HRT

[Beckycw]

Hello! I am posting because the last few months have been awful and I just want to see if anyone can relate?

I am 40 - nearly 41. About 3 months ago, I just stopped being able to sleep, this was followed by anxiety and feeling really depressed. My periods were coming every couple of weeks. I felt like I was in a fog and really irritable. I thought at the time it could've been the pantoprazole meds I was taking for reflux and came off them. Some people said that they had some of the above symptoms since coming off this drug so I was waiting for it to come out of my body.

It then occurred to me that this could be peri. I started 2 pumps of gel but didn't feel much benefit so then upped to 3 pumps and noticed I felt better straight away if that's even possible. However the utrageston has made me feel worse. I took it continuously for a few weeks as taking 2 at a time made me feel horrible. Ive since been off it for 4 days and still feeling crap, I took it mainly vaginally but a few times by mouth. Shouldn't it be out of my system by now?

I also increased the venlaflaxine to 112.5mg. The problem is I don't know whats working and whats not. Ive got a horrible feeling that increasing the venlafaxine could have a negative impact on my mood. I am overthinking everything and crying as I am writing this. I feel so out of control of everything in my life and at times feel suicidal but know I couldn't leave my husband or children.

I feel depressed as I feel that I cant do the things I used to do.....go back to work (I've been volunteering but feel so anxious when I am there and just want to come home). I feel anxious even meeting up with a group of friends. What the hell is wrong with me? I feel like I have had a breakdown and am so wanting to get back to normal but am trying so hard. I feel like this is going to be forever and I am so disheartened each day. I think sometimes I may have turned a corner, then I have another crap day. I am dreading tonights sleep as I wake up so early in the morning and just start thinking. I also dread the weekends due to the lack of structure. Where have I gone? I miss the old me so much.

Have you had medical advice about all of this?

Yes I have, a psychiatrist and a meno specialist

It's always hard to know what is working if you use ADs and HRT together.

The advice from NICE is not to use ADs for hormonal depression/ anxiety but obviously you are seeing a psych. Were you on ADs for long prior to HRT?

I'd have thought the advice would be to stop the ADs and focus on HRT to see if that helps.

It's best to do the 12 days a month of Utrogestan for 2 reasons

1 you are in peri and have periods still
2 you may get fewer psych symptoms on 12 days rather than using it daily.

I think my consultant would have put you on estrogen only (gel) to get the dose right, then added in progesterone after 10-12 weeks. This is long cycle HRT which can be used safely in peri and really reduces the side effects that progesterone can cause.

There is also a tablet form of 3-monthly hrt called Tridestra.

You could discuss this with your meno consultant.

Also, there are other types of hrt totally suitable which do not include Utrogestan- Femoston is one.

Utrogestan is good, but it's more about its long term safety profile. for younger women having early menopause, the other types of progesterone are safe, especially Feomston.

Thank you JingIlingXmasbells. To answer your questions....I have taken ADs for a very long time, so they are not a new thing. Thank you for your recommendations re progesterone. The meno specialist said I can take Cyclogest instead of Utra as I tolerated it well during my IVF.

I know you are very knowledgeable on meno and I was wondering if you knew if an increase in Oestragel could make you feel more emotional in just one day? Ive been in tears this morning after increasing to 4 pumps, could it affect me this quickly? Do you know if lots of women also have a feeling of dissociation? When I increased to 3 pumps I felt better a few hours later. The reason I increased again is because I have been getting night sweats which wake me up. I have only been on 3 pumps for just under 2 weeks, is this long enough?

I will try to help but it's hard as you are using ADs and HRT.

(Has anyone suggested that your long term depression etc may have been hormonal all along, especially if you have had fertility issues. Has anyone mentioned that?)

I doubt that increasing estrogen by 1 pump would make you feel as you did.

TBH I'd try to stick with 3 pumps for a good while. The advice is 3 months before swapping to another dose. I appreciate that may seem like ages, but 8 weeks or so might be worth trying rather than increasing so soon.

Have you had other forms of treatment for your mental health - CBT, mindfulness, counselling? I'd assume yes, but maybe it's worth trying one of those again now?

Thank you. The fertility issues were on my husbands side but I do think I could have been perimenopausal after having my twins at about 37. I was off balance and dizzy, dry eyes etc and then things seemed to calm down and other things have been cropping up, like itchy skin, forgetfulness, lack of confidence etc.

I am going to stick to 3 pumps for the 3 months. I stopped the utrageston on Monday night - would I still be feeling low now? I took 100 mg continuously and by the end was feeling really sick. I was also belching quite a bit which I am still doing now (strangely when I am stressed or nervous). I have also developed tinnitus - not sure why this could be?

I am having therapy.

Thank you so much for your response.

It might take a little longer for the effects of utrogestan to wear off. I take it cyclically, and find that after the last dose it can be a week before I feel 'normal' as some effects are due to withdrawal, not the absorption. You might also get a bleed now you have stopped it.

Thank you. When you say 'normal' - do you mean the anxiety, nauseous feeling has worn off?

Yes.

Hope you feel better soon.