First of all, the last thing a migraineur needs is dosing with oestrogen and second of all the last thing a spoonie needs is a new slew of drugs and their side effects on top of whatever nest of medications they are already juggling. Woah – there’s a mixed metaphor for you, and as good an illustration as any of just how MESSY things can get with multiple medications.
A quick look, then, at what symptoms HRT attempts to address;
- hot flushes
- night sweats
- vaginal dryness
- loss of sex drive (libido)
- stress incontinence: leaking urine when you cough or sneeze
- thinning of the bones: this can lead to brittle bones (osteoporosis)
(from the NHS page on HRT)
I started getting night sweats a couple of years ago. What with my already multifarious symptoms I kind of put it down to more fibro crap. I’d wake up with wet hair and a soggy duvet. It’s worth sleeping alone if this is going to be exacerbated by a partner, or if they are in any way irritated with you – their irritation is something you can probably live without. It did pass, though. I don’t get it any more, so it wasn’t forever. I have a bath in the morning anyway, and really, that seems to me to be good enough. That is to say – not worth taking a drug for.
Hot flushes. Hard to say when this started since it overlapped with getting too hot taking the dog out, ending up sweating and then having cold sweat next to my body. By the time I had problem solved the dog walks the spontaneous hot sweats were only an addendum to my problem solving prowess. This is what I did – I bought merino wool thermal vests. These can be worn on their own in the summer, since they don’t look particularly like underwear, and can be worn for exercise as well. Like cashmere, merino wool is excellent at dealing with sweat AND it’s smell. Cotton tops just get wet and stay wet and are horrible. They also have to be washed after one wear. Not the merino or cashmere garment. The fibers wick away the wetness so you stay comfortable, and don’t stink up, so you can wear them for several days. They wear well, too. I bought my black long sleeve ones a few years ago now, and they are still going strong, and I have just bought a cami vest to try out, and if it is good I’ll be getting another couple. Because you don’t need to change them you don’t need to buy many.
My other thing is that rather than have my hair short I just always have a hair grabby thing handy. If I am hot I put my hair up, if not I let it down. I wash it most days. Evidently ‘late’ middle aged women seem to have taken to having short hair in droves. It’s up to you, it’s not the LAW.
Be careful if you get vaginal dryness. I haven’t had a problem with this so far, but having worked at Sh! I happen to know that lubricants have different properties so it’s worth getting a bit of advice on which brand to go for. Some people’s bodies are a bit trigger happy with thrush, and I know that some lubricants are more advisable than others for this. You can get a basic one on prescription, but it’s not a medication as such, so has no systemic effect. Also, again with the cotton, or even worse, man made fibres. Silk knickers are the most breatheable.
Sex drive? Meh – it’s not brilliant, but I’m alright once I get going. Not being very sexually driven is a bit of a relief actually. I wouldn’t medicate for it. In any case the female version of Viagra is a massive dose of hormones – which for the migraineur, again a no no.
Stress incontinence is not something I have a problem with, but then I’ve never given birth. Kegels. I guess? And those disposable gussets? Develop a no sense of humour rule? And no sneezing. Definitely no sneezing.
Brittle bones. This is something women can be prone to. The answer is weight bearing exercise. If you want to, or you are too posh to do your own housework then go to the gym. Personally, I’m doing what I can within the limitations of my spoons.
I do use one hormone. And it’s a good one. Because of the migraines, and the really AWFULNESS of hormonal ones I have used progesterone based contraception for many years. I have had injections and pills over the years, but eventually I started getting some side effects so I was offered the Mirena coil. I’d never fancied coils much, since I always imagined they would stab you to death from the inside. This despite there NEVER being any headlines about women being stabbed to death by their coils. Regular coils are, again, a no no for the migraineur, since they actually make periods heavier (and with endometriosis in my picture, too, any blood is too much blood, so too much blood is WAY too much blood). The Mirena coil, however, has a tiny release of progesterone which near enough stops periods entirely. This genius piece of engineering is staying in until it is ALL OVER. It’s quite new, and maybe it’s a bit expensive, because it was slightly tricky to get, but you know, they actually use it instead of hysterectomy, so good it is at it’s job. And this, bubs, can also be good for seeing off any cheeky little womb cancers that think they might like living in your pouch.
So that’s my plan, anyway, and so far it is working for me. It’s up to you what you want to do, but HRT is not the only game in town. It’s an option, but not for everyone.