PA, surgical menopause, HRT and IBS


Hi not sure where to begin!

I am approx 2 years after being diagnosed with PA, have had IBS for I can't remember how long, not on medication for it currently managing it through diet; avoiding wheat and lactose and too many carbs. Had an op for severe reflux approx 10 years ago. Full hysterectomy 4.5 years ago which put me into surgical menopause. Currently on Methotrexate 20mg and leflunomide 20mg. Was advised by consultant to take HRT for long term bone density (some history of osteoporosis in family) so have been taking elleste solo for last 7 months - recently upped to 2mg. Also had carpal tunnel ops on both hands Nov 20 and Feb 21 so had to stop RA meds for a few weeks to aid recovery. I exercise by walking and riding a bike, used to go to the gym frequently prior to covid. I am having a bit of a relapse with RA, recently had leflunomide upped to 20mg from 10mg, but I am still suffering in certain areas. I suffer with headaches and migraines and high BP as well as being undertall for my weight - someone needs to make me an appointment with the vet I think!

My question is more about the type of HRT to take and the effects on my IBS as well as my PA and any contraindications. Not sure where to look for advice as I feel like I am going around in circles on the internet, my Dr's ask me to do a consultation on line so I don't get to speak to anyone, and they don't have any dr that specialises in any of the above, and now I have found that my consultant has moved on and she was great.

Can you point me in a reliable direction please?



  • Tom
    Tom Member Posts: 522

    Hi, @teabe and welcome to the forum. I see that for some time you have had IBS but managed to control it (have you tried goats milk?), but also have PA, menopause and to cap it all have a flare up.

    Your condition is complex and cannot find appropriate links on our site. I have taken the liberty of forwarding your post to the Helpline Team, who I hope will be in touch with you and can help.

    Good luck and do let us know how you get on.

  • helpline_team

    Hi @teabe

    Thank you for posting on the helpline forum. I’m sorry you are having such a tough time – that’s such a lot to deal with. As Tom says, your condition is complex, and you have done really well to explain what your dealing with.

    If I am understanding correctly you have psoriatic arthritis (usually shorted to PsA) and rheumatoid arthritis (RA), as well as the other conditions you have mentioned, including IBS.  I’m only clarifying this because PsA can be associated with bowel conditions and it is the treatment options for PA (PsA or RA?) that you are asking about.

    You ask to be pointed in a reliable direction for advice on the type of HRT to take and the effects on your IBS. I would suggest that GUTS UK would be the best point of contact for you for this.  

    I have also provided a link to our RA information. This includes tips on managing a flare up, which may be helpful.

    You are, of course, very welcome to call us on our freephone helpline: 0800 5200 520 for more tailored support. It may help to talk things through with one of our helpline advisors. We are here to support you and can provide a listening ear around the impact your inflammatory arthritis is having on your quality of life and make suggestions you may not have considered. We can also make sure you are getting evidence-based information to help you to make informed decisions about your treatment options and can signpost to other appropriate organisations if necessary. I do hope you will call us.  

    I hope this is helpful.

    Best wishes


    Helpline Team