Does anyone else feel like HRT “wears off” after a while?

[MrRobinsonsQuango]

I started taking the gel and capsules for peri menopause, after my GP prescribed them to me. My symptoms (hot flushes, brains fog, poor sleep, heavy periods) start to recede which was great. About 10 weeks in they started to creep back in. I go back to the doctors and she claims she can’t really change the dose of either which lm sceptical about. Pushes the coil yet again, lm sick of this being pushed as the cure for ills. I really doubt it is and if it isn’t then l bet they won’t be in a hurry to take it out. That’s before the massive amount of pain when they insert it without proper pain relief

Then moved onto the patches, good start again but now 8 weeks in the symptoms are coming back yet again. Cue poor sleep, period all of the time (started on day 23 this time and this will be the case for the next 8-10 days). To be honest l fared better being on the contraceptive pill!

I’m now thinking about going private as l don’t feel the NHS have a proper grasp of it. I can’t really afford it but already sick of the lack of efficacy lm getting from the HRT. My testosterone was low and way outside normal range for example. NHS won’t do anything about this but l doubt it’s helping r

Ask your GP to refer you to a gynaecologist, you'll possibly have to wait for a while though. The wait for a face to face appointment in my area is 6 months.

Unfortunately NHS is very varied with some doctors being good and others being rubbish.
You can increase the dose, maybe the dr wants to see you on a few months before doing so? The patches come in different strengths for starters! So of course you can.
Personally I had to up the dose to get the effects and that worked for me. I do a combo of private and NHS as I also needed testosterone which was rock bottom and my fatigue etc was insane. But I couldn't get on NHS, others have been more successful. You have to say low libido.
Have you tried some of the various forums or Balance app. They can give you some good advice? Read up and then go back to Dr with some clear demands? Or else try experiments yourself (add 1 pump gel if you have any leftover?). Sorry its rubbish isn't it.
I also don't want the coil and this was heavily pushed !

I wonder whether you body adjusts somewhat to the higher level of hormones by producing less or the initial response may be partly placebo.

Regarding libido I found testosterone helps. I had a private blood test and got a prescription from superdrug as my gp would not prescribe. I get private bloods done every 6 months to check my levels are in the normal female range.

Ask the dr to refer you to the nhs menopause specialist. That's how I got my prescription for testosterone. It was a long wait and I could have bought it from Superdrug but my dr refused to keep a check on it if I bought it myself and didn't wait for the menopause clinic to see me first.

OP, if you can afford it, pay to see an actual gynae. My private gynae consultant does HRT as well as all the surgical stuff.

Also, he gives a private prescription which you can take but updates your GP to ask them to prescribe and usually within a week so you don't need to pay for the private script.

A gynae consultant told me that the best way to control bleeding is local progesterone, ie a Mirena coil. But if you are against it, then that’s that.
If your symptoms are returning it sounds like you need more oestrogen

I had my mirena inserted under GA- painless and really works

5 or 6 marinas inserted over 30 odd years and no more than a brief pinch; they worked wonders for me, my last period was in 1994 and my last one went in when I was late 50s. When that came out I nearly asked for it so I could have it gold plated and made into a necklace.

But if it’s not for you then I did have to have my patches dose tweaked after about 5 years on them. I’d definitely second seeing a gynaecologist or menopause specialist if you can.

I agree with @Carriemac . I finally went for a Mirena IUD last year and wish I'd done it years ago. No more period knickers. I still get gruesome cramps but no bleeding.

I've been using the Mirena for years, had it first inserted 2008 - never had a period since then. I've never needed local anaesthetic for it to be inserted but they do offer it.

I'm on a fairly low dose of oestrogen gel alongside it now and my symptoms have almost fully resolved.

It is the best option for progesterone, but if you really don't want it then that's fair enough, but it can take a while then to find the right balance of doses

You could ask your GP for referral to a menopause specialist within the NHS.

Are you post menopausal?

If not , it may be that your own hormones are lower at the time you feel your hrt has worn off.

I'm wondering the same thing. I'm on Evorel 100 patches and Utrogestan, and recently low mood, irritation, rage, poor sleep, anxiety and hot flushes have started to return. I have experimented with wearing an additional half a patch, but it doesn't seem to be doing anything. I don't really know where to go from here.

I felt exactly the same. The everol conti 50 patches were wonderful at first, then they wore off...i was advised first of all (by the menopause specialist at my gp surgery) that i couldn't increase the dose in the first 12 months....then a few weeks later i was advised to increase the dose by cutting the patches and using an extra half at every change day...

By this stage i had started having side effects and didn't want to increase the patches. I never got back to the lovely way i felt at the start and i gave up and binned them off.

I was told hrt can wear off, then our peri nurse went off sick. I was moved to GP who isn’t on hrt themselves and whose stock answer to HRT is this protects the womb (it is the only technical answer of a sentence they come out with) never been warned with a history of fibroids you could be in trouble but yet again up and down the country seems a mixed response.

I don't think it is placebo. As the app l have where l track my periods shows my periods have been longer of late. I have also been noticeably more sweaty, despite the weather cooling down

It is very much a mixed bag. I need to review the NICE guidelines to see what they specify about medications.

I have given both routes about 3 months each now. Things don't seem to be getting any better.

The coil fixation drives me insane. I wish l could have it written on my notes in capitals and in red: SHE DOESN'T WANT THE COIL!!!!!! SO DON'T MENTION IT. People have said doctors get financial incentives for them and of late l am beginning to think that's true.

When I first started on HRT I felt an almost immediate difference (improvement) and this lasted for about 8 weeks. Then the flushes and night sweats began to happen again. I had a 12 week review and mentioned this and the doctor said she wasn't at all suprised and that I just needed a higher dose of estrogen. I've been on patches since the start. I was initially on 50mg patch and then moved up to 75 and have been on that ever since. I also didn't want a mirena coil, I had been on mini pill for years so never had periods. I stayed on the mini pill and take utrogestran as well. So every night I take the mini pill and a utrogestran pill and twice a week I change my estrogen patch. Been doing that for over 2 years and feel great. I see a doctor privately though.

Are you taking the maximum dose allowed?
When I started, I was on two pumps of gel, then moved up to three after three months, where I was settled for ages (until I had problems with the gel) and am now on the 75 patch.
I can't see why your GP won't up your dose unless you started out at max, which is unusual.
The coil would cover the progesterone part but not the oestrogen part - what did your GP want you to do about that?
(Generally it's the lack of oestrogen that causes the symptoms anyway).

I'm sorry I don't have much to offer in terms of advice...but just wanted to drop a comment to commiserate about the mirena coil. They push it hard here in the UK. It's incredibly frustrating. I had a non hormonal copper coil and I pulled it out myself (very dangerous I know) bc I had constant infections for a year and they would always fob me off when I wanted it removed. I ended up with pelvic inflammatory disease because of it and was on strong antibiotics and they still insisted I finish the antibiotics to see how I 'got on' before they would offer me the option to remove it. Sooo yes, there is no way I'm having an IUD with 'localised' HORMONES inserted. I know some get on with it, but I've had several friends with Mirena that had hair loss, weight gain, and depression that cleared up when it was removed.

I increased my oestrogen dose without going back to the GP, as it was clear that I wasn't getting enough as the night sweats, mood swings etc had returned. I thought it would be a waste of an appointment tbh as I figured they would just say, try a higher dose and see how you get on.
When I ordered the repeat prescription online I added a note saying I had increased the dose and would need more bottles of gel to last for the six months. This was before the HRT presecription payment certificate so it made sense to get as much in one prescription as possible.
They have never said anything to me, but then the GPs at my practice seem to be really clued up about HRT.