What is the 'goal' with HRT?

[CremeDeSudo]

I'm a bit confused about what we're aiming for? Is it to never get night sweats? I'm on 4x pumps estrogel at the moment and 100g progesterone (which I had to get prescribed by the specialist due to hysterectomy 5yrs ago). I've just had to increase my sertraline because my anxiety has been gradually getting worse over the past year, and I'm still getting night sweats, I get brain fog

Am I expecting too much?

I think it’s to maintain sex drive, sleep, energy and stable moods.

It could be that your body isn’t absorbing the gel properly? Has your GP checked your levels since starting it?

mine defo stopped the night sweats, helped with hip/joint pain and also take for bone health.
still have brain fog and tiredness.

ooh yes as pp said I take my progesterone with magnesium at night to help with sleep

Sertraline is an SSRI and they can cause or add to the problem of night sweats. Some people find that reducing their dose or switching to a different sort of antidepressant helps. Have your night sweats got worse since you’ve increased your sertraline dose?

Can you explain why you've been given Utrogestan when you have no uterus?

Women who have no uterus do not need progesterone as part of HRT.
The exception is if you had endo and then it's given to prevent regrowth of endo (which can be stimulated by estrogen.)

SSRIs do not work for menopausal anxiety. The correct treatment is to adjust HRT (NICE menopause guidance- online.)

To answer your question, HRT is to relieve symptoms like flushes, night sweats and the rest. It's also used by some women to treat or prevent osteoporosis.

It's worth considering another form of HRT like a patch as you may not be absorbing gel very well. Everyone's skin is different.

I'd also query why you are using progesterone- you say you had to get it from a specialist- why?

My aim is to live a normal life where any symptoms do not interfere with my day to day functioning.

I can remember my 'before' benchmarks in terms of energy / tolerance / joint pain / temp control / rage / mood

When any of the above decline to a level that is affecting me, my work or my family then it's time to look at the dose or - as others have suggested - the delivery.

I needed more estrogen, but every time I tried to increase it I was getting severe cramping. I waited 13mths to see the specialist. She suggested trying a spray estrogen, but when I said I felt like it could be linked to my cycle (kept ovaries) and perhaps I was being 'overloaded' with estrogen at certain points in the month she agreed to let me try progesterone. It's actually helped loads and have successfully increased estrogen to 4 pumps (previously only managed 2). I hated the patches, and had the same cramping issue with them.

Interesting someone mentioned night sweats with ssri medication as I started increasing my dose on Wed and have had night sweats the past 3 nights

Utrogestan (or most types of progesterone) can increase body temperature.
TBH it's best to avoid using progesterone if you can avoid it.
Estrogen only HRT is very safe long term re. breast health whereas adding progesterone increases risks.
The only reason to use progesterone is to keep the womb lining thin. It doesn't have any effect on your ovaries. The cramps can't be period cramps as you have had a hysterectomy.

Yes this was part of the confusion. She was considering looking inside to check for scar tissue in case the estrogen was reacting to it.

Why has taking the progesterone helped with the cramping?

👏 This...

To function and have quality of life.

Why has taking the progesterone helped with the cramping?

I'm not sure exactly what you mean but a lot of women report 'phantom' periods in perimeno and meno.

They have all the signs of a period (ie cramps) but the period doesn't happen. This seems to happen for months after their last period.

So, maybe that's what you're feeling?

If you Google phantom periods you'll find some links to endo.

My guess it will go away on its own eventually.

My gynaecologist prescribed oestrogen after my total hysterectomy. She said the goal was to have no symptoms. I adjusted the dosage until I had no symptoms.

I took it as the joint pain meno rage and anxiety were making life very difficult.
I had to stop driving.
Hrt took months to settle down.
Such a difference to my life though.
I had hoped being fit it may have been easy to go through menopause.
How wrong was I.