HRT and mood

[BrenFurlong]

Hello
I'm using HRT 50 estradot patch and 200mg utrogestan for 14 days. I sometimes feel low and have pmt the week leading up to my bleed/period but for the past 2 months I've felt low, flat, a bit tearful, negative and lacking in enthusiasm for anything for the past 2 months throughout each cycle. This isn't normal for me and I wondered if I could be low in either of the hormones? I've had a blood test and b12 and iron are nicely in range.
Any advice or experience would be appreciated. Thanks

It'll be the Utrogestan.
A lot of women feel like you. It's really, really common.

It's worth talking to your GP about changing your HRT for something else, like a combined patch which has Norethisterone (instead of Utrogestan) or even a Mirena coil.
There's also a tablet form of HRT called Femoston which some women find good.

If you want to continue with Utrogestan, you can use it vaginally. This is off-licence in the UK but allowed in other countries. The same capsules are inserted at night, vaginally (as high as possible.)
Your GP may or may not know about this.
The benefit is that it doesn't get into the nervous system and cause low mood.

Have you heard of Elizabeth Bright? She has a book, and some interviews on YouTube, her take is that women need sufficient dietary fats to make all the hormones nec to function properly.

@JinglingSpringbells thanks for your reply. I use the utrogestan vaginally as the mini pill made me feel very depressed so I knew I was sensitive to progesterone.

So what do you want to do next?

Under a specialist, you might have the option of longer cycles, where you take Utrogestan less often (this is usually monitored with ultrasound scans.)

Or you could try some of the other types of HRT.

Micronised progesterone (Utrogestan) is unique in HRT as all the other types are synthetic (like the Pill and mini pill.)

It's well known for being a love-hate drug. I was told when I started it that I'd love or hate it, and to give it 3 months to decide.
I'm ok on it but use it vaginally. I still get side effects but they are tolerable.

I'm not sure what to do next. The regime has been going well for the past 3 years and now I feel there's a change in mood certainly and hot flashes in the utrogestan part of my cycle. Does it mean more oestrogen or more/less/different progesterone.

I didn't realise you'd used it for that long-something made my think it was just a few months.

They usually suggest increasing estrogen first to see if that helps. Sometimes the further you get into peri, and more your own level falls, you need a bit more.
You'd need to try 75mcg patch or you could swap to gel and use 2 pumps or 3.
2 is the equivalent (roughly ) of the patch you're on now but everyone absorbs differently.

That makes sense. Thanks for your reply. I'm not due to have a review until October, I'll try to get an appointment sooner. It's difficult as different Drs have different answers.