HRT or anti-depressants?

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I have been to GP to ask about HRT due to hot flushes/poor sleep. She suggested that HRT carries small risk of Stroke/Heart Attack. She said anti-depressants could be a safer alternative. Does anyone have any thoughts on this?

I have a history of breast cancer in my family, and have had DVTs due to a blood clotting disorder. I'm also overweight.

They still gave me HRT.

I went to my GP first, she suggested anti-depressants, but I knew I wasn't depressed. I went again, armed with the NICE guidelines... she told me the 'side effects' would be 'death'.

I then changed GP surgery completely, went to another one where a male Dr did all the risk stuff then decided that even though he was happy to give me HRT, he wanted to check with a consultant.

I saw the consultant, the head of consultants was also in the appointment as a routine thing, they both said I could take it.

I first went to the GP in September 2016. I have been taking HRT for a month and while I'm faffing a bit with dosage, I feel about a gazillion times better. But really? 2 years?

I'm glad I came here for advice, I'm glad I read and read and read.

I followed Liz Earle on instagram, and a woman called Dr Louise Newson, who both kind of made me feel empowered to ask directly for the 'right' things.

So - go back and ask directly for stuff. Good luck.

Thanks Ohthegoats - I have made the appointment!

Glad to hear HRT has made a difference to you. Long may it continue. Life's too short to be tolerating it - some people are very lucky not to have any menopausal symptoms. But for those of us that suffer it's really grim. So enough's enough!
It's amazing how much research one should do themselves and not rely completely on the doctors suggestions!

This forum amongst other websites have been very helpful.

I've been to see my GP's and after talking through the reasons for not wanting the antidepressants, I have now been prescribed HRT! After years of not wanting them and trying natural alternatives, I now feel so GLAD to have them in my hands!!!

I have been given one called Elleste Duet 1mg tables (due to still having regular periods). I've been told to start taking them on the first day of my next period, so I'm now counting down the days!

I'm being positive about these and totally relying on them to sort out my terrible, disruptive, constant night sweats and help me get back to feeling normal again! Maybe desperation is the word I'm looking for!
Has anyone tried this particular brand?

I have been on both ADs and HRT - both at the same time for a while
My own personal findings are that the AD did nothing for the hot flushes but did help with low mood. The HRT nailed the hot flushes and also stopped the rages which were making me vile to be around.
I tried switching from sequential HRT to the continuous one as I was sick of having a monthly bleed (am 54 FFS) but continuous gave me painful breasts and constant spotting/bleedthrough so abandone that and for a while was on nothing. Back came the mood swings and the flushes so am now back on sequential HRT and off the ADS.
Bloody sick of it all to be honest!

Oh, and Pipadee, Elleste is the brand I am on and they are fine

I'm another who's been prescribed AD for peri menopause. While it has dramatically changed my mood and anxiety for the better, the aches and pains and hot flushes are disturbing my sleep and not nice during the day.
I've been advised now to consider HRT. If I go ahead, I then want to stop the AD.

I'm 46 and just starting with irregular periods even though it's gone down to two days for a while.

I was having difficulties in my marriage at the same time I started the peri menopause. I was given anti depressants which helped with my low mood and irritability. HRT wasn’t mentioned. I have had really no other symptoms of the menopause since and haven’t had a period for nearly two years.
When do we know when we are through the menopause?
When would I know if I should have HRT.
I’m not in a sexual relationship but I am aware I am very dry vaginally.
Any advice welcome.

Mary- there is masses of info about 'what is menopause' online- Dr Louise Newson has a great website for instance.

Menopause- or rather post menopause- is defined as 12 months without a period. You are post menopause.

If you have vaginal dryness , see your GP and ask for estrogen treatment (creams inserted) to sort it- if you don't, it's likely to get worse and you may have more symptoms that take longer to improve.

Good morning.
I have been on HRT (Elleste Duet)since March and it has been a god sent. My worse menopausal symptom was insomia and HRT took care of it pretty quickly.
However, recently , I have been suffering from broken sleep or practically no sleep at all.
I am going through a difficult time at the moment and , while coping really well during the day, my anxiety creeps in during the night.
I was wondering about asking my GP to prescribe 10mg of citalopram (as I believe it can ease anxiety) .
Can it be combined with HRT?

I guess it depends what you want ADs for- is it anxiety (you mention a difficult time) or it is insomnia?

Have you tried self-help and lifestyle measures first? Exercise, no booze, no caffeine after midday, mindfulness, meditation, yoga, talking therapies ( counselling or CBT if you are experiencing emotional stuff?) I personally don't think it's a great idea to reach for meds for the stuff life chucks at us, IF we can cope in other ways as meds all have side effects and are more a sticking plaster than a cure.

Are you able to talk to people to try to get some relief from the difficult times?

Just quickly... it's worth asking for a blood test to check thyroid levels if experiencing low mood, tiredness, poor sleep etc. Low thyroid is really common in middle aged women, and the symptoms may be incorrectly attributed to peri-menopause.

www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/symptoms/

Thanks dementedma, it's good to hear that you are getting on fine with Elleste Duet. And that roisinagusniamh is fine on them too. I can't wait for the first day of my next period (first time I've ever looked forward to that!!) just so I can start taking them!

Is Elleste Duet a Continuous HRT tablet? I'm unsure what the difference is between Continuous and Sequential? I'm 53 and still have regular periods!
I'll update this chat and let you all know how I get on with them - once I start taking them.

The whole Ad vs HRT is so confusing
I was given elleste duet 1mg for night sweats and mood swings, the GP never mentioned anything other than HRT, she gave a knowing smile when I said I’d tried herbal remedies
Elleste stopped the sweats but over the months it became obvious that it didn’t suit me. GP gave me femoston 1mg then upped it to 2mg. I ended up sat in tears with a different GP on Thursday, I’ve felt horrendous, suicidal at times, have self harmed and have been an utter out of control nightmare. I’m back on 1mg and have to go back in three weeks, sooner if needs be. This GP said she always offers antidepressants before hrt, she has offered them to me but I’ve said no. I’m going to see how I go these next few weeks but I’m looking at stopping hrt completely, been on them 15 months. I’m fed up of having more migraines and generally not feeling that good for half the month. I suppose it will be a case of stopping, seeing how I am without it for a few months and trying to find something that works for me.

You need to look at this a bit more scientifically to get to the bottom of why HRT isn't working. :)

Femoston and Elleste have different progestogens in them, This is what usually causes women to feel low until they find one that suits.

Are you on sequential or continuous? If it's continuous/ no bleed, it's far better to change to sequential so you get a good 2 weeks with only estrogen and see how the dose of that suits you.

If neither Femoston or Elleste suit you, there is the option of the Mirena coil, Utrogesan, or Provera as the progestogens.

You'd combine those with a separate estrogen as a patch, gel or pill.

Thanks Queen I’m on sequential, unfortunately it takes a few days of estrogen before I feel normal, so I get around 10 days being ok but then it’s back to the progesterone, migraines and low/bad moods. I bleed for 7 or 8 days which runs over into the estrogen cycle and so it begins again. I did mention to the gp about trying gels but she was far more concerned about my mood and wanted to get me off the 2mg straight away. I’m going to do some reading up and DP still thinks I should look at seeing a specialist in hrt if I decide to stay on it. There looks to be a clinic just over an hour away.

One option if you find something that is a bit better, is to use long cycle HRT. There is a brand if it's still around called Tridestra which is a 3-month cycle so you take the progestogen for 14 days every 12 weeks.

The other option is to create your own long cycle in the same way. This is done by using estrogen and a progestogen and only using the progestogen every now and then ( such as every 6, 8 or 10 weeks.)

This is usually never offered by the NHS because a) GPs aren't qualified / in the know to prescribe it and b) you are advised to have a scan every year or so to make sure the womb lining is not getting too thick on a long cycle (and the NHS won't provide such scans but you can do it yourself privately.)

I have been on long cycle for many years, ranging from 10 to 6 week cycles, under medical supervision.

Menopause clinics- if they are NHS clinics be aware you may just get a GP doing a 'menopause clinic' and they may not know much more. Sadly I've read on here about women full of hope about these clinics and come away no further forward.

The BMS (british menopause society) has a list of clinics and drs on their website- mostly private but not all.

Wueen you’re brilliant! I’ve had a look at menopause matters, there are two specialists at two clinics, one of which I’d looked at earlier
I’m going to see how I go for now on the 1mg, Ian’s back to the go in three weeks

the menopause matters site / specialists is slightly out of date so you need to check they are still around. BMS site has the same and more.

Tilly apologies- it seems that the MM site links directly to the BMS for specialists- it didn't used to.

Ive not found the progestogen bit of elleste as bad as i feared. Especially considering ive never got on with the pill or even mirena cos im sensitive to hormones, but whilst i dont feel as brilliant as on the oestrogen ones, its still far better than i was feeling before HRT.

It’s a personal choice
I was put on ADs aged 40 when peri kicked in and was told I was too young as meno doesn’t happen till age 52. No mention of peri menopause.
Almost a decade later I’m on HRT bc ADs can’t fix the physical symptoms of lack of oestrogen.
They can help with anxiety sleep depression but there’s more to meno than that.
Do your research and make an informed choice rather than letting someone make a choice on your behalf, it’s your body