perimenopause/pmdd and qlaira/femoston

[vintagefiend]

Hello, I'm after information re qlaira and/or femoston for perimenopause/pmdd.
I'm 44 and have had the most awful year due to hormonal shifts, primarily related to periods: week of anxious hell prior to period, then severely depressed mood during and for a couple of days after- which doesn't give much time for any normal days. I'm so fed up and very fatigued to boot.
I tried oestrogel 2 to 3 pumps daily but that possibly augmented symptoms- certainly it didn't help and i was still having my cycle- i was hoping it would switch me off- ironically i may not have taken enough to do that but i really can't face experimenting any more with oestrogel!
I've had zoladex injections which put me into a chemical menopause and the resulting depression was crippling- certainly it got rid of the pmdd as no cycle and stopped feeling ragey but the depression has been far worse (i'm still waiting for it to wear off- tho i'll prob have major pmdd when it does!)- i was using oestrogel once again for addback hrt but it didn't cut through the depression.
I've seen a gynae and he's suggested ssris (anti deps) taken for the two worst weeks of my cycle. i'm happy to do this to start with as i definitely need to feel a bit better before i start thinking about hormonal treatment- but i would prefer ultimately not to rely on the antideps due to side effects of weight gain, grogginess, possible dependence, no libido etc and a feeling that hormones at least treat the cause not the symptoms.
So that's why i'm interested in qlaira, femoston and anything i haven't thought of and would really appreciate some words of advice/experience. Sorry this post is longer than i intended!

Hi. There's a lot going on there. Just wanted to say, I'm on qlaira which has stopped low level persistent bleeding and also improved my mood greatly. Went from continual sobbing suicidal mess with peri menopause to only sobbing for a couple of days a month. Result.

Tried HRT first (Premarin I think) but that worked for some stuff but still affected my mood adversely. Had to work with GP trying things out. Also on Abby's castus but not sure if that's working on mood or not. I think it probably is. GP suggested that too.

Good luck.

Thank you so much 80swaistcoat and sorry only just realised you'd replied to this message! really, really interesting that qlaira works so well for you- i will definitely ask my gynae about this when i see him in a few weeks. i cant start straight away as my cycle's not yet restarted after chemical menopause xx

Hi vintagefiend just wanted to let you know you're not alone. I am peri menopausal and for the last couple of years I have suffered with dreadful mood swings, depression and anxiety.

I am only okay for about 10 -12 days each month. The anxiety is the worst. I have no appetite, I am tearful and panicky and dread being on my own. But I also feel very depressed, thinking life is pointless and have no hope for anything good happening in the future. At my worst I have broken down in tears to my DH and Mum and it scares me (and them) how low and desperate I feel. But then thankfully it disappears and I feel okay again until the next time.

It is really, really bad and I have been to Hell and back with it over the last 2 years. I have tried HRT and then going back on the BCP. Neither really helped. The HRT was too weak and I reacted badly to the synthetic progesterone in the BCP.

I am hoping to try 100mg patches (to surpress ovulation) with separate Utrogestan to see if that can control my symptoms.

I wish you lots of luck. No one can understand how dreadful hormonal depression and anxiety can be unless they've experienced it.

Hello this is the original poster, just different name (different computer!) thank you CowardlyLyon- i do appreciate the response and i really feel for you- it's unbelievably shite! i have a friend who's off work with the same so at least that's someone i can communicate with who understands- we do it via facebook- neither of us is up to actually making a trip to see one another- or even speak on the phone for that matter!
like you- she just cannot be on her own- her mum's been staying with her but she has to fly back to australia in a couple of weeks so i dont know what she'll do.
i can only really cope with being with my partner- otherwise i'm better on my own- tho i am starting to find it quite depressing- i cant work so feel pretty useless. i just cannot cope with any responsibility- my in-laws and partner ferry kids to and from school as i can't cope with the school gate! life is just on hold.
very interested that you're thinking of patches to suppress ovulation- that's def on my radar- i really hope that works for you. i have to wait until my cycle restarts after the chemical meno before i can try anything else- it's def starting to reappear as i'm spotty, anxious and cannot sleep!
like you, i find progesterone pretty scary- really lost it on the mirena coil, for example, but i gather there are different types (like the utrogestan that you're hoping for) and i'm hoping that the prog in qlaira or femoston is a bit kinder than that in the mirena. can i ask which bc and hrt you tried? also can i ask how old you are- if that's not too personal?!
take care xx

It's total crap isn't it? Basically I feel like someone has handed me an anxiety disorder, out of the blue, for no reason. Before this I was Miss Independent and bold as brass. I just cannot believe what I have become over these last two years???

At least I am virtually symptom for up to 2 weeks every month though. If I was like this every day 24/7 I would have necked a bottle of paracetamol long before this. On the days when I have the anxiety and depression life really doesn't seem worth living, it's really that bad.

I'm like you in that I can only really bear being with my husband and children. Even being with my lovely Mum stresses me out and puts me on edge. But then when the anxiety and depression disappears I am really sociable and love seeing my friends.

I can't bear any responsibility either or having to sort anything out. It sends me into a panicky mess and I feel sick and hopeless. I do manage to hold down a part time job but only because I can do it with my eyes shut. I still dread going in though when my anxiety is bad and it's a real battle.

Do you and your friend still manage to get some good days every month? Even those with really severe symptoms usually get a good 7-10 days each month.

I am 45 now but all this crap started a couple of years ago. For HRT I tried Estradot patches in 25mg and then upped to 50mg patch, with separate Utrogestan for 12 days a month.

My symptoms were a bit better on HRT but I was still quite up and down with my symptoms returning cyclically every month. Typically I was crippled with anxiety and very low mood for several days mid cycle, then for several days before my period. Sometimes my symptoms wouldn't appear until the first day of my period and last for a week or so. But it still only made me symptom free for about two thirds of the month, and the bad days were just as bad as pre HRT.

I had read that the BCP was better at controlling hormonal anxiety and low mood because it is several times stronger than HRT. Firstly I tried Microgynon, and took the packets back to back as advised by my GP. It seemed to suit me better than HRT, and my mood felt more stable. But it gave me daily brown spotting and although running packs back to back I still had light 'periods' and the anxiety and depression would return with a vengence.

So my GP switched me to Marvelon which is meant to not give you the daily spotting as it's more oestrogen dominant. For the first 3 weeks on it I was Heaven. Back to my old self at last, confident and outgoing again. I genuinely thought I was 'cured'. I was so happy.

But then I had a brief 4 day break at the end of the first pack (we went away and I forgot to pack the 2nd pack) and the anxiety and depression came back with a vengence again. I started the 2nd pack assuming they'd disappear after a few days. But 2 weeks later I was still anxious and depressed and it felt like it was getting worse, not better. In the end I broke down in tears to DH because I felt so low and desperate. It scared me how dreadful I was feeling. I knew there was a good possibility that I was having a reaction to a build up of the synthetic progesterone in Marvelon having taken it continuously for over 5 weeks with just a 4 day break. So I stopped taking it.

My mood started to lift within 24 hours but then really crashed again just a day later. In desperation I saw my GP and he suggested I try Mirtrazapine which is an AD that's good for anxiety. Funnily enough as I left the GP my mood started to lift again and I realised my period had started. Not sure if that had been the cause of the awful couple of dips?

Sadly Mirtrazapine didn't agree with me. I was fine at first, but then started to feel jittery and wired on about day 5. My sleep was iffy too. Then on day 9 I had quite a nasty panic attack. The only other time I have ever experienced a panic attack was when I tried Sertraline a couple of years ago, and I had to stop it too after a month because it sent my anxiety through the roof and I wasn't sleeping. I don't think this was a coincidence that it happened again on Mirtrazapine? So I don't think ADs are right for me.

So I am just waiting to see my consultant in a week. I am tempted by either a 100mg patch with separate Utrogestan, of whether to try Qlaira because I do feel I improved a lot on the BCP but just couldn't tolerate the synthetic progesterone.

Sorry, that turned into an essay!

thanks so much, cowardlylyon and no apology necessary!
that's all v helpful- just looked up the different progs: microgynon has the prog that's in the mirena, whereas marvelon has the one in cerazette.. think i've got that the right way around- i'm v sleep deprived!! i know i can't cope with mirena but i have taken cerazette and been fine BUT that was over a decade ago so i might not now.
think qlaira has a kinder progesterone and i've read that it stops ovulation so that's why i'm interested. at our relatively young age i think we do need higher amounts- as u say.
i dont even know if i have good days now! that sounds a bit tragic but what i mean is that the chemical meno was so catastrophic for me and it is finally wearing off but those 3 months were hideous. prior to that the friggin oestrogel did not make me happy and i stuck that for 3 months. prior to that- ie without intervention i think i had some good days but they were def dwindling per month! i started all these treatments because i felt that most of the time i was feeling crap- but, thus far, the treatments have been worse and i didn't think there was a "worse"!
to be honest- right now, my mood is not too bad and for that i'm grateful. i feel anxious and extremely tired but nothing like the depression i have had- possibly the citalopram is working on my depression tho perhaps making me anxious as u found with the sertraline.
anyway very best of luck next week- i'll keep my fingers crossed for you xx

I've only just come across this thread, so this may no longer be of use, but I wanted to recommend the website Menopause Matters. It's really useful, even if you're not yet menopausal, and has members with longer term experience of Qlaira and Evorel 100.

I can identify with so much of what you write here - damned hormones!

thank you acorn this is the original poster funnily enough i saw your message when i was trying to access menopause matters through my hotmail account. i desperately need to talk to someone on there! i keep forgetting passwords etc and have found it difficult to join argh! but will persevere! i've been on qlaira for a over a week now and am v weepy but do i stay the distance? will it get better? so fed up and i know women on here get it! is it the progesterone? i'm getting v despondent trying different things! x

The worst thing I did was come off it. Have had some disastrous attempts with other things since then. I had side effects for at least two months and didnt feel better for at least three, so try to hang in there to give it chance to work.

I would also suggest you have a look at this:
www.pms.org.uk/assets/files/guidelinesfinal60210.pdf

Have a nose at Professor John Studd's website. Dr Annie EVans' site is useful too.

Good luck x

thanks acorn- unfortunately i've had to come off the qlaira- i will look at the various sites you've suggested- cheers x

Are you taking anything at all now? Have you tried the bio identical route? Patches plus Utrogestan (taken vaginally to minimise side effects) might suit you better x

Hi acorn thanks for the enquiry! i am going to try patches next- i have a gynae appt next week so will hopefully get them then- i'll keep u posted x

If possible, have at least 100mcg patches so that they will suppress ovulation. In peri menopause, anything less can be counter productive (I learnt the hard way!) x

right thank you- that makes perfect sense- i had less than that over the summer: 2 pumps oestrogel and altho i took some of the progestogen, i don't think i needed it as felt pmdd before taking it ie ovulation was not suppressed...and of course this put me off topical oestrogen. and boy! like u i felt dreadful!
thank u that really corroborates what i feel (and pray!!) is the right course of action for me x

2 pumps of Oestrogel is probably too low for you. I use that and am 6 years post meno! You should try 3 pumps for a couple of weeks then up to 4 pumps (the products is licensed for this amount- see leaflet in pack.)

I totally agree with Polly. I am on the equivalent of 4 pumps, but doc happy to up this if required.

thanks polly and acorn- basically, at one point i built up to 4 pumps oestrogel probably for less than a month and it didnt work so i'm wondering if a) i didn't give it long enough and/or b) it's not enough for me...i don't know and i guess it'll be my old friend trial and error! i think i read that prof studd recommended 200mcg patches to prevent ovulation but that was some years ago- i dont know if this amount still stands. i dont know what my point is- i just want some semblance of normality- i cannot wait to get my patch on thurs that's for sure!

Vintage, I so know how you feel. I am in the same boat. Studd did originally say 200mcg, but more recently they think 100 mcg should be sufficient. I think I am still ovulating on 100 mcg patches, so wonder how I'd be if I tried 150mcg.

I am also wondering about Yaz. I know it's a higher risk pill, but I am desperate!

Vintage, I so know how you feel. I am in the same boat. Studd did originally say 200mcg, but more recently they think 100 mcg should be sufficient. I think I am still ovulating on 100 mcg patches, so wonder how I'd be if I tried 150mcg.

I am also wondering about Yaz. I know it's a higher risk pill, but I am desperate!

poor you, acorn- you know i understand!!
i'm planning not to take progestogen, as oestrogen only is the only permutation (of hormonal treatment) i haven't tried! (i've had combination, i've had progestogen only and i've had chemical menopause!) so i guess i'll know for sure if i'm ovulating on the patch if i have a bleed- does that make sense?! if it works then i'll have hysterectomy but no removal of ovaries (this is my own plan, not yet sanctioned by medics!)
i wonder how the patch compares to a birth control in terms of oestrogen? i know u said 4 pumps oestrogel is about 100 mcg and i strongly suspect that it won't be high enough- personally i want to take contraceptive pill amounts and not fanny around with lower amounts of oestrogen! i know docs like to start low and build up but i'm too fed up now!- actually my gynae has very few qualms re my age and higher oestrogen was v happy for me to take any contraceptive pill
i wondered about yaz but i'm certain i can't tolerate progestogen which presumably it contains?
bit of a ramble- sorry got kids plus neighbours kids in the room- difficult to concentrate!

Yep, your plan makes total sense - though over the longer term will you need scans to ensure there's not too much build up?

From what I've read, hard to compare BCP with patches/hrt as the BCP is synthetic estrogen and is therefore 3-4 times more potent. The progesterone in Yaz is meant to be closest to bio identical, hence the reason it's also used in hrt sometimes (Angelique?).

Have you looked at Menopause Matters forums? There are loads of really knowledgeable people on there who've helped me a lot. It's not all old ladies with hot flushes, I promise!

Hang in there x

thanks again acorn-
for some reason i just cannot access the menopause matters website- v frustrating! however, i've been able to read several threads on there and it's been very very helpful- i just can't actually join in the conversation!
could i ask how long you've been on the 100mcg patch and why you think you might still be ovulating? hope u don't mind all the questions! i just think i might ask for 150mcg off the bat on thursday x

Of course (though a bit of a tmi alert!) ... Have been on them for three months. The first two months, I felt fine - no side effects, and when I stopped the prog for three days, I had a light bleed. This month, I have sensed my hormones have gone haywire, at times too high and others too low. That's the main reason why I think I have ovulated. Also, the bleed I am having is really heavy/thick and more like a real period, along with stomach ache. Boobs are painful too. I'm convinced this is more than a withdrawal bleed?

right got you and thanks as v personal questions! it's all so helpful- it sounds as though for you, ovulation was initially suppressed but not the last month- in fact your last month sounds very much like my experience on 2 pumps oestrogel when i had awful pms moods, heavy periods and felt like hormones sometimes high sometimes low (which utterly confused me as i didn't know if i needed higher or lower amounts oestrogen in terms of medication)
the penny's really dropping now- i think i understand what's going on and why things haven't worked!
hope we both find something that works- it must be within reach! x

Absolutely! Do keep me informed of what you try. x