hot flushes happen about twenty times per day and every time I wake in the night (usually about three or four times). My skin is permanently sticky, my bed sheets and bed clothes need to be changed far more regularly than normal, my pillow is often like a cold damp flannel – sweated on so much when I’m asleep that it doesn’t dry out and just gets cold.

I’ve been suffering like this for six months. I also have other health problems – two dislocating knees, a crumbled destroyed hip, and multiple slipped discs in my back. I am having a total hip replacement operation this summer. I also have frequent and intense migraines.

So I have enough trouble without sweating like an elite athlete just sitting watching TV. It’s just one deeply uncomfortable problem I can do without. And since it’s relatively easy to do something about, I finally gave up trying to be natural like my mother, and asked my GP to prescribe HRT.

I collected my first dose this morning and was so desperately excited to get started that I stuck my first patch on in a Waitrose car park. I couldn’t even wait to get home. I’ll take my first progesterone tablet last thing tonight before I go to sleep (because it can make you feel drunk). And that’s me off. Relief is in reach on the horizon!

Ocular Migraine

I think I’ve just had an ocular migraine for the first time in my life. Here’s what happened:

A small smear appeared in my vision, like a tiny thumb-print on a pane of glass, which then started slowly expanding. Wherever I looked, it was there to the left side of my vision, but I had the impression it originated in the centre (and moved away every time I tried to look at it). Then it developed flashing rainbow edges, very bright and jagged, which expanded outwards more and more, until, after about 10 or 15 minutes it disappeared. I got the impression it expanded so far that it went outside my field of vision.

It was terrifying. I thought I might be about to have a stroke! But later, when I texted my friend and happened to mention it, she was able to tell me what it was straight away. It’s migraine with aura. And this is the aura. Migraines I’ve had for years and years, but this vision disturbance is brand new to me.

My friend also told me I shouldn’t be on oestrogen HRT if I have aura because there is an increased risk of stroke. All I can say is thank God I’m already almost weaned off the HRT. I’m just doing half a pump of Estradiol gel now (and taking progesterone tablets to protect my womb). I can’t wait to be off all this artificial hormone stuff and go back to my natural state. Hot flushes are far preferable to strokes.

Menopause Discomfort (50 excerpt)

Another major issue I have to contend with at the age of fifty is the menopause. My poor body is so confused. The other day I went outside to admire the natural wildlife meadow that is my back garden, when I sneezed and slightly wet myself. Sometimes I put on a jumper because I’m feeling cold then immediately break out into an intense sweat all over my body – I’m cold enough to need a jumper, then literally one second later so hot I can barely stand to be just in my bare skin!

The menopause is a constant irritation, a battleground of extreme temperatures, a never-ending reminder of my stage of life and bodily misfortune. I never feel comfortable. I’m twitchy all the time with a niggling, perpetual aggravation, whatever I’m doing, wherever I am. If I’m not sweating and wetting myself, my back is aching, my knees and hips are giving way, or I have a hideous, painful migraine. And I’m rapidly putting on weight in the middle of my body.

Recently, I got so fed up with all this, that I made a doctor’s appointment to try hormone replacement therapy, hoping that perhaps it’ll stabilise the migraines and sweating. I’d try most things if there was a chance of living without this continual discomfort.

I thought I’d use natural remedies as well, alongside the medical solution, so I did some research into the most helpful supplements to take. Apparently all of these can all help:

  1. Black cohosh
  2. Vitamin B6
  3. Sage leaf
  4. Oil of Evening Primrose (for omega 6)
  5. Fish oil (for Omega 3 to balance out the omega 6s)

Utrogestan

Utrogestan is a medication women take when they use HRT. I have just started taking it five days ago because my mirena coil has gone a year-and-a-half past its sell-by date and I’m on estradiol HRT. I’ve decided to reduce my HRT with the goal of stopping it completely. But I have to wean off it gradually, over 2-4 months. If you stop suddenly and go cold turkey you could get an overnight menopause with severe symptoms.

My HRT consists of taking oestrogen gel and a progesterone tablet. You have to have the progesterone tablet if you take oestrogen because if you don’t, the lining of your womb can be damaged. Utrogestan is a body identical manufactured hormone so it’s pretty good, but there is a major side effect. About twenty minutes after taking it, you feel extremely sedated, like you’ve been drugged. It’s hard to get up and walk. You feel dizzy and your eyes want to close. Your body wants to fall to the floor and sleep. This is very strong for about 15 minutes but then slowly wears off over the next hour.

At the moment I’m undecided whether I can cope with this every evening for 2 months. I’m desperate to come of my HRT but I have to take it slowly, which means using the utrogestan for a while. It’s a daunting prospect. But perhaps this effect will lessen over time. I’ll let you know. If I forget, remind me! ***

But the main point of this post was to let other women know that the dizzy, soporific, druggy effect they feel after taking progesterone is normal, and caused by the fact that you have to take a high dose in order for it to make its way through your system to your womb before it’s all digested. There are other methods for getting progesterone into your system so if you don’t feel a reduction in the sedation you could speak to your doctor about this.

*** UPDATE Yes, the effect not only lessons over time it doesn’t happen at all. I only experienced the sedative effect about 2 or 3 times and then never again.

*** ANOTHER UPDATE From time to time, I still get the effect of suddenly being very drunk/drugged/sleepy for 20 minutes. I’m wondering whether, to prevent this, the utrogestan pill must be taken at the same time as applying the estradiol.

Hormones Are Powerful Things

And now I’m worried I’ve given myself cancer. I take HRT to help prevent hot flushes and migraines relating to the menopause. It comes in the form of a colourless, odourless gel that you spread on your arms, but you can only use this if you also have the Mirena coil fitted in your womb giving you the progesterone component of the HRT. If you just have the gel alone it’s likely to damage your womb and/or give you cancer. The Mirena coil works for 4 years as part of the HRT process. The other day, I looked in my diary to find out when I’d had the coil fitted and it was five-and-a-half years ago. I’ve been giving myself the oestrogen gel for a year-and-a-half without the progesterone component and no-one from the medical profession ever got in contact with me.

I panicked, naturally, and sent my doctor an econsultation message (there’s no way I could get an actual, real, face-to-face appointment in Covid times, they simply don’t allow it). Over the phone, the doctor prescribed me progesterone pills to take as a matter of urgency and asked me to book an appointment to have my coil taken out and a new one put in.

However I don’t want to be on HRT at all, or to have a new coil, I want it removed for good. But because I started down this route of tampering with my hormones I can’t suddenly stop. It’s going to take me about three months or more to wean off the HRT, slowly and carefully, and I can’t leave my womb unprotected that long. And actually, if I get unbearable hot flushes I might decide I need HRT for a bit longer after all. In which case I’d need the coil.

The progesterone pill has to be taken on an empty stomach and I NEVER have an empty stomach, so this is very difficult for me. It says in the documentation that the pill should be taken two hours after eating and an hour before eating. Well, I managed it for two days but it’s not sustainable. I was STARVING. And I’ve also been getting continuous powerful migraines (I’ve had six in the last nine days). I have no idea whether they’re connected to suddenly starting the progesterone pill, probably unlikely, but in any case, I stopped taking them today. I’m going to have to leave my womb to get damaged for a little longer. What’s another four days after 1.5 years?

But BOY am I getting cramps now. Which is very worrying. I only took the progesterone for two days but it was obviously powerful stuff. I feel like I’m ovulating again.

I’m all messed up internally and I feel out-of-control over my own body. All I want is to be natural and have no HRT and no coil. But it’s going to take a long time to reach that goal.

Here’s hoping I don’t develop womb cancer before Thursday.

Hot Flush

What does it feel like to have a hot flush when you’re in the menopause? Well, I write about this in 50:

Everything is normal, then suddenly it begins with a mini explosion of heat originating around the ears and neck, before swiftly radiating out over the shoulders. The heat then expands in all directions over the head and down into the body in pulsating waves of such extreme heat that it demands immediate adjustment of clothing. Perspiration breaks out everywhere, including in places I’ve never sweated before: on my chin, shins, stomach, back, and inner arms. The back of my neck becomes moist, and hair clings to the skin as if I’ve just done a work-out at the gym. Rivulets of sweat run down my chest between my breasts. Sweat breaks out on my face and forehead, which shines and glints in the light, even if it’s an overcast, gloomy day. The temperature remains at an unbearably hot intensity for about three minutes, pulsating in slow waves from extreme, to impossibly extreme, before it suddenly, rapidly dissipates and I start to feel a magnificent relief. Sadly, this is instantly followed by being unpleasantly cold as my body instantly cools, the sweat useless on my body, my clothes hanging in chilly wet patches. This happens about twenty-five times per day and every time I wake at night, which can be up to five or six times. Bed sheets, pillow cases, and pyjamas have to be changed every few days. I need to wash frequently, especially under the arms. The need for antibacterial soap is paramount. Everything about this is tedious and irritating. It’s not painful, but it’s deeply unsettling and exasperating.

The menopause induces a raging internal climate change.
But why? What is the point of this suffering?
I don’t think anyone knows. Mother nature has not revealed her reasons.