HRT not working!! So GP suggests combine with Mirtazapine??

[SweetieTime]

Today I have been for my 3 month review since starting taking HRT (Elleste Duet). I explained although I haven't had any adverse side effect my menopause symptoms (poor sleep, mind fog, anxiety, low mood, lack of labido) haven't improved. So she has prescribed 15mg Mirtazapine an AD to treat the poor sleep.

Since looking into the Mirtazapine I am not sure this is the right course of action. Has anyone else has similar experience and did this help or should I go back and request looking at a different HRT?

It does help with sleep, it does not at all help with libido, the opposite for me. You could try it in the short term and then book another appointment to discuss?

Also obviously helps with anxiety and low mood too

Taking an AD just feels too much. I was hoping the HRT would have sorted out the symptoms I am having. I think I am going to give it a bit longer before going back to see GP.

sorry but she's wrong. NICE says treat your type of symptoms with HRT and specifically says ADs are not right treatment.
If you aren't getting a good result after 3 months, the advice is to try another sort.

You could try patches because pills are poorly absorbed.
Not sure what dose you are on now, but if it's 1mgs estrogen, then next step is to try 2mgs.

GP clearly out of touch, as are most when it comes to HRT and meno.

Thank you Polly for your reply. I am currently on Elleste Duet Conti which are 2mg estradiol and 1mg norethisterone acetate. I have listened to the podcast by Dr Louise Newson with Liz Earle where she suggests it is a common mistake GPs make giving ADs for Menopause symptoms.

I will go back to request different type of HRT I think rather than start on ADs.

Have you thought about going onto a sequi regime? You would have a monthly bleed, but the advantage of sequi is you'd not be taking Norethisterone daily. Norethisterone can cause low mood as it's a synthetic progesterone and well known for causing PMS type stuff.

You don't have to use conti HRT, ever. I am in my early 60s and still use sequi.

You might also want to think about patches or a combo of estrogen gel and Utrogestan ( micronised natural progesterone.) Lots of options but you need to lead the GP!

Thanks for all the advice. I am 43 so new to all this but not having periods which is why I think GP prescribed conti HRT - I suppose she had to start somewhere. I will go back and ask for a different option that might be more suitable. I guess it is trial and error until we find something that makes me feel back to normal.