HRT review or antidepressants?

[Blizzardofbuzzards]

Hi I've been on Kliovance (combined hrt) for a couple of years and it's really helped with hot flushes and insomnia. However I've felt recently less settled and have had an increase in anxiety and have been tearful (at both good and bad things, reminiscent of pmt or early pregnancy). Also my libido has packed its bags and left which is causing friction with my dh.

A few months ago I had to be prescribed Vagifem as the dr couldn't perform a smear test due to vaginal atrophy. I'm still a bit dry.

I went to the GP thinking I maybe needed a review of my hrt and maybe also to try testosterone (for the libido issue). She gave me a prescription for fluoxetine which I am very wary of starting as I'd had this years ago (for pnd) and found the side effects quite unpleasant.

I'm not sure whether I can be referred elsewhere for specialist advice or if I should just accept the ad treatment. Has anyone else been in this position and been able to resolve it?

HRT is the first line treatment for low mood. Testosterone is added for libido.

Your GP should not offer ADs without first tweaking your HRT.
Honestly if I had a £1 for ever post I've made on this I'd be a billionaire. :)

GPs are a complete and utter nightmare re HRT (bar a small handful.)

The first step should be to increase the estrogen in your HRT.
OR swap pills for patches as pills lose a lot of the product in digestion.

You might also if you can put up with a monthly bleed, try sequi not conti because it's the progestogen in HRT that tends to cause low mood.

sequi regimes reduce that to 12 days a month rather than daily.

You have other options like the Mirena and a estrogen (gel or patch) or combined patches, or sequi patches, or a different pill ( Femoston.)

Not sure if you can demand a referral but if you've got £200 to spare you can always self refer to a meno specialist and bypass the GP.

also, pill form estrogen changes in the system and actually dampens down libido.

Thank you @JinglingHellsBells for your very helpful post. Sadly I don't have a spare £200 since my oven just needed replacing . If I could send you a pound or two, would!

I'll see if I can speak to another GP who's more clued up even if only to pursue a referral. Armed with your helpful information I'd at least have an idea what to discuss.

I would!

Really hope you get some better treatment, OP. So many just fob off with ADs.

Thanks @TaimaandRanyasBestFriend !