dizzy, shaking, tingling flushes

[catgotyourbrain]

Hi
I am 47. In last few months I have rapidly descended into menopausal symptoms. Typical meno story as I thought it was panic attacks and depression (some of it is but how much?). I was prescribed Fluoxetine (which I have found worked in the past), as I just had really awful palpitations and shaking feelings of doom!

Now the 'doom' feeling has receded somewhat I've realized it's lots of menopause symptoms I'm getting; including really awful hot flushes which can be every 2-3 mins. These flushes are waves of heat and cold, starting in the centre of body and ending in tingling numbness and dizzy light-headedness. Palpitations and shaking too. Sometimes I am awake 3am onwards and by morning I feel I've done a day's work! I've had to spend hours lying really still in bed as I've been so dizzy.

I have spoken to the GP who has prescribed:

Progesterone (daily as haven't had period due to coil for ages and blood test said definitely in meno), and four pumps of estrogel daily. This has been three weeks now. The super-hotness of the hot fush has calmed but that's about it. I am so so dizzy a lot of the time and feel faint.
I rang GP in desperation and she said it might take a while to kick and, and has given me Prochlorperazine (for vertigo) which I have tried once and couldn't feel any effect - but am loathe to take as it is quite a full-on medicine.

Thanks for reading - has anyone experienced this vertigo with menopause - what did you do?

I have even tried the Epley manouevre for vertigo which is supposed to help (It didn't)
I am starting to think I'm imagining it all but I am having to lie down so much!

I had raging dizziness with my peri or my anxiety, not sure which, it was constant, horrible and very debilitating…. I tried acupuncture, yoga and supplements- in the end the thing that worked for me was the magnesium supplement supplied by Newson Health and it literally stopped! I had had it for months…

@catgotyourbrain Okay a few ideas... if this is the same GP who gave you ADs instead of HRT it sounds as if they don't understand menopause too well and also NICE guidance - pinned here on this page- goes against what your GP did.

Onto the HRT issue- 4 pumps is a massive dose, Why are you being told to use that? The starting dose is 2 pumps. That's 1.5mgs estrogen. Most tablet form is 1mg or 2mgs. So you might want to cut right back to 2 pumps or even 1 and build up gradually.

It is also more sensible to start hrt on a cycle (called sequential regime) to see if you are ok on the estrogen dose before using progesterone daily. So that would be at least 2 weeks of estrogen only. (Some specialists would tell you to try a whole month on estrogen only to get the dose right.)

You also can't rely on blood tests to show post menopause. They are very unreliable. (Mine showed I was post meno 18 months before my last period!)

You'd then use progesterone for 12 days in a month and have a withdrawal bleed.

If you are using Utrogestan its known side effects are dizziness! It's on the leaflet in the box.

I assume you are taking it last thing at night as the leaflet says? That's to avoid feeling dizzy during the day.

So....

Cut back on the gel to 2 pumps.
maybe stop using Utrogestan daily? Give yourself a break and then start a sequi regime.
If you want to know how to use sequi, happy to give more advice.

I hope this helps. I've used this regime for over 12 years under a consultant.

Oh @jinglinghellsbells that is all very enlightening but also alarming!

I have spoken to three different GPs. The first prescribed the antidepressants, the second said that most of my symptoms were typical of anxiety (!) and the last is the only one with an interest in menopause - she prescribed the progesterone and said to take it every day 'unless you want a period' - to which I said - "who in their right mind would want a period?", she also said I could choose how much estrogel to take 1-4 pumps; then last week I was so dizzy I called and spoke to yet another GP who told me to up the estrogel to 4 pumps!!.

I have been taking the progesterone in the morning so that's a bad idea!
I feel angry that nobody seems able to join the dots here. It's a discrace!

@pinkrabbits39 thanks I will get a magnesium supplement

@catgotyourbrainI'm not surprised you feel crap on that cocktail! Honestly, some of these GPs need to be struck off.

This is on the patient info which I have copied for you from online info. Utrogestan

Description of selected adverse reactions

Somnolence or transient dizziness may occur 1 to 3 hours after intake of the drug. Bedtime dosing and reduction of the dose may reduce these effects

It also adds a caution about using machinery if affected.

The leaflet in gel says 2 pumps is the starting dose.
I was advised by my meno consultant (top dr in UK ) to start with a pea sized amount and increase until it sorted my flushes and insomnia. I now use 1 pump in the morning and 1 at bedtime.
I was also advised to use the gel for several weeks to get the right dose than use a progesterone for 10 days to bring on a bleed.

4 pumps is a huge amount- it's 3 mgs and 3 x the amount of the usual 1mgs in a tablet form of estrogen.

It's a complete disgrace that a GP doesn't even read the prescribing notes that go with a product. It clearly says on the leaflet in the box that 2 pumps is the way to start (or less if someone needs less.)

I took Utrogestan once- too early- about an hour before I went to bed and almost keeled over due to dizziness. I now take it as my head hits the pillow OR I insert it vaginally (my dr's preference) as it completely cuts out the effects on the nervous system/ brain.

I am sure that is you reduce your gel and stop using Utrogestan in the morning your dizziness will go.

I'd also suggest you consider stopping Utrogestan altogether for a few days- you might get a very light blood loss - and then consider using it on a sequi regime for a month or so, otherwise it's impossible to know what's working and what has side effects.

And find another GP :)

Well, thanks to @JinglingHellsBells I have stopped the Ultrogestan. No dizziness now!

I am so pissed off that a GP would prescribe anti Vertigo tranquilisers before investigating if it's a side effect! Now I have to face getting my out of date Mirena changed so I don't have to take oral progesterone. Having read Caroline Criad-Perez's newsletter this morning with accounts of really painful Coil procedures I am not looking forward to that. (there's a reason its way out of date.....)