GP suggested antidepressants!

[HormonedOut]

I've been on HRT Estradiol and Utrogestan for 11 months now. After a bit of trial and error I found 2 pumps worked for me. My anxiety went, I was sleeping well, restless legs went, still felt extreme fatigue and brain fog but other than that a lot better.

Recently however the anxiety has come back and it's worse than ever! Restless legs a little bit too. Really affecting my work. I did start Wegovy a few months ago so went to GP to see if this may be interfering but they said there's no evidence of this. So expected to discuss adjusting HRT but instead they recommended antidepressants. I'm really not comfortable with that, I don't have low mood particularly. Anyone else have any experience of this? I'd prefer to adjust Estradiol but not sure if I need to increase or decrease. Thanks.

Restless legs - I had that with low ferritin, do you have a recent blood test result?

@Droolylabradors was last checked 8 months ago and was normal. I don't normally have low levels.

Youe hormone levels go on changing and declining through peri into menopause so it's possible that two pumps isn't enough for you any more. You could experiment with increasing the estrogen dose though probably best to check with the GP that your progesterone dose is sufficient.

If it’s oestrogel, the new pump bottles don’t dispense the same amount as the old shaped bottle, a few milligrams under each time amount to quite a high percentage over the week. My symptoms came back, I bought some jewellery scales and started weighing it and when I was back to getting a correct dose, the symptoms that had returned, went.

@LuckyCharmz it is Oestrogel. That's really interesting, and my bottle did change. I might try upping my dose slightly then. Was a bit worried as when I was asked to try 3 pumps at the beginning (old bottle) I got a flickering eyelid and felt totally wired! So reduced back to 2. I will give this a go, thanks.

If this is actually true, then it's very serious. I'm using a dose to help my bone density and need to use what's prescribed. I'm now onto the new bottles and will count the number of pumps it gives. If it's more than 64, that's an issue. The cannister is supposed to contain the same amount of 80gms.

However, I have discussed this with my consultant who says there is (always?) a 5% up/down possible fluctuation with medicines.

Can you use oestrogen patches instead of gel to see if it is the pump issue?

why oh why do GP's think that the solution to everything for women are anti-depressants! its really boils my p@ss.

I have ridden the menopause pony completely un-medicated. mainly because of a history of cancer and dvt in the family, but also because i wanted to go as long as i could without anything.

i can honestly say, im 3 years now without a period, the hot flushes have all but disappeared and my mood swings come and go only occasionally and i really do think i am over the worst (touch wood). and atleast now, i don't have to start weaning myself of anti-depressants.

i do take pain medication everyday, and if i dose too high, i get restless legs but i find if i take an antihistamine just before bed, the problem is solved.

sorry i went on a ramble then... but i hope my last tip helps

To keep it simple @HormonedOut the advice from NICE is to adjust HRT before offering other drugs.

So your GP is a bit out of line/ out of date.

It's easy to trial the dose with gel. That's the bonus of it compared to pills or patches.

Also, restless legs affect men and women, young and old. As does a twitchy eyelid- usually a sign of stress and tiredness.

Give you gel another go and you can increase by half a pump- you don't need to press the pump right down for a full 'dose'.

i do take pain medication everyday,

what's your illness?

@HormonedOut I had appalling anxiety in peri menopause and can’t have HRT due to recent breast cancer. GP put me on sertraline and it has worked wonders. Anti depressants aren’t just a treatment for depression

Yes I certainly wasn't happy about being directed towards antidepressants. Felt unnecessary and likely to cause more problems longterm. Surely that's for anxiety that's not menopause related.
@catmomma67 thank you, the antihistamine before bed is worth a go.
@JinglingSpringbells I will trying upping it half a pump🤞

I get that they may be a replacement if you can't take HRT and glad they are working for you. I just felt having both seemed a bit overkill.

NICE menopause guidance 2015 is very clear on this. (It's online if you need to check.)

ADs and other drugs are for women who can't use HRT for medical reasons.

The guidance advises GPs not to use them except for women unable to use hrt.

A return or an increase in symptoms is treated by adjusting HRT. (This is in all GP guidance on menopause too.)

Thank you @JinglingSpringbells very helpful

I'm just looking at NICE guidelines now and as Jingle said it's quite clear antidepressants shouldn't have been offered, if HRT can be used. An alternative to adjusting HRT should have been CBT for anxiety. Male GPs 😡

Hmm I noticed less symptom management when I went into the new shaped bottle. But since I haven’t got any of the old one left I can’t weigh to compare the two.
Any other ideas? Are we certain it’s the same mass in each bottle? If so then as pp says, too many pumps from the new shake bottle wouldn’t be good.

Was it the same GP? I pushed quite strongly for HRT and was told majority of people didn't need it and could manage without it, but would I like antidepressants. I didn't want antidepressants. A few months later, I tried again expecting to have to fight harder for HRT, and saw a different GP in the practice who just suggested trying HRT - no fight. Pot luck.

No different one from the female GP who had prescribed HRT originally. A male junior doctor/senior house officer who went off and spoke to another male GP about it, 2 heads clearly aren't better than one female one.

GP put me on antidepressants because ‘evidence shows somesuccess with meno symptoms’.
This went on for ages until I started to do my own meno research. Increased my Estrogel pumps and Utrogestan and feel much better than with ADs.

Can’t solve your medical issue but I can confirm thst if you go to your GP with any kind of ‘female’ problem, they’ll try to fob you off with antidepressants. Even the female GPs do this.

I had to go private to get surgery for my womb tumours and endometriosis because my GP was convinced that what I needed was a happy pill and a counsellor.

😐

It's just shocking that after almost 10 years since the NICE guidance came out, some GPs are not up to speed. They must be living under a rock and not even reading the basics.

Also, the new suggestions about offering CBT are fully not accepted by many meno experts. The idea is that you can learn to 'control' flushes or low mood etc.

It's fine for women who can't use HRT or don't want to, but CBT won't protect your bones or heart.

It's also not practical- there's a massive shortage in the NHS of CBT qualified staff, so actually getting an appt would be nearly impossible. So the option is you fork out £50+ a session privately.

Interestingly, there was a recent poll (saw it on X) about HRT and almost half of all GPs said they were not confident in prescribing.

If you can afford to go privately to an expert, which I know shouldn't be necessary in an ideal world, it's one option.

Middle-aged female GP was the one who told me most women can manage without it. I was so desperate by that point. She apparently specialises in gynae too. I don't have night sweats though which confused her no end. Male GP listened and offered.

Good luck OP - it shouldn't be such a lottery.

@IFancyACuppa fair point, I guess it's more the individual GP that makes the difference. Night sweats have never been a major issue for me either. Bit hot before HRT but nothing awful.
@JinglingSpringbells yes chances of getting CBT are probably zero. I wondered if it might help manage anxiety alongside HRT, but I guess if the HRT was working well then I wouldn't have the anxiety. As you say CBT suggests symptoms are psychological and as I'd never experienced anxiety before menopause this is clearly not the case.
@Ivee AD are a nice cheap option for them I guess! I felt rather condescended to by the GP suggesting them. He then asked me to explain why I wasn't keen. Next time I'll mention the NICE guidelines!