Should I ask for a change...

[ficklemissfickle]

In my HRT prescription? Long post, been on HRT - oestrogen only - for about 5 years, (have a mirina in situ as well) Initially was on tablets but then changed to patches which I really liked, however, after some time, they started reacting with my skin dreadfully and I had to discontinue, went back on the tablets and then tried the gel, thought that was going ok but then skin reacted to that too so back on 2mg oral preparation. I'm okay taking the tablets really but my mood has plummeted, I feel utterly worthless, everything is a chore, I have lost all enthusiasm for work, feel taken for granted at home and my self worth has plummeted. This week I've returned to work after a week off and have made a few silly mistakes because I'm just not "with it". I do all the self-help stuff pretty routinely, drink minimal alcohol, run and practice yoga regularly, keep a journal and try to sleep well. I'm 50 next year and I'd like to feel bit more self assured & proud of myself, instead I just feel hopeless and useless. Im not good at admitting to others when feeling low, it's been a tough year, for reasons in addition to lockdown, but lockdown has made me pretty insular and not wanting to socially engage with others, I like my own company but wonder if I should - when able - get out more? I have two very good friends but just sick of saying same stuff to them, husband pretty self absorbed as are the 2 teenage kids. I also,don't like to show vulnerability at work, it's a small team and pretty passive aggressive with its competitiveness. I just wondered if it's hormone related and maybe tweaking HRT would be a solution or whether I'm just low. Any thoughts gratefully received & it goes without saying - I know I am extremely fortunate compared to many - which just makes the despair worse!

You don't really have many options if you have tried patches, gel and pills. The only thing you could do is have the mirena removed and go onto another type of progesterone - which would be a combined patch or estrogen plus another progesterone.

What happened with gel? Did the alcohol make your skin sore? Where did you apply it?

Maybe you also need to find your mojo by doing something new- another hobby, learning something, whatever turns you on ?

Inner thighs and upper arms, resulted in eczema type patches. Just wondered if there were different brands of patches that might suit my skin better and if anyone else had similar experiences? Thanks for your response.

I've not used patches but Estradot is tiny I've heard.

I find oestrogel irritates my skin(dry patches, little itchy pimples) if I leave it on for too long. I used to put it on in the morning after showering. I tend to only shower once a day as more often irritates skin,so the gel would be on for 24 hrs. When I switched to putting gel on last thing at night, so it got raised off the next morning, this stopped the irritation.

I had the same thing. Patches worked brilliantly for ages and then I seemed to get a reaction to them. I now have an implant for oestrogen but that has its own issues as it is hard to get the dose right. Might be worth discussing with your doctor? Also consider if the mirena is affecting your mood?

That's interesting about putting it on at night. Did you find it worked as well? I guess it would be totally absorbed over that period?

Why would the Mirena only start being a problem now? Though if it's been in situ 5y it may be due replacement - could that have an effect? Would now be the right time to try a different progesterone?

I, too, have Mirena + oestrogen HRT. The best patches for me, I find, are Estradot. They are the least irritating and stick the best. Unfortunately the pharmacist says they are unavailable, so I have to make to with whatever she can get. Currently Estraderm.

Although the instinct is to apply a patch after the shower, I find they stick best and irritate least if I apply them at virtually any other time.

Though that's by-the-by.

Certainly you should look at tweaking your dose. I was on 50 for several years, and suddenly needed adjustment upwards to 75. Made a huge difference to me. If that doesn't work, would you consider antidepressants? I had an AD when tweaking my HRT dose didn't help. It definitely helped and I came off it very easily after about 18m. A few years later I recognised the symptoms, didn't wait to try tweaking my HRT, but went straight back on the AD. This time I was only on it for 6m.

Yes, I found putting it on before bed worked as well as mornings for me. Instructions say you need to leave it on for "at least an hour" before showering or getting skin wet. I always feel that a few hours "must" be better than just over 1 hour, but after 7 or 8 hours of sleep it must have done all the absorbing it going to!

@OverWintered The absorption from gel takes an hour. There are some very scientific papers looking at blood serum levels of estrogen, by time, and you will get as much as you are going to get in an hour. No more absorption takes place after that.

Interesting convo .. especially since I am considering switching from Estrogel to a patch. I'm at 4 pumps Estrogel - increased October 29 - and the first few nights were amazing! I slept and felt fantastic. Now I'm back to waking up at 4:00 am and not going back to sleep. And getting hot feet (weird, but apparently it's yet another menopause symptom!!) all night.

So I am wondering - do I need yet another increase? FIVE pumps?? Or maybe I just need the steady dose of a patch.

Anyone have any ideas? Thx!

I'm gong to try putting it on at night now then, thank you. It's Estrogel 75 and I use just one pump.

@JinglingHellsBells ahh now that's useful to know, thank you.

If patches and gel don’t work there’s new estrogel spray out called Lenzetto. Might be worth asking for it?