Alternative Medication to HRT - Depression and Anxiety.

[Daphnesmate01]

Anyone take anything as an alternative to hrt for depression and anxiety and insomnia in relation to perimeno? I have beta blockers which are great, amitriptyline to sleep...now for low mood? I have tried HRT for a short while but it does not seem to agree with me (I ended up with very heavy periods) and currently having a cyst examined, though not thought to be sinister. I have never had a good reaction to any type of hormonal pill.
Anyone?

@Abraid2 and @SparklingLime do you use just one capsule of Utrogestan every other day? All month? Do you get periods? I’m taking 2 capsules 12 days per month orally and I’m not keen on the side effects...

That’s right. I do still get v. occasional periods although I am on continuous, and if they continue I will be scanned to check the lining isn’t too thick. At the moment this is too difficult to organise. The doctor feels it’s probably just the uterus adapting.

@JinglingHellsBells same question please! Are there fewer side effects from taking them vaginally? And do you get left with any residue?

I seem to have raging pmt for the 12 days I’m taking the utrogestan plus another week until my fake period starts. It’s pretty upsetting as it means basically 17 or so days a month I have pmt and then I have a five day period so I only get a week when I’m not a hellbeast or bleeding. I’m not sure it’s better than it was prior to going on hrt! I’m taking 2mg sandrena gel every night too. I’d rather take the utrogestan every other month but I’m worried that would be dangerous because of the risk of endometrial cancer.

@Abraid2 thanks! Do you get pmt symptoms at all?

Sorry for hijacking, OP! I’ve inky just started on my hrt recently - am in my early 40s and have been peri menopausal for about 3 years.

Not on this combination. I feel quite energetic and even-emotioned.

Wow, maybe I should try taking it that way! Thanks

we've all heard of bad experiences with the Mirena, but there are 1000s women happy with it - they just don't come to forums

I'm on my third one and perfectly happy with it. I can't use any other hormonal contraception so it's a godsend. Bit worried about having to have it removed next year - not likely to replace it to be honest (am 52) and I wonder what my body will be like without it.
It never stopped by periods though, still get them most months, though mainly quite light, but go on eight days, and about every four months I have a heavy one.

Impossible to know if some of this is peri meno related though.

@NewKittyMeow Hope I've got the right poster- yes, you do get residue. There are still some side effects (more me, anyway) - it can make me very hot at night. But I don't get the sleepy, dopey feeling the next day.

I can't see how anyone can use it daily if they have a sex life as there is residue and I'd be worried the efficacy of was reduced.

You can use it vaginally at any time of day but obviously there is the gravity factor if you aren't in bed.

@Daphnesmate01 I think you asked about adrenaline? Yes, everyone has adrenaline but there was this myth going around online, which was coming from some dodgy medical sites, that there was such a thing as 'adrenaline rushes' or words to that effect.

Your body does chuck out adrenaline in response to fear- it's meant to so you can run away!- but anxiety starts in the mind, not the other way round.

@JinglingHellsBells hmmmm I’m not sure that will work for me in that case...

Sorry, I meant to say thanks for responding!

:)

I'm not sure how any women use it daily if they have sex, although you could insert if afterwards. But even using it 'normally' I have to wear pants in bed as it does seep a bit.

Some people insert it anally.

Just sayin’.

I know @Abraid2! My consultant offered that as option 3- evidently more popular in Europe!

I might try!

Gosh! So many options...

Oh good! @JinglingHellsBells is there!

Hi JHB, we have spoken before, I am on conti ustro capsules and oestro gel.

My Pharmacy (Spain) didn't have ustro 100 mg OTC this month, only 200 mg. I was wanting to give sequi a try anyway, am I right in thinking I only take this dose 12 days a month?

Pretty sure that is correct, but wanted to check what others do.

Also, on a personal level, what benefits do you find from sequi rather than conti? If you don't mind sharing? Am 49 and post menopausal for 5 years minimum.

Thanks so much. (Sorry for hijack OP)

Anally good to know! @Abraid2

Sertraline. Used for various reasons but also bad pmt

@BillieEilish Yes, that's right. 200mgs for 12 days.
Reasons for using sequi?

Well, two in my case.

I tried conti with Utrogestan for 3 weeks and got spotting (which is normal) but also a migraine each day as the levels fell. I am sure both of those might have disappeared if I'd given it longer.

However the main reason is I've been on hrt for a long time (12 years) and most research shows that the cancer risks are higher with conti, by about 1.3%. No one is sure yet if Utrogestan is safer anyway (and that increase may not apply) but certainly with all other types of progestin there is a higher risk of b cancer with conti, if the stats are right (and there is a question mark over that too!)

Fabulous, thanks so much JHB. I must have read that somewhere because I had this is my mind already about conti.

TBH conti somehow feels less 'natural' to me (scientific term!) than sequi. Also, I was prescribed conti quite some time ago and things seem to have moved on since then.

I'm going to give this a go (as I am likely to be on it for the long haul!)

Although, for anyone on conti reading, it has worked very well for me.

Thanks again.

It's worth a go @BillieEilish. TBH I don't like having 'periods' in my 60s and they are heavier than before, but only last 2-3 days, and as I'm doing longer than a monthly cycle (through my consultant) I just think of all the good days and not the crap ones!

Setraline, yes I think I tried that and the last time I felt very nauseous but thinking about giving it another go.

The nausea only lasted a few weeks for me

But Sertraline is an SSRI which Nice says should not be used for menopausal anxiety/ depression Really don't know why Drs are still doing this.

Yes I’ve read the recommendations too. Weirdly enough sertraline has been a game changer for me

@Daphnesmate01 Extract from Nice- copied from link above.

Vasomotor symptoms
1.4.2Offer women HRT for vasomotor symptoms after discussing with them the short-term (up to 5 years) and longer-term benefits and risks. Offer a choice of preparations as follows:

oestrogen and progestogen to women with a uterus

oestrogen alone to women without a uterus.

1.4.3Do not routinely offer selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) or clonidine as first-line treatment for vasomotor symptoms alone.

1.4.4Explain to women that there is some evidence that isoflavones or black cohosh may relieve vasomotor symptoms. However, explain that:

multiple preparations are available and their safety is uncertain

different preparations may vary

interactions with other medicines have been reported.

Psychological symptoms
1.4.5Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).