Category: The HRT Diaries

I had it all planned. Every symptom, in order. Then I sat down, the GP said “So, what brings you in today?” and I said “Oh, I am just a bit tired.” Ten minutes later I was back in the car park, furious with myself.

The moment

GP appointments are short, and perimenopause brain fog does not help. You know you are not yourself, but when it is your turn, the hot flushes, the 3am wake-ups, the rage and the forgetting all shrink into “a bit tired”.

Why it matters

• Early advice helps. The NHS says early advice can help reduce the effects of menopause and perimenopause on your health, relationships and work.
• There are real options. Depending on your symptoms, your GP may talk to you about HRT, CBT, or non-hormonal treatments.
• Some symptoms always need checking. The NHS says to see a GP about palpitations, periods that are getting heavier rather than lighter, or any bleeding after 12 months without a period.

Try this: the checklist

Write these down and take them with you, or show the GP your phone:

• My main symptoms (top three first): for example brain fog, night sweats, low mood
• How long I have had them, and whether they are getting worse
• My periods: date of the last one, and any changes in how often or how heavy
• How it affects me: work, sleep, relationships, confidence
• What I have tried so far, and whether it helped
• My questions: Could this be perimenopause? Is HRT right for me? What else could help?

1. Lead with the impact. “I am not coping at work” lands harder than “I feel a bit off”.
2. Bring your tracking. A week of the Brain Fog Log or sleep notes is gold.
3. Ask for a longer or double appointment if your surgery offers them.
4. Ask about a menopause specialist if things are not improving.

Track it

Start a symptom record now with our free Brain Fog Log, then copy the summary for your GP. Join the club for the printable GP checklist.

Sources: NHS: Symptoms of menopause and perimenopause; NHS: Treatment; NHS: Things you can do. This post is personal experience and general information, not medical advice.

Me, in the bathroom, holding two patch boxes: “Is it this one? Did I change it on Tuesday or was that last Tuesday? What day is it?”

The moment

Sequential HRT sounds simple on paper. In real life, with brain fog, it can feel like a pub quiz you did not revise for. Which phase am I in? When did I last change it? Why is there a sticky square on my hip from three patches ago?

Why it is confusing

• Sequential (cyclical) HRT is usually for women who still have periods. You take oestrogen every day and add progestogen for the last 10 to 14 days of each monthly cycle, so there are two phases to keep track of.
• You should usually have a bleed at the end of each progestogen phase. The NHS says to speak to your doctor if you do not.
• Continuous combined HRT is different. It is usually for after menopause, and you take both hormones every day with no break.
• Patch timings depend on the brand. The NHS says you usually change a patch every few days, but each brand is different, so always check your leaflet.

Try this

1. Set phone reminders for every patch change and every phase switch.
2. Mark a calendar with two colours, one for each phase.
3. Keep the boxes apart, labelled “Phase 1” and “Phase 2”, so you cannot grab the wrong one half-asleep.
4. Apply to clean, dry skin with no moisturiser, and peel off slowly to avoid marks.
5. If you miss a change or mix them up, check the leaflet or ask your pharmacist. Do not guess.

Track it

Our HRT patch tracker is on its way: a simple two-colour calendar so you always know which week you are in. Join the club to get it first.

This post explains how sequential HRT generally works. Your prescription is specific to you, so always follow your GP, nurse or pharmacist.

Sources: NHS: Types of HRT; NHS: Treatment. This post is personal experience and general information, not medical advice.