Hrt cause problems with PaA?

Hey y’all. I’m Angie. First time posting in discussions. Idk if anyone is on hrt, but I had a hysterectomy in February and since starting hrt( estrogen), I’ve been hurting so much more than I was before and skin is drier and itchier and no plagues but more little bumps mostly on my face and arms. My gyno referred me to a rheumatologist. That appointment is in August but I have an appointment with my gyno tomorrow. Supposed to discuss bio-identical hrt. I have never had any swelling in my ankles other than when I was pregnant. Now it doesn’t go away. I have so many allergies and very sensitive to medication, I’m hoping for some hrt that doesn’t have so many side effects.
I guess my question is has anyone else ever had these problems and what hrt helped you? Idk what to do anymore. I’m beginning to think the side effects and worsened PsA problems are worse than the not flashes.

Thank you for reading. God bless.

Disclaimer – I’m not a doctor or a pharm but I’ve worked in a national pharm for 15 years…

HRT is simply hormone replacement therapy, it’s not the name of a specific medication. You need to find out which estrogen you’re on (manufacturer). Although all medications (at least in the USA) are required by law to have the same amount of active ingredient you may do better on a different manufacturer with different inactive indgredients. Also, horomones are tricky things. Even though every version has the same active ingredient you might do better with active ingredient from manufacturer B than you do from manufacturer A. It’s going to be trial and error.

How old are you? This is an important consideration in terms of medications you take because you shouldn’t be on any hrt for more than about 10 years. There are serious, long term possible side effects that need to be considered. Also, did you have a hysterectomy only? Or did you have a radical hysterectomy with the removal of ovaries? This is also critical. If you still have ovaries the hrt may not be needed or may be able to be drastically reduced since ovaries produce the hormones being replaced. Removal of the uterus (hysterectomy) only shouldn’t cause major problems in terms of hormones. The thing is, many doctors automatically start hrt with a hysterectomy without waiting to see what is actually happening with patient. You may not need hrt or may be need a small dose rather than a full replacement dose. You might want to consider a trial of no medications, see where your body actually is, and make decisions from there. It could be you do better with no meds.

Menopause often causes skin problems. Dry, itchy skin is fairly typical of menopause in general and probably is not being caused by hrt. I’ve heard from others that OTC soy-based menopause products may help with skin issues more than actual hrt. And, of course, there’s always the option to change your skin care routine to include a heavier skin cream in general, something specific for dry skin issues that has oatmeal in it may be worth trying. I, personally, am hooked on the Bath and Body Works skin cream (not lotion, cream).

Swelling in ankles is probably a medication side effect. If it doesn’t decrease within a month you’re going to want to look into switching, assuming you can’t live with it.

HRT meds come in many different forms. Pills. Creams. Patches. Vagina inserts. You may do better on a different form of the same med. I think it’s worth trying different forms of the same med to see what happens. I’ve heard of woman doing better on birth control for their hrt than straight, traditional hrt meds, but again, this is very indiv and personal in nature.

Before trying any biologic med or “all natural” med or compound check with your insurance (USA) as insurance companies perfer meds that are pre-manufacturered as well as tried-and-true to any biologic hormone or compound. Personally I would stay away from any compound at this point, they’re much more expense, your insurance won’t want to pay for it, and the compound is only as good as the person making it. I perfer my meds to be made via automation where as much of the human error element can be removed as possible.

I also am extremely sensitive to meds, which is a blessing and a curse. If a med is going to work for me, it’s REALLY going to work at a very low dose. But if it’s not going to work or going to have side effects it’s going to REALLY have side effects. I preach to everyone “low and slow” … start off on a very, very low dose, even well below what is considered standard theraputic dose, and increase slowly from there, listening to your own body doing it’s own thing. As an example, I take a medicaiton for nerve damage/pain. I take 100mg twice a day and get complete relief. The starting standard theraputic dose of this med is 300mg three times a day. I’m so far below standard it’s almost like I’m not taking the med! But it works for me, and what works me is the critical thing.

Listen to your body. Start low, start slow, increase gradually. Good luck.


Hey azurelle. Thank you for answering. I’m 46. I’ll be 47 in October. I still have my ovaries but I was premenopausal when I had to have the hysterectomy. I didn’t start hrt right after surgery. I’m been on it for a couple of months tho. I tried the suppository type first of estradiol. I too have low tolerance and very sensitive to medication. It was the lowest dosage available for the type. I couldn’t handle it. Oh I was having some major hot flashes and other female problems are the reasons why my gyno put me on hrt. I’m now on 1 mg pill once a day and I’m having some awful side effects. I was started on the lowest dosage of .5 mg pill once a day. The problems returned after a month on it. She increased it to 1 mg.

I wasn’t having much pain really before the hysterectomy or hrt. I did have aches and pains In my hips, my hands and left shoulder but nothing like it is now. I had 2 surgeries on my left shoulder and the last one fixed it. I was having no problems in range of motion, even though it did hurt usually when the weather was wet and/ or humid. I live in South Georgia where that’s pretty much every day In the summer months. But now oh my gosh, I hurt all the time and all day and night. Having trouble washing my hair again, cooking, anything and everything that I have to use my shoulder. My knees are swollen and hurt. My ankles as I mentioned before also.

I research every thing because of all my allergies and sensitivities. The bio identical hrt is biologically the same as our bodies produce. My insurance will pay a portion of the cost. Yes it will be more than the estradiol but if these side effects subside it will be worth it to me.
I’m hoping and praying that my gyno will do blood tests and it will show that I don’t really need hrt anymore. But honestly I don’t think that is what will happen.

I think I covered everything lol my memory is horrible and now even worse. If I didn’t answer a question, just ask again please.
Thank you again.

I’m going to bounce in with my two pence worth. Many of the issues you’re describing I get with just PsA on its own. I’m post menopausal now. But at the start of my PsA I was probably coming to the end of the menopause anyway. Indeed when it started I got a bit confused because (other than joint pain being so much worse) much of the rest felt like I’d returned to the menopause with a vengence. But I hadn’t, it was all simply PsA.

I didn’t do HRT as I had always never got on with the Pill anyhow and so couldn’t see how HRT (as in more synthetic hormones) would work for me anyhow.

I don’t know if this helps but thought it worth saying.

Hey poo. Thank you for answering.
Are you saying you have not flashes from just the PsA??
My husband and I were talking earlier tonight. I was trying to explain to him what I think had happened. Which I may be way off, but it seems like my PsA got horribly worse after the hysterectomy. Like it caused something to happen in my body to activate it or aggravate it badly.
I was fine just hunkie dorie before and now I think I’m going crazy! I mean how could a surgery do that? Is it even possible? I’ve been doing ok, really well. Then BAM!!! I’m falling apart! :cry:

Thank you again.

Hi Angie,

Yes I got hot flashes from PsA. And I also got them from steroids. And I also got them from the menopause. And I also get them when it’s humid. I also get them when I’m scared or more so nervous. Certainly they were always far worse in the throes of the menopause but they’ve never gone away.

My PsA was ignited by having a bunion correction operation, of that I’m absolutely sure. As I never had it before then and it came on after the operation and hit me like a truck road crash all of a sudden. Makes sense really, as PsA is caused by your immune system simply having severe problems. So obviously having an operation where your immune system has to work hard to make you better from the operation, it has the chance to go just haywire. Anything that happens to you where your immune system has to work hard can of course make it go haywire and so make your PsA worse. Conversely when your immune system is stupidly busy making your PsA just hell on earth and then suddenly needs to turn its attention to something else, often your PsA can feel a lot better too.

I can better analyse what my PsA is going to do or not do if I analyse what my immune system is doing or not doing. That is always a better gauge for me. So it would never surprise me that having a surgery makes your PsA go just stupidly awful.

Good point, Poo. I thought exactly the same @AngieB, i.e. that distinguishing some PsA symptoms from menopause ones can be quite difficult. I’d include ‘dodgy thermostat’ in general, dryness of some tissues, exhaustion, loss of libido, depression etc. …

And surgery, especially on bone I believe, though possibly of any kind, certainly can trigger PsA or a PsA flare. Generally speaking, to be ‘blessed’ in this way, we need a genetic susceptibility plus some sort of trigger. The list of possible triggers is such a very long one that I don’t think it’s worth entertaining such notions as self-blame or regret. I think I had PsA at a low-level before my bunion operation in 2010 but after that it went crazy.

Me too. Ten years now post menopause and still the hot flashes…for me, IDK if “flashes” is the right word. I’ll start sweating profusely—mostly from my neck up. I think of flash as something sudden and quick. Mine are sudden, but they don’t go away quickly. I usually have a very hard time cooling off. The sweating is embarrassing when sweat is beading up and dripping off my jaws!
Anyway, I’ve never taken hormones either. I’m afraid of them. I think my “hots” come from a lot of different things, not just menopause—things that Poo mentioned, plus no apparent trigger at all.
Also, it sure seems a lot of people’s PsA symptoms flare after a surgery—really makes one hesitant to have any kind of surgery!

Same here @Grandma_J. I’ve decided it’s my lot in life to always be ‘hot’ and not in the nice sense of the word. Dripping with sweat at the most embarrassing and ridiculous of times instead. I was a little like that before the menopause too. However the only good thing about getting older is that it doesn’t seem to matter much anymore. I can at least blame it on my age now instead. :upside_down_face::rofl::upside_down_face:

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Aawwww! thank y’all so much! I’m not crazy! Yay! :grin::grinning::blush:
I’m considering telling my gyno today that I want to try not being on the estrogen and see what happens. Even on it after the increased amount, I wake up hot and sweaty and just uncomfortable more days than not. I still freeze my husband at night and in the morning. And thanks to y’alls replies, I know it’s not just I’m my head.
Oh Lord, y’all just don’t know, well, y’all evidently do, lol.
I can’t wait for my rhuemy appointment in August. Especially if he confirms the gen practice doctors diagnosis so many years ago. I’ll be able to give my mother in law a solid reason for all my ills! Maybe she’ll shut up then. Lol
Sorry but ugh that woman!

Thank y’all so very much!!!
I’ve got to get ready for my appointment. I will update when I get back. Thank God I found This group! Thank God for every one of you!

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Hey poo. I understand about being hot, not I’m a good way, all my life. As far back as I can remember, I’ve always been the one sweating bullets when every one else was usually cold. But I never considered it to be hot flashes. Just that I am not natured. Was my reason or excuse anyway. And yes, now I just blame menopause. :blush:

Grandma j hearing every thing y’all have said, I will not agree to any surgery again unless it’s to save my life. That hysterectomy done enough.
And speaking of being hot, I don’t think I’m going to get a shower before my appointment. I did get one yesterday evening. I don’t have the energy for it today and I’m already having a flash. Praying she won’t do an examine down there. :open_mouth: sorry if TMI.

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Hey sybil. Are you saying that PsA can cause the horrible dryness too like menopause???
If so, I got hit doubly then. Figures with my body.
Yeah I’m going have to remember that, “dodgy thermostat”. :+1:

Well I think so. There’s Sjogren’s syndrome which causes dryness of mucus membranes and is sometimes a co-morbidity of PsA. But short of that, a certain amount of dryness does seem common with certain autoimmune diseases including PsA. I’ve noticed it in my eyes and sinuses and my optician attributed the eye issue to PsA.

It’s not something that has been discussed much recently. You could enter ‘dryness’ in the search option … I’ll have a go myself now.

Okay, I checked. Hmmm, not a lot … I still reckon that PsA can cause dryness of various bits & bobs and if we’re talking vaginal dryness there can be various reasons for that. I guess there are likely to be some knock-on effects from your hysterectomy but I’m pretty sure that PsA will be complicating the picture at the very least. So your docs do need to be sure that they’re not jumping to conclusions but should take account of the wide-ranging effects of this disease.

Hey sybil. Thank you again.
I’ve read about sjogrens syndrome. Thought it maybe one of my problems. I stay thirsty.i even wake up during the night cause I’m so thirsty. I take an aloe drink to bed every night. My eyes are either feeling like sand in them or oozing. Could be allergies causing that tho.
Yeah I’ll check it out some more.

Doc office is packed today. Been here over an hour and still haven’t seen the doc.
Good thing I have something to read. :blush:

Yes, it does all sound quite familiar. Lots of us here are thirsty beasts through the night. You’re posting while waiting to see the doctor … lol! Hope you get in soon.

I’m guessing the thirst factor is part of the PsA? Or could it be something else?
Yes thankfully I took my kindle and my doc office had Wi-Fi hehe. Lol yes I got called back and done workup then sent back to wait a little longer. Usually I’m in and out I’m a matter of minutes but once in a while they take a lot longer, like today. I was there for 2 hours.

But she agreed that I could get off the estrogen and see what happens. I go back in 3 weeks unless I have any issues or problems. Yay!

Oh one more thing, I’ve lost 4 pounds! Whoohoo!! Just 25 more to go.

Thank y’all so very much for responding. I’ve learned a lot. God bless y’all!
To be continued…

There seem to be lots of odd things that happen with PsA. Many of them, e.g. waking with a very dry mouth, have been something or nothing for me anyway, just a bit annoying and may pass, plus we can’t always be 100% sure it’s the disease. Flag up any eye issues with your rheumy for sure though, 'cos PsA can most definitely affect the eyes (that one is worth checking out on the search facility - the magnifying glass symbol at top of page).

Your appointment - sounds like a result! Good luck Angie, let us know how things go from here.

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Good morning, Sybil.
Thank you for responding. Just getting coffee now. Seems the only thing that “quinches” my morning thirst. I’ve been This way for as long as I can remember.
The eyes problems concern me too. They’re either dry, feeling like sand in , or “draining” . This morning they’re a bit swollen feeling too along with the draining. I’ll definitely use the search engine and see what I can find.

Last night was the first night without estrogen before bed. No real change in sleep or the waking up hot sensation. But doc said it could take a couple of days for it to get out of my system. So time will tell. I’ll keep y’all posted.

Hope and prayers every one had a good pain free day.

I love this thread! I too am going through menopause and it is very hard distinguishing between PsA and menopause symptoms. I was recently sick—sickest I think I have ever been. Flu like symptoms but tested negative for flu. Still put me on Tamiflu because doctor thought it could be strain that doesn’t test positive. Over 103 degree fever. Ended up getting two “Cadillac “ shots—antibiotic and steroid—a couple of days apart after it just wouldn’t go away. Sick for three weeks. Now I have hot flashes followed by cold as my “dodgy thermostat “ can’t seem to get back to normal. Carry a sweater everywhere I go in this Florida heat with something cool under it. On, off, on, off all day. Other menopause/PsA symptoms as well—fatigue being the main one. List of symptoms is long. I was thinking about calling my doctor but maybe it is what it is. On Humira and still taking folic acid. Also take curcumin and reacted magnesium. I don’t do hrt—I figure it is a natural part of life all women go through. Thanks to all of you for your responses—it helps so many of us who don’t post and just follow threads that seem to apply to us. I am sure I am not the only one, lol. I learn so much from all of you! And thanks Angie B for starting this discussion—I hope you get some relief!