Problems with taking the pill/coil - is HRT out of the question?

[TailofTwoKitties]

I'm just hoping that someone here might have had the same issue.
52, peri, usual symptoms, but the brain fog, vertigo and mood swings are the worse. HRT would seem like a life saver but when I've been on the pill or Mirena in the past, I've had some side effects. Bad nausea, dizziness - but the main problem is that my boobs just grow and grow, and haven't ever gone down, even with weight loss and coming off the pill/coil. I can't risk my boobs getting even bigger on HRT, I'll fall over. Has anyone else managed with HRT with these sort of issues? Does it really cause that much weight gain?

Also, how does HRT affect fibroids? I was always told that they would shrink and go away when the menopause started, so the thought of heavy painful periods coming back doesn't sound ideal. GP didn't have enough time to go through this with me, just told me to call back when I'd had a think about what to do.

@TailofTwoKitties It sounds like you’re weighing up the pros and cons carefully, which is really smart. HRT can be life-changing for symptoms like brain fog, vertigo, and mood swings, but if you’ve had issues with hormonal treatments in the past, it makes sense to be cautious. Totally normal and understandable.
1. Breast Growth & HRT – Is It Inevitable?

• Some women *do* experience fluid retention and temporary swelling when starting HRT, but this often settles within 3-6 months.
• If you’ve had persistent breast growth with the pill or Mirena, you may be more sensitive to certain progestogens. *Micronised progesterone (Utrogestan)* might be a gentler option compared to synthetic progestogens.
• *Lower doses of oestrogen* (e.g., starting with one pump of gel or a low-dose patch) could reduce the risk of unwanted side effects.
• Keeping a *symptom diary* can help track any changes and spot early signs of unwanted effects.

2. Does HRT Cause Weight Gain?

• HRT itself doesn’t directly cause fat gain, but *oestrogen can affect fat distribution*, leading to more fullness in the breasts or hips.
• Some women actually find HRT helps maintain a healthier weight by improving sleep and reducing cravings linked to hormone fluctuations.
• Choosing *transdermal options (patches or gel)* rather than oral HRT may reduce fluid retention and bloating.

*3. HRT & Fibroids – Will They Grow?*

• You’re right—fibroids often shrink after menopause due to declining oestrogen.
• However, *HRT can sometimes stimulate fibroid growth*, especially if using higher oestrogen doses.
• If your fibroids caused heavy periods before, you might want to opt for *a lower-dose oestrogen or consider Mirena again* (as it helps control bleeding).

Next Steps:

• If you want to try HRT but minimize risks, you could ask about *starting low and adjusting gradually*.
• A **menopause specialist GP (if available) might be able to discuss your concerns in more depth.

Just to reiterate you’re not alone in this even though it can feel so isolating—it’s all about finding the right balance for ‘you’. X

Hi OP. I can only offer my experience and not give any guarantees.

Micronised progesterone = massive sore breasts and depression.

Mirena Coil = massive sore breasts for two months then absolutely normal again. No depression.

You can also try the other types of progesterone.

In my experience it was the progesterone that caused the soreness. Oestrogen was a total dream.