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Menopause

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Everything HRT, diet etc help/advice

9 replies

Queenie24 · 05/03/2022 18:17

Good afternoon
I am hoping for help/advice please. I am currently in peri menopause, I am using 3 x 500mg (0.5) gel every day and then a pregestaron tablet for 14 days. I am also on antidepressants all these started Easter last year but I’m still getting night sweats, low moods, headaches, feeling sick and dizzy, no interest in sex at all and now dry and itchy down below and heart palpitations. Sleep has improved but I’ve started taking some herbal capsules by acti lap for night time so think that’s what’s helping that.
I think I need to look at alternative ways to help myself other than medication as a lot of the symptoms appear on the side effects info for the antidepressants I’m taking. What I suppose I’m asking is for any help and advice on where to start with having a balanced plan to help me move forward.

OP posts:
Nickersnackersnockers · 05/03/2022 21:40

Can you clarify your prescription. What dosage of estrogen are you taking?

Queenie24 · 05/03/2022 22:03

3 sachets of 0.5mg each but the label says 500mg.

OP posts:
Nickersnackersnockers · 05/03/2022 22:18

Sorry I am still confused. I have a patch that only administers 50mcg per 24 hours. So 500mg is 500,000 mcg.

Queenie24 · 06/03/2022 08:25

I use 3 sachets of gel and each one is 0.5 mg gel. So I have 1.5 mg a day. I have no idea what the 500 microgram in the label from the pharmacy.

OP posts:
Nickersnackersnockers · 06/03/2022 19:40

Hopefully someone else will be along soon who can help you as I am not familiar with your prescription

JinglingHellsBells · 06/03/2022 21:02

@Nickersnackersnockers

Hopefully someone else will be along soon who can help you as I am not familiar with your prescription
You're confused :)

You can't compare patches and gel the way you are trying to.

@Queenie24 You are using 1.5mgs of estrogen.
That is a medium dose.
Tablets and gel is used in mgs. Most tablets are 1mg or 2mgs.
Gel can be varied from as little as 0.5mgs upwards.

Depending on your age, you might need more than 1.5mgs estrogen.
You could need 2 mgs ( 4 sachets.) BTW Sandrena comes in 1mgs sachets so why are you not using those?

The first step when using hrt is - if your symptoms are still there- to increase estrogen. So do that for a few weeks.

You also do not need 14 days of Utrogestan. 12 days is enough (this is on the leaflet.) 14 days is more for women who have more bleeding each month and need to control it more.

Have you beengiven anti Ds for menopause or pre existing depression?

If it's for menopause, this is not first line treatment- HRT is.

NICE advises using HRT for anxiety and 'depression' caused by loss of estrogen.

Maybe you need to stop the ADs with your dr's consent.

They don't help with menopause and as you say may cause side effects.

Queenie24 · 06/03/2022 21:12

Thank you so much for responding. I’m using the 0.5mg sachets as that’s what the doctor has prescribed, I wonder if the 1mg are not available? I will ask. I’ve also been told 1.5mg is the max I can have. I will read the leaflet as I was told to take the Utrogestan for 14 days then not for 14 days.
I still have periods that last near on a week but light.

Im so confused by it all.

The antidepressants are for menopause related low mood and bad thoughts. It was the first thing that was suggested before hrt.

OP posts:
JinglingHellsBells · 07/03/2022 08:02

@Queenie24 My suggestion is that you either

1 Change to another GP who knows about menopause

or

2 Learn as much as you can about hrt and treatments, and go back to challenge your current GP , telling them what you want. (They clearly know little as they are giving you incorrect information and treatment.)

The NICE meno guidance is pinned at the top of this page. It was published in 2015 so your dr has had almost 7 years to read and follow it. They clearly have not.

This is from the Diagnosis section.

Psychological symptoms
1.4.5 Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6 Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

It says clearly that HRT is the first line treatment, not ADs, for low mood.

The 2nd point is that there is no limit on Sandrena at 1.5mgs. That is nonsense. The other gel- Oestrogel- has an upper limit of 3mgs per day (and some women use even more.)

The Utrogestan is usually taken for 12 days per calendar month.
Most consultants advise using it on the same day each month - like from the 1st for 12 days, or from the 15th, for 12 days.

Utrogestan can cause low mood in some women, so reducing it to 12 days (rather than 14) is fine. In fact the leaflet in the packet says 12 days.

I think your GP is muddled, because some tablet forms of HRT have 14 days of progesterone.

I hope this helps. You are going to have to be assertive, or see another dr! You might also consider stopping the ADs as they are not recommended - see NICE- and tell your Dr this.

Queenie24 · 07/03/2022 14:22

Fab thank you.
I’ve read through all the information and think my action plan is

  1. Get off the antidepressants - how I’m not sure, I will speak to Dr about this.
  2. Ask about CBT
  3. If symptoms still don’t improve after stopping antidepressants request an increase in the gel. I am unsure why my dr is saying I’m on the maximum.
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