Low mood and bleeding - on hrt.

[Ahumanjellyfish]

Hi all,

I have posted recently with some personal problems and low mood. This low mood has persisted, and I thought maybe it was related to stress etc.

I take hrt (oestrogen gel and vaginal progesterone 12 days). I have one breakthrough bleed per month it appears like clockwork and presents as a “period”, I usually get grumpy and hungry before it arrives.

This month I felt terrible pmt that persisted, prior to the “period” (though it was lighter than usual) and after, the mood continued where it usually gets better. Alongside carb cravings, I wondered if I was having a depressive “episode” as my mood has been unusually (slightly terrifyingly) low. Now, oddly, just over one week after finishing my period, I’ve started bleeding. At first spotting and now it seems like a proper period. I’ve been on hrt for a year now and was in a routine, bleeding once monthly. I’m wondering if this odd low mood is related.

I've booked to speak to the gp but can’t speak to them for another month. I was going to ask for antidepressants but I think maybe something odd is going on with my hormones. Any ideas? Has anyone else had this? Thank you all in advance this is such a great supportive board!

Are you against a mirena coil ? It would hopefully stop any bleeding.

I sadly have no answers, but am here because after about 18 months on hrt (2 pumps oestrogel plus mirena coil), which have been amazing and changed my life, I've been having light bleeding, pms symptoms (sudden tearfulness, anxiety, low mood) and some hot/waking in the night like when I had periods.

I initially went on hrt for pmdd (after 25 years of begging for help with it, I was finally referred to the menopause clinic and offered hrt, at age 47!). It's been so wonderful, I've felt able to function for the first time in my life.

I'm wondering if the period-like symptoms are due to the natural hormone changes as surely despite hrt our hormones still fluctuate as we near menopause? So the doses need adjusting accordingly?

If symptoms come back it’s often said to increase your dose after speaking to the GP.

Depending on your age, it's possible that your own cycle will interrupt the HRT withdrawal bleed. If you're still in your 40s, or your periods were regular-ish prior to HRT these little blips are common.

If you have low mood, the first line of treatment is to increase your estrogen. You can do this yourself if you are using gel.

Go up to 3 pumps from 2. The licensed dose is anywhere from 1 to 4 pumps, depending on what everyone needs.

It makes sense that as our hormones are still changing we'll need to adjust the dosage.
My GP just said it's normal; my next nhs gynaecology appointment is a year away (trying to get a cancellation slots sooner).
I'll try adjusting the oestrogel.
I hope you're feeling ok, OP. Pms lows are so hard.

Jingle spring bell bells - that’s interesting. Ever since starting hrt I seem to have bleed post progesterone or a few days prior to finishing the progesterone and presumed this was a period (realise that if it starts before finishing the progesterone unlikely a withdrawal bleed). So that bleed would last around five days give or take a day, and monthly.

as mentioned this last month bleeding post progesterone then the most horrific pmt and now it seems bleeding ++ more like a heavy period (was spotting) so perhaps explains the really low mood (and bingeing on carbs). I am on a reasonably high dose 75mg daily. I had been wondering if I should be on such a high dose but maybe now thinking is this right 🤔 . Thanks Dusty , I am wondering if my dose needs adjusting - I’m scared of the coil. I don’t deal well with the progesterone - so have it vaginally (though thinking the coil would only have a local effect (?))

pinkglobe I am really sorry to hear your journey sounds similar to mine. I had pmdd too for years and it was only in my 30s realised the mood was only two weeks of every month, and the truth came in pregnancy- I was ill, was working + and my mood didn’t dip once!

your theory makes sense, the fluctuation in hormones may be the cause. I’m 45 and on 75 mg which I thought was quite w high dose. It’s reassuring to hear your gp said this is normal, I’m waiting for a gp appointment. You're right pms lows are horrible - no other words to describe them. Last week was the worst I’ve had for years. I hope you’re ok too, keen to hear how you get on. Keep in touch.

🙏 everyone I was at an absolute loss, so helpful to have support here!

I realise this is an old post - but I wondered how you are doing now? I am in the middle of a horrible low mood dip after finishing my first withdrawal bleed - I didn't get any side effects on the estrogen or progesterone patches so I don't think I'm intolerant. Do you think the first withdrawl bleed is confusing for the body hence the mood swing?

@inthewoods4 it takes a few months for you to get used to it x

Thank you. It was a bit of a shock as I usually feel anxious the day before and during my period, so this is new for me. Thats reassuring that it might get better in a few months x

Yes when I started, I had awful bloating, indigestion, heartburn all settled within about 3 months or so x