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Thread: Female Issues

  1. #1
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    Female Issues

    Hi. Sorry to the guys - you can just skip this thread.................

    I always come here to get "real life" and professional opinions on things.

    Does anyone have experience with menopause/hormone replacement therapy? I ended up going to a gyn yesterday trying to get some help (after 6 years). But apparently, if you don't have insurance, they don't really want to help you longer than 15 minutes. And they just suggest hormones for anything. I've read everything I can out there, which is just more confusing. I had my list of questions and history and everything but I didn't really get any answers. The only thing she suggested was to have a pap smear, which does not have anything to do with menopause. I thought they would do blood tests or something, but I didn't even get any kind of exam.

    Anyway, if there are not any tests for estrogen/progesterone, etc. how do you know which one you need or have too much of. I don't like the idea of starting pills that have worse side effects than the problem just to see if they work. What if they don't? I don't know what to do.

    I don't want to join a menopause website or chat because they just try to sell their product. If anyone wants to continue this discussion here (with details of my problem) or email me privately, please do. Thanks.

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    Hi Susan1 - not sure what kind of issues you're having but I'll share a bit of what I know. I recently underwent an almost complete hysterectomy, leaving only my cervix. I am in my forties. My doctor refused to consider hormones as there is both breast cancer and uterine cancer in my immediate family. I was slammed into menopause by the surgery and was dealing with night sweats, sleep disturbances etc. I have a friend who works for Webber Naturals so asked her for advice. She steered me to a product called Klimakt Heel produced in Germany. A naturopathic doctor she knew recommends it to patients. I used it and it helped me a lot.

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    Susan1, there are hormone levels you can get done, in terms of bloodwork. I'm not sure what the costs entailed would be (I'm sure astronomical, like so much else in our health system, sigh). There are natural hormonal preparations you can get at places like Whole Foods, or other health food stores. Additionally, soy products can increase estrogen levels, so just switching out from regular milk to soy milk can make a mild difference. Wishing you luck, it's something I'm not yet familiar with (but of course, the clock is ticking...)

    Oh, and pap smears, while having nothing to do with menopause, are a positive thing to do for health maintenance; if you have a family cancer history, yearly; if not, then every 3-5 years should be adequate.
    I am free of all prejudices. I hate everyone equally.~W. C. Fields

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    hystersisters.com - it saved my life years ago. No sales pitches for products, the forums are full of women who share advice and ideas. I recommend it to everyone female. And it's never too early to talk about these things. I had cervical cancer years ago, and a complete hysterectomy almost 5 years ago. Was on Premarin, both pills and cream, went cold turkey once my mom was diagnosed with breast cancer (my aunt died from it in her late 60's). Doctor told me I could stay on it since my, um, parts had been removed, but I refused.

    There was a hysterectomy/menopause thread here a few weeks/month ago - lots of good advice there.

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    To all above so I don't have to copy (and I'm bouncing around as I think)....... I don't need to have a hysterectomy or anything like that. Everything was always perfectly fine at the gyn every year.
    Yesterday she told me that there are no tests for estrogen (beyond if you are pregnant or not). I had the FSH and luteinizing (sp) tests a year ago that were exactly right down the middle of the range that says you are in menopause. Uh, I know that. Have been since 2005. Stopped going to gyn (no insurance) in 2007 (no problems). However, still having hot flashes, night sweats, hair loss that are getting worse. Previous gyn had me try soy - it made me sick (which just about everything does). Yesterday she said some of the over the counter things work for some women and some don't, so that was not a lot of help. Progesterone cream used to work in the summer, but I kept reading about it causing (or helping, depending what page you read, geez) hair loss, so I stopped.
    Why have so many people at my age had hysterectomies? I can't find anybody who has/had normal menopause. It's supposed to go how your mother's went and my mom's was pretty much nothing. She thought she was pregnant because she wasn't having periods. They said no it's menopause. That was it. No hot flashes, night sweats, any anything. I guess I got all the symptoms she did not have. Both my aunts had hysterectomies. Other women I had talked to at work over the years had them too. No breast cancer in the family. All my mammograms were normal. I did have fibroids 10 years ago, which previous gyn said not to worry about unless I was planning to get pregnant (not) unless they caused pain (none). I've also had fibromyalgia for the past 15 years. And I just seem to have developed high blood pressure this past week (when it was normal last Friday)!!!!!!!!!!!!!!! What???????? Just shoot me now.
    I'll probably call about the pap smear Monday. That should be mostly covered under HCAP? I'll ask her again about blood tests. (Uh, my gyn yesterday didn't look old enough to even be out of medical school. What does she know about hot flashes!!) (How do I find the other thread?!!!!!!!!!!!!!!)
    Forgot to mention, checked at Walgreen - the estrogen/progesterone combo pill is $70/month. But individually, they are $8 and $12/month. Huh? Plus, they are each on the discount drug list at $5/month (the combo pill is not), so $$$ would not be a hardship if this is what I need to do.
    Last edited by Susan1; 09-27-2013 at 09:16 PM.

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    Well, I guess I'm the one who had a normal menopause, but I can't help you with any hormone advice. I had hot flashes that were annoying but never debilitating. Never talked to a doctor because I never needed to. After about eight years, I do still get hot flashes some of the time - more in the summer than winter. I can almost time them by other things. If I get up at night to use the bathroom, I can plan on a hot flash about 10 minutes later. I used to be able to time them after eating as well - about an hour after eating.

    There are other things that can cause hot flashes. My sister gets them from niacin. You might also want to explore whether or not you are getting enough of certain vitamins and minerals. My one issue, that had me a bit worried for a while, turned out to be just general drying out of everything - even to my eyes and fingernails. I have been taking vitamin D over the last several months and that seems to be helping quite a bit. Oh, and I started taking fish oil a couple of years ago and that has helped a lot of things too - especially my blood pressure.

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    There are many drugs that will cause symptoms of hot flashes. Especially if you have been diagnosed with fibro and started some medications with that treatment. Or on any medications or even some over the counter meds, like some allergy meds. Check with your pharmacist. She/he can tell you what type of estrogen treatments are available including those "natural" over the counter treatments. Again, before using those, I would consult with the pharmacist to see if anything you take or use will interfere with them, or even which ones to trust. There is no FDA regulation of those natural remedies - which means that the amount of whatever drug varies from manufacturer to manufacturer and even batch to batch with the same manufacturer Do you drink red wines or eat foods high in salt? Drink high caffeine drinks?

    Also, hot flashes, night sweats, hair loss can be symptoms of many diseases. A thyroid screen might be needed, ANA checked, lots of other labs to be considered. If you are in the US and it seems that you are, once you get enrolled into a healthcare plan ask for a good internist to help you determine if these symptoms are part of another disease. GYNs tend to think specialty. However, the younger ones are more likely to think about other disease processes just because they have recently done their internships. If you seem to have developed many "new" diseases like elevated BP again, that should be evaluated with all the diseases/symptoms - best done by an internist

    If you have symptoms of vaginal atrophy, they can do scrapings to measure the amount of estrogen and prescribe a topical estrace cream.

    I think that the number of women who have undergone menopause without hysterectomy have to be in large numbers on this board.

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    Quote Originally Posted by A.H.Black View Post
    Well, I guess I'm the one who had a normal menopause, but I can't help you with any hormone advice. I had hot flashes that were annoying but never debilitating. Never talked to a doctor because I never needed to. After about eight years, I do still get hot flashes some of the time - more in the summer than winter. I can almost time them by other things. If I get up at night to use the bathroom, I can plan on a hot flash about 10 minutes later. I used to be able to time them after eating as well - about an hour after eating.

    There are other things that can cause hot flashes. My sister gets them from niacin. You might also want to explore whether or not you are getting enough of certain vitamins and minerals. My one issue, that had me a bit worried for a while, turned out to be just general drying out of everything - even to my eyes and fingernails. I have been taking vitamin D over the last several months and that seems to be helping quite a bit. Oh, and I started taking fish oil a couple of years ago and that has helped a lot of things too - especially my blood pressure.
    Kind of makes me wonder if some of my "hot flashes" are not menopause hot flashes. I can be sitting in the air conditioning eating ice cream between 8 and 9 p.m. and I get one. Or if I am just watching t.v. freezing and get up to go to the bathroom, I get one. I've looked up "sweating" and the only thing is excessive sweating that you would use special deodorant for or something like that. The only place on me that sweats is my head. It glues what little hair I have to my head and runs in rivers down the side of my face. Or in the middle of winter with the heat turned down, I can vacuum one room but by the time I get to the second room, everything from the neck up is soaked. Why does that not sound like menopause hot flashes to me?

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    Quote Originally Posted by numbers123 View Post
    There are many drugs that will cause symptoms of hot flashes. Especially if you have been diagnosed with fibro and started some medications with that treatment. Or on any medications or even some over the counter meds, like some allergy meds. Check with your pharmacist. She/he can tell you what type of estrogen treatments are available including those "natural" over the counter treatments. Again, before using those, I would consult with the pharmacist to see if anything you take or use will interfere with them, or even which ones to trust. There is no FDA regulation of those natural remedies - which means that the amount of whatever drug varies from manufacturer to manufacturer and even batch to batch with the same manufacturer Do you drink red wines or eat foods high in salt? Drink high caffeine drinks?

    Also, hot flashes, night sweats, hair loss can be symptoms of many diseases. A thyroid screen might be needed, ANA checked, lots of other labs to be considered. If you are in the US and it seems that you are, once you get enrolled into a healthcare plan ask for a good internist to help you determine if these symptoms are part of another disease. GYNs tend to think specialty. However, the younger ones are more likely to think about other disease processes just because they have recently done their internships. If you seem to have developed many "new" diseases like elevated BP again, that should be evaluated with all the diseases/symptoms - best done by an internist

    If you have symptoms of vaginal atrophy, they can do scrapings to measure the amount of estrogen and prescribe a topical estrace cream.

    I think that the number of women who have undergone menopause without hysterectomy have to be in large numbers on this board.
    I've never taken anything for fibro. My stomach can't tolerate anything stronger than tylenol. It's just always been do what you can do until you can't and then try again tomorrow. Thyroid is always fine. I only drink caffeinated pop through lunch time - never caffeinated coffee. No wine, not much salt. I'll check with the pharmacist at CVS about estrogen and stuff today when I go take my blood pressure. I'm supposed to do that all weekend and let my regular doctor know on Monday. I'm not going to be able to enroll in a health care plan though. No job, no money to pay, not eligible. I'd do Medicaid but I probably don't qualify for that either and I'd have to go to some sleazy place in a bad part of town. I am just SOL everywhere I turn.

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    Quote Originally Posted by Susan1 View Post
    Previous gyn had me try soy - it made me sick (which just about everything does).
    Yeah, too much soy can wreck your thyroid. Could be what happened in your case.
    Last edited by heckles; 09-28-2013 at 04:36 PM.

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    Hot flashes can come regularly for some people or completely random -- like mine. I don't get night sweats so much anymore (sometimes during the day), but I still don't sleep worth a damn at night. I tried some herbal OTC remedies recommended by my (female) gyn, but I wasn't very good at taking them regularly. I know people who swear by evening primrose and black cohosh, either blended or separately. My major problem is vaginal dryness. Gyn had me try suppository estrogen but it didn't really help, and I can't find anything that really does help.

    Sometimes, getting older sucks! Good luck with finding relief!
    Haunting the Princess of Pink since 20/07/11...

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    with the new aha, you should be able to get some insurance or some type of assistance, even with no job or no money to pay for things. Many, many physicians take Medicaid patients, not just in sleazy parts of town, you might be surprised on who qualifies for Medicaid/why and the physicians who treat them. I worked in a facility that as part of my job duties was to get pre-auths for certain types of care/diagnostic procedures and many patients/physicians were part of the Medicaid programs. In my state there were at least 2 plans that you could enroll in as part of the Medicaid programs. Each had its advantages/disadvantages, some physicians participated in both, some in only one. Also if you live in an area where medical universities do outreach clinics, most are either free or pro-rated on income.

    There are some "standard" thyroid screenings - usually only a T3, but there are more comprehensive ones that include the T3, T4 and T7 (I think that those are the entire thyroid screens) the FSH levels can change. It's kind of important to not assume that since one thing was normal once, that it will always be normal. When talking to a pharmacist make sure that you get the pharmacist and not the pharm tech. Pharm techs are great - my niece is one. But for a comprehensive discussion on all OTC and natural remedies, other foods or things that are perhaps causing the side effects of hot flashes.

    Traversing the medical system, being your own advocate is hard to do. But if a physician is willing to write prescriptions, such as HRT, without doing some deeper probing about what issues are, I would be leary of them. The young doctor that you said what does she know about hot flashes - she might not have experienced them per se, but that doesn't mean she doesn't have knowledge of menopause.

    I started peri-menopause at age 36 - hot flashes, night sweats etc. I entered natural menopause at age 52. I am empathetic to the night sweats, hot flashes, etc. I just think that one should be evaluated for other disease processes before jumping to HRT. It is not just breast cancer risks associated with HRT, but HRT may increase the risk of heart attack, stroke, breast cancer, and blood clots in the lungs and legs. Especially now with the high BP that has developed, I would think that your doctor would be a little reluctant to start it. The nih site is not one that promotes any product and may give you more information. http://www.nlm.nih.gov/medlineplus/d...s/a601041.html

    eta: none of this is medical opinion, but personal advice that I would give anyone. I am not a physician, just a consumer of medical care.
    Last edited by numbers123; 09-28-2013 at 06:13 PM.

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    Quote Originally Posted by numbers123 View Post
    with the new aha, you should be able to get some insurance or some type of assistance, even with no job or no money to pay for things. Many, many physicians take Medicaid patients, not just in sleazy parts of town, you might be surprised on who qualifies for Medicaid/
    **So I don't have to reply to the whole thing in one place I'm just indenting and **. And before I forget - thank you!!!!!!!!!! And I am not arguing against everything you say, just discussing, which I can't seem to get to do in person with a real doctor.
    **I live in Ohio. I will not qualify for the new healthcare and they are not expanding Medicaid here. I wish I would have signed up for Medicaid years ago. Even with the long term temp jobs, I probably would have qualified. But dopey me, I thought I would get a real job like any day now and figured it would be too confusing to try to cancel the application or something.

    Also if you live in an area where medical universities do outreach clinics, most are either free or pro-rated on income.
    **The other day was a gyn who takes HCAP. It was a Women's Center connected to a hospital in a nice medical building, but the people all looked like they were poor. I know - who am I to judge. I was there too. It felt like a Planned Parenthood of something. <Oh, geez, there was a guy sitting on one of the two person seats that must have been 500 lbs. - took up the whole thing - waiting for a female to come out.> Anyway, I paid $34 just to tell her my symptoms. I didn't expect a pap smear, but she didn't do any kind of exam or the normal gyn things, just the blood pressure, which should not have been an issue in the first place. I guess I got what $34 buys you. And I just want to say that I used to have good jobs and excellent insurance. I'm not a deadbeat or a charity case or trying to cheat welfare or on drugs or whatever..............My life and health have fallen apart in the last 5 years and I don't have any help and I'm tired of being sick and tired and being treated like I'm some lowlife because I don't have insurance. (Heck, back in 1996, insurance paid for the whole titanium rod in my leg and visits to the ortho and twice weekly physical therapy, and wheelchair and walker, etc., etc., etc.......when I had money.)

    There are some "standard" thyroid screenings - usually only a T3, but there are more comprehensive ones that include the T3, T4 and T7 (I think that those are the entire thyroid screens) the FSH levels can change.
    **I don't think I've ever had the T7. The others were normal 6 months apart. And I have all of the symptoms of both hyper- and hypo-thyroid. If I took medication for one, it would just make the opposite symptom worse! Years ago, my dog went through lots of problems - Cushings (pills $75/month) cysts, skin conditions (we went to a doggy dermatologist!!!!) We ended up going to an internist and he tested for thyroid. He put her on Synthroid and she was a whole new little person - her hair and skin cleared up and she was happy and peppy for the last couple years of her life.

    But for a comprehensive discussion on all OTC and natural remedies, other foods or things that are perhaps causing the side effects of hot flashes.
    **I shouldn't have gone on Saturday. They were way too busy. I looked at the Estroven stuff in that aisle. They have different ones for different symptoms. How'm I supposed to know!?

    Traversing the medical system, being your own advocate is hard to do. But if a physician is willing to write prescriptions, such as HRT, without doing some deeper probing about what issues are, I would be leary of them.
    **That's what I thought. But as I said above - that's what $34 gets you. If I had insurance, I'm sure she would have done all kinds of tests and things to figure out how to help me.

    I started peri-menopause at age 36 - hot flashes, night sweats etc. I entered natural menopause at age 52.
    **That's supposed to be the median age. I hit it a month before I turned 47, after only about 3 years of peri. I have cousins who are in their early 50's who haven't even had peri symptoms.

    Especially now with the high BP that has developed, I would think that your doctor would be a little reluctant to start it.
    **You would have thought, huh? Recommend HRT and get rid of her for someone who can pay the big bucks. (Oh, it was 143/83 at CVS yesterday and 121/79 at CVS today -- after watching a guy run a red light at a busy intersection - you'd think it would have been through the roof. Weird. I'm going back out later. I think I'll run by CVS again!)

    The nih site is not one that promotes any product and may give you more information. http://www.nlm.nih.gov/medlineplus/d...s/a601041.html
    **I read everything and I just get conflicting statements. Medline plus is one of my bookmarks! But one place will say you get hot flashes because you have less estrogen. Then another says you get hot flashes if you are "estrogen dominant" (wrote that one down). So which is it. I need to see "me" on paper to know what to do. Funny, back when I was diagnosed with fibro, the doctor had all my blood test results and said I was "healthy as a horse on paper". Oh well.

    eta: none of this is medical opinion, but personal advice that I would give anyone. I am not a physician, just a consumer of medical care.
    **And I greatly appreciate having someone to discuss this with!!!!
    Last edited by Susan1; 09-28-2013 at 08:14 PM.

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    Quote Originally Posted by Really View Post
    Hot flashes can come regularly for some people or completely random -- like mine. I don't get night sweats so much anymore (sometimes during the day), but I still don't sleep worth a damn at night. I tried some herbal OTC remedies recommended by my (female) gyn, but I wasn't very good at taking them regularly. I know people who swear by evening primrose and black cohosh, either blended or separately. My major problem is vaginal dryness. Gyn had me try suppository estrogen but it didn't really help, and I can't find anything that really does help.

    Sometimes, getting older sucks! Good luck with finding relief!
    Yeah, I used to wake up 2-3 times a night in the summer soaked and have to change. Now I am freezing when I go to bed, actually shivering when I am falling asleep. I fall asleep too fast and wake up an hour later and can't go back to sleep for hours. And I wake up too early but don't really feel awake enough to do anything. Then I fall asleep if I am watching t.v. or reading in the afternoon.
    I've used evening primrose oil and grape seed extract at different times, with no change. I'm afraid of black cohosh, which is in one of the Estrovens, because stomach cramps are common (which means I will get them). I can't even take one coated generic Advil without cramps.

    Getting older does suck!

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    I've had a quite normal menopause, I think. Night sweats for maybe a few years, but they are gone now. Hot flashes - yes- but only occasionally. And of course vaginal dryness.

    I've a friend who has had a much rough time with hot flashes and she used alternative medicines, which really worked for her. And started eating soy again, which she removed from her diet for health concerns (don't remember what they were).

    Do research on alternative remedies, you may find one/some that work for you, and you'll avoid the issues associated with hormone therapy.

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    I'm interested in other people also getting freezing cold. I call them cold flashes. Nobody ever seems to mention them in the "what to expect" literature. I find I get cold flashes every bit as often as hot flashes. It's the balancing of body temperature that's the problem. I go back and forth a lot.

    I notice others have also mentioned dryness. One of the sites I read mentioned that Vitamin D can help prevent the worst of the dryness. It has helped me. I thought I was getting enough Vitamin D because I walk outside every day, but apparently many people don't get enough of that nutrient.

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    Some great suggestions here. I've been having hot flashes, night sweats (I always get out extra pajamas for those times I wake up soaked in the middle of the night), moodiness, & migraines for about 3 years now. I've tried black cohosh and evening primrose oil and some generic something-or-other with black cohosh and a few vites in it. Not a whole lot of success. What seems to be working OK is CVS's menopause supplement. Lots of B vitamins. I'm not supposed to be on hormones so I'll avoid them if I can, but a migraine or a hot flash can wipe me out for a day.

    I also echo the recommendation for a full thyroid panel (not just TSH).

    Is there a free or low-cost clinic in town that can help you?
    BARK LESS. WAG MORE.

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    I guess I am going to be harsh here. It sounds like you are embarrassed or something about your lack of employment and what that says to you about healthcare.

    The affordable healthcare act means that you do need to purchase healthcare insurance, but that there are plans that either are affordable or you have access to things like Medicaid or Medicare. And it means that since you have not had health insurance in the past, your pre-existing conditions (if any) are not excluded in your ability to get insurance. Since I do not live in Ohio, I do not know the contact numbers for any plans or brokerage sites. Maybe someone with a little more knowledge on Ohio or even multi-state participation in healthcare brokerages since Ohio is one of 36 (I think that is the correct number) states to participate in one. Although you say they are not expanding Medicaid, you should contact an office to see what you might qualify for. AHA is a topic for PI threads and has been in countless ones over the years.

    Yes, it does sound like you are judgmental. I doubt that the doctors in the clinic knew what you paid for the visit. My brother had a similar complaint - that his physician should have known which each healthcare facility charged him what for a CT scan. I would say that 95-99% of the physicians do not know what a visit payment is. Unless it is a private practice where the physician personally handles billing and payment, which I don't know that there is anyone like that any more - billing is a complex thing, most in coding have additional education, some at a BS level. Billing and payment are generally set by standards - usually what is allowable billing based upon the billing code according to ??.

    As for finding a "just me" to specific details, we are all unique. I have just returned from an ED visit, where for the 4th time in a 5 year period I have had external ear infections that develop abscesses requiring IV antibiotics. No ENT, dermatologist, internist or whatever has ever been able to say why I develop these abscesses, even with the premise that it is part of my eczema we still don't know why. So no matter how much research I do, or how many sites I read, there is no one with an answer. (yes I am irritable at the moment - my ear hurts!)

    I have several doctors, as I said. At any one time in the office waiting rooms, I can see a variety of people in a variety of clothing, manner of cleanliness, weight issues or whatever. I don't know who does or does not have an income level or what you think that puts them in a classification that you have seemed to relate to the women's clinic. I assume you associate a women's clinic like that as indigent care? Which may or may not be the case.

    My physicians no matter what specialty spend no more than 15 minutes with me, unless it is a scheduled annual physical where my internist schedules a 30 minute visit. even new patient visits are around 20-30 minutes max.

    My hope is that you consider other reasons for the hot flashes, night sweats, hair loss. And that you present them to a healthcare provider in the form of - I know many women experience these as part of menopause, but could they be part of another disease process. I also hope that you find someone in the area who can guide you in the aha.
    Last edited by numbers123; 09-29-2013 at 03:48 AM.

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    I am 65 and one of those who really had no problems with menopause other than hot flashes and night sweats. They were bad and lasted longer than I expected they would, but that's about it. I took one round of hormones, and about that time results of a study linking hormone therapy with increased chances for heart attacks were published, so I never did any more. I felt fine except for the hot flashes, and they eventually stopped so I just didn't see the need.

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    I was having all those symptoms, hot flashes, night sweats, sleeplessness and thought I'd go crazy. The lack of sleep was interfering with my job. My doctor prescribed short term sleep medications which helped me through the worst part. Then she prescribed a really low dose estrogen patch combined with progesterone pills. That was a life saver. I did that for a couple of years and she recommended that I go off of that because I do have a family history of breast cancer. I still have hot flashes, which are annoying, but I'm sort of used to them now and they don't interfere with my life too much. I still have some trouble sleeping but melatonin helps with that.

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