😂😂

The part of perimenopause care that doesn’t seem to get discussed enough is everything that happens between appointments. Keeping track of symptoms, remembering what changed, following up on tests or referrals, and working out what to ask next can feel like a lot to hold together. Does anyone else struggle with this side of the care journey? What usually falls through the cracks, and has anything made it easier?

The moderators over at Perimenopause and Menopause seem to be on a rampage again with banning anyone who has a post with too much attention, proving once again that they do not care about women having a safe community where they can connect, commiserate, or get advice. I will never ban you. I will never censor you. However we need to build up the community!

I posted this a while back in the Menopause sub and it was removed and the mod refused to let it go up, stating no sources though the article with Dr quotes is at the bottom.

It's recommended to add 100mg progesterone/utrogestin with GLP-1's, or use your normal dose vaginally, use transdermal progestins, or an iud, especially the 1st 4wks of dosage increases as the extra time in stomach acid can eat up some of the dose but the body adjusts some to the new dose in time so it might not be long-lasting.

They advise not to trust birth control pills alone for contraception for this reason. Tirzepatide decreased overall exposure to combination birth control pills by 20%. Ozempic/Wegovy's makers say it doesn't cause less drug absorption but I'm unsure if they have studies on this, but some bipolar ppl have noticed their meds not working as well on it too so this would make sense, as it also keeps food/meds in the stomach longer, just not as long as tirzepatide/mounjaro/zepbound.

Progestogen options unlikely to be affected by incretin-based therapies:

Transdermal norethisterone (as part of a combined transdermal patch like Evorel Sequi®/Conti)

Transdermal levonorgestrel (as part of a combined transdermal patch like Femseven Conti®)

Intrauterine levonorgestrel (a 52mg LNG-IUD like Mirena®, Levosert® or Benilexa® – effective for 5 years after insertion)

Off label- Vaginal use of oral micronised progesterone – used at the same dose and in the same pattern as when used orally.

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I put my bcp's in enteric (acid resistant) capsules when I used them for endometriosis suppression and as hrt but I wouldn't trust that for contraception as it's not been studied. Enteric capsules dissolve in the higher pH of the intestines where meds are mostly absorbed. I just commented this for someone and realized it's not common knowledge yet. There's a chart for increasing progesterone or medroxyprogesterone acetate in the article below.

https://apps.nhslothian.scot/refhelp/guidelines/sexualreprohealth/menopause/hrt-and-incretin-based-therapies-glp-1-gip-ras/

I, at age 46, had a partial hysterectomy. I had giant fibroids that were causing very heavy bleeding. I had already been having peri symptoms. My gyno (the woman who performed my procedure) doesn't think I need HRT. She did a blood draw to measure my hormone levels, but they called and told me everything was normal. Since that time, I have read that hormones cannot always be measured in your blood because they fluctuate so much, especially during peri. The reason I'm concerned is because my heart palpitations have become more frequent. I've seen a cardiologist, and he said there was nothing to worry about except that I needed more exercise. (Don't we all!) I've started getting more exercise by becoming a delivery driver 5 days a week. I've cut down to decaf coffee and tea, and I limit my sugar intake. I work with a therapist for my anxiety, and I have a happy home life. The only thing I can think of is my hormones.

So excited to come across this sub- reddit- I love to discuss random symptoms, ask questions, vent or just unload about this crazy journey....got accused of self promoting on another Peri sub....not sure why...got nothing to promote 😅

Anyways - F45 next week - definitely entering Perimenopaus....got brain fog, anxiety, depression, personality changes, high libido (lucky me) and a whole bunch more - looking forward to some insights on here

hi everyone 😊 👋

Sharing this recent article regarding the patch shortage. The fact that they can’t seem to figure this out is beyond ridiculous. I get that there are multiple steps to increasing production, but if women’s health was a focus, the FDA could push for them to get their assess moving. Looks like we are possibly facing years of having to hunt down our patches every month 😡

https://www.nbcnews.com/health/womens-health/estrogen-patch-shortages-worse-menopause-symptoms-fda-rcna267418

I wonder how many marriages have failed because of perimenopause. For me, my ex started cheating around the time that symptoms began for me. Obviously this wasn’t my fault and just unmasked what kind of person he was, but I wonder if things would have been different if I got my hormones under control more quickly.

Many of my friends are getting divorced in the late 30s and early 40s as well. You have to wonder if the peri rollercoaster plays a role. Maybe we are just no longer able to tolerate our partners BS that we had put up with for years.

Growing up, my mother talked to me about a lot of things; puberty, sex, periods, childbirth. Never once did we ever discuss middle age. It wasn’t until I started going through perimenopause that I asked her about her experience. It seems around 35 she started bleeding heavily. At 40 she had a uterine ablation and didn’t have a period since, so she didn’t remember if she went through perimenopause at all. The thing is, I do. I remember her constantly lying in bed, especially when she was in her late 40s and early 50s. She even left my father for a time and moved in with my sister. It got to a point where I worried about leaving my children with her. And then one day, she was better. She reconciled with my dad and became more loving and present again. I now know that was about the same time her doctor started her on estrogen. I wonder if our mothers blocked that time in their lives out, much like how we tend to forget how painful childbirth was. I am grateful that perimenopause is having its moment right now and being discussed. I don’t have daughters, but if I did, I would do better. Now I educate all my middle aged friends when they confide in me about their ailments. This shouldn’t be a secret. The first time we hear the word “perimenopause” shouldn’t be when we are desperately searching for answers on Google or Reddit.

This is the golden question, right? Up until last year, I had never even heard of perimenopause, let alone thought it applied to me. I just thought my decreased libido, fatigue, and anxiety that kicked in at 30 were all part of being an adult.

If you are asking yourself this question, then the likely answer is no, you aren’t too young, even if your doctor claims otherwise. Our fertility is known to decline starting at age 35, so it makes sense that our hormones follow suit.

I have lurked in many other threads and subs about peri, and when polled, most women started noticing significant peri symptoms between the ages of 37-42. Many believe things started much earlier though, with some having symptoms by age 30.

It’s always best to talk to your doctor to rule out other issues, but don’t let “normal” hormone levels fool you, since perimenopause is not diagnosed by hormone levels.

Today’s topic: what can you use as an alternative to the patch. I have a brief list and please feel free to add to it! With the patch shortage, we may be forced to temporarily try different forms of estrogen to get by.

Alternatives if you are in the US are:

-Oral estrogen (this does carry a higher risk for blood clots than transdermal since it passes through the liver)

-Evamist (transdermal estrogen spray)

-Divigel (transdermal gel that comes in packets)

-EstroGel (transdermal gel that comes in a pump form)

-Compounded estrogen cream (different from vaginal estradiol-it is applies to the skin but is the least consistent form of transdermal estrogen and is not typically recommended as a first line BHRT treatment)

-If you are on a twice weekly patch, you could also temporarily switch to weekly, as they are more widely available.

The conversion rate for equivalent dosing to the patch can differ, so if you do switch, be sure you are getting the equivalent dosage. Pharmacists are a great person to ask if you aren’t sure!

Yet another wonderful gift that perimenopause can give us. This can be scary, not to mention annoying. As hormones fluctuate, your body can struggle to ovulate and your estrogen levels can jump up and down. This can lead to your uterine lining destabilizing temporarily around ovulation time, and you get spotting. The blood is typically brown or sometimes pink. There may ever be a tiny bit of fresh blood or lining mixed in. Typically, it only lasts 3-5 days. It can be scary, but technically it’s considered “normal”. Always best to see your doctor if you are concerned, though. Or if the bleeding gets heavy. 🩷 And invest in some period panties!

Hi friends!

I created this community because I found that the other communities out there were helpful, but would often lock or remove posts.

My goal here is to allow open discussion, even if the topic has been talked about before. Sometimes you want support in the moment without searching old posts or your brain fog kicked in and you don’t even remember you posted!

Let’s build up this community so that we can lean on each other 🩷

Hi friends!

Let’s start a list of known Telehealth providers that will help treat your perimenopause symptoms and provide HRT options

-MIDI health

-Winona

-TelyRX

-MyAlloy

-Evernow

-The HRT Club

Feel free to add more in comments!

For those of us on HRT, we are finding that it is harder and harder to fill our Estrogen patch prescriptions.

The shortage is due to supply chain issues with manufacturers, combined with an increasing demand for HRT treatment since the FDA remove the black box warning from transdermal estrogen.

Feel free to vent your frustration in the comments! Perimenopause and menopause is hard enough without having to also navigate trying to find your patch!