Anti depressants on top of HRT??

[Sadmum71]

I have been on a variety of different hrt drugs for about 3 years. In desperation I started visiting a private clinic. My main symptoms are not feeling myself, low mood, irritability, brain fog and The Rage.

I am now on Utrogestan 200mg (vaginally), Evorell 100 patches and Tostran gel. And still I feel like crap most of the time. I think I react to progesterone as I had a bad time mentally with a Mirena coil too, but as I keep bleeding they keep giving me more of it. (I'm going for a scan about that shortly too).

But I spoke to the GP. I don't like the huge amount of drugs I'm taking for no real change. And now he's prescribed Fluoxetine on top of everything else. He says the doses of HRT I'm on are very high and to look at reducing them. But that's another trip to the £250-a-visit specialist.

Anyway, my real question is, who takes anti-depressants on top of HRT? Does it help? I thought hrt was supposed to sort out mood but GP just says in some women it doesn't work...

BTW, I'm fit, healthy, visit the gym, have a social life and I've tried talking therapy...

Well, I take antidepressants on top of HRT, but I was on them for a long time before I started the HRT. I feel good on the combination I'm on - paroxetine for depression, a Mirena and Oestrogel.

I hope you get sorted, because it sounds miserable.

I ditched utrogestan for the mirena and it changed my life. Took 8 weeks to settle and now I sleep well and I'm happy again after feeling suicidal on utrogestan.

I do have a friend on an ssri alongside HRT.

Is there anything else you can change? I've had a load of counselling this year and that's really helped me too.

@Imalongtimepostingmum I'd give a Mirena another go if I could as maybe balancing that with more oestrogen would have been OK. But I bled all the time on it so probably not allowed. Maybe the utero scan thing I'm having will make things clearer...
I've tried therapy in the past few months but I'm all talked out, I have various exercises and what have you but when I'm having a down day I don't feel it's really helped.
I asked the GP about jacking in HRT altogether but he says I need to talk to the private clinic about that. Even a short chat on the phone to them is charged at £120. It's a farce!

Why won't GP deal with your HRT, does he not support it?

I had a hysteroscopy as I was still bleeding on mirenaans TVU showed endometrial thickness of 6mm. They did a D&C and scraped out all the endometrial lining and I havent had any none period bleeding since. (still get small periods). Mine was private.

Are you private for your ultrasound?

The scan is through the NHS. The GP doesn't want to mess with my HRT as he feels 'too many cooks' situation. The private clinic has been giving me blood tests to get my levels correct so it seems a shame to throw it all away. But if my levels are correct and I still feel crap what's the point!?

Hell yeah. I think if I wasn't taking both I or someone would die. I was like you irritable mood swings and very low. I tried Prozac that's what you are getting also. I couldn't get an hours sleep anxiety and tinitis felt like human torture went back to GP and she gave me Mirtazipine Lowe dose and I started to sleep really well. You should try them for about 8 weeks before you will know if they are helpful. Six to eight weeks is how long an antidepressant takes to get used to. I was on Prozac years ago for baby blues and they really helped me. I found I clenched my jaw with them but I was happy so I didn't care. Don't think after a few months I feel better I'm coming off them because I did that and it was because of them I felt better. Good luck with everything. 🍀🌺🌺🌺

I take ADs as well as HRT. They work for me.

Utrogestan made me feel really really tearful and low. I switched to cyclogest pessaries and feel so much better. I think it’s fairly common for Utrogestan to have this effect. Anti depressants may well be really helpful, but I would maybe also discuss trying a different progesterone too.

Utrogestan made me more depressed. Change progesterone.

I think on reflection you're all right. I'm scared of taking the ADs, I still haven't picked them up from the chemist! I'll see if the clinic will change the progesterone. Though they always bang on about Utrogestan being the best, being the most bio-alike or least synthetic or whatever they call it...

You can reduce the amount of progesterone but it has to be balanced with the estrogen and under medical advice.

Women who are intolerant to it can use less, but under supervision.

If you want to investigate this yourself, a poster left a link to a new white paper on menopause, authored by one of the best meno consultants in the UK/world (Nick Panay.)

She started the thread yesterday. It's a few threads down the page.

If you read the paper (it IS long but it's also in paragraphs) you will see he suggests some women using 100mg progesterone or fewer days BUT they should have scans to check the womb lining now and then.

Presumably you're on 200mgs daily as your estrogen is a high dose?
You might get away with a 50mcg patch and 100 Utrogestan.

Not sure from your posts if you are peri or post meno and using progesterone every day rather than on a cycle?

I'm on a high dose of Progesterone as I keep bleeding and it's all about 'protecting the womb lining'. I do 200mg every day continuous and because of that my Oestrogen patch is also high to balance it. And because I said I still felt miserable they gave me Tostran gel as well about a month ago. I am being sent for a scan to check on my womb lining as I had a 10 day bleed again recently. I take it vaginally to try and avoid the side effects which helps a bit but not entirely.

Over the years I've had problems with bleeding all the time with a contraceptive implant, with a copper coil and with a mirena. It's never been investigated before.

What dose of oestrogen and were you blood tested before being prescribed tostran? If you weren't then the testosterone might be giving you the rage.

I wonder why you were never offered an ablation all those years ago?

This HRT issue is a bit chicken and egg isn't it.

If you're on 100mcg patch then you will need 200mgs Utrogestan anyway.
But if you were on a lower patch you might be able to use less.

I can't imagine using 200mgs Utrogestan daily. It would be horrendous.
I do 200mgs for 12 days on a cycle.
I tried 100mgs daily (I'm post meno) and had a constant migraine.

I have mirena, evorel 75 and 50g sertraline (25g for first 2 weeks).
Been on it all for 2.5 years now and wish I'd done it a couple of years sooner as mentally I was feeling horrific for so long.

It's a great combo for me - I feel as happy as when I was in my 20's. No stress, no anxiety, no low days - it killed the rage off within 2 hrs or taking the first tablet.

Change progesterone to cyclogest I guarantee you won't have the same issues. I find it calming and actually energising. I sleep well. And my skin calms down. My periods are almost what could be considered normal after years of flooding and 8-9 days of it

Also had hyperplasia and polyps all related to too much oestrogen. Don't reduce your progesterone until you've tried a different source.