My story: I started HRT when I was postmenopausal

Fiona, 62, says her generation of slightly older postmenopausal women have missed out on being offered HRT, but could still reap the benefits

‘During my late 40s and 50s, I considered myself lucky that I did not suffer from any menopausal symptoms. But back then, I thought symptoms were limited to sleep disturbances and hot flushes.

‘I’m unclear on when my actual menopause was because in my mid-40s I had a Mirena coil fitted to control heavy bleeding, which I’d experienced for 10 years. I think my menopause was probably sometime in my early 50s.

‘When I was 47, we moved to Canada, where I registered and worked as a pharmacist. I am utterly amazed at how little I knew about hormones considering I worked in a pharmacy. It just seemed of no relevance to me, and I was busy navigating working in a new healthcare system.

‘Now when I reflect on this perimenopausal time, I can now see that I actually did suffer many issues, including recurrent UTIs, burning mouth syndrome, travel anxiety and a plethora of IBS symptoms, all of which were new to me. However, I didn’t realise their significance and I dealt with them myself.

‘We returned to Scotland in 2019 when I was 57 and all was well until November 2021 when I started to develop pelvic and abdominal pain radiating down my legs, which was severe enough for me to admit defeat and speak to a GP.

‘The GP thought I had developed diverticulitis and prescribed me antibiotics. This made me feel worse and did not resolve my pain. I knew it was not gut related. Over the next six months, I was sent for two ultrasounds, an MRI and a referral to gastroenterology. I was given multiple prescriptions for codeine and amitriptyline, hyoscine and mebeverine.

‘The pain in my thighs and legs was the worst symptom, but nothing was really helping. I didn’t take many of those medications as they didn’t help or just made me more tired.

‘By February 2022 I thought I was going to have to give up work, aged 60, but I struggled on and just came home to bed every night with a hot water bottle. It was a very grim time.

‘In May, I got a letter to say I’d been referred to the persistent pain clinic and a recommendation, in the meantime, to try the low FODMAP diet. I cried when I got that letter as I knew I had no gut issues and felt abandoned.

‘We went on holiday with my daughter’s young family and I remember sitting on the plane thinking I wouldn’t care if we crashed as at least the pain would be gone.

‘In July I was desperate for help. I have a good friend who is a GP and although I don’t like mixing friendship with health needs, he offered to see me privately. We had a great talk about persistent pain and got to the subject of HRT. At the same time, one of the pharmacy technicians I occasionally work with said to me ‘you need HRT!’ and told me to download the balance app.

‘My GP friend prescribed Oestrogel and Utrogestan and within a week, I was completely better! All my pain had gone and my life resumed! My palpitations, which I hadn’t realised were a symptom, disappeared too.

‘I was worried my own GP wouldn’t continue my HRT, but she agreed to continue it. She wouldn’t give me Utrogestan as she said it wasn’t transdermal and increased stroke risk – I knew she wasn’t correct, but I thought I’d rather have her on board than argue at this point.

‘I’ve been on Evorel Conti for almost two years and it suits me perfectly. Since I started HRT, I have lost about two stone with the Full Diet, but it was honestly pretty easy as I’m a very healthy eater. I feel full of energy too, so I’m not going to retire yet.

‘In autumn 2022, I did the Confidence in the Menopause online course as I realised I have so many opportunities in my job to help peri and postmenopausal women. Many of my friends have now got HRT as I can’t stop myself talking about it.

‘In Scotland, community pharmacists can prescribe Trimethoprim/Nitrofurantoin as appropriate for UTIs, however I find most of the UTI consultations I have involve women between 40 and 70 so I take this opening to discuss use of vaginal oestrogen and genitourinary syndrome of menopause (GSM).

‘I do worry about the 60-80-year-old group as they totally missed out and so many suffer from pains, insomnia and GSM. I know there isn’t much research in this age group but many are being denied even a trial of HRT if they are over 60.

‘I cannot believe I was so ignorant for so long, and I’m a bit ashamed of my lack of awareness. I am making up for lost time now though and spreading the word. I get colleagues calling me now asking for advice and am encouraging lots of conversations about it. I’m pretty passionate about all this and would like to share my tips with other women:

Talk to other women – a lot!
Educate yourself – balance is a great resource
Talk to the next generation down so they will recognise the less common symptoms.’

To find out about the Confidence in Menopause course see https://newson-health.teachable.com/p/confidence-in-the-menopause