Please recommend the best HRT for me.

[RosieSun]

I’m a regular poster but have name changed as I have never started a thread and nervous about this. I’d be glad of advice.
I have my 2nd GP appointment the day after tomorrow for menopausal symptoms, where I am expecting to be prescribed HRT. I suspect I have been peri for 4 years, but I didn’t realize, as my symptoms accumulated gradually as follows:
20lb weight gain; hair thinning; tiredness; vertigo; mild hot flushes; stress incontinence ; back ache and stiffness; low mood; general rage and now high anxiety with frequent chest soreness and shortness of breath. The anxiety is dreadful and the worse symptom by far. I am on the mini-pill, married but no sex life to speak of, but I want this to change once I’ve sorted myself out.
I stopped the mini pill at the start of the year when I wanted to check if I was menopausal. I had no periods for 4 months, then the heaviest two of my life (could barely leave house some days) and so I went back on the mini pill.
I have read up on HRT and I think I would like gels/patches but I got the impression at my first appointment that they were going to give me a combined pill instead, which will be disappointing if true. I don’t want a mirena coil fitted as I had one before and encountered problems with its removal.
My bloods have been taken twice with FSH readings of 72 and 70.
Until all this my health was good. I am 47, a bit overweight (BMI 26/27), diet not bad. I don’t smoke and gave up alcohol in the summer as I was feeling so lousy. I had covid in Sept 2020 and I thought I had long covid before reading up on the menopause.

Sorry for the long post, just trying to jot down any significant factors. If anyone reading this is has experience of HRT and can recommend a prescription for me that would be great. (I have read many websites, including Louise Newson’s.)

Hi @Theblacksheepandme. Why are you scared of testosterone? I keep hearing about how hard it is to get prescribed on NHS is UK so I really hope it works wonders for you! I found lack of sex drive miserable.

@BeerLoas afaik from 45 GPs can prescribe HRT based on symptoms alone, as it's so likely to be peri/meno from that age. Before 45 can still prescribe but might ask for blood test to confirm. In fact, I had a blood test at over 45 to rule out some other things that might have been causing my symptoms. Does sound like your symptoms fit. For me the worst one was 'the rage' and it was making me and my family miserable, and just was not like me.

KarmaComma
Hi @Theblacksheepandme. Why are you scared of testosterone? I keep hearing about how hard it is to get prescribed on NHS is UK so I really hope it works wonders for you! I found lack of sex drive miserable.

I'm afraid that if I use too much that I will end up having irreversible side effects. I am in Ireland where you have to pay for everything so the doctor actually suggested testosterone. Lack of sex drive is miserable you're right. Hopefully it will work.

Ah. I've not read up about testosterone use, so don't know much about it, other than it's to improve libido. I don't rate my chances of getting any prescribed so haven't bothered to read up. Have you looked at balance app? I check everything I'm reading with what the menopause doctor advises - I find her so matter of fact and she just seems to put things into context really well.

KarmaComma
Ah. I've not read up about testosterone use, so don't know much about it, other than it's to improve libido. I don't rate my chances of getting any prescribed so haven't bothered to read up. Have you looked at balance app? I check everything I'm reading with what the menopause doctor advises - I find her so matter of fact and she just seems to put things into context really well.

Thanks for that KarmaComma. I have spent all evening reading information on balance app. I don't feel quite afraid now taking testosterone. I must listen to the podcasts tomorrow. It really is about educating oneself.

Absolutely. There's so many scare stories out there, so much disinformation, and womens health is so taboo anyway. I find it so strange that I knew next to nothing about the menopause until it actually happened to me. Why aren't women talking about this more?!

I listened to a podcast with the menopause doctor about taking HRT in general. When she said it's a hormone deficiency, there's no way we'd just expect people to ignore any other type of hormone deficiency, it just all clicked for me. We need these hormones and it's not right to leave us suffering when it's so easily treated.

Hi everyone. I’ve been hopeless checking the thread for new posts but here I am, better late than never 😳 !
@bluejelly how did your review go? Any change to your HRT and any benefits yet? That’s good your increased dose has helped @putthehamsterbackinitscage . Yippee😀 welcome (back 😉) @KarmaComma . I was on evorel sequi (50s) too, but changed at first review. On new regime I seem to be bleeding a little every day. I reckon I must be ‘Always’ best customer by now! Hi @Theblacksheepandme . That’s lousy you are not seeing improvements yet. I’m interested to hear your estrogen levels were high but your symptoms haven’t improved. Id thought the point of HRT was to put the levels back up and make us feel better. Does this mean you’ve had a big change in your levels but neither are putting you in a good place? I hope the new variable dosing helps you.
I’ve seen an improvement in most of my symptoms, but they are still there. The anxiety is by far the worst. I’d take your testosterone in a heartbeat though. I do hope give it a go.
Welcome @BeerLoas . I’m no expert but your symptoms sound pretty peri to me. I sympathize. I often review the rage I have in my head trying to work out if it’s a rational ‘’seeing the light’’ in how people treat me, or if my hormones are turning me into a mean person. I swing between not giving a toot what people think, to being ultra sensitive and over analyzing all my interactions and conversations with people. It’s exhausting! I think going to your GP first would be a good start.
i am plodding along , feeling better than I din in the autumn/ winter (pre HRT). I’m always better generally as the days get long and bright though. My anecdotal musings are far from a scientific study on the pros and cons of HRT. I have a few weeks until my next review so will see how I get on in the coming month. I must confess I did have a little road rage incident I’m not proud of. I shouted at another driver for going straight on in a left only lane. Only to later realise they changed the road markings and she hadn’t done anything wrong. I must keep my strong opinions on all matters inside my foggy head from now on! (Especially when they are bloody wrong!)
anyway keep posting all, good and bad. We’re here to try and help….

I'm sorry RosieSun but your road rage story made me giggle. I am going to give the testosterone a go and report back if it makes a difference.

I heard Louise Newton (?) interviewed on Radio 2 today about the challenges of getting varying forms of HRT as the moment. As someone just starting my journey i was outRAGED (!) at the difficulty procuring essential medication. Hope no-one on here is experiencing that.

Good on you @Theblacksheepandme . If it doesn’t work for you I will send you a SAE to forward it on….lol …I’ve heard it’s good for energy and brain fog! Btw I actually thought I saw road rage incident lady at petrol pumps this morning. Thankfully she didn’t see me.

I was reading about the HRT shortages in the papers today @BeerLoas the irony being it’s probably Louise Newson (and Davina!) promoting transdermal HRT that’s escalated the shortage (I don’t mean I’m blaming her- the pharmaceutical companies should be keeping supplies up better) .
I think shortages have hit patch supplies here too. I didn’t get the good patches this time. I have huge ripply squares I have to tape on because they don’t even bloody stick properly. And you are meant to be able to swim and bathe with them! I can barely breathe in mine without it curling up and falling off. I have to stick it on the front of my thigh and hold my leg out the water when I have a bath, else I’d be getting through 7 patches a week….😆

I had to see hospital gynaecologist for another matter and he suggested i ask G.P. for what he considered "the Gold Standard" which was Mirena coil + Oestrogel. I was not expecting to get a coil again at 64 but it has worked very well for me, until the Oestrogel shortage, just hoping my G.P.has sourced an alternative for me when I collect m prescription tomorrow.

I'm in Ireland and there is an Oestrogel shortage here too. I was taking Divigel but at my review it was changed. I guess I will just continue using the Divigel until I can get the Oestrogel. My pharmacist is very good and is trying his best to get it for me.

Definitely an oestrogel shortage here - my prescriptions are still monthly only, and for last 2 months not able to get gel.

I have patches (50) and gel to ' top up' on days that I need it. Only I haven't got any gel this month whether I need it or not! Hoping I can ring round tomorrow when everything is open again to find somewhere that has some.

It has made me think, though, that I have been using the gel to top up daily, my rage has come back. I'm thinking what I actually need is a review of my hrt and probably higher dose patches now. It's coming up to a year since I started and I think that it's pretty normal for need to increase? Also going to ask for longer prescriptions because probably the only reason I haven't asked for a review yet is because I feel I already spend so much time sorting this prescription out - between phoning for repeat, getting prescription, going to chemist, finding my prescription is short an item, chasing round for it etc. easily takes a week of my limited energy to get 4 weeks supply.

P.s. saw there's a new Davina documentary about meno which includes using testosterone! Might be interesting for some of us. It flashed by when I was insta scrolling so will look for more details.

Sex, Mind and the Menopause channel 4 9pm tonight!

Hi Folks. I hope everyone is doing well and managing to get their HRT @Astrabees , @KarmaComma & @Theblacksheepandme . @KarmaComma . I started on 50 patches and am now on 75, I haven’t noticed a difference but trying to be patient. If you think it may help you should ask to try them. They are big though.

I’ve to get a GP appointment for 6 month review in a few weeks. It’s so hard to get an appointment at all I might be best trying now for June!

I am plodding away with 75g patches and a 14 on, 14 off Utrogestan cycle. I still have all the meno symptoms I had in 2021 (pre HRT) but they are mercifully all on lower volume. My sore bones/muscles/joints have cleared so that’s good. Anxiety, low libido and frequent urination worst symptoms.

I have started a low carb, super healthy (by my standards at least!) eating plan this month and I am enjoying it, but do miss bread/toast/sandwiches/hot cross buns…everything a carb fiend loves 😀 . I’ve also started weekly swim, yoga and daily short walks. Im planning to start weight training after reading all about loss of muscle and strength, but haven’t booked it yet . Too busy and weather’s been too nice. I hope everyone is having a nice week.

Hi RosieSun it's nice to hear from you. Wow you are being really good with diet and exercise. I was on a low carb diet for a long time and lost loads of weight. I stopped and the weight has crept up on me. I just found it so difficult trying to come up with meal plans. How are you finding coming up with ideas on what to eat for dinner? I have been stuck in a rut lately not doing any exercise but I am forcing myself to go walking everyday now. I must start doing weights again. I was so good with diet and exercise but sometimes when you stop at all it is difficult to get back to it. I started my Testosterone about a week ago and that may start helping. I know it can take 3 months to start working. I am starting to feel a little better with some of my symptoms. My vagina feels a lot better. My heart palpitations have lessened. Anxiety is better but work is less stressful at the moment. I will have to see how I react when put in a stressful situation on how I will deal with it. I am sweating less in bed. Is it possible for you to get Testosterone? It may be a boost to help with your anxiety, low libido and frequent urination.

I’m glad you’ve started your testosterone @Theblacksheepandme . Be sure to update us on how it goes for you. I’m tempted to ask for some too. How are your other symptoms going? I’m glad you are better downstairs, that must have been awful. I’ve thankfully been spared and problems that way so far (other than always needing a pee..lol).

It’s a fickle journey of ups and downs I find. Sometimes I’m certain the patch is nothing more than a placebo they invented for gullible middle aged women to save the NHS money!

I feel healthier already (if a bit hungry) on my low carb next diet. This week I’ve had (as you kind of asked 😀 ): berries & yoghurt for breakfast; Greek salad or soup and cheese for lunch. Dinners not very exciting so far: roast chicken & veg; mushroom omelette & salad; Indian chicken & chickpea curry & green beans; garlic & herb marinated lamb chop & peas & tenderstem broccoli.

I am snacking minimally on fruit & few almonds - just 4pm really.
I am also allowing myself a few dark chocolates & 2 glasses red wine per week.

I am totally missing my morning toast but otherwise good so far.
if you have good meal tips do share!

Those meals sound really nice. I just got so fed up of trying to come up with something for dinner everyday. I must try again as it really does work. I just got tired of trying to come up with replacements for rice, pasta, potatoes and bread. I got a lot of recipes from everylastbite.com. I gave up drink and sugar but to be honest I really don't think I could do that again. All this menopause crap is hard enough without living a little. I know its important to look after oneself but I think what you are doing is a lot better.

Ok, so an update on my Testosterone. I now have my sex drive back which is good.

Downside is I have put weight on and I don't know if it's the Oestrogel or Testosterone. I have put a significant amount on the last couple of month's. I know from my reading that HRT is not supposed to do this but I look really bloated. I asked my husband to be honest and he thinks I looked bloated a few weeks after starting everything but more so since Testosterone.

I guess I am going to have to go on a really strict diet and do loads of exercise and see if I lose weight. It is a pain because I am starting to feel quite good.

The only thing as well lately is that I am tired a lot and could sleep anywhere and at anytime. I think I need to try to motivate myself more. I'm working from home and have got quite lazy once I finish work. My husband has recently had to start going into the office and I am missing having his company at lunchtime and for my morning break.

@Theblacksheepandme good to hear the testosterone is making a difference! Do t know about bloat. I always try to think back to regular cycles - bloat is pre menstrual usually, so progesterone? Too little estrogen? Worth having a rad up.

I still haven't been able to get any gel, so the gp has prescribed me an extra 25mg patch. As my first patch is 50 and it's the combined oestrogen and progesterone, I now have a 25 oestrogen patch to add to that. It's not been going well. I was supposed to give it 3 months to 'settle' but I've called up in tears last week because my mood is all over the place after a month. I feel like I've gone cold turkey. Managed to speak to pharmacist on weds who is going to advise dr to give me 50 patches (so would be 100 altogether), but he really annoyed me by saying I should also consider anti-depressants.

I'm not adverse to anti depressants and believe in general that they've done a lot of good for people. But I've no history of depression. I've never take. ADs. I've never experienced depression. Though I often feel depressed over the last month (since stopping gel), surely that's hormonal???? Everything I read says there's no evidence that ADs can help with menopausal low mood. I'm scared that the GP surgery is going to turn into my enemy rather than my ally. And I'm furious that I was doing so much better and all of this had been brought on by shortage of the medication I need!

Hi @Theblacksheepandme . Good to hear your update, mixed as it is. Do you think your new weight gain is actually fat, or are you just bloated retaining fluid? Had you experienced any peri weight gain before HRT? I’d already packed on a good bit before I realized I was peri, a few years ago.
Also, I thought testosterone was meant to give more energy so that’s not good you are more tired. Has it helped with anything other than libido? I’m sorry to hear of the weight gain. I’m on a constant battle with mine too!

I had GP phone appointment last Friday. I really meant to update here (but have been lazy). When I told her about low libido she was sympathetic but said there nothing she could offer on NHS, which is what I feared. She actually suggested I look around and consider a private consultation, as if they prescribe me testosterone, then GP will be able to , but that they cannot just give me it. I had read up about this, but was still a bit gob-smacked at the ‘if you can afford private you can have it’ outcome! I’m not sure what to do now, especially as DH and I never talk about any of this stuff. We have a shared bank account so I wouldn’t be able to have a private consultation even without him knowing about it.

The GP also gave me Sertraline as my anxiety hadn’t gone away. I’m on day 3 of taking just half the dose I’m meant to. I feel quite nauseous, lightheaded, tired and not-quite-with it. She had said to start them when I am off work as they are difficult to begin with, but I’m starting to feel I’m ruining the bank holiday break as I don’t feel like doing anything but can’t let on why. I’ve also taken a bad reaction to my latest HRT patches, skin a perfect massive square of red itchy inflammation. I’m not due to collect new patches until Tuesday.
I bet you are all glad to hear my miserable update…😂how is everyone else doing with HRT?

Hi @KarmaComma . I cross posted earlier and missed seeing your post. Sorry to hear you are down. I can relate to this as they upped my patches from 50 to 75 but it’s not helped my MH issues (more anxiety with me).

It’s true we are not meant to be fobbed off with ADs at menopause. However if we try HRT and it’s not helping issues, it might sometimes be worth trying ADs. I’ve just started but I had the prescription a few days before opening it as there is, I guess such a stigma to it. I’m quite well informed on these things but still have little voices in my head saying ‘you shouldn’t need this’ ‘just pull yourself together’ ‘this is a weakness giving in and taking meds for this’ . But you know what, I’ve just said to myself, do it, give yourself a break and try them . If they work, great. If they don’t, go back down the tweak HRT/lifestyle improvement route full throttle. Having said that, the AD side effects so far are bloody awful I can’t face taking todays. Will put off until tonight and hopefully sleep through worst of it!

I hope you get a solution soon. I had hoped to switch to gel but shortages sound terrible!

It's diabolical, isn't it, that only if you can afford to go private can you access some medication that affects your quality of life.

My low mood is exactly what drove me to the GP in the first place, coming up to a year ago I think. I could handle the hot flushes and weeing all the time. The constant waking in the night was awful, but I was managing. But the feeling of being irritated all the time, loss of interest in anything, weepy, etc was awful. I felt like I wasn't me, and it was affecting my family too, which I suppose was the biggest driver for me getting help. The past couple of weeks I've felt exactly like that again. I really feel like I can get better on the right dose of oestrogen, because it happened before! Fingers crossed. Really wanting the increased patch to work. Or, the gels coming back in stock!

Good luck with the ADs. I don't feel there is a stigma anymore, In my experience you find that when you start talking to people about them, you realise how many people are taking them. Hope the worst of the starting side effects are over and you settle down with them very soon.

Thanks @KarmaComma i still feel yukky on day 4 of the pills but determined to see it through. Mind over matter. There is nothing I have to do today which makes it easier.

What age are you? (If you don’t mind me asking!). They do say the younger you are the more estrogen replacement you need. I’m 47 and on 75g patches now. I can totally relate to your post. I’m still up at least twice a night and wee all the time but none of that’s anything compared to feeling flat or anxious!

i feel for you x

Hi all

I hadn't posted in bc a while either.

@Theblacksheepandme it's good to hear testosterone is helping a least a bit. I would say don't automatically think that's the cause of weight gain or boost though...

At 5 months in, and ok I'll admit I've really not kept an eye on what I'm eating and drinking - other than my wine habit has had to be cut as it really didn't agree with me anymore, but I think (not brave enough to face the scales) that I've gained at least a stone maybe 2....

But it's overall worth it.... I have my life mostly back - my mind is a lot clearer - I've started an MBA an d applied fir a new job.

I'm currently on Evorel Sequi with a Evorel 50 patch to top up estrogen and other than rare days, the rage has stopped , and I can think rationally.

For info I'm nearly 53 and feeling more like how I did at 40 - long may it continue - even if I am 25% fatter 😳