HRT - is it for me?

[Autumnwoman]

I'm 47 and beginning to think about HRT after reading up on the benefits - mainly long-term bone health. I do have some perimenopause symptoms

• Periods getting slightly closer together
• Periods lasting a couple of days longer
• Loss of libido
• Annoyance at husband
• Migraines (had these for 10 years or so but they have worsened)

I'm fairly sure the doctor would prescribe me HRT based on my age and symptoms.

However, I'm conscious that I'm very sensitive to hormones - in my 20s the Pill made me feel depressed (or perhaps my relationship at the time did - I hated the fact that I couldn't trust my own emotions).

I've just spent a week on the med to delay periods for an upcoming holiday and it made me sweaty, anxious, insomniac and cross. There's clearly hormones I'm sensitive to.

Knowing this information, what do we think my chances of finding a "sweet spot" HRT combo are? Or should I just battle through?

I could never take the pill as it made me nauseous, emotional, anxious and pile on weight. When I once had the morning after pill I vomited for 24 hours straight. I was therefore really worried about starting HRT but I’m a few months in (patches) and having no negative effects whatsoever, only positive. I wish I hadn’t put it off for so long!

So how do I find out if it's progesterone I react badly to?

I feel like each woman's body is going to have its own natural make-up of hormones - how on earth is an off-the-shelf product going to replicate this?

I'm not opposed to seeing someone privately if they are able to do more than the NHS are in terms of tailoring something specific - but I'm also aware there are a lot of snake-oil peddlers out there.

That's what scares me about mirena too. It's interesting that @MarcusBrigstockesfringe had a good experience with it though - did it actively improve the mental health symptoms associate with your cycle or did you just not feel any worse on it?

Track your cycle and keep a record of your physical and mental symptoms for a few months and then compare them to a graph of how hormones during your cycle. I at my best around ovulation when estrogen is high and progesterone is at its lowest. Then I feel progressively worse as progesterone rises in the run up to my period. I also tried a progesterone-only pill and had horrendous side effects within a week. I've been told that body identical progesterone and mirena may be easier to tolerate, but my side effects are so extreme I've not been brave enough to try them.

I typically get migraines the week before my period is due. It sounds like perhaps transdermal oestrogen would be helpful. I wish there were an online guide where you could plug in your symptoms and it would use AI to assess you!

Felt about a billion times better! Not having progestone systemically was a game changer for me. Localised and effective.
Plus I am able to have 100mcg of oestrogen with no additional progesterone. Imagine having to have 300mcg of utrogestan if you are on high does oestrogen. I'd lose my mind.

I don't take HRT because I am scared the utrogestan would cause me to lose my mind, but I am beginning to worry about the negative impacts of not being able to take oestrogen. That's really useful to know that the mirena coil has worked for you so maybe I should give it a go. My gynae did say that if it badly affected my mental health they would treat it as an emergency and remove it within 24 hours, but even that seems too risky given how severe my symptoms were whilst on the pill.

I am 42, been taking HRT (gel and progesterone tablets last 2 of cycle) for a few weeks and feel so much better. My Dr recommended the gel as it has a lower risk of blood clots compared to the patch. It absorbs well and ive had no adverse side effects. Definitely give it a go.

I don’t have a womb so think I read I won’t need the progesterone hopefully!