To just ditch HRT completely

[menopausalmeltdown]

I am 46, hit perimenopause at 42. Since then I have tried nearly every possible hrt combination (sequential, combined, gel, patch, spray). Currently on 100 oestrogen patch and 200 Utrogestan (vaginal).

Migraines have been a real problem for me and the gynaecologist thought it was probably lack of oestrogen. Since upping the patch the migraines haven’t disappeared but have become less frequent.

However I feel absolutely rock bottom. Constantly exhausted and depressed and have put on a huge amount of weight. I just do not know where to go from here and am thinking about ditching hrt altogether.

Anyone able to offer suggestions or had anything similar. The only things that I haven’t tried are the Mirena (I’m reluctant as so many people have issues) and Cyclogest. Has anyone tried either of these?

Thanks all!

I went through it without HRT because it's only used as a last resort in the US as it increases the risks of stroke, heart attack and cancer while you're on it

@LifeExperience Do you have any evidence for this?

Question. Is the Aimovig available NHS?

My doctor said that people vary greatly in how they tolerate the progesterone component. It’s needed to avoid oestrogen thickening the womb, but maybe this could be reduced?

Have you had your general bloods done recently? Just to rule out other causes.

Yes my Aimovig is NHS. You do have to have tried everything first which I had.

Don't give up just because one treatment hasn't suited you! Keep going back to your GP, keep trying as there are so many migraine treatments out there. Just because you have side effects with one doesn't mean another won't be right for you.

It's a good point re progesterone. I think k it can only come down if the oestrogen does. I think definitely need general bloods

Thank you that's so helpful. I feel as though it's definitely worth a look

I was put on HRT at age 30 (hysterectomy), and I’m still on it well over 30 years later. I just get really bad joint pain if I come off it, so the benefits outweigh the risks for me.

I take Premarin (combined) with no side effects whatsoever.

I've been taking HRT for four months now, which isn't long but I feel worse if anything. Sleep is awful, anxiety is as bad as ever...I'm still an irritable cranky irrational bitch. I really can't feel any positive effects.

Yes you need Vit D to absorb hormones so add these to your diet.
also you need some testosterone as the 3 work together.
Its v up and down tbh. Its good then you need more of one and then have to tweak the dose.
Currently on
EverorEl 70 Patch (oestrogen) x2 week
2 x 100 Utrogestan (progesterone) nightly
1/8th Testogel sachet nightly

Its a journey unfortunately XXX 😬

Sympathies OP. I'm 48 and for the last 3 years having a pump of oestrogen gel a day and progesterone for the last 14 days of each month. Still have periods but they can vary. What has really helped me, and it is boring, is giving up alcohol completely, doing loads of exercise (Heather Robertson videos on Youtube, highly recommended), and trying to eat healthier, but especially the exercise I feel is the only thing that is holding me together. I agree it sounds sensible to check your blood for other stuff, it could be a deficiency or a different imbalance of some kind, but also look at your general health and how you could boost it.

Hormones are so complex to balance. When working well and effectively they constantly fluctuate and interact with every part of our lives. So replacing them artificially is something that takes trial and error and adjustments.

I believe I’m on the ‘gold standard’ of hrt in terms of risk vs benefit; 2 pumps of oestrogen gel a day, Mirena coil, topical vaginal cream twice a week ( no far more effective than the pressures in my experience) and lastly a dab of testosterone daily. It’s taken a long time to get this far and I really regret not asking for the testosterone much sooner.

It’s worth persevering if you are suffering with your quality of life. In my friendship group it’s about 50/50 who do or don’t use it.

This is not accurate - it is not a last resort in the US at all now. I suspect you were a victim of very old research (or you believed the misinformation/chose to go natural which is your call).

HRT tablets have, in some old studies, increased a risk of stroke slightly. Not patches/gel/spray). That research is now debunked: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675220/ In women who do 1.5 hours of cardio a week HRT reduces risk of heart disease/stroke.

Breast cancer risks are negligible, heart benefits outweigh (like 9 women per 10,000). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780494/#:~:text=HRT%20and%20Cancer%20Risk,women%20%E2%89%A570%20years%20old.

Some cancer risks are reduced on HRT. See above study.

Really important to cite current information before scaremongering.

FWIW some studies have suggested natural progesterone cream is useful, because it is basically just being on HRT.

Have you trie bHRT? (Bioidentical HRT). I didn’t get on with HRT as prescribed by my GP and was recommended this and it was a game changer - but you do have to have full blood screens and it’s only available privately. I’m in Surrey so go to a clinic here, but my sister and a friend go to the Marion Gluck clinic in London.

https://www.webmd.com/menopause/what-is-bioidentical-hormone-replacement-therapy

If you have bloating I would check for SIBO - small intestine bowel overgrowth. Basically your stomach bacteria has moved somewhere it shouldn't - causes leaky gut and issues with hormones and its also the place where another poster has mentioned serotine is made which can be affected.

I went gluten free to reduce the horrid bloating which has helped alot. Maybe worth just doing a healthy eating review plus there have been quite a few issues reported with the oestrogel absorption when it changed manufacturing sites / bottle design. There’s another long running thread on here where we were discussing it as as lots of women -me included- had been happy on oestrogel for years then last year it was like it stopped working. I’m trying to get on with Sandrena gel instead at the moment but it’s not the same.

Hi @menopausalmeltdown I’m sorry that you’re going through this. I had a similar experience and what worked for me might be worth a try for you. I was on a max dose of HRT, still getting drenched at night, feeling generally unwell most of the time and relying upon triptans to just get through regular debilitating migraines. By chance, I had a medical consultation for a separate issue and the consultant recommended a ketogenic lifestyle to reduce inflammation. It wasn’t easy but I embraced it and a magical by-product was almost no more migraine. I’ve had just 3 in the last seven years and none were very severe or long-lasting. I weaned off the HRT, the sweats reduced massively and I no longer keep triptans at hand. Life-changing.

Thanks everybody so much for your helpful comments. I really feel that I have a few more things to try. I have been feeling so awful so it's nice to think that there's a way forward. Thanks again