How you might feel on sequential HRT! (the moods etc)

[PollyPerky]

I thought I might share my knowledge after being on HRT for 10 years.

This is a question that comes up here alot. Shame that drs don't explain it all a bit more.

If you are on sequi HRT (the sort that gives you a bleed each month) then half the pack (if tablets or the progesterone you take separately if using gel or some kinds of patch) is a progestogen. That's the equivalent to progesterone you'd have in the 2nd half of a fertile cycle, after ovulation.

Many of us used to feel crap during the 2nd half of a cycle with PMS. Unfortunately you may feel this way with your HRT as it's replacing the hormones you had.

There are around 3 types of progestogen available in HRT, also the Mirena coil and also natural micronised progesterone (Utrogestan.) It's sometimes a case of trying different brands to find one that doesn't give you PMS.

You may also find that the PMS settles after a few months.

[NickyNora]

Thankyou. I have never exoerienced anything like this. I can't get out of bed today. Today is my last day child free before Christmas. Shopping isn't finished. Tree isn't up. I have never felt so scared of how i feel.

I am scared of how bad next month will be now!

I hate this. I felt awful for months. Then got tge shock of being told i was in the menopause. HRT is awful.

My GP is sick of me going to her & told me not to come back until my review in January.

I'm sick of me!!

[NickyNora]

I didn't have PMT or nad periods/pains. My GP gave so little information.

I dont know how i should be feeling. I feel like the GP presuned i wanted HRT. I has no knowledge of HRT. Why would i?

Maybe i need anti depressants?

[PollyPerky]

I'm so sorry . What you are feeling is not normal with HRT. I've used HRT for 10 yrs and had nothing like you describe. Maybe a bit irritable and short tempered around the progesterone phase but that's all.

If it doesn't work for you, stop or ask to try another type.

[LaGattaNera]

I am using utrogestan tablets & oestrogel.
I never had PMS when menstruating. Never really had bad moods, no crying or irritability and no tender breasts or abdominal bloating or period pain. Really felt well the whole way through my cycle and light bleed 3 days.
However since starting HRT 3 weeks ago I have all of these symptoms now! The period type pain is all the time. My breasts feel heavy and sore - I don't have big ones but my bras now feel tight and I am uncomfortable. I feel absolutely wiped out on the progesterone, I feel drugged and like I have got off a long haul flight but without the benefit of a holiday!
I started on HRT 3 years after last period as was having increasing night sweats, insomnia and felt teary. I feel I have swapped one set of problems for another set. GP talked about teething problems initially and review in 3 months and didn't seem interested. These are not just teething problems. They are making my life just as unpleasant as pre HRT just a different set of issues.

[PollyPerky]

LaGatta If you are using Utrogestan every day then this is something that can happen. Can you go back to a sequi regime? or are you on that now ? Assume not.

You could be intolerant to progesterone. You can reduce it to 10-12 days a month with your dr's approval. 10 days is the minimum though some consultants will allow 7 days a month only if the woman has access to private scans to make sure the lining is not getting too thick.

You will get a 'period' at the end of each cycle, but might reduce the side effects.

[LaGattaNera]

Decided to do sequi so as not to have progesterone everyday but the whole set of issues I have now have a more negative impact on my life than before. I do alot of sport and running and my boobs hurt all the time and I have the period pain thing all the time. Before HRT I had the odd night with sweating and poor sleep but it was not every night and I could still get on with my life, my exercise and other things. I feel worse now. GP is away on holiday now but wasn't really keen that I change anything so soon. Just fed up with it to be honest and unlikely to continue. These are more than teething issues imo. I feel worse hormonally now than I have all my life.

[LizzieSiddal]

Gosh reading this is putting me off HRT. I’m 52 and have always had awful PMT, my Periods st the moment are every 3 weeks

I don’t like the idea of having more progesterone if it makes my pmt as bad as it is now.
Is there any other option with HRT?

[LaGattaNera]

I am not an HRT expert but the period pain thing and breast issues, I though were related to the oestrogen. As PollyPerky says though, everyone is different and I am merely stating my experience so far and know from reading on here many many women have benefited from HRT and feels miles better. I had my meno at 46. I know that if you still have a womb, you need the progesterone to avoid the lining building up as that is what oestrogen does - builds up the lining.

[PollyPerky]

I didn't start this thread to worry people. I simply wanted to mention why some women feel a bit low during the 2nd half of a cycle with sequi HRT.
The trick is to get the right type and the right dose.

Bigger sore boobs might mean too much estrogen, so try reducing the dose. Period type pain can be the uterus 'waking up' under stimulation of estrogen. All of this might settle down in a few weeks.

HRT is not mandatory! If it's not suiting you, stop , unless you are using it for premature menopause. Or try changing the dose till it's the right 'fit'.

LaGatta- I assume your dr told you to start with a low dose- 1 pump? If you have gone straight to 2 pumps that might explain why you feel as you do. My consultant told me to start with a pea-sized blob (about half the amount of one pump) and build up over several weeks to get relief of flushes. So I went from half a pump to 1, then 1.5 and then 2.

[NickyNora]

I'm 44 PollyPerky if I was a few years older i would stop taking it.

I was wondering if the dose was increased would the side effects increase too? Or would it help?

3 days into the estrogen tablets & I'm improving in myself but having a very heavy & painful period...

I think its good you started this thread PollyPerky. My GP will have 10 minutes to talk to me. Its not enough time. Possibly had I been prepared for side effects, I could have coped better.

As women we need to know the reality of HRT & have a better awareness of how it works as well as the limitations of HRT.

[Efnisien]

I'm on elleste duet 1mg.Towards the end of each pack (green pills) I feel absolutely rotten.Terrible back pain,cramps and heavy period.The hot flushes have disappeared but if I'm honest would rather put up with them than the period/pain/cramps and low mood.Back for review upon completion of this boxful or should I go before?Really don't think I'm getting on too well on them.

[Efnisien]

(New to HRT,first batch of pills)

[NickyNora]

Everything I've read sats2you really need to try any particular HRT for 3 months minimum...

[NickyNora]

typos!

[PollyPerky]

It's important to realise that most women come to forums to ask for advice or to say they have problems. There are loads of women on HRT who have no problems at all but they won't come along here, often.

I've noticed though that many women don't understand what's in their HRT pack of pills and how the 2 hormones can have side effects sometimes.

GPs tend to prescribe pill for HRT but there is a huge range available.
Apart from pills where there are 2 hormones in the monthly pack, you can get each hormone separately so you can mix and match.

Many GPs do not feel confident with this, so they will reach for the pills.

However, don't get me wrong- many women love Femoston or whatever and are FINE!

If you are having problems, you can always try:
Estrogen-only patch
Estrogen gel

These come in different strengths so you can start low and increase.
Pills tend to come only in 1mg or 2mgs.

If you have a uterus you will need progesterone too for so many days per cycle. This tends to be the hormone that causes PMS.
You can have:
Mirena coil
Utrogestan
Norethisterone
Provera
Some types of the mini pill.

It is unlikely you GP would be confident with these except the Mirena and Utrogestan (but many are misprescribing the amount as shown by posts here.)

You do need to give ALL HRT 3 months to settle down. Don't give up after 1 month.

If you feel dreadful on it, change to something different.
If you are one of the rare women who is intolerant to many types of progesterone you may with drs' supervision reduce the dose per cycle to 10 or even 7 days instead of 12 or 14.

This is best done under supervision in case you have any problems; there is a small risk of the lining thickness not being controlled enough with lower doses. The NHS won't offer pelvic scans as routine to check this but privately you can have them if you pay.

If you want to use HRT and have real issues finding one that suits, ask your GP for a referral to a meno consultant.

[NickyNora]

In your experience PollyPerky, if the dose is increased, do the side effects also increase ? Or do women tend to generally feel better so more tolerant of the side effects?

I absolutely agree about all the,women feeling good won't come to forums like this, why would they?

Excuse me if this is a stupid question but how do you know your on the right HRT? How should we feel? Whats a,realistic explaination?

My GP didn't actually tell me how i would feel it what to expect.

Thankyou for sharing your knowledge. It really helps.

[PollyPerky]

I don't know the answer to the first question! If you need more estrogen then you'd feel better. Increasing the progesterone is likely to make the PMS stuff worse.

It depends what your meno symptoms are. Mine were hot flushes and insomnia. I made a lot of lifestyle changes like more exercise, 'clean eating' (hardly any sugar or carbs) 5-7 fruit and veg a day. no booze etc.

HRT can't do everything.

I feel like I did before meno but the downside is my bleeds on HRT are heavier than my normal periods pre HRT and I do sometimes get cramps with them which I never had except as a teenager.

If you get the dose and type right you ought to feel as good as you did before peri meno.

[NickyNora]

I have hypothyroidism so not really sure how i feel. Its so incredibly similar to being in the menopause that i didn't realise or expect to be told i was post menopausal.

I will go back in January & see about changing HRT.

In the mean time i will look at alternatives so at least i will feel like i can chose to come off it too.

Thank you PollyPerky