Has anyone found that HRT has made anxiety/depression worse?

[bellissimiaow]

I've suffered from worsening anxiety since lockdown and since working from home, along with many other possibly perimenopausal symptoms such as night sweats, brain fog, tearfulness, mood swings, itchy skin, insomnia, exhaustion etc. Went for blood tests which came back positive for perimenopausal and gp prescribed sequential HRT patches 2 months ago. I'm 47 and still have regular periods.

Since then my anxiety has become even worse, to the point where this week I've pretty much had a breakdown and now been signed off work with stress for a month. I was already taking 100ml sertraline antidepressants for anxiety (have taken these for years) so gp has increased these to 150ml.

I don't know whether all this is being caused by my hormones or just life, and whether the HRT has now made it better, worse or it was getting worse anyway.

I don't know whether to stay on the HRT for a bit longer to give it time to work. Its the one where you wear an oestrogen patch for 2 weeks then a progesterone one for 2 weeks - I'm currently in the second progesterone week.

Can anyone help? I feel absolutely dreadful now. I can't think straight, I feel shaky, my heart is racing and I'm breathless. The panic is overwhelming and i just want to crawl into bed and hide.

You might be progesterone intolerant. I find that progesterone makes my depression worse.

Progesterone has a terrible effect on me, severe anxiety, extreme can't get out of bed fatigue, weight gain, very very low mood, lack of appetite - it's taken being on HRT for me to realise quite how awful and debilitating it is.
I did suffer from PMT but never realised it could be the raising progesterone levels in my cycle causing it - now when I look back I can see I've been progesterone intolerant since my teens.
HRT can be tailored so you take less progesterone or take it vaginally which is supposed to be gentler - that route sadly hasn't worked for me yet.
I am seriously considering stopping HRT so that I don't have to go through the progesterone stage - but I worry because of the benefits of estrogen, which really works for me.

If you’re still having periods you might be better switching to a type of HRT where the amount of hormones stay the same the whole month long rather than fluctuate as this may be what’s causing issues. For example, taking the mini pill as part of the progesterone part, oestrogel and one utrogestan 100mg every night (this is the method I have) or you can completely replace the utrogestan by having a mirena coil fitted and then use oestrogel. You’ll have less side effects from oestrogel and utrogestan than you will from a patch - well, that’s the general consensus anyway.

Thanks for your replies, if it's the HRT that's making me feel like this I honestly don't think any of the benefits are worth it as I mainly wanted to try it for the anxiety issues.

Do you think I'd be better scrapping HRT altogether and just sticking with antidepressants?

That's why I had to stop hrt, I took utrogestan I couldn't get on with it.

I saw a Dr the other day who recommended cyclogest via the anus for progesterone, supposed to have less side effects. I'm in Spain but I'm pretty sure it's available in uk. I will have to give it a go.

I take anti depressants but they don't seem to touch the sides now with menopause.

My consultant told me today that a Mirena coil should be my next trial after trying only 1 x 100mg Utrogestan vaginally for 10 days per month (I'd been using 2 x 100mg which is a double dose apparently). I explained that I was worried about having progesterone via the coil, a device I had no control over, she told me two things to consider :

1. There is far less progesterone iemitted from the Mirena, so less chance of side effects

2. Removing a Mirena is far easier than inserting one and accordingly and the nurses within GP practises will remove them, so I wouldn't be stuck with it if I had an adverse reaction to it.

I'm still not convinced but apparently you have to have tried everything (including the Mirena) before you will be considered for a hysterectomy on the basis of progesterone intolerance.

@Rina66 Do you mind if I ask who your consultant is? (You can PM if you want to !)

It's just that mine has never suggested vaginal Utrogestan can be reduced. My dr is a very experienced consultant and I will ask if vaginally use can be reduced but at my latest appt this wasn't suggested, even though we did discuss the pros and cons of vaginal use.

Yes hrt made it all worse for me. It's been 7 years since starting the peri menopause and for me, it's the hike of oestrogen that has brought on all my symptoms and hrt made it worse every time. I tried 4 different types and methods.

Not everyone need more oestrogen to feel better. Saying that, I would give it another month to make sure that it isn't right for you.

To respond about the progesterone, the last trial I attempted, under a very experienced gynae who works at the local hospital also said that I could do 10 days of 100mg utrogestan vaginally but that was in the basis I was on the lowest dose of oestrogen. She said that the risk of thickening of the womb leading to cancer was actually very low and rare, but did suggest doing an annual scan. She really wanted me to try 3 months and then go on the mirena.

As it is, this was a complete fiasco. I never had as many hit flushes as I did on when on the gel!

@JinglingHellsBells can you PM me and I'll reply? I still can't work out how to do it, perhaps it's because I'm in my phone?

[quote Rina66]@JinglingHellsBells can you PM me and I'll reply? I still can't work out how to do it, perhaps it's because I'm in my phone? [/quote]
Sure. It's under My Mumsnet- top right of page and then you will see private messages.

I’m doing well on the oestrogel - less achiness, brain fog, insomnia etc - but I think the utrogestan stage of the HRT cycle is affecting my mood. I am already anxious and prone to depressive episodes, so I’ve been keeping an eye on mood changes just in case, whilst trying not to over analyse.

I am on 2 pumps of oestrogel and read on the Menopause Matters website that the alternative dosage for vaginal delivery is 100mg/12 days. So I’m going to discuss this with my GP before the next utrogestan stage.

(It’s messy tho, having tried it!)

@JinglingHellsBells sorry, I have been trying to reply to you but I'm not being sent a confirmation email in order from Mumsnet in order to log in to my messages.

To put your mind at rest, I had an email yesterday from my new consultant, after they had consulted with their colleagues, to say the regime had to change to 14 days of 1 x 100mg progesterone, so I will try that and see how I go. It is progress as my previous consultant refused to allow me to use the Utrogestan vaginally as my estrogen levels were too high at 756.

Thanks Rina for the update. Maybe MN are doing something new with registration as I thought anyone could message once they had joined.

I am going to discuss this with my consultant, sometime, who is a leading meno expert.

I do know this advice of reducing the dose it not mainstream.

There have been several trials on it but all with very small numbers of women ( like 50 to 60 in the trials and often using low doses of estrogen.) I think some drs feel the evidence is not quite there yet to make this change to the dose for all women.

Hi OP,

It isn’t surprising that you felt the progesterone made you feel worse , it’s a common problem .
HRT isn’t the cure all it is often presented as

This is my fear too, so I haven't started it. I reacted quite badly to the pill.
It's interesting hearing more anecdotes, as suddenly hrt is being presented as a cure all.
Sorry you're feeling rotten @bellissimiaow

I hated the pill too.
HRT is steriod medication so is likely to come with side effects , either early or late.
Medicine is constantly evolving. A medical professional should always say ‘ current research indicates the following risks and benefits’ .
Be very wary of anyone who is evangelical about this issue as it remains very nuanced

Yes. I was only on it a month, anxiety through the roof and gained a stone in weight. Not worth it for me.

I think I may also be sensitive to progesterone. Apx 15 years ago I was prescribed the mini pill and within weeks was sat staring at the floor all day in what I can only describe as a devastated mood. I came off it against doctor’s orders - him wanting me to let it settle down for a few months. I’m now experiencing going through peri menopause and consultant gynaecologist recommended a Modena coil, (I have genetic blood clotting disorders which rule out taking HRT orally). A few weeks late I am crying multiple times a day anytime I’m alone, my confidence is on the floor and I feel like a different person than pre coil. I’m awaiting advice and oestrogen patch from my GP - but like many of us, I’m finding it hard to access GP services. I don’t know whether the oestrogen will balance this out or whether to get coil removed? I just left my job to embark on an intense post graduate programme and this is making it so hard for me to engage as I normally would.

A mirena coil!

@selfishjeanss , I’m sorry to hear how difficult it is for you .

Yes. I was on it for a while. I started taking it mainly because, at fifty, I was in a high profile job and had to commute every day. I was concerned about having debilitating flushes. However a couple of side effects were increased depression and anxiety (I was always inclined to both anyway), and hemiplegic migraine on a regular basis. Therefore I stopped taking it.

When I stopped, the flushes happened in the evening, almost never at work, didn't last long and depressive and anxiety tendencies went back to how they were and no migraines. I wished I had never started but sometimes you panic a bit, in my case because of having read how awful the peri-menopause stage was. It really wasn't.

I kept myself fit and well, ate healthily, took vitamin and mineral supplements to protect my bone density.

I had periods but less and not heav; about eighteen months after stopping HRT, I had my last period and that was wonderful!

Thank you @Taketheredpill .. it’s not forever. I won’t be hushed

@Plumtree391

I had a similar experience. I had (have!) a lot on my plate and the peri symptoms were distracting and draining. My GP gave me patches with no argument but with the attitude of try it , if you hate it just stop . So I did try it . I had great sleep at first , it didn’t last ( a week or so ) but HRT is not licensed for sleep problems. I found that HRT brought with it other new symptoms !
Stuff that -especially as there are known medical risks with taking the medication. I’m seeing a lot of influencers promoting HRT , almost as if it’s a life style choice rather then medication. I have my own suspicions about why this is happening.
Menopause transition is a difficult time for many of us . I found myself depressed , angry , worn out. But it is a transition . It does pass ( yes I know there will be the anecdotal 90 year old with constant hot flushes, god help them )
For me peri was worse than post menopause .