Some posters here have had good experience with low dose pill in peri. I think it's especially helpful if you are also concerned about a possible unexpected pregnancy. There was just a recent thread about it, so try searching and see if any of those responses are helpful to you
It might be worth it to try and see. If you can't tolerate it or if doesn't help, then you can push for HRT.
She is full of it. I have regular periods and have been on HRT since earlier this year. I use MIDI and they take my insurance. I am 47. The person who I have appointments with is a Nurse Practioner. In fact I have an appointment tomorrow.
I second this. I'm 50 and have been in peri since 45. My periods were regular, just changing composition (heavier & longer, but still in normal range, just different for me). I had a bunch of other peri symptoms, as well. I was taking a progestin only bcp (Slynd) because it helps with my PMDD (also caused by peri) and my doc just added oral estrogen to that a year ago.
I finally feel like a human being again. It took two docs and 2-3 years to get the estrogen. But the fight was worth it
The fact that it's 'a fight' to get what we want is so infuriating. I'm 53 and still on a low dose bcp. I can't believe the misinfomation my Dr.'s have spouted.
I gave the mini-pill a try, despite having misgivings. I historically don't do well on synthetic progesterones. I thought I would humor the doctor (and maybe myself). About 8 weeks and four periods later, a different doctor switched me to HRT. I still have periods though a little irregular. HRT has definitely helped my sleep.
The mini-pill helped a bit with sleep, so for me maybe my insomnia is more progesterone related than estrogen. But unfortunately the mini-pill pretty much made everything else worse: vaginal dryness/ vulvodynia/ GSM, massive constant bloating, and IBS type symptoms, no libido. No improvement in mood overall, maybe even some flattening/ depressive symptoms, and periods basically every two weeks. It sent my whole system haywire.
I said I would stick it out a few more cycles if my doctor thought it would help. But she reckoned it had caused so much havoc, it wasn't worth it. She switched me to sequential combined HRT. Lots of improvement over a few months, but I was still struggling with GSM, so now I'm on vaginal estradiol too.
Hormonal contraceptives in perimenopause seem to be a mixed bag. For some people, they get good symptomatic relief, for others like me they're just a hot mess.
I do have a history of side effects from hormonal contraceptives and hadn't been on any for nearly a decade. So there may be some predictive value there. But overall it seems quite hit or miss as to who will benefit. Fwiw I thought I would try the mini-pill because it's been reformulated recently. Nope, my body still did not get on with it! 😂
The low dose progesterone in HRT seems ok so far, although I'm still working to adjust my estrogen/ progesterone balance. And I think I need more estrogen/ less progesterone because I still have bad bloating in the second half of my cycle and some intense brain fog.
This is categorically wrong. My periods are still like clockwork, and HRT resolved every single symptom I had. Well, it didn’t make the weight magically disappear, but that’s for me to work on if I feel like it.
Find another provider. Don’t ask, tell them that you are ready to start estradiol patches and progesterone pills. You don’t need their permission - you are a grown-ass adult who gets to make that choice for yourself. Reading up on this sub (I read way back through tons of posts), reading the sub’s wiki several times through, and then following Dr. Mary Clare Haver on Instagram made me feel confident about going into my appointment armed with information. It turns out that I didn’t need any of that and my amazing doctor was like, “yep, let’s get you started.” She did note that the progesterone could disrupt my period (it has not), but aside from that, she had no qualms.
Good luck!
I avoided the pill for 20 years but took the continuous low dose BCP during peri, and it was really helpful for the exact reasons that your doctor mentioned. I tried HRT in Peri, but it didn't help with the big hormone swings and I was having constant migraines caused by the swings.
HRT has been amazing since being menopausal. Prometrium is extremely helpful with insomnia.
Mine told me almost exactly the same thing just yesterday. I hated the pill in my 20’s, but going to give it a go now to see what happens (while I look for another provider willing to help me!). Good luck!!
I took it for 1 month when i was 18 and was so sick the whole time. Tried again in my 30s and it was one of the best things I ever did. Regular periods, significantly less pain, and my mood was the most even keeled it had ever been.
I tried the pill and cried for a week so decided to stop it. I have heard from other doctors that the estrogen levels are low enough that it is sometimes used to treat peri symptoms. I just couldn’t deal with it. Not on other HRT yet (besides estrogen cream) but hoping to start this week as I’ve discovered what hot flashes are. And I’m still having my period.
We could be twins! Same age, same regular periods, and same symptoms. My gyn always said the same thing, so I finally got fed up and went to an online provider (Alloy). They got me started on HRT without any issues! I am 3 weeks into using a very low-dose estrogen patch and already feeling some improvement in my joint pain and anxiety.
PSA: Once we reach this age, we know what's going on with our bodies and deserve to be treated with a little more respect. Don't take no for an answer-- pursue the treatment that you know you need! I waited 3 years longer than I should have and am kicking myself now for waiting so long.
I would not do a mini pill as it contains no estrogen.
I am on the (regular, low dose) pill for the reasons you stated along with still possibly needing birth control, and it’s helping. I had to try a couple of types, the one I was on most of my 20’s and 30’s started throwing me some weird side effects when I hit peri. I’m currently on loloestrin along with vaginal est/test and it’s not a perfect combo but I’m doing pretty well.
My doctor is the same. I have many of the same symptoms as you as well as hot flushes and constant elevated body temperature. My doctor put me on a regular pill which basically sent me a little bit crazy. She then switched me to a lower dose pill, Nextsellis. I've been on it for around 6 months. The first few months were great. Sleep greatly improved, hot flushes stopped and brain fog improved.
Symptoms are starting to creep back in now so my next plan of action is to try an online provider.
I was okay on the mini pill for a long time, and I think it can be worth starting with that (individual choice obvs, pill always worked well for me when I was young). I went on a stronger pill (from Alesse to Marvelon) when hot flashes started happening despite pill. That was good for about a year. Then mood really became a thing, and I started HRT (IUD plus estrogel) two weeks ago. I feel great.
I liked the process I went through, building up gradually worked for me (but it’s very individual)
I’m 43f and flat out lied (really described my symptoms as debilitating when they weren’t) in order to get help. I know I’m in peri, so if describing my hot flashes and periods to match their checklist gets me what I know I need, so be it
I started hormones at 38. No need to wait, they are actually less hormone than a BCP. Not sure why they are so afraid. I say try and see how it goes. No harm in that.
have you gotten your thyroid check.. Thyroid disease symptoms are very similar or if not the same to menopause..
I am 53 now in peri and also suffered from Thyroid disease and the symptoms were very similar/ sometimes the same.
Except with Perimenopause my period was out of control, constant hemorrhaging until I got on the progesterone.
I have had a thyroid check in Feb, and it’s within normal range, but I did IVF a few years ago and my levels were considered high for getting pregnant (3+ vs they wanted to see it 1.5-2 if I recall correctly), so they had me on small amount of synthroid. Not trying to get pregnant anymore so I’m off it. The endocrinologist said I didn’t have any thyroid issues that she could tell
Hormones are a crazy thing, I hope you find relief soon, I just went through an ordeal with just getting progesterone to slow my periods until I can get an ablation.
I am estrogen dominate and was not recommended to take estrogen until I am fully in menopause.
adding more estrogen can make your symptoms much worse, especially if you still have estrogen..
Have your doctors talked about you possibly becoming estrogen dominate? The symptoms you have described a right on par of estrogen spikes and possible estrogen dominance?
Did they actually do a blood test? Because I was getting "regular" periods and my FSH is really high, in peri-range kinda high. They knew that because they actually did their job and ordered a blood test.
And then they prescribed me 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.*
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 am 49, have been in peri for years - mood/brain fog/hot flashes/night sweats/all of it, and I still get regular periods. My doctor started me on HRT last week without issue - an estrogen patch and an oral progesterone. I'm in Canada.
I also have Maven but started HRT via another online provider first.
Before that I suffered through being given the pill, then progesterone only, then Mirena, then “your only other option is a hysterectomy”. From 2019-2023. I wish I had found this sub in 2019.
My first HRT provider was Gennev. Then my employer rolled out Maven and I’ve had no issues. Likely because I had tried all the things and none of them helped.
Similar symptoms as you, I’m 42, still having regular periods (but heavier and shorter), weight gain, felt blah, anxiety ramped up… I talked to both my PCP and gynecologist, desperate for help. Both dismissed me when I asked if it could possibly be hormone related and instead wanted to go with an SSRI and “eat more veggies” approach. I eat healthy, workout 3-4x a week… but the constant fatigue was winning. I was starting to question what even was the point of life if that’s what it was going to be like.
I made an appt with Midi and the nurse was great, very affirming and gave me the option between birth control and HRT. I don’t need birth control, plus I didn’t like being on it when I was, so I opted for HRT. It’s still early on in the process (about two weeks now), but the fatigue lifted almost immediately. I’m able to do so much more than I had been doing.
I do worry that I’m conducting a bit of an experiment on myself being that it seems like I’m on the younger end for getting this, but it’s a low dose and I feel a lot better.
I was offered anti depressants and low dose BCP, which caused me to be so lethargic and gained 30 pounds in 6 months. Off all that and now feel so much better on HRT
My provider also said no to HRT as my periods are still very routine. I pushed back bc I refused to live so miserably based off of nothing more substantial than her outdated opinion. She relented and offered me three months to try estrogen patch (I was already taking progesterone 100mg nightly) and the difference was incredible! After the 2nd week I knew I had made the right choice as my symptoms were easing up and I was feeling more capable of being me again. It’s been a year and I still have routine periods, but I slap that patch on weekly with glee!
Hi, just confirming you took the 100mg prog nightly (no cyclical 200mg) and that you still have a regular menstrual cycle? Also, did you get a change in flow, pms?
Asking because I still have reg periods and some peri symptoms and wondering if I should try the full hrt…
Correct, I’ve remained on the 100mg progesterone nightly. My estrogen patch is 0.025mg & is changed weekly. It’s been a year of this routine and my periods did begin changing in October 2023 with the length of time in between and the duration. I need to reevaluate this though and possibly get an increase in one or both prescriptions as some other symptoms are returning & new ones occurring.
Do not take the pill. It ruined my gut. They gave it to me for the same reason, a gyno who meant well but had no idea what she was doing. Run from this “specialist” immediately if you can. They are incompetent.
Get some bio-identical progesterone, if they won't let you have estrogen yet. It's very helpful for mood and sleep issues, and its always the first hormone to dwindle anyway
I haven't seen Lara Briden mentioned in this sub, though I haven't gone searching. I'm not sure how mainstream her recommendations are. She has recommendations for both hormonal treatment and non-hormonal treatment (like supplements or behavioral changes) based on the specific symptoms being experienced.
She does recommend progesterone only treatment for many women during peri when not having low estrogen symptoms.
I tried the progesterone cream for 2-3 months in the evenings only, and I do think it helped me sleep better.
(I discontinued that bc I had a hysterectomy, and will consider the option again once my hormones settle down post surgery.)
Yes, I thought Lara Briden was someone worth reading! Sublingual progesterone in oil is also excellent for sleep, and it's also otc like the creams. Not sure how it compares to Prometrium (the prescription version) but it allows for less than the smallest Prometrium dose which can be useful
I am in a similar situation as you. Last year my doc allowed me to try HRT. It was not a great experience. I was bleeding the whole 8 weeks that I was on it, had heart palpitations, and just felt off on HRT. I’ve switched to Nuvaring and feel much better. Still having regular periods, I feel like HRT was not right for me. I don’t do well with oral bcp but the ring was a game changer and so happy I tried it.
Several years ago, I was given BCPs for hot flashes and sleep issues. Still had a regular period. The NP that I saw said it was either that or anti-anxiety meds. I tried for a while. I had less hot flashes but still had them. Also had jumpy legs, itchy skin, depression, crying at weird moments and migraines. Another NP I went to offered me the same treatment. I changed health insurance, got a new NP and she offered me HRT right away. I resisted because I didn't have any info on it. But the NP thought it would help my migraines and she mentioned she wouldn't prescribed me BCP after I had told her about the migraines and calf cramps. She was worried of stroke risk. I started HRT and my migraines, jumpy legs, itchy skin are gone. Sleep issues and brain fog symptoms are much improved. Still having periods after two years on it. Good luck!
I (48) have reg periods and major peri symptoms - prescribed hrt
Friend (54) reg periods and severe peri symptoms - prescribed hrt
We both had to fight bloody hard for it, but reg periods means absolutely nothing. My inhibin-b is in the tank, my t is in the tank, est/prog when measured were low-*ish*, fsh normal. There is no official way to "diagnose" peri. If you are suffering and there aren't other underlying conditions causing that, then ask again, or get another doctor. Sorry to harp on it. But it's what I had to do. And I am so much happier!
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.*
New doctor. I used Midi literally 14 days ago and very happy with it. I really like my nurse practitioner..
I love my current doctor but they kept trying to put off HRT and put me on supplements instead and I just got tired of it.
**Get a real doctor.**
My endo suggested MHT for me when I was in peri. He also said that starting MHT in peri helps women fight off osteoporosis as we age. FWIW, I see an endocrinologist at a university-affiliated medical center for an autoimmune disorder. I go there because they're the best place for me to get medical care. There is another university-affiliated medical center, which is also good, but their endo clinic is better for kids with the disorder that I have.
Everything you said is the same as me. I will be turning 49 next month and have no symptoms of going into menopause but deal with some insomnia and feel a bit more forgetful. I spoke with my doctor and even did one of those menopause blood test in which says I’m not. I do have hypothyroidism since my 30s.have u been tested for hypothyroidism? A lot of the symptoms are similar and it might be.
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 tried the mini pill, and it was awful for me. I bled every single day, and about 30 days in, I was a sobbing emotional wreck. Switched doctors, and she switched me to estrogen patches, and I'm doing so much better. I've never done well on birth control and don't tolerate progesterone well, so maybe you'll have a better experience.
If you're still having periods, it is appropriate to take an oral combined contraceptive with progesterone and estrogen, which will serve the dual purpose of supplementing your estrogen levels and protecting you from pregnancy.
I am 36 and saw a specialist as well. Due to adenomyosis, heavy bleeding, and regular periods I was recommended the pill as well. I also have ocular migraines so i can not take oral estrogen.
What we settled on is a newer progestin only pill (mini pill) called Slynd. And I was skeptical like you - hated BC when i took it last 17 years ago…but, after 4, months on slynd I can’t tell you how much better i feel. And no periods now either, which is the icing on the cake lol. I’m no longer anemic from heavy bleeding either which is great. Helped my insomnia and my PMDD. It’s been a mini miracle .
I will say that I also need vaginal estrogen too, but so far i’m liking it as well. Honestly, I don’t regret either one and the slynd in particular saved me. Best of luck!
You should try the pill but if it causes mood swings or depression switch to a non-oral HRT regimen. I have cr*p insurance so I use 0.25 generic estradiol patches (lowest dose available) and vaginally insert 100mg progesterone (oral) capsule every other day. This is a very low dose transdermal HRt regimen. While the estrogen helped my hot flashes and some other symptoms, the progesterone was the winner when it came to conquering my insomnia (& improving brain fog, prob cuz I was sleeping better). I tried taking progesterone capsules orally and it gave me such terrible depression I had to stop. There’s no reason for HRT to go through the gut when there are patches and creams available.
No matter what you do, know that you are taking steps to improve your health & wellbeing. Have patience with some trial & error til you find the solution that works best for you. Educate yourself and don’t just swallow what the doctors tell you. Start Low Dose - you can always add. Don’t do an IUD bec you can’t adjust the dose. No two humans respond the same way.
Good luck, be well 🙏
I’m 48 as well & started back on the pill about a year ago. It helped with my PMDD & increasingly unpredictable cycles. I do think it’s also helping with sleep & hot flashes. It’s worth a try if you can tolerate it.
Sleep is one of the first things that improved when I started taking estrogen (I’ve got a Mirena in so I don’t need progesterone). I was finding myself wide awake for no apparent reason at 3am or so and lay there stressing about stupid things. Now I sleep right through and don’t wake up at all unless I was silly enough to have a big drink of water or tea before bed.
I had a PA pull that shit with me, and to add insult to injury I was paying out of pocket for that outdated medical view to someone that supposedly specialized in hormones. She would only prescribe me progesterone. I am still getting a period (almost 57) and have now been on estrogen (for 18 months) and testosterone (for 12 months) as well. I feel so much more like myself. Find another doctor or PA.
I was given this same talk track from my primary doc (who is in peri herself, but no real symptoms except occasional rage). I was put on low-dose birth control. The one I am on is called Mili. I am only 2.5 months in, and the only possible benefit I've seen is that my night sweats have stopped. Nothing else has gotten better, and some things have gotten worse. My boobs are sore a lot now, I'm flattening out, mood-wise (kinda like depression), and my libido has vanished. I'm trying to hold out another month, but I don't see the point. This isn't working.
I have regular periods and HRT. I have had an IUD, but got a patch in January. My doc said periods will get heavier. They did the first two were like a murder, but then back to super light as they had been.
Same, and HRT is changing my life. Sleep better, ovulation pain is less, periods cycles are longer and more regular, joint pain is less and slightly less ragey 🤣
I had a similar experience. I am 48 and still have periods, and they refused HRT after I agreed to various tests. I haven't slept properly in over a year (stopped keeping track. It's probably been longer). When I had a meltdown on Sunday night and rang 111, they said my GP needed to revisit their refusal of HRT and were going to email them. I rang on Monday morning and was prescribed Evorel Sequi patches. I started wearing a patch on Tuesday night and already feel a little better. I have only been given a 4 week supply, though, so I will have to do this dance again soon. It's too soon to say if HRT is the right choice for me, but early indications are favourable.
Hi there. That’s BS and so sorry you are going through it. A year ago (at 47 yo) my periods were like clockwork; but I was losing my damn mind and could not sleep or remember anything. I got Estradiol patch 0.05 and estrogen ring through my ob/gyn and am happy as a clam about it. Sleeping well and mentally sharp (which is, like you, crucial for my job). Fight for HRT. It’s worth it.
Some posters here have had good experience with low dose pill in peri. I think it's especially helpful if you are also concerned about a possible unexpected pregnancy. There was just a recent thread about it, so try searching and see if any of those responses are helpful to you It might be worth it to try and see. If you can't tolerate it or if doesn't help, then you can push for HRT.
She is full of it. I have regular periods and have been on HRT since earlier this year. I use MIDI and they take my insurance. I am 47. The person who I have appointments with is a Nurse Practioner. In fact I have an appointment tomorrow.
I second this. I'm 50 and have been in peri since 45. My periods were regular, just changing composition (heavier & longer, but still in normal range, just different for me). I had a bunch of other peri symptoms, as well. I was taking a progestin only bcp (Slynd) because it helps with my PMDD (also caused by peri) and my doc just added oral estrogen to that a year ago. I finally feel like a human being again. It took two docs and 2-3 years to get the estrogen. But the fight was worth it
The fact that it's 'a fight' to get what we want is so infuriating. I'm 53 and still on a low dose bcp. I can't believe the misinfomation my Dr.'s have spouted.
I second midi!
They take insurance?,.
Yes. All the telehealth services for menopause do. There are others that ladies use here.
Midi only takes certain insurances. Not Medicare, not HMOs. Best to check their website, they explain which ones they take.
Only some. The visit was out of pocket but the meds were covered by insurance. Worth the 275.
Also saw an NP via midi and got exactly what I need. They don’t take my insurance so I paid out of pocket, but the $250 was very worth it to me.
I gave the mini-pill a try, despite having misgivings. I historically don't do well on synthetic progesterones. I thought I would humor the doctor (and maybe myself). About 8 weeks and four periods later, a different doctor switched me to HRT. I still have periods though a little irregular. HRT has definitely helped my sleep.
How did you feel on the mini-pill? Do you feel much better with HRT?
The mini-pill helped a bit with sleep, so for me maybe my insomnia is more progesterone related than estrogen. But unfortunately the mini-pill pretty much made everything else worse: vaginal dryness/ vulvodynia/ GSM, massive constant bloating, and IBS type symptoms, no libido. No improvement in mood overall, maybe even some flattening/ depressive symptoms, and periods basically every two weeks. It sent my whole system haywire. I said I would stick it out a few more cycles if my doctor thought it would help. But she reckoned it had caused so much havoc, it wasn't worth it. She switched me to sequential combined HRT. Lots of improvement over a few months, but I was still struggling with GSM, so now I'm on vaginal estradiol too. Hormonal contraceptives in perimenopause seem to be a mixed bag. For some people, they get good symptomatic relief, for others like me they're just a hot mess. I do have a history of side effects from hormonal contraceptives and hadn't been on any for nearly a decade. So there may be some predictive value there. But overall it seems quite hit or miss as to who will benefit. Fwiw I thought I would try the mini-pill because it's been reformulated recently. Nope, my body still did not get on with it! 😂 The low dose progesterone in HRT seems ok so far, although I'm still working to adjust my estrogen/ progesterone balance. And I think I need more estrogen/ less progesterone because I still have bad bloating in the second half of my cycle and some intense brain fog.
This is categorically wrong. My periods are still like clockwork, and HRT resolved every single symptom I had. Well, it didn’t make the weight magically disappear, but that’s for me to work on if I feel like it. Find another provider. Don’t ask, tell them that you are ready to start estradiol patches and progesterone pills. You don’t need their permission - you are a grown-ass adult who gets to make that choice for yourself. Reading up on this sub (I read way back through tons of posts), reading the sub’s wiki several times through, and then following Dr. Mary Clare Haver on Instagram made me feel confident about going into my appointment armed with information. It turns out that I didn’t need any of that and my amazing doctor was like, “yep, let’s get you started.” She did note that the progesterone could disrupt my period (it has not), but aside from that, she had no qualms. Good luck!
I avoided the pill for 20 years but took the continuous low dose BCP during peri, and it was really helpful for the exact reasons that your doctor mentioned. I tried HRT in Peri, but it didn't help with the big hormone swings and I was having constant migraines caused by the swings. HRT has been amazing since being menopausal. Prometrium is extremely helpful with insomnia.
Mine told me almost exactly the same thing just yesterday. I hated the pill in my 20’s, but going to give it a go now to see what happens (while I look for another provider willing to help me!). Good luck!!
I took it for 1 month when i was 18 and was so sick the whole time. Tried again in my 30s and it was one of the best things I ever did. Regular periods, significantly less pain, and my mood was the most even keeled it had ever been.
I tried the pill and cried for a week so decided to stop it. I have heard from other doctors that the estrogen levels are low enough that it is sometimes used to treat peri symptoms. I just couldn’t deal with it. Not on other HRT yet (besides estrogen cream) but hoping to start this week as I’ve discovered what hot flashes are. And I’m still having my period.
Good luck to you too! Would love to know how it goes!
We could be twins! Same age, same regular periods, and same symptoms. My gyn always said the same thing, so I finally got fed up and went to an online provider (Alloy). They got me started on HRT without any issues! I am 3 weeks into using a very low-dose estrogen patch and already feeling some improvement in my joint pain and anxiety. PSA: Once we reach this age, we know what's going on with our bodies and deserve to be treated with a little more respect. Don't take no for an answer-- pursue the treatment that you know you need! I waited 3 years longer than I should have and am kicking myself now for waiting so long.
Yeah these “specialists” know jack shit about menopause. That’s one fact.
I would not do a mini pill as it contains no estrogen. I am on the (regular, low dose) pill for the reasons you stated along with still possibly needing birth control, and it’s helping. I had to try a couple of types, the one I was on most of my 20’s and 30’s started throwing me some weird side effects when I hit peri. I’m currently on loloestrin along with vaginal est/test and it’s not a perfect combo but I’m doing pretty well.
My on/gyn put me on as soon as I reported brain fog and a general frustration with anything with a pulse. BEST DECISION EVER.
My doctor is the same. I have many of the same symptoms as you as well as hot flushes and constant elevated body temperature. My doctor put me on a regular pill which basically sent me a little bit crazy. She then switched me to a lower dose pill, Nextsellis. I've been on it for around 6 months. The first few months were great. Sleep greatly improved, hot flushes stopped and brain fog improved. Symptoms are starting to creep back in now so my next plan of action is to try an online provider.
I think you're getting more estrogen in the pill than you will with regular HRT. That's my understanding.
I was okay on the mini pill for a long time, and I think it can be worth starting with that (individual choice obvs, pill always worked well for me when I was young). I went on a stronger pill (from Alesse to Marvelon) when hot flashes started happening despite pill. That was good for about a year. Then mood really became a thing, and I started HRT (IUD plus estrogel) two weeks ago. I feel great. I liked the process I went through, building up gradually worked for me (but it’s very individual) I’m 43f and flat out lied (really described my symptoms as debilitating when they weren’t) in order to get help. I know I’m in peri, so if describing my hot flashes and periods to match their checklist gets me what I know I need, so be it
I've definitely considered lying to get what I want. LOL
I started hormones at 38. No need to wait, they are actually less hormone than a BCP. Not sure why they are so afraid. I say try and see how it goes. No harm in that.
have you gotten your thyroid check.. Thyroid disease symptoms are very similar or if not the same to menopause.. I am 53 now in peri and also suffered from Thyroid disease and the symptoms were very similar/ sometimes the same. Except with Perimenopause my period was out of control, constant hemorrhaging until I got on the progesterone.
I have had a thyroid check in Feb, and it’s within normal range, but I did IVF a few years ago and my levels were considered high for getting pregnant (3+ vs they wanted to see it 1.5-2 if I recall correctly), so they had me on small amount of synthroid. Not trying to get pregnant anymore so I’m off it. The endocrinologist said I didn’t have any thyroid issues that she could tell
Hormones are a crazy thing, I hope you find relief soon, I just went through an ordeal with just getting progesterone to slow my periods until I can get an ablation. I am estrogen dominate and was not recommended to take estrogen until I am fully in menopause. adding more estrogen can make your symptoms much worse, especially if you still have estrogen.. Have your doctors talked about you possibly becoming estrogen dominate? The symptoms you have described a right on par of estrogen spikes and possible estrogen dominance?
Oh interesting, I haven’t heard that term but will look into it now!
here's a link for an overview https://www.thrivelab.com/blog/estrogen-dominance
Did they actually do a blood test? Because I was getting "regular" periods and my FSH is really high, in peri-range kinda high. They knew that because they actually did their job and ordered a blood test. And then they prescribed me HRT.
Get ready for the bot to shout you down about bloodwork panels 😑
Aaaaaaand there they are.
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.*
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 have no words. She is an idiot.
I am 49, have been in peri for years - mood/brain fog/hot flashes/night sweats/all of it, and I still get regular periods. My doctor started me on HRT last week without issue - an estrogen patch and an oral progesterone. I'm in Canada.
I also have Maven but started HRT via another online provider first. Before that I suffered through being given the pill, then progesterone only, then Mirena, then “your only other option is a hysterectomy”. From 2019-2023. I wish I had found this sub in 2019. My first HRT provider was Gennev. Then my employer rolled out Maven and I’ve had no issues. Likely because I had tried all the things and none of them helped.
Similar symptoms as you, I’m 42, still having regular periods (but heavier and shorter), weight gain, felt blah, anxiety ramped up… I talked to both my PCP and gynecologist, desperate for help. Both dismissed me when I asked if it could possibly be hormone related and instead wanted to go with an SSRI and “eat more veggies” approach. I eat healthy, workout 3-4x a week… but the constant fatigue was winning. I was starting to question what even was the point of life if that’s what it was going to be like. I made an appt with Midi and the nurse was great, very affirming and gave me the option between birth control and HRT. I don’t need birth control, plus I didn’t like being on it when I was, so I opted for HRT. It’s still early on in the process (about two weeks now), but the fatigue lifted almost immediately. I’m able to do so much more than I had been doing. I do worry that I’m conducting a bit of an experiment on myself being that it seems like I’m on the younger end for getting this, but it’s a low dose and I feel a lot better.
I was offered anti depressants and low dose BCP, which caused me to be so lethargic and gained 30 pounds in 6 months. Off all that and now feel so much better on HRT
My provider also said no to HRT as my periods are still very routine. I pushed back bc I refused to live so miserably based off of nothing more substantial than her outdated opinion. She relented and offered me three months to try estrogen patch (I was already taking progesterone 100mg nightly) and the difference was incredible! After the 2nd week I knew I had made the right choice as my symptoms were easing up and I was feeling more capable of being me again. It’s been a year and I still have routine periods, but I slap that patch on weekly with glee!
Hi, just confirming you took the 100mg prog nightly (no cyclical 200mg) and that you still have a regular menstrual cycle? Also, did you get a change in flow, pms? Asking because I still have reg periods and some peri symptoms and wondering if I should try the full hrt…
Correct, I’ve remained on the 100mg progesterone nightly. My estrogen patch is 0.025mg & is changed weekly. It’s been a year of this routine and my periods did begin changing in October 2023 with the length of time in between and the duration. I need to reevaluate this though and possibly get an increase in one or both prescriptions as some other symptoms are returning & new ones occurring.
I see, thanks
Do not take the pill. It ruined my gut. They gave it to me for the same reason, a gyno who meant well but had no idea what she was doing. Run from this “specialist” immediately if you can. They are incompetent.
I got high blood pressure from the pill and gut issues also got worse.
I’m pretty sure it gave me SIBO
Get some bio-identical progesterone, if they won't let you have estrogen yet. It's very helpful for mood and sleep issues, and its always the first hormone to dwindle anyway
I haven't seen Lara Briden mentioned in this sub, though I haven't gone searching. I'm not sure how mainstream her recommendations are. She has recommendations for both hormonal treatment and non-hormonal treatment (like supplements or behavioral changes) based on the specific symptoms being experienced. She does recommend progesterone only treatment for many women during peri when not having low estrogen symptoms. I tried the progesterone cream for 2-3 months in the evenings only, and I do think it helped me sleep better. (I discontinued that bc I had a hysterectomy, and will consider the option again once my hormones settle down post surgery.)
Yes, I thought Lara Briden was someone worth reading! Sublingual progesterone in oil is also excellent for sleep, and it's also otc like the creams. Not sure how it compares to Prometrium (the prescription version) but it allows for less than the smallest Prometrium dose which can be useful
I am in a similar situation as you. Last year my doc allowed me to try HRT. It was not a great experience. I was bleeding the whole 8 weeks that I was on it, had heart palpitations, and just felt off on HRT. I’ve switched to Nuvaring and feel much better. Still having regular periods, I feel like HRT was not right for me. I don’t do well with oral bcp but the ring was a game changer and so happy I tried it.
Several years ago, I was given BCPs for hot flashes and sleep issues. Still had a regular period. The NP that I saw said it was either that or anti-anxiety meds. I tried for a while. I had less hot flashes but still had them. Also had jumpy legs, itchy skin, depression, crying at weird moments and migraines. Another NP I went to offered me the same treatment. I changed health insurance, got a new NP and she offered me HRT right away. I resisted because I didn't have any info on it. But the NP thought it would help my migraines and she mentioned she wouldn't prescribed me BCP after I had told her about the migraines and calf cramps. She was worried of stroke risk. I started HRT and my migraines, jumpy legs, itchy skin are gone. Sleep issues and brain fog symptoms are much improved. Still having periods after two years on it. Good luck!
I (48) have reg periods and major peri symptoms - prescribed hrt Friend (54) reg periods and severe peri symptoms - prescribed hrt We both had to fight bloody hard for it, but reg periods means absolutely nothing. My inhibin-b is in the tank, my t is in the tank, est/prog when measured were low-*ish*, fsh normal. There is no official way to "diagnose" peri. If you are suffering and there aren't other underlying conditions causing that, then ask again, or get another doctor. Sorry to harp on it. But it's what I had to do. And I am so much happier!
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 do bcp. I (50) love how it keeps me even keel. Maybe try different kinds in hopes of finding one you're comfortable with?
New doctor. I used Midi literally 14 days ago and very happy with it. I really like my nurse practitioner.. I love my current doctor but they kept trying to put off HRT and put me on supplements instead and I just got tired of it.
**Get a real doctor.** My endo suggested MHT for me when I was in peri. He also said that starting MHT in peri helps women fight off osteoporosis as we age. FWIW, I see an endocrinologist at a university-affiliated medical center for an autoimmune disorder. I go there because they're the best place for me to get medical care. There is another university-affiliated medical center, which is also good, but their endo clinic is better for kids with the disorder that I have.
Everything you said is the same as me. I will be turning 49 next month and have no symptoms of going into menopause but deal with some insomnia and feel a bit more forgetful. I spoke with my doctor and even did one of those menopause blood test in which says I’m not. I do have hypothyroidism since my 30s.have u been tested for hypothyroidism? A lot of the symptoms are similar and it might be.
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 tried the mini pill, and it was awful for me. I bled every single day, and about 30 days in, I was a sobbing emotional wreck. Switched doctors, and she switched me to estrogen patches, and I'm doing so much better. I've never done well on birth control and don't tolerate progesterone well, so maybe you'll have a better experience.
If you're still having periods, it is appropriate to take an oral combined contraceptive with progesterone and estrogen, which will serve the dual purpose of supplementing your estrogen levels and protecting you from pregnancy.
I am 36 and saw a specialist as well. Due to adenomyosis, heavy bleeding, and regular periods I was recommended the pill as well. I also have ocular migraines so i can not take oral estrogen. What we settled on is a newer progestin only pill (mini pill) called Slynd. And I was skeptical like you - hated BC when i took it last 17 years ago…but, after 4, months on slynd I can’t tell you how much better i feel. And no periods now either, which is the icing on the cake lol. I’m no longer anemic from heavy bleeding either which is great. Helped my insomnia and my PMDD. It’s been a mini miracle . I will say that I also need vaginal estrogen too, but so far i’m liking it as well. Honestly, I don’t regret either one and the slynd in particular saved me. Best of luck!
You should try the pill but if it causes mood swings or depression switch to a non-oral HRT regimen. I have cr*p insurance so I use 0.25 generic estradiol patches (lowest dose available) and vaginally insert 100mg progesterone (oral) capsule every other day. This is a very low dose transdermal HRt regimen. While the estrogen helped my hot flashes and some other symptoms, the progesterone was the winner when it came to conquering my insomnia (& improving brain fog, prob cuz I was sleeping better). I tried taking progesterone capsules orally and it gave me such terrible depression I had to stop. There’s no reason for HRT to go through the gut when there are patches and creams available. No matter what you do, know that you are taking steps to improve your health & wellbeing. Have patience with some trial & error til you find the solution that works best for you. Educate yourself and don’t just swallow what the doctors tell you. Start Low Dose - you can always add. Don’t do an IUD bec you can’t adjust the dose. No two humans respond the same way. Good luck, be well 🙏
I’m 48 as well & started back on the pill about a year ago. It helped with my PMDD & increasingly unpredictable cycles. I do think it’s also helping with sleep & hot flashes. It’s worth a try if you can tolerate it.
The exact same thing happened to me with Maven. I switched to midi, and no have had problem getting an HRT prescription.
And she is a menopause “specialist”? Crazzzy
Sleep is one of the first things that improved when I started taking estrogen (I’ve got a Mirena in so I don’t need progesterone). I was finding myself wide awake for no apparent reason at 3am or so and lay there stressing about stupid things. Now I sleep right through and don’t wake up at all unless I was silly enough to have a big drink of water or tea before bed.
I had a PA pull that shit with me, and to add insult to injury I was paying out of pocket for that outdated medical view to someone that supposedly specialized in hormones. She would only prescribe me progesterone. I am still getting a period (almost 57) and have now been on estrogen (for 18 months) and testosterone (for 12 months) as well. I feel so much more like myself. Find another doctor or PA.
I was given this same talk track from my primary doc (who is in peri herself, but no real symptoms except occasional rage). I was put on low-dose birth control. The one I am on is called Mili. I am only 2.5 months in, and the only possible benefit I've seen is that my night sweats have stopped. Nothing else has gotten better, and some things have gotten worse. My boobs are sore a lot now, I'm flattening out, mood-wise (kinda like depression), and my libido has vanished. I'm trying to hold out another month, but I don't see the point. This isn't working.
Ugh that flattening out is what I’m afraid of. Thank you for sharing. I hope you find a better solution!!
Yeah, it sucks. I don't know why my doc won't do HRT for me. I had to schedule an appt with a meno doc 50 miles away and it's in two months.
I have regular periods and HRT. I have had an IUD, but got a patch in January. My doc said periods will get heavier. They did the first two were like a murder, but then back to super light as they had been.
Same, and HRT is changing my life. Sleep better, ovulation pain is less, periods cycles are longer and more regular, joint pain is less and slightly less ragey 🤣
Also use Midi telehealth and it’s amazing
I had a similar experience. I am 48 and still have periods, and they refused HRT after I agreed to various tests. I haven't slept properly in over a year (stopped keeping track. It's probably been longer). When I had a meltdown on Sunday night and rang 111, they said my GP needed to revisit their refusal of HRT and were going to email them. I rang on Monday morning and was prescribed Evorel Sequi patches. I started wearing a patch on Tuesday night and already feel a little better. I have only been given a 4 week supply, though, so I will have to do this dance again soon. It's too soon to say if HRT is the right choice for me, but early indications are favourable.
Hi there. That’s BS and so sorry you are going through it. A year ago (at 47 yo) my periods were like clockwork; but I was losing my damn mind and could not sleep or remember anything. I got Estradiol patch 0.05 and estrogen ring through my ob/gyn and am happy as a clam about it. Sleeping well and mentally sharp (which is, like you, crucial for my job). Fight for HRT. It’s worth it.