Will antidepressants really solve my day and night sweats?

[ChurchlightJane]

Initial phone appointment earlier to discuss Meno symptoms. My mood is pretty stable but physically I'm wrecked. Night/day sweats, disrupted sleep, very painful joints, exhausted all the time.
I'm obese and both maternal grand parents died of heart attacks so I've been told I may not be a suitable candidate for HRT which is what I was asking for. I was told antidepressants might help my sweats and I'm seeing the GP face to face tomorrow for blood pressure and weight checks.

Has anyone had a good outcome re using antidepressants to help with the sweating? Im a bit worried re taking antidepressants so may decline them if that's all ok deemed suitable for but I am also a sweaty tired mess. Any good news stories out there?

Nope, I can't see it to be honest but I'm happy to be proved wrong. So many women get fobbed off with anti depressants when it comes to menopause.

I don't see how it can.

Your symptoms are due to hormonal changes.

ADs are for mood etc. Not physical changes due to hormonal changes.

They impact the brain (usually? Always probs) not the body and I mean not hormonal things.

So no that's weird.

Can you try another doc? There may be some forms of treatment for your symptoms that are less problematic with your history. I mean I don't know. But ADs seems like such a stupid suggestion I wouldn't feel confident in the doc who said that!

They didn't help me. I had years of constant hot flashes at night.

No it just makes you care less

I'm just a couple of months further ahead than you. I was prescribed paroxetine for the hot flushes and disturbed sleep. They didn't want to give me HRT as I have 3 risk factors, BMI over 30, high blood pressure (which is controlled by medication) and history of migraines (which have declined from 2 a week to 3 in a year after I started taking the blood pressure medication)

The GP said I would know in 6 weeks if the antidepressants would work. I used that time to start on a healthy eating plan and lost almost a stone, I still have another 4-5 stone to go. Last week I had a phone consultation with the GP, told her they weren't working and that I had lost a stone. She agreed to put me on the lowest dose of the patches to start, and I need a blood pressure and weight check in the first month before she will prescribe any more.

I've only been on them a few days but I'm hoping they will help, and the GP has said she will increase the dose if needed.

So no, the antidepressants didn't work for me but I said I would give it a go and the GP seemed more willing to try the HRT then, especially with the slight weight loss.

@ChurchlightJane Your dr is incorrect.
Read the NICE guidance pinned at the top of this forum.

Anti-Ds are not recommended as treatment for flushes etc in women who are not clinically depressed.

What is worrying is that your dr doesn't seem to be aware that estrogen is actually beneficial for heart health! That's why women with early menopause are advised to use it!

Topical estrogen does not cause blood clots. It actually helps reduce build up of plaque in the arteries.

This is in all the research and it's old news so again, worrying your GP is out of date.

Obviously from a health point of view, you need to lose weight, regardless of HRT.

But your grandparents heart issues are not relevant- heart disease is usually related to lifestyle and can be prevented.

The only reason you can't use HRT re hearts is if you have had a recent heart attack , stroke, or perhaps a history of blood clots.

I really appreciate everyone's response here. Thank you. I'm going to take the NICE information and see what the GP says. In conversation last night someone said the woman i spoke to is a nurse prescriber but I wouldn't have to expected that to make a difference to the advice.

Is is possible they have decided you actually need anti depressants based on your phone call?

It's a good point but I doubt it. I was very clear that my symptoms are physical. In my initial online consultation I said that the sweats and joint pain were the worst of my symptoms by far.

Can't take hrt due to contraindications with my other medication. Hot flushes and night sweats. Did some research and got a prescription for clonidine. Take 50mg twice daily. On day 3 and either imagining it or it's a wonder drug. Had 2 full nights of sleep.

@ChurchlightJane

This is from NICE

Cardiovascular disease

1.5.4 Ensure that menopausal women and healthcare professionals involved in their care understand that HRT:

does not increase cardiovascular disease risk when started in women aged under 60 years

does not affect the risk of dying from cardiovascular disease.

1.5.5Be aware that the presence of cardiovascular risk factors is not a contraindication to HRT as long as they are optimally managed.

Thank you so much for such a detailed response JinglingHellsBells and everyone else.

Saw the nurse practitioner who feels my BMI and cholesterol are too high but has taken bloods and will call me Friday. I mentioned the NICE guidelines but she said they didn't fit with my circumstances.

Docs giving women ADs for all sorts of issues that are actually physical / or a reaction to something shit going on and that is what needs sorting, is a well known problem.

@ChurchlightJane

Thank you so much for such a detailed response JinglingHellsBells and everyone else.

Saw the nurse practitioner who feels my BMI and cholesterol are too high but has taken bloods and will call me Friday. I mentioned the NICE guidelines but she said they didn't fit with my circumstances.

How exactly do they not fit?

Also, if you are over 45, NICE says do not do blood tests.

You are being given very bad (non) treatment.

Can you see someone else because the nurse sounds clueless.

How on earth can she say your circs don't 'fit' when NICE says categorically that even women with active heart issues can have HRT?

She's only a nurse- not even a dr and not presumably trained in prescribing for menopause.

@JinglingHellsBells. If the bloods have been taken for hormone levels they should not be done but it is possible that they have been taken to check for other things. I don't think OP has specified what is being tested
One of my friends is a GP and regularly now has to explain to irate women because they have been told tests should not be needed when, in fact, she is not testing hormones but is being thorough by checking things like thyroid levels, anaemia, vit D deficiency, etc that could cause similar symptoms or to rule out other more concerning conditions before prescribing

I agree @IvorHughJarrs

But the OP does say that the nurse feels her weight and cholesterol is an issue when neither are contraindications for HRT.

What's so wrong is that the OP ought to be given support for her weight loss, and if HRT helps her to exercise and be more positive about aiming to be healthier, all to the good.

Too many old-school drs (and nurses) link HRT to the Pill. It's a totally different product and is shown to prevent heart disease, diabetes, and also improve the good lipids in the blood (all the things this nurse thinks it will harm.)

I'm going to go against the grain here. I had horrible night and day sweats for six months (soaked bed sheets, cooking dinner in my bra, restless sleep with periods of insomnia) I was 46, normal BMI, Morena coil for the last 9 years.

I went to the GP and we discussed the symptoms and he suggested anti-depressants. I said that my mood was stable but the sweating and insomnia was debilitating but I'd be a guinea pig and try them.

I started them in June, Effexor XL 37.5mg (Venlafaxine) the lowest dose available. The side effects were nausea on waking, clenching teeth during the day and reduced ability to orgasm. The night sweats and day sweats reduced over a month and disappeared completely over six weeks. The side effects took three months to reduce to barely noticeable and my orgasms are back.

I had a medication review with my GP three months in and I was brutally honest about the pros and cons. We agreed that I would continue on the Effexor tablets for longer but if any other symptoms started we'd review other medication.

I know I'm not out of the woods and menopause is an ongoing thing, but I have a reasonable GP.

@TheLongRider But why is your GP going against the robust medical advice of NICE? They insist that ADs are for women who because of other health issues cannot use HRT and for them the good 'side effect' of ADs can be reduced sweating etc.

Why are you happy using a mind-altering drug when you don't have depression?

There is a massive campaign to stop GPs doing this (by meno experts) because it's simply incorrect treatment.

It will also not help your heart or bone density.

It's your choice 100% but your GP is not doing what the guidance in 2015 asked GPs to follow.

I'm not in the UK. There was a small study from 2014 that indicated that a low dose of Venlafaxine may help with night sweats specifically.

jamanetwork.com/journals/jamainternalmedicine/fullarticle/1876676

I was willing to try it as a first option, my GP agreed that this is such a low dose of Effexor that it wouldn't be therapeutic for depression.

Other than no periods courtesy of the Mirena and a few other symptoms I wouldn't know I was menopausal. My mood and weight are stable. My main issue was night sweats and the medication has solved that issue. There's more than one way to skin a cat.

I know of the NICE guidelines but as yet I'm not symptomatic enough in my opinion to benefit from HRT. I'm aware of heart disease, osteoporosis and the other risks of less than ideal oestrogen levels but I'm not there yet. It's a work in progress and so far so good.

Anti depressants are a major cause of night sweats.

@TheLongRider

I'm not in the UK. There was a small study from 2014 that indicated that a low dose of Venlafaxine may help with night sweats specifically.

jamanetwork.com/journals/jamainternalmedicine/fullarticle/1876676

I was willing to try it as a first option, my GP agreed that this is such a low dose of Effexor that it wouldn't be therapeutic for depression.

Other than no periods courtesy of the Mirena and a few other symptoms I wouldn't know I was menopausal. My mood and weight are stable. My main issue was night sweats and the medication has solved that issue. There's more than one way to skin a cat.

I know of the NICE guidelines but as yet I'm not symptomatic enough in my opinion to benefit from HRT. I'm aware of heart disease, osteoporosis and the other risks of less than ideal oestrogen levels but I'm not there yet. It's a work in progress and so far so good.

There is nothing to justify a GP prescribing ADs when NICE says it's incorrect treatment.

They say very specifically that HRT is the first line therapy.

You are certainly symptomatic enough for HRT.

Sorry- this is not personal against you, but it makes me very cross because so many women are being denied incorrect treatment and it's nothing short of dire that GPs are flouting guidance that has come after menopause gynaecologists across the UK have spent years formulating correct guidance.

The 2015 NICE guidance was supposed to be a major step in helping menopausal women. If GPs continue to ignore them, what does that say about them?

Also, your link- no one denies that ADS help vasomotor symptoms.
But they are supposed to be for women who cannot use HRT.

@JinglingHellsBells

Also, your link- no one denies that ADS help vasomotor symptoms. But they are supposed to be for women who cannot use HRT.

...but if a woman makes an informed decision not to take HRT that is her right. @TheLongRider says she is aware of the NICE guidance but has chosen not to go down the HRT route as yet and she also says she is not in the UK so her doctor will, presumably, work within frameworks other than NICE. There are significant numbers of women choose not to take HRT for many reasons

@IvorHughJarrs I agree with your 100% if that is what happens. Yes, women should make informed choices.

If someone goes to their dr and says 'I don't want HRT (for whatever reason), so what else can you suggest?' Yes, of course the dr should offer options.

But here, I don't think it did. The poster went to the dr with severe night sweats, has a Mirena, (so no idea how far into menopause she is) and the first thing her dr offers is HRT.

In the UK anyone who is menopausal before 51 is supposed to be offered HRT to prevent other illnesses.

I appreciate she's not in the UK but the IMS (International Menopause Society) which also says the same things NICE covers a lot of Europe but maybe she is outside of that or in Southern Ireland.