Peri and can't have HRT, so... Prozac???

[hidethetoaster]

My peri symptoms are bad and getting worse, I can't function for about 10 days of every month due to brain fog and fatigue, as well as having a long list of other symptoms (night sweats, panic attacks, etc).
GP is being helpful, but apparently I can't have HRT due to double-sided migraines with aura, and due to family history of strokes and high blood pressure (although my blood pressure is and has always been normal/on the low side).
GP suggested Fluoxetine (Prozac) instead. I'm doing my research, but can anyone tell me:

• did Prozac actually help you with brain fog and fatigue?


• did Prozac make you feel different? Did you still feel your full range of emotions?


• How easy or hard was it to come off Prozac?

Thanks 💐

Hmm. Obviously don’t have the full medical details but transdermal HRT shouldn’t necessarily be a no from what you’ve said.

You need to see a menopause specialist, asap. Go to a private peri/menopause clinic.

The GP is a menopause specialist.
She works one day a week at my local gp surgery and she has a really impressive set of relevant qualifications and experience. The OP was her advice to me.
I was hoping someone here might have been down this path and could share personal experiences ? 🤞

@hidethetoaster You definitely should not accept prozac.

It sounds as if your dr is a bit behind the times and working on old guidance from 30 years ago.

1 Look up The Migraine Trust and their guidance on HRT (they say women with migraine can use HRT - it's not contraindicated anywhere.)

2 Your dr sounds as if she is equating the risks of the Pill with HRT. Modern, transdermal HRT does not cause blood clots or increase your risk any more than not using it. It also gives cardio vascular protection so reduces the risk of heart disease and clots. The Pill is 5 x the strength of HRT and it uses synthetic hormones.

HRT is body-identical - the hormones are exactly the same as your own. You are not at risk from clots/ stroke from your own estrogen, and you are simply replacing that through HRT. (This is what your dr doesn't appear to 'get'.)

3 Your family history is not relevant here. It's what you have at the moment that counts. That would be a recent heart attack or stroke or blood clot. Even high BP is not an issue because the rule is to manage that with drugs or lifestyle.

I have used HRT for over 12 years under a very experienced consultant (who trains other drs.) On my maternal side of the family there is heart disease and stroke. It's never even been considered as that's not a contraindication. I have also had migraine all my life since puberty (not with aura.) Again, it's not relevant.

I'd see another dr or take information along to this one. Or pay to see a meno specialist.

The GP is a menopause specialist.
She works one day a week at my local gp surgery and she has a really impressive set of relevant qualifications and experience

What are her quals and training?.

It doesn't sound like it.

I'd go back and challenge her on all of the above.

migrainetrust.org/live-with-migraine/self-management/migraine-and-hormones/#:~:text=Hormone%20replacement%20therapy,-Hormone%20replacement%20therapy&text=Having%20migraine%20does%20n

I don't know if this link works as the URL is so long to copy and paste! However, you can see the website in it and can search for HRT/ migraine and it comes up.

Your dr is clearly confused. HRT is not contraindicated BUT the Pill for women who have migraine with aura is.

They are completely different drugs.

High blood pressure has absolutely nothing to do with HRT. In fact transdermal HRT can often help with high blood pressure. (I am under the Newson Health clinic and have been through all this with them, you can definitely have HRT).

Your Gp isn’t as much of an expert as they think they are.

If you had a thyroid deficiency you wouldn’t accept Prozac as a treatment - you’d want thyroxine wouldn’t you? Why would you accept Prozac as a treatment for oestrogen deficiency?

No advice but thanks for posting this OP, it's really interesting. I am approaching peri I think and I'm on the mini pill because oestrogen fluctuations give me migraine with aura (and numbness etc). I have a strong family history of heart diseases which saw me put on preventative statins and I developed chronic hypertension after the birth of my last child which means I am on blood pressure medication permanently. I've wondered if all of this would prevent me from being able to have HRT.

@CornishGem1975 Maybe watch Dr Newson on This Morning, yesterday just after 10am? It's easy to find on the ITV site as it's linked on their Home page. She covers a lot of the myths on HRT and also the protective effects to the heart.

There is a lot of evidence that HRT (transdermal) protects women's hearts. Basically it stops the arteries clogging up.

(Women suffer from more heart disease post-menopause when estrogen levels fall. Before menopause they are protected by estrogen, but without estrogen their risks rise to the same as men's.)

When you say a strong history of heart disease, what does that mean? Heart disease is the biggest killer in the UK ( only recently overtaken by dementia for women) so the reality is that almost everyone has some family history.
Mine is maternal uncle died at 51, gran heart attack at 60. Parents , slight TIAs in their 80s.

Thanks @JinglingHellsBells I will give it a watch. I want to be as informed as possible before I speak to the GP!

I am on Prozac (Flouxetine) for depression:
did Prozac actually help you with brain fog and fatigue? Hell no
did Prozac make you feel different? Did you still feel your full range of emotions? Hell no, it numbs so you lose the lows and the highs and just feel pleasant
How easy or hard was it to come off Prozac? No idea as still on it.

prozac is for depression. You aren’t depressed. It also would not address your symptoms of brain fog, if anything they should be offering you ADHD type medication to help with focus and concentration (since you cannot safely take HRT).

Following as I am also peri I keep being offered the mini pill and either Prozac or sertraline never hrt. I have seen the consultant had a scan to check nothing going on and it came back clear still waiting on a follow up appointment. Whenever I mentioned hrt they just ignore me and suggest the pill or coil

This is surely bullshit OP. Offering a woman Prozac, or an AD instead or HRT. This GP sounds like she's from the dark ages. Listen to Jingling, she's very knowledgable. Educate yourself on what say Newson is saying and go back to your GP informed.

I can’t take HRT in any format. It gives me thrush immediately even in tiny doses.

I take Venlafaxine which is recommended for the menopause.

@ArseInTheCoOpWindow The first line of treatment for menopause is HRT. Other medications- such as antidepressants, pain killers and blood pressure meds - are only for women for whom HRT is medically contraindicated.

They don't address many of the issues of menopause (heart disease risk increasing, pelvic floor deterioration, arthritis, and bone loss) but it just happens that they work to an extent on vasomotor symptoms (hot flushes.) And they all have side effects, sometimes very unpleasant ones.

Has anyone suggested to you that you might not get thrush if you used something like Actigel to alter the vaginal pH?

No no one’s suggested that. I’ve seen several menopause specialists.

People who get thrush like me don’t have lots of thrush cells. It’s just they are over sensitive to very few. I’ve had it all my life. No anti biotics, no pill, even adolescence triggered it.

Thrush thrives in certain pHs and also it can be systemic thrush that is in your gut but makes itself known more in the vagina.
It can be a gut issue - too much refined sugar (carbs) is one factor as well as an imbalance of gut bacteria.
The treatment is an oral drug Nystatin for thrush.

I am under an oral specialist for recurrent thrush due to autoimmune issues- I have sjorgens and lupus and thrush is very common if you have those. I have persistent vaginal and oesophageal thrush. I still take HRT (oestrogel, utrogestan and mini pill). I find a probiotic - Biokault - and Daktarin oral gel used nightly helps to keep it controlled.

Oh wow, thanks everyone especially @JinglingHellsBells
Plenty to follow up on.
I can speak to a different menopause advice service through work, and I think my BUPA might have something very limited in the package so will check.

Once l get it, it’s impossible to get rid of.

It gets totally reistant to medication, and l have to take months worth.

I’ve tried the anti Candida diets, but they made no difference.

I'm on HRT and have high blood pressure and take meds for it

@hidethetoaster
I was prescribed Prozac instead of HRT in January this year, by a male doctor. I took it for 2 months but it didn't help my meno symptoms. I have disturbed sleep and whilst taking the prozac, I still woke during the night but got back to sleep easier than before. It did not help my flushes at all.

After the 2 months, I spoke to a female doctor and told her I didn't want to continue with the prozac. She prescribed transdermal Oestrogel but told me that I would have to wean myself off the prozac by reducing to every other day as the withdrawal side effects could be horrendous. I didn't wean myself, I just stopped taking them and I was ok.

I don't know if this helps to answer your question?

It really does. Thank you

The GP is a menopause specialist.

She's told you a load of bollocks, so obviously not.