Think carefully about HRT

[Gratefulthankful]

After years of suffering from anxiety I noticed it was building up again and getting worse. My husband has always felt that my anxiety became worse following having my first merina coil fitted 10 years ago. A couple of good friends said how their anxiety had just gone following hrt so, having watched the mariella fostrop programme on tv and having had enough of my night time sweats, I took myself off to the dr who put me on hrt evorel conti patches. All started off ok, sweats stopped almost immediately. I diarised everything and gradually noticed I was getting really extreme anxiety - being violently woken at 5 am as though having electricity jolted through my body, and such bad anxiety, palpitations , joint pains and muscle aches. I went to see a hormone specialist who did a blood test, said everything was ok and changed my hrt to a tablet and progesterone gel.... well, my god, I have never felt the veins in my inner thighs throbbing so much at night, I was in agony. The change in tablet had messed my head up a bit too and after coping with this for 2 days I decided enough was enough and gave myself a day then went back to the patches- but oh, what a nightmare that was! The next morning, I couldn’t even move my eyes in their sockets as I felt I was falling out of bed. If I moved my head I had horrific room spin and just wanted to violently be sick.,The anxiety had changed to major depression and I felt there was only one way out of this and it wasn’t good. Luckily
my husband saw what was happening and got me an emergency Gp app who recommended coming off everything.... needless to say, I did and I had a pretty awful few days coping with that! I have since had another bout of major anxiety and depression and have decided to get the coil removed and start having counselling. I’ve been through a hard couple of years with loosing both my parents, and my aunty and uncle. I am now on a couple of tablets from my dr agomelatine and buscpirone and am taking life very slowly and carefully. I have always been into yoga and keep practising that as well as walking and cuddling my doggies. Has anyone any similar experiences and kind words of advice??

Yes I had loads of problems with progesterone products, anxietc, weight gain etc. I'm on oestrogen only now and have no side effects at all. Unfortunately you probably can't take oestrogen only at the stage you are at. Try lots of different ones. Some are better than others.

@Gratefulthankful

I'm a health writer who writes on HRT and I've also used it for 11 years (under a top consultant.)

Here are my thoughts..sorry it's going to be long!

First, it is very common to have mood swings or negative reactions to some types of HRT- it can take a while to find the right one.

The worst one for depression can be Norethisterone. This is in many types of HRT both pills and patches.

In a conti type of HRT is continuous- so you are getting both hormones daily in the patch (compared to a sequential typ of HRT which follows a natural cycle- only 14 days per month of progestogen (Norethisterone.) )

It's actually better to always start HRT with a sequential type. This is because you can see which hormone is causing any issues- you get a good run of estrogen only in a month before adding in 14 days of progestogen.

The way your GP dived in with a conti patch means you'd never know if the estrogen was too high or low or if the type of progestogen didn't suit you.

The second and rather more worrying thing is that the 'hormone expert' (who is it?) gave you unlicensed drugs. said everything was ok and changed my hrt to a tablet and progesterone gel.... There is no progesterone GEL that is effective in keeping the womb lining thin. Are you sure it was progesterone gel and not estrogen gel?

What you had sounds like an unlicensed, 'compounded' product that mainstream consultants do not prescribe. This is because it's not enough to keep the womb lining thin and there is a risk of build up which can eventually be serious.

Without knowing what sort of estrogen tablet you had, it's not possible to say how that affected you. Again, it might have been too high a dose, too low a dose, or the one that didn't suit you. Do you know what it was and the dose?

What Mariella uses is estrogen gel and micronised progesterone ( Utrogestan- it's a capsule you swallow.) I use this too.

I think you have been really unlucky to have had poor treatment from both the drs you saw and especially the so-called expert.

My advice would be you see another expert but one who is better qualified (because too many drs are jumping on the HRT/meno bandwagon and are not necessarily experts.)

I take bog standard low dose tablet form of HRT and feel great. I do not believe a low dose HRT tablet can make anyone feel the way you described. I felt a bit PMT ish in the first month then it settled.

madcatlady women can't take oestrogen only unless they don't have a uterus.

I was on HRT for a while. I regularly had migraines, just as I had as a younger person on the pill. The only benefit was no longer having flushes. When I stopped taking HRT the migraines stopped, the flushes returned but not badly, nothing I couldn't cope with. I wonder now why I went on it.

Sorry I've just spotted this bit.

I have since had another bout of major anxiety and depression and have decided to get the coil removed and start having counselling.

Am I right or confused here? Have you been using estrogen PLUS a type of progestogen PLUS the Mirena coil all along?

If you have then it's NO WONDER you feel as you do- your body is FULL of progestogen. Far too much.

You only need estrogen if you already have the Mirena.

Did you not tell your drs you had a Mirena all along?

I am progesterone intolerant but can just manage a Mirena coil (which has also stopped debilitating, torrential and seemingly never ending periods). That in combination with oestrogen gel makes me comfortable, happy and productive. I doubt that would be the case without appropriate HRT.

I too suggest you see someone else.

Forgot the highlight your quote

I have since had another bout of major anxiety and depression and have decided to get the coil removed and start having counselling

As above! You have used the Mirena coil all along AND estrogen AND a progestogen in it?

If so, that's why you had the side effects. It's an overdose of progestogen. You don't need counselling, you just need the right HRT.

sorry, if they don't have a uterus or have the Mirena

I've reread it too. Why on earth would you be put on conti patches if you had the Mirena fitted?

This doesn't make sense.

Also, HRT is NOT a cure for chronic depression and anxiety.

Agree 100% with Jingling Mirena coil and more progesterone? Madness.

I suffer from depression but not anxiety as such. HRT, when it's the right meds and dosages (which is only known thought blood tests which I assume the OP has never had?) works well in the main combatting the depression and hot flushes etc.

Insist on seeing a menopause consultant (not just a gynie, they need to be specialists like with any medical condition) I go to the Chelsea & Westminster Menopause Clinic in London but had to persuade my GP to get me referred.

I have the same HRT as Mariella - unfortunately the Oestrogel isn't working as well as it should be so may have to change. Testosterone has helped with libido problems though.

Fibbke I agree it's not a cure for CHRONIC depression or anxiety BUT I was informed at my Menopause Clinic earlier this year that loss of oestrogen upon menopause does cause depression. My oestrogen levels are too low and the dosage is still not 100% effective but at least I can now get out of bed in the mornings.

Yes sunshine I agree it has lifted my mood a bit - stabilised me really, I was having terrible mood swings. I think my dose is a bit low tbh but gp seems convinced 1mg is fine.

Sorry pressed too soon... but I did say not a cure for CHRONIC depression which the OP sounds as though she may have

HRT has absolutely killed my libido. Apparently the tablet form can do that. I really must try and find a meno consultant but I live in the middle of nowhere and have no idea where to go.

Sorry Fikkbe - where is your nearest large town? There may be a Meno Clinic at the hospital there - if no clinic then check for a gynie who specialise in Menopause and get a referral from your GP.

GPs do not have specialist knowledge about how much your dosage should be and as I stated up thread, blood tests are needed to ascertain what your levels are. I didn't get a single blood test until my appointment at the Menopause Clinic.

If your libido has died (as mine did) you need testosterone. GPs are not aware of this and I'm not sure it can be prescribed except through a consultant. I use Tostran Gel and it's taken 4 months for my libido to return (not as strong as it used to be but it is back, thankfully!)

Good luck x

Fibbke Sorry, again :-(

I live in the rural West Midlands and my GP referred me to the Chelsea and Westminster menopause clinic at my request (very late menopause so I think she was happy to refer).

Mirena had me under psychiatry and prescribed tranquillisers. as well as weight gain/ daily bleeding for several months.

Recently had a total hysterectomy (was peri menopausal and having bad anxiety and mood swings anyway) so this as meant having a prescription of Evorel HRT patches.

I feel the best I have felt in years My moods are fine, aches and pains diminishing and anxiety has almost vanished. I still have the occasional hot flush & night sweats so presume dose will need increasing at some point.

Sorry you are suffering op, hope you feel better soon

See! I’m useless! Yes, it was utrogestan- progesterone capsules and estradiol oestrogel.

Yes I did tell the dr that I was on mirena coil. They felt that as it was on its 5 th year it probably was at the end of its use. Having read more I see that it is the end of its contraceptive use, but can give off progesterone for 10 years.

You aren't useless at all! But who prescribed the utrogestan while you still had the Mirena fitted?

OP your experience illustrates exactly why women need to see a specialist and not rely on the GP!* Although I'm surprised to learn that the Mirena can still give off progesterone long after its contraceptive use.

*The GP should have arranged for the coil to be removed not just accepted it was near the end of its life!

Thank you all so much for your lovely, kind, useful, informative comments. I have felt totally lost and at the mercy of possibly too many drs/ consultants. I have decided to have the coil removed, it has been in 5 years and then I am going to just see how things go. I will have more hormone tests and try to go to the Chelsea and Westminster clinic as I have heard about that one before. But, I am giving myself and my body some time off!! It has been an awful journey and one which I was lucky enough to have had some friends who came to my help. I’m just taking one day at a time and not rushing/ pushing anything.

This is my first time on mumsnet so I really am an original, original poster and I would really like to thank you all for you kindness. I’ve said before to several of my kids friends mums, we need to be more like this and be there for each other. Thank you all so much. I am going to consult a nutritionalist too as I feel I want to explore all avenues - thank you all xx

Aw! Good luck and report back!