'It's been a nightmare'

Carol Cacacie did not realise what a rollercoaster she was embarking on when she started taking hormone replacement therapy (HRT) in 1992, at the age of 41. Having had both her ovaries removed after suffering severe menstrual pain, she was prescribed oestrogen to prevent an early menopause.

She tried oestrogen tablets but they were ineffective and her skin was found to be allergic to patches. She was then prescribed an implant; a pellet of slow-release oestrogen, inserted under the skin, which was replaced every five months. Unbeknown to her, over the next 18 months, her oestrogen levels started to climb exceptionally high.

At the same time, the hormone was having less and less effect: when Mrs Cacacieneared the end of the five-month interval, she found that menopausal symptoms, such as night sweats, hot flushes and vaginal dryness were returning. "It got to the point where I was beginning to get no benefit," she says.

When Mrs Cacacie, who lives in Staines, west London, was investigated, it was discovered that the level of oestradiol (one of the oestrogen hormones) in her blood was disturbingly high (1,600 instead of the normal 500 to 700). Her gynaecologist is refusing to give her any more oestrogen until her own levels of the hormone are normal.

"Coming off the implants has been difficult," says Mrs Cacacie. "The doctors have been taking blood tests every three months now, for 18 months. Each time I go for a test, I think the level will be back to normal, but each time it is still high." Because she is not allowed HRT, Mrs Cacacie has to live with the symptoms of an early menopause. "It has been a nightmare, an absolute nightmare."