HRT never helped, in fact I think it has made me worse. Why?

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Hello, I'm 45.

2.5 years ago we went through a nasty financial crisis, and we came close to losing our home. The stress and anxiety were horrible, and everything looked bleak. I started suffering with insomnia. At the same time I noticed my periods were getting lighter and only lasting 3 days, but my PMS was getting worse.

I went to see my GP who started me on ADs, and after a few weeks I started to feel better. But each month my PMS symptoms were breaking through a bit. I then found the Menopause matters website and wondered if I was peri menopausal and actually needed HRT to control my PMS anxiety/low mood each month. I fitted the pattern of 'reproductive depression' with my history of PMS, and then severe PND, and now struggling with anxiety/depression in my mid 40s.

So I came off the AD and started trying various HRT regimes. Patches + Utrogestan, Femoston and even the BCP. But they never helped get rid of the anxiety/depression which would arrive every month, and often lasted 12-14 days. But these bad days never really followed a set monthly pattern (I know because I keep a diary).

And all the while in the background, we still had these dreadful money worries to contend with, with accompanying anxiety and stress.

But this New Year our financial situation improved . So I booked an appointment to see Dr Annie Evans. She was very sympathetic, said I was 'a classic case' for peri menopause anxiety & depression, and started me on 2 x sandrena sachets + separate Utrogestan.

I followed her regime for 2 months, but each week actually felt worse. My anxiety and depression became constant, with no more good/normal days at all. I was so bad I was signed off work, and was close to being housebound. Insomnia was awful too.

My GP who was so concerned that she put me in touch with our Crisis Team and they started me on Trazadone 5 weeks ago. But I still used the sandrena gel every day. I didn't get chance to use the Utrogestan as both months my own period started before it was time to use it.

But because I still seemed to be getting steadily worse, 2 weeks ago I went to see Prof Studd ( totally uninterested in listening to me, and didn't explain a single thing) and he prescribed me 3 pumps of oestrogel with separate Utrogestan, but not to start Utrogestan until June.

So I have been following his regime, but feel that I'm still getting worse day by day. And for the third month in a row my own period has arrived on time, despite taking no Utrogestan to cause it.

Can it be that actually I have never needed HRT? It never stopped my bouts of anxiety/low mood each month, last year. And now after nearly 3 months of top quality, strong doses of oestrogen from 2 leading specialists, I have just got worse and worse? Am I just overloaded with oestrogen, and that's why my anxiety and depression has got steadily much worse?

My oestrogen level when I saw Studd was 744 p/mol and I was mid cycle. So a decent level, and yet I was feeling dreadfully low and anxious.

I have never suffered with any physical peri menopause symptoms like hot flushes or vaginal dryness or headaches. My own periods have stayed regular and normal (just lighter) since just taking the stronger oestrogen gels, and with no erratic bleeding.

Can taking high does of oestrogen, when you don't actually need to, cause extreme anxiety like mine? I think my depression actually is caused by my anxiety. And maybe the reason my AD isn't really helping is because I'm pumping myself with high dose oestrogen every day?

I'm beginning to wonder if I should never had started down the HRT and all it's done is mess up my own hormones really badly and cause unnecessary misery. Perhaps I should have just stayed on ADs?

Any advice or insight would be really helpful, thank you.

@Jules36912 Many women think they need to ditch HRT when often all it needs is a tweak (my meno consultants says sometimes it needs at least 3 changes to get it right.)

I use the same products as you do.

First, the sickness is the estrogen- like morning sickness. it's best to start with a really low dose- one pump. Use that for a couple of weeks then build up to 1.5- 2 pumps (you can press the plunger down to get half a measure.)

You can also divide the dose- 1 pump morning, 1 pump evening.

Utrogestan- you can use it vaginally which will stop the doped feeling. This is how it's used in most of Europe. use the same 2 capsules but push them as high as you can near your cervix. My meno gynae ( a UK expert) prefers that way if women are ok with it. It's stops the fuzzy head feeling and doesn't enter your whole system in the same way. Do this at night and you may need to wear pants in bed as some does seep out.

if you are having sex, swallow the capsules that night!

You need to allow 12 weeks to see the best effects.

Loads of women do give up on HRT without knowing all these options.

Good luck.

Many thanks for your reply, it is greatly appreciated. Do you think the terrible anxiety will also subside eventually? Perhaps it’s also a side effect? Thank you 😊

@Jules36912 If you anxiety is caused by low estrogen it should help. It is unlikely it's the gel causing it. The post I left about the Youtube video might help you too. it's about 6 threads down.

@Jules36912 I have felt jittery since increasing my oestrogel. It feels like internal anxiety if that makes sense. So not in my head but in my body. Maybe you have similar. But like you, I hope it settles! Good luck x

Yes that’s exactly it - a weird jangly anxiety but dazed and detached all at the same time. I can cope with my normal anxiety (after all these years!) but this is not pleasant....

I am just hoping it settles which I know isn’t easy. I did get it when I first went onto one pump and it must have gone at some point and only returned when going up to 3 pumps. So there is hope. 🙏🏻

How many pumps are you on @Jules36912 I got these symptoms just going up by one pump over a month apart so if you went up faster than that may go a bit slower if you’re sensitive to the increases like me. Just a thought

@Ceetee23 I started on 1 sachet but cut down to about 2/3 of a sachet but still feel weird. It seems the Estradiol makes me jangly and jittery and the Utrogestan makes me dazed and numb. I do have a tendency to overthink these things however. I’m back to work tomorrow after 2 weeks and a little worried about how I will cope. I will give it 2 more weeks I think before checking in with the doctor again. Good luck x

You might find Oestrogel easier to manage if you are using Sandrena. With the pump of Oestrogel you press out what you need. What amount is in the sachets as they come in 0.5 and 1 mg doses (I think). If you are using 3 x 1 mgs that's a lot.

@Jules36912 You said you've been on this for 2 weeks but are using Utrogestan too? If you are still having periods, the regime is Utrogestan for 12 days per month usually starting on days 15-16. (not daily.) I'm not sure why you are using it already after just 2 weeks?

@JinglingHellsBells my prescription is 1 ultrogestin for 25 days with 1mg Estradiol and then a break for 5 days with Estradiol only. Apparently you can either take it like this or take 2 ultrogestin a day for 12 days...

@JinglingHellsBells I mean Utrogestan 😂😂😂

@Jules36912 Oh dear....the daily regime (or 25 days) of Utrogestan is for women who are post menopause. That means no natural period for 12 months or over age 54. Are you post menopause?
Were you told to use it for 25 days?

It's no wonder you feel 'flat' taking it daily- it's known to be sedating.

I have used hrt for 12 years and am very much post meno but have never used continuous Utrogestan because I don't like the effects of using it daily. I tried that way for 3 weeks and hated it.

When I first started with HRT my gynae consultant (who's a meno expert) put me on estrogen only for 3 months, using progesterone only once every 12 weeks (I was in late peri then.)

That was brilliant as it allowed me to get 12 weeks of only estrogen (gel) to get the dose right. I started with half a pump and went up to 2 gradually.

I carried on with these long cycles for years (under medical supervision- don't try it yourself) and only reduced them after a while, as the bleed was too much on that length of cycle.

FWIW I'd suggest you stop using Utrogestan daily and go onto the cyclical regime using it for 12 days each calendar month.

@JinglingHellsBells thank you this is very helpful! I still have regular periods and I’m 48, no hot flushes or insomnia but horrendous PMT, heavy periods and very sporadic mood swings, joint pain etc. I think my GP thought I was sensitive to progesterone which is why she recommended this regime, but maybe like you say it is making it worse? I will question it at my 1 month review 😊

I think my GP thought I was sensitive to progesterone which is why she recommended this regime, but maybe like you say it is making it worse?

If she thought that ^ why has she put you on a regime that gives you natural progesterone every single day?
If you/ she reads the patient into for Utrogestan, the 'default' regime is 12 days a month. Daily is an option for women post menopause.

If you have heavy periods, she'd have been better off suggesting the Mirena coil and estrogen gel.

IF you are sensitive to progesterone there is a pill type of HRT called Tridestra which is long cycle and the progesterone is only used for 2 weeks every 12 weeks.

This, sadly, is why so many women give up on HRT because their Gps are clueless often.

@JinglingHellsBells if you are UK based maybe you could recommend a menopause specialist? Many thanks 🙏

@Jules36912 I will PM you.

@JinglingHellsBells would you mind PMing me too? It sounds like you have someone very good.

Hi there can I ask what you decided to do?

yes! Serious problems with Sequi so stopped with one patch to go in the packet - and after just 2 pumps of oestrogel (should start Utrogestan in 13 days time) and I feel even worse - if that's possible. What I don't understand is that I have gone through 10 or so packs of Sequi and didn;t have any side effects until recently; last three packs.

Vitamin levels and thyroid can be part of the picture too. I was doing ok ish on HRT 50-53 but hit a wall. Due to having to fight for SEND support for my child I was massively stressed. GP suggested upping HRT but it wasn’t touching my depression, exhaustion and other issues. I suspect I have thyroid problems too but a visit to a health food specialist and on B vits, fish oils and passiflora for the stress and I’m feeling on the road to recovery. Prolonged stress hits us hard and depletes all sorts. Hoping the combo of vits and HRT will help restore me. It might be that other things in addition to the HRT might support you better.

I’m still struggling with HRT I’m afraid; if I don’t take it I have hot flushes, I’m glum and have no joy in anything but if I start the estrogen I become anxious and woolly headed like I can’t think, although I have more energy. I’ve never lasted long enough to introduce the utrogestan. I suffered terribly with anxiety in my adolescence and early pregnancy so wonder if estrogen actually exacerbated my anxiety. I have concluded that it just isn’t for me 🥺

Just having the Mirena coil massively helped my PMT

@KangarooKenny has your mood improved with the mirena? I'm getting one tomorrow and am petrified! Only getting it to try and tackle the bleeding I experience on HRT ( which i need).

Thanks

Honestly, I was worried about the fitting after reading on here, but it was just like a smear. I actually laughed when she’d finished as it was nothing, and I was so worried. Had a wasted sleepless night the night before.
I had the PMT rage and it’s got so much better now. I’m not on oestrogen, just the coil.