Utrogestan depression

[JJkate]

Hi, I've been on hrt for two years; estrogen gel and utrogestan tablets. I find I'm badly affected by the utrogestan (very low mood, irritable etc) so have been able to convince the Dr to let me take 3 pumps of gel with two utrogestan tablets. This has taken the edge off the utrogestan low mood but only a bit.

I tried taking utrogestan vaginally but the side effects were bad. I dare not try the coil as the thought of having something that has to be removed feels like such a loss of control if it doesn't work out. My question is, do I just put up with this? Low mood for 12 days a month forever?

If I stop all hrt I can't sleep and have very inconsistent mood changes with peri symptoms so opted for this as the least worst option as at least I sleep however I'm feeling so ground down by this depression and irritabity each month and also worry that I'm taking too high estrogen dose. If anyone has found a way out of this please could you share your stories. Thanks.

Well, it was:

Get onto the table
Legs apart
GP finds strings
Gets hold of them with an implement
Tells you to cough
It comes out.

So maybe three minutes?

I had two inserted and removed in a year when I was trying to figure out a method of birth control in 2010. And I've had one out since using it for HRT.

I have never encountered a GP who would make you keep it in if you feel that it's not right for you (other than encouraging you to ride out the initial bleeding)

I have so far managed ten days of oral progesterone before I have suicidal thoughts so not due I could last several months. I tried it again to see if the vaginal application had helped and lasted three days.

Hi all,

Thank you for your replies, it's really helped me think about my options. Even though anecdotally I've heard others say the same in real life, I'm surprised there are so many of us on here reacting badly to this drug. I think it must be pretty common.

I have decided that the coil is not for me as I already react badly to utrogestan, I couldn't take the pill when younger as it made me feel awful emotionally (don't get me started on the horrors of the morning after pill) and judging by the responses here I guess the coil would be similar and the risk of having something inside me that I couldn't take out easily is too big a risk. At least with utrogestan I know I don't have to swallow that pill and will feel better in two or three days.

So I have asked if I can switch to the combined patches and see how I get on. The Dr I spoke to said there is no combined patch that matches the amount of estrogen I'm currently on (3 pumps) so I will need to drop down. She said see how I get on for a couple of months and if no good I could then try higher dose estrogen patch and synthetic progesterone tablet which might suit better than utrogestan or I could try oral estrogen and oral synthetic progesterone. I asked if I will suffer side effects from dropping estrogen dose and if I should taper, I also asked if I could top up the patch with a bit of gel. She doesn't know and is going to check about this before she issues my new prescription. I will report back with an update. If anyone has any advice and experience on this please let me know.

As an aside, this experience has really made me wonder about the women I know who are wobbly/bad tempered even when young and wonder if it could just be a hormonal/physiological thing and nothing to do with personality and upbringing and wonder how much control we actually have over this stuff? For example a woman I know who had to have a hysterectomy has become a different person, from laid back happy to withdrawn, snappy and adversarial. Perhaps the future isn't trauma therapy or anti depressants but hormonal treatment. I've read some interesting stuff reported about people who have taken hormones when transitioning in terms of how different it made them feel and behave (both positive and negative). I'd be interested in thoughts on this if anyone has any e.g. how much do our hormones affect our mood/behaviour and how much control do we have over that? (I certainly feel at the mercy of mine when on this demon progesterone).

Also, I thought it would be good to canvas re low mood;

If you switched from gel and utrogestan/gepretix to gel and coil - did it help?

If you switched from gel and utrogestan/gepretix to combined patches - did it help?

If you switched from gel and coil to combined patches - did it help?

If you switched from any of the above to synthetic oral estrogen and progesterone did it help?

If you stopped HRT completely how was it?

Anything else useful you think would be good to share please do.

@JinglingSpringbells i started sertraline a good few years ago after prolonged health anxiety and OCD (during my 20s and 30s) so it didn't coincide with peri starting.

I'd be interested in those who have transitioned to patches as well. Good question OP!

Did you or do you have side effects on it? Namely around libido, feeling numb down below etc? Sorry if too personal

My sympathies. Some people find utrogestan better and some find synthetic progesterone better - is it worth trying something different? When I tried utrogestan vaginally, I went from perfectly happy to 'life is utterly pointless' in the space of 5 days. It was worse than synthetic progestins, and I didn't do great on those!

My suggestions are:

When I still had a cycle, after a couple of years on a normal cycle of HRT I was able to change to a 3 month cycle. I had an HRT tablet called Tridestra that had a 83 day cycle so I took the progesterone tablets for something like 13 days and oestrogen only for 70 days. It meant I only had to suffer for 13 days out of 83.

I later changed to Tibolone which is a medication that stops hot flushes and protects bones like Oestrogen does. But, for me at least, it didn't replicate oestrogen in other ways. I lost collagen etc.

Later, once I had no cycle at all, I changed to my current regime of Elleste Duet continuous. The same dose in every tablet, both oestrogen and progesterone. I found if I take the tablets for more then 3 days I got depressed, so I take for 3 days, have a day off and then do another 3 days.

I am still getting the benefit of oestrogen and the protection of progesterone but taking it this way stops the progesterone emotional impact building up.

Hope the above helps in some way

@AnotherNaCha good question. I'm only on the low dose of 50 per day and I think it has affected my sex drive. Obviously the menopause and having young twins doesn't help so it's all a bit muddy. I still climax when we do but it takes more work to get there. I think the sertraline is a contributing factor. But. I find the testosterone (female version called androfemme) has helped this issue. I would really recommend testosterone for those who are low. I have more energy and more libido. Unfortunately it's a private prescription but the tube lasts ages.

I don't want to dismiss low mood caused either by HRT or not, but it's worth taking a very holistic approach to menopause even if you're using hrt.
My consultant is a huge advocate of lifestyle and diet to help with HRT.

There's increasing evidence that gut health impacts on mood and depression. Follow the experts on the Zoe website for this.

Also, MIND says that exercise is as good as ADs for low level depression and anxiety. There is a 40% placebo effect of ADs and no one was ever supposed to use them for years unless they have very serious MH issues. Other methods like CBT are supposed to be offered.

It's 'annoying' to put it mildly that Utrogestan has become the default progesterone. Because specialists know it's a love-hate option.

Years ago when I started on HRT, no one was using it. Now, it seems everyone is unless they choose patches with synthetic progesterone.

Fortunately, I've never had any mood effects from HRT other than slight irritability towards the end of the progesterone cycle.

If you're finding your GP isn't up to speed, and you can afford it, speak to a specialist who knows about all the options.

@JJkate the change from patches and utrogestan, to patches and Mirena was like night and day for me.

I absolutely love having the coil in. I couldn't take any hormonal contraception and I tried many over the years. Utrogestan made me feel suicidal for two weeks every month.

The mirena had a little settling in process, massive boobs for a while and initially very tired. Two years on and it's properly brilliant.

@JinglingSpringbells I hear you but mood-wise I was fine before HRT. I started taking it to help with bladder issues and became profoundly depressed within two weeks. So the effects of progesterone are very real for those of us who are sensitive to it.

I did say I wasn't dismissing that. I've made a lot of posts about how it's being (IMO) prescribed without warning women they may not like it - and there are other options.

It's also the fact that it's heavily promoted as being by far the safest option. But it's not so safe if it makes you want to take a dive off a bridge. If I had a penny for every GP who had tutted at my patch use and tried to switch me back to utrogestan.
I also feel the dosage for utrogestan is just too high, I know doctors say it isn't as strong as the synthetic progesterone so the dosage has to be higher, but I'm not totally convinced.

Hi everyone, so I spoke to GP, she said she had to go away and speak to another GP for advise but I should probably try the patch instead and it would help. She said the highest patch was only equivalent to two pumps of gel so whilst I was waiting for her to get back to me I tried to lower my gel dosage a tiny bit every day (I have jewellery scales). I managed to get down to 2.5 pumps a day over two weeks however I had shitty symptoms such as anxiety and insomnia. I got sick of waiting for the call back so went back up to 3 pumps. When she did get back to me she prescribed the patch. I wore it for two days and again had bad anxiety and insomnia amongst other symptoms and had important stuff going on so thought I just couldn't handle it at the moment so have reverted back to gel and tablets. However the only thing now is it's been about 4 weeks and I haven't settled down to how I was before, every day I've felt really flat and low and close to tears and it's really getting to me. I don't think there's any point speaking to GP as they seem to be clueless. Does anyone have any idea how long it might take to feel better? I don't remember feeling like this when I first started hrt.