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Climara: Abdominal swelling that is NOT "Swelly Belly"? Climara: Abdominal swelling that is NOT "Swelly Belly"?

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Unread 12-31-2004, 09:58 AM
Climara: Abdominal swelling that is NOT "Swelly Belly"?

Hi Sisters!

I have been on the Climara patch for 4 months...after time I got the dosage adjusted to where I did not have menopausal symptoms. It took several months after my TAH/BSO.

My doctor said in November that I was to discontinue it "in a few months". Well, in the meantime, in the last 3 weeks I have had some problems with what I thought was what we all call "Swelly Belly".

It was true that I had "way overdone it" at work and I was put on "restricted duty" on 12/17. Since then I have been in the office and out of my regular driving job, which was quite physically demanding.

Well, in the last 2 weeks the "swelly belly" has continued and been present all through the day. Usually my earlier swelly belly was more at night, after a day's activities. Now I wake up in the morning and it is there. Plus, the feeling of pressure is also more in the upper part of my abdomin, and more on the right side. (where the liver is).

I was due to put on a new Climara patch tomorrow, but instead I took off the patch and don't plan to put another on tomorrow.

Reason? I read (which I'd read before when I first got the patch 4 months ago, but it never registered, obviously) on the warning label that one of the "severe side effects" is abdominal swelling and pain. Possibly also liver enlargement. WOW! This really freaked me out and it confirmed what I had thought: that MAYBE I did not have "swelly belly" now as I first thought, but MAYBE it was the Climara causing all my abdominal bloat, ache, and even the fatigue that has set in the last 3 weeks. Some more reading on the internet lent weight to this suspicion. Why my doctor never considered it is beyond me...if it turns out to be true, I will certainly educate her to this side effect.

A word to you to be aware of this AND also wondering if others experienced anything similar with Climara (or other) patches?

I expect I will have some hot flashes, night sweats, foggy brain or other symptoms coming on...but aren't these better than having possible damage to my liver and all this discomfort and pain?

Also wondering if any of you have gone off the Climara patch "cold turkey" with any major problems? (I was on .05)

Thanks for any sharing and are all my "rocks of strength"...

Deb in Ohio
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Unread 12-31-2004, 10:28 AM
Climara: Abdominal swelling that is NOT "Swelly Belly"?

Hi Deb

If you haven't already called your doctor about what you suspect, it would be a good idea to do so. You really should have your abdomen checked even if you aren't going to continue to use the estrogen patch.

I don't have experience to share with going off HRT cold turkey so hopefully someone who has some will reply. You might also want to look around in the No-Hormone Desert Oasis to read what others are using in place of hormones. You'll probably find some there who have quit cold turkey.

Let us know what your doctor says, okay?

Unread 12-31-2004, 11:48 AM

I already have an MD appointment next week. I, of course, discuss everything with her.

I just wanted to see if anyone else here had experienced similar.
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Unread 12-31-2004, 01:53 PM
Climara: Abdominal swelling that is NOT "Swelly Belly"?

I am glad you let me know about this post. I am also on the generic form of climara 0.05mg.
When my pain came back in June, I decided to take my patch off to see if it was maybe endo returning. So I left it off for 2 months.
I didn't notice much change til about the one month period. While my hot flashes increased sooner, I was not expecting this----I became very anxious, felt like I had things crawling on me, couldn't sit still, felt like my muscles in my arms were spasming...called mom and grandmother (who is on premarin) and she said when she went through the change she had these symptoms and the docs all thought she was crazy..then they went away when she started the HRT. Once I put the patch back on ( mainly cause I couldn't stand it anymore--and the pain never changed) I felt back to normal about 2 days later.
I have never heard of this side effect, now you are going to make me do some homework...LOL

Unread 12-31-2004, 02:45 PM
Climara: Abdominal swelling that is NOT "Swelly Belly"?

Hi I'm sorry you are facing this difficulty. Were you having any other symptoms besides abdominal swelling, that might indicate an imbalance?

Liver enlargement is a VERY rare side effect of estrogen, and much more attributable to oral estrogens than the patches. Those warnings that appear on the Climara packages are the same ones that appear on any estrogen-containing product; they are legal boilerplate language that basically encompasses any possible condition that can be attributed to the use of any type of estrogen; they're not tailored to the delivery method. This is an FDA requirement, that any estrogen containing product have these warnings on it, whether or not there has ever been a single documented case of a particular side effect with that product. It renders those lists of symptoms of limited use to us, unfortunately

More likely, sometimes estrogen use (especially if it's a little too much or results in estrogen dominance; ie not balanced by testosterone/progesterone) can cause an increase in an adrenal hormone called aldosterone, which prevents the excretion of salt by the kidneys. If enough salt is not excreted, abdominal swelling and bloating can result. This is actually a fairly common side effect of estrogen dominance and occurs to a smaller degree in PMS; however, PMS doesn't last forever, so the condition tends to resolve itself in a few days. For us, however, this imbalance (even if it's slight, but has been going on over time) can cause the swelling to worsen with time.

There are a couple of things that can help if this is what's happening to you. The best would be to balance the estrogen with progesterone and/or testosterone. You'd go by symptoms to tell which to try... if your libido is fine and you just have the swelling, and maybe some insomnia, then progesterone would be the logical choice to try.

Failing that, your DR may prescribe a very low dose of a diuretic such as Lasix... it can promote the excretion of salt and enable you to eliminate the excess fluid.

If you really feel your liver may be swollen, I would see a DR immediately (not next week). However... and this is just my ... I would try staying with the patch and adding a little progesterone cream until seeing the DR, and see if that helps with the swelling.

Quitting your HRT cold turkey is rarely a good idea (exceptions: life threatening side effects such as stroke). It is possible to wean down gently... you would still have symptoms, but it's a little easier on your body that way. Meanwhile you could have a discussion with your DR about non-hormonal methods of symptom management if that's the route you choose. As (((April Dawn))) mentioned, the No-Hormone Desert Oasis is a good place to get information on alternatives that don't use hormones.

I hope this helps!
Unread 01-02-2005, 06:09 AM
Climara: Abdominal swelling that is NOT "Swelly Belly"?

I did quit the patch (Climara, 0.6) because I noticed swelling around my abdomen and extreme itching at the site. After about 3 weeks, I couldn't stand the hot flashes and foggy brain, so I started back up. As I write this today, again I have the swollen upper abdomen, and occasionally I still get hot flashes, but I feel so much better when I have a patch on. I think I need to go to the doc, but my doc relocated and I have to find another one.

My daughter who lives with me tells me that since my surgery, I have become much more confrontational with my anger, which is a big change for me. There are days when I get angry for no apparent reason, and I just say exactly what I am feeling. Then I feel badly about blowing up on whoever was the recipient of my anger. But other than these things, I am so glad not to have a period or cramps, that I think my family should just relax and be understanding of my "changes". After all, they are usually the ones who blow up, and they don't have any hormonal issues...

I think that we women are at a disadvantage when it comes to our health and have a lot of trouble finding doctors and professionals who are knowledgeable about our bodies. After reading your post, I am going to find another gyn immediately. I am having itching and discomfort and need to deal with this as well. Thank you for sharing...everyone!
Unread 01-02-2005, 08:20 AM
2 days later...

I took off the patch and now it is 2 days later. My abdomin has definitely gone down and the ache and pressure are gone. I feel like a pressure valve has been released. I almost feel "flat bellied", then I look down...oh well!

I've had a few hot flashes, night sweats last night, and some mild foggy brain off and on. I also noticed a chemical taste in my mouth and I have had some diarrhea, which I assume is the chemicals coming out of my system. I've been drinking LOTS of water to flush my system out.

I hope to ride this out for a while and see if I can get through any withdrawl symptoms and some of the other mild discomforts.

I had already been 6 years with perimenopausal symptoms and am turning 50 (eek!) next month. My mom went through a very early menopause, so I think I was likely almost there anyway.

I have been over on the "No Hormone Desert" and am planning out some natural supplements to take, based on what some others have recommended.

I hope this works. I would like to be off of this ERT. I don't like the odds for breast cancer (I have cystic breasts anyway) and other health issues. I sure did not like the way it made me feel. Not at all.

I have been very active in the past...sort of a "jock", but feeling miserable with the medication has put me off of any physical activities. Now that I am not bloated and hurting I am already thinking of getting back on the bike and on the trail. I just feel SO much better already! And it's only been 2 days-

I'll keep you posted on how I do...I imagine it will be difficult. My doctor only wanted me on this through Christmas anyway, so it has been a goal to get off all along.

I hope I can stay off...if not, I have a closet full of patches!

Deb in Ohio


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