Suicidal a few days before any bleeding, please help.

[Tootsey11]

Can anyone help please, this has been happening the most of this year, a few days before any bleeding I am thinking all sorts. I can't go on like this anymore. Once the bleeding kicks in mood improves until the next time.

Problem is I am perimenopausal and can have bleeding every 10 days or so. I am on 50 conti combined patches and these were working well for the first 2 years. This year I have felt all symptoms coming back and now the added bonus of this. My Gp is the most useless man I have ever encountered, there is no other option of a different Gp, and no other Gp surgery taking on patients in the area. Today is a bad day with these thoughts, I'm on my own, partner at work and adult son who is my only real support is sick in bed.

Are my hormone levels too low, too high? Any advice please anyone.

Gosh, I’m really sorry. You obviously need to have the dosage/actual HRT changed.
Where I live there is a private menopause clinic, ran by 3 women GPs, it’s £150, is this a sum you can find?
I would actually write an email to the GP and the practice manager stating the facts and requesting they get back to you asap. Can you have a coil and then top up with oestrogen?

Big virtual hug, I know only too well what you’re going through. But there is help.

I had similar, out of the blue feeling suicidal. Initially fobbed of with ad's before conti. Not much changed, swapped GP and she put me on Evorel and estrogen and told me to double dose when these moodswings happen and to ask for double the dose if in time it became less effective.

Made such a positive improvement. In maybe a year I have had one mild moodswing.

Thank you for the response. I'm trying to read up on things, possible pmdd. Am I right in thinking that estrogen and progestogen fall just before bleeding and then rise again.

I can go private, but services here in Northern Ireland are woeful with long waiting times. I've had the mirena before which at the start I found very difficult to deal with but it settled. I do not want to go down that route again as I have atrophy and lichen schelorus (sp) also as well as endometriosis.

Yes they do. And that’s when your body craves magnesium.
Ever heard of Mindy Peltz? Check her out on Instagram, or in Dr Chatterjee’s podcast.

You could get an online appointment and speak to a (reputable) consultant in England from home. Sorry to hear you are feeling so terrible, it shouldn't be like this. Some women are very sensitive to progesterone changes, which can lead to feeling so very low in mood/suicidal. Hang in there, once your hormones are sorted, this will get better.

Really sorry to read this but great you have the insight to realise what might be causing these feelings. My first reaction was to change GP and it's awful that it's not possible. Is it worth discussing with 111? I've no idea but would hope they may know of other services you could try in your area - is there a well womans service at a hospital nearby? Only other thing I can think of at this stage is to ask for antidepressants which may help while you get your hrt right.

Would a higher dose of both estrogen and progestogen be better? I know it's trial and error as what works and what doesn't, I'm that up and down each day, I've no idea if something works or not. I've always had pms bad, always thought that was it, now I'm thinking it's been pmdd all along and no doctor has ever picked up on it.

@Castellanos there is a woman's clinic, tried that. I have severe tinnitus as well and have been advised to stay away from anti depressants.

Ah okay, that's unfortunate. I just add a Google - https://www.menopausematters.co.uk/ this organisation will take an email consultation with a Dr for £30. Terrible that you don't have proper GP service for this, but might be worth a try if you can afford it...Good luck.

Tinnitus is a symptom of perimenopause for some women.

I think you need a consultation with a reputable menopause specialist to help you work this out, but you can start keeping a diary of your symptoms, to help you and the specialist figure out how best to help you.

I have Mirena coil and take Sandrena. I don’t take anything for the first 4-5 days when my period should be, my normal dose is 0.5g, and 10 days of the month I need 1g. It fluctuates and I up the oestrogen accordingly. My sign ‘it’s not ok’ is waking up at 3-4 am, so I just take more oestrogen for the next few days.

@BuddhaAtSea so you know when roughly your normal cycle is so you can adjust things. My problem is I have never had a regular cycle, ever. I would bleed for 10 days at a time in my teens, in my twenties it went to 4-5 days length but coming every 10 days or so. Now in my late forties I'm bleeding whenever, sometimes every 7 days, maybe every 10, sometimes a gap of 3 weeks. But I know when it's within a day or 2 as the severe anxiety kicks in, tinnitus gets so bad, thinking of ways I can successfully do myself in and a day into bleeding and I'm fine again. I didn't realise how much I rely on my son, he is the only thing keeping me here when things get unbearable. Partner just does not get it and has told me to do whatever I'm going to do.

I can tell you what helped me, but it does not mean it will work for you. I started taking Utrogestan (microsnised progesterone) every single day, even though I was still having periods (suggested by my Consultant). So not breaks from the Utrogenstan ever (and also 4 pumps of Estrogel). Having the progesterone every day, stopped me having any further periods, and stopped the massive lows. That was some years ago and I haven't looked back.

You need to get some help with this OP, as soon as you can.

If it’s PMDD I think it’s due to instability in progesterone levels. I had mood issues/suicidal thoughts related to my cycle for years ( to the extent I thought it was normal!)but after PND twice I went on long term high dose ad’s then moved to low dose antidepressants once I was well ….and no problems with suicidal thoughts at all now. However i also am on the mirena ( also peri) so have low dose continuous progesterone which ,for me, helps sleep and thoughts. Would you not try anti-depressants or the coil again full stop?However pre kids when I was struggling to get pregnant I saw a herbalist and was put on Angus castus..this really improved my cycle length. I thought evorel conti wasn’t generally given to women still menstruating regularly as you can end up with breakthrough bleeding…..also if you are only on 50mcg this is a low dose if you’ve been on it 2 years already, perhaps you need more, I’m on 4 pumps gel after 2 years which is equivalent to 100mcg patch.

Ps just checking that you are up to date with your smears , that Gp has excluded other causes of bleeding and that your Gp has checked your thyroid levels?

@Notthegodofsmallthings what dose were you on daily? I am open to any suggestions but, I found the mirena hard to deal with although it did stop all bleeding. Reading up on the dosage I'm not sure I could deal with utrogestan daily.

Paid privately to get thyroid checked as Gp wouldn't do it. All fine. Has not checked anything else but smear due. Can't seem to get an appointment and a clear time of no bleeding to give an accurate result.

@wudubelieveit Was advised not to take anti depressants by ent as most if not all are otoxic for our ears and definitely not for tinnitus sufferer. My previous coil was put in under GA, due to atrophy, Ls and a tilted cervix. If I wanted another I had to have a another GA. I nearly did not wake up from that GA, eventually waking to 2 nurses shaking and pulling at me. They still don't know what happened at that time.

I take Utrogestan 100mg every day, and four pumps of the estrogel. When I only took the Utrogestan for 2 weeks, I had this low, low feeling before my period, the drop in mood was massive, like falling off a cliff. I know it seems strange that taking it everyday rather than just for two weeks works, but it does (for me). I guess it could be the fluctuations in progesterone that cause the bad feeling, so having the same dose each day must level that out. I'm certainly not any kind of expert though, just a woman sharing what worked for her, and hoping it might help you.

@Tootsey11 i think your best bet in that case ,seeing as you felt better during the first 2yrs of hrt would be to go back and ask for a dose increase…many people need a dose increase at some point .

This is good advice.

@Notthegodofsmallthings I think you are right, googling some charts it's those last few days of the luteal phase which is causing this issue when progestogen is low. Will see can I change from these patches.

Thank you all. The joys of being a menopausal woman.

Good luck Tootsey11, I'm sure you will start to feel much better again once you get this sorted.

Op there is a menopause service at the mater hospital which your GP can refer you too. Often they don't even need to see you and will write back to your GP with advice on how to treat. Demand that your GP refers you (write to practice manager if need be). So sorry you are going through this.

Problem is I am perimenopausal and can have bleeding every 10 days or so. I am on 50 conti combined patches and these were working well for the first 2 years.

@Tootsey11 Did you mean you were on continuous combined HRT?
That's both hormones in the patch, every day.

These are a bleed-free type of HRT for women post menopause (at least 12 months after their last natural period.)

If this is the case, then your GP has you on the wrong sort.

Unless I've misunderstood?

You've talked about the luteal phase etc but this shouldn't apply if you are on a conti combined type of HRT as you won't have a natural cycle.

Going back to basics, you are either on the wrong type (and it should be sequential, with a withdrawal bleed every month) OR you are just not getting on with the Norethisterone which is in patches (and this is a very common problem.)

Can you clarify, perhaps?