oestrogel for perimenopausal depression/anxiety

[vintagefiend]

Hello,
I'm afraid I'm writing again because I feel so desperate. I posted very recently regarding the emotional symptoms of perimenopause. I have been prescribed oestrogel by GP (my suggestion- also a progesterone)
I have been advised on here that hrt can take a while to work and I have only been on it for 6 days.
The problem is that I just feel so dreadful today and I'm so worried that it might not work that I just need to hear that it does! I'm taking 2 pumps daily (with exception of today- decided on 3!)
do pills like femoston or qlaira have better results for mood or is it six of one etc?
i wonder if kontiky is reading this as i feel that we have very similar symptoms- ie nothing vascular- essentially all mood- and you said that you were beginning to turn a corner after 2 months on estrodot...has that continued?!
thanks to anyone.
i'm 43 and my bloods are normal (but my mind is not!)

hello
You need to give it time. Drs say give any type of HRT 12 weeks.
I wouldn't muck about with the dose just yet- give yourself a good number of weeks on a certain dose then re-assess. If you chop and change the dose from day to day, you won't know what's what.
Femoston is just 'normal' HRT but in pill form. Gel- like you have- and a separate progesterone is the gold standard and better than pills for all sorts of reasons ie less clotting.

No one can tell you if it will work. You are having an early meno at 43 so you need HRT anyway, regardless of whether you have moods etc, but not sure what you mean by your bloods are normal- does this mean you have no meno symptoms except mood swings? If that is so, why has your GP suggested HRt instead of maybe a 'talking therapy'- counselling, CBT etc - and assessment for depression?

thank you pinkfrocks- extremely helpful as always!
very reassuring to know that i'm on the gold standard and also that femoston is basically the same- i don't feel i'm missing out now!
by normal bloods i mean that my fsh is normal and re other symptoms i find my moods very much worse the week or so prior to period- suggesting a hormonal element-also i have the odd tell-tale sign like awful acne, brain fog and headaches...things that i've never had before.
that said, i take your point about depression and will keep it in mind particularly if the hrt has done nothing after 12 weeks.
i defintitely feel better knowing that i'm on something that often works!

Hello vintage fiend how are you feeling

thank you very much for asking peterspots!
I am cautiously optimistic.
Last week I felt crappy and had what I believe is called "crashing fatigue" - everything was a monumental effort and i lost perspective and was terrified that that was how it was going to be. However, that fatigue suddenly lifted, thank goodness. I'm approaching my period so always a dodgy time but i'm so relieved not to feel that utter exhaustion. prob a bit too early to assess oestrogel (day 11 of application) but just possibly i do feel a bit better, certainly i feel no worse and it is early days.
how are you? are you now on hrt?

Fingers & toes crossed for you. Started HRT patch on Friday. Time/patience are really hard. My face and pelvic/bladder are not good at the moment.

thanks peterspots and best of luck to you!

mmm I am gel and progesterone (coil) I use two pumps in the morning and I am on a antidepressant for anxiety which only started two years ago when my periods stopped. yet still every morning is tough I don't feel like me until lunchtime. I am beginning to wonder if it is because the gel and tablets aren't taken in the morning.

oops sorry it should say are taken in the morning

oops sorry it should say are taken in the morning

But if you use your HRT at night, it will be an even longer delay until you feel ok by midday, surely? I don't honestly think it works like that. The way it does work is to keep a constant level of the hormone in your system- you;d need to go for several days at least and more like weeks to notice any difference, so I really doubt if it's when you use/ take medication that is making you feel like this,
More likely to be your body clock/ circadian rhythm.

women who stop HRT usually say it's only after 3 months that they sart to notice symptoms again.

i got extremely anxious with the coil! i'm a bit prone to anxiety anyway but the coil took it to another level! obviously that's just my subjective experience but thought i'd share- some women find the coil to be marvellous, though.
also, any anxiety or low mood i have are definitely worse early morning- i can feel very different by late morning.

Gerijrich
Just to clarify that as a gel + coil ( ie Mirena) user, this is not the same as gel + progesterone. Mirena is a synthetic progestogen delivered continuously to the uterus to keep it thin. Pinkfrocks was referring to actual progesterone ie micronised progesterone.

I presume you have been on the coil for some time, in which case, it is likely your periods stopped when you became peri-menopausal and your oestrogen levels began to decline. Periods often stop completely in women using the coil even when not menopausal. Therefore it is a pity your doc gave you an antiidepressant for anxiety at this point brecause it is highly likely that this was caused by the drop in oestrogen - which you noticed physically as your periods stopped. What your doc or specialist shold have suggested at this point was an increase in gel rather than ADs. I would suggest you go back to your (hopefully) specialist and try to come off the ADs but increase your gel dose. I don't use gel but an oestrogen patch with separate progesterone = equally the "gold standard" ie biologically identical hormones to our own, applied transdermally (ideally). This may well help you feel better (ie increase in gel dose).

As vintagefiend found - some women experience anxiety with the coil anyway so you might also like to consider changing to progesterone - although that is also fraught with problems ie taken orally or vaginally and the associated side effects!

Have you had a thyroid functon test as well as blood sugar?

vintagefiend you may not yet be peri-menopausal if your bloods are all normal and periods are regular. There are certain hormonal changes that occur during the late reproductive phase when periods can become more frequent and heavier but before changes in the standard hormones measured ie oestrogen and FSH can be detected by isolated blood tests - but symptoms are noticed. Single blood tests aren't very helpful anyway - your doc should be looking at symptoms and your periods as indicators of menopause. Despite this I know women in your position are treated with oestrogen especially by specialists but sometimes this isn't sufficient to regualte the cycle and prevent mood swings, whereas ( from what I understand) the pill (such as Qlaira) can do this. The latter though involves high doses of synthetic progestogens for much of the cycle - which can also be a problem for progesterone intolerant women.

thanks for that bellaciao.
firstly, i do hope that gerijrich sees your post as i do think the mirena coil can be awful!
i'm very interested in what you say about qlaira...certainly i will give the oestrogel a proper try but i just wonder why qlaira might differ- is it just a higher dose of oestrogen? obviously i'd be very cautious as it has progestogen- i'm just curious as to all that's out there- tho, as pinkfocks explained- i do know i'm on the gold standard!
also interested in what you say about maybe just being in late reproductive phase but, as u say, i get the impression that specialists will treat women in my position with HRT and often expect the blood tests to reveal nothing (i've gleaned all this from mumsnet meno forum!)
i do wonder if the oestrogel will be "strong" enough- i've been diligently applying it for two weeks and am now experiencing my standard heavy period- i'm a bit peed off that it has't made a jot of difference, i'm sure a pill would have done after 2 weeks- but i know i'm being impatient and prob irrational- i know it takes time- i just thought it might have some impact after 2 weeks grrr!
as an aside, i used to take cerazette in my thirties and that was fine- so i'll maybe look into which progestogen is in qlaira and see if it differs from the coil for a start.
certainly for now i'll persevere with gel etc but it's really good to know that there are other options and i've seen a couple of positive threads re qlaira so i'll keep it on my radar.
thanks again.

Qlaira is a 3 phase (or maybe 4!) combined contraceptive pill but it is one of only two (as I understand) which contain the bio-identical estradiol rather than the synthetic estrogens. There are only two tablet free days so the dip in oestrogen doesn't really have time to kick in. The estrogen is in 3 strengths to mimic the natural menstrual cycle to some extent - 1 mg, 2 mg and 3 mg. Here is the product info:
www.medicines.org.uk/emc/medicine/21700

The difference from HRT is that high concentrations of (a synthetic) progestogen are part of the pill (dienogest) and it regulates the cycle. No god if you are progesterone intolerant but some women find it helpful during early peri-menopause.

Of course it is a tablet HRT whereas you are using gel which delivers estradiol directly into the blood-stream. There are also discussions about Qlaira in peri-menopause on the Menopause Matters Forum.

Thanks for all that info Bellaciao- I'll get reading!

It does work, it really does. I promise. Just like you my main peri symptoms were sudden unexplained anxiety and depression. Also irrational thoughts and feelings of dread. No reason for any of them and they arrived out of the blue. It was absolutely terrifying and I became someone I didn't recognise. I also started suffering with insomnia which was soul destroying.

I thought I was having a mental breakdown. 2 GPs tried to put me on ADs but I suspected it was hormonal because I felt very similar to when I had PND many years ago.

Finally my GP agreed to let me try HRT patches with separate progesterone 12 days a month.

That was 3.5 months ago. I got off to a rocky start convinced the HRT wasn't doing it's job. I was still having lots of ups and downs and insomnia. I was panicking thinking it wasn't going to help me.

Then about 4 weeks ago I felt a change. I felt more settled and more in control. I suddenly felt much more like my old self. I was laughing again. Making plans with friends. Taking care of my appearance.

In these last 4 weeks I have felt re born. I had a minor wobble for a couple of days when I ovulated but other than that I have felt great. I am so grateful to HRT.

You just need to give it chance

Also meant to add that just prior to all my horrible mental symptoms my periods had suddenly become very light and only lasting 3 days, if that (previously had quite heavy periods lasting at least 6 days).

Also noticed my hair had become much more dry and wispy. Plus had very achy ankles. Yet my FSH levels read as 'normal'.

wow! thank you so much ginger- that is absolutely what i needed to read!
very reassuring to hear from someone who has had exactly the same symptoms as me- including history of PND.
I feel very optimistic now- i feel i can even accept that i may have to wait several weeks- i just couldn't believe that it could work and got pretty negative which is obviously easy to do when you feel crappy anyway
i cannot wait to actually make plans again!
thank you- i will definitely give it a chance

Glad to help. Plenty of people know about the physical issues surrounding menopause, such as the hot flushes and night sweats. But few people seem to know that hormone imblances can cause anxiety and depression too.

Have you looked at Prof. John Studd's website? He specialises in hormonal depression and anxiety. You will recognise an awful lot of what he talks about.

I was lucky enough to be seen by s consultant gynaecologist who specialises in menopause. She told me that my history of PMS and PND meant I was far more likely to suffer anxiety and depression when I became peri menopausal. This is because I'm overly sensitive to any hormonal changes.

Both my Mum and my Grandmother also suffered very similar symptoms when going into their 40s. My poor Mum was prescribed tranquillisers for nearly 2 years (this was nearly 40 years ago) and her symptoms only disappeared when she had to have a hysterectomy at 44. Within days of the operation she felt so much better and more like her old self. She threw away the tranquillisers and has been perfectly well ever since.

Bloody hormones!

hi ginger, yes i have seen prof studd's website and it definitely rings true!- it's interesting that he believes that many women are misdiagnosed with bipolar disorder/depression when, in fact, it's a sex hormone issue- shows how powerful these hormones are
interesting that your mum and grandmother experienced this- i know that my paternal grandmother struggled and she really wasn't one to complain, so it must have been bad!
i feel lucky that i am well-informed enough (via mumsnet!) to address all this-there must be a lot of poor women in the dark.
thanks again and hopefully i'll post on here in a couple of months' time singing the praises of HRT!

I remember some of my mum's friends developing 'nerves' as they were called then around the time of the menopause. It seemed quite 'normal' for women aged 50+ to suddenly lose confidence, become agrophobic, give up work etc.
They also developed insomnia and palpitations. They tended to be treated with drugs for insomnia, ADs, and other stuff, rather than what was really needed- oestrogen. This was 40 years back by the way.

pinkfrocks yes! My poor Mum suddenly and inexplicably started 'suffering with her nerves' in her 40s. She suffered the tortures of the damned with extreme anxiety and panic attacks. I don't recall much of it as I was still at primary school but I do remember days when she couldn't even get out of bed.

This was nearly 40 years ago too. Not too surprisingly all her suffering ended when she had a hysterectomy and took oestrogen.

Going further back my Mum can remember her mother 'suffering with her nerves' in her 40s too. She was often unable to leave the house and would burst into tears at the drop of a hat. She was considered to have had some sort of nervous breakdown. So tragic when all she needed was oestrogen.