New to hrt and it's awful

[VixVox]

Hoping someone may pop along to give advice. I started hrt a week ago ( 2 pumps oestrogel and one 100mg ultrageston for 25 days), and honestly, it's been awful. I'm still in peri but my most troubling symptoms have been occasional hot flushes/ night sweats and insomnia/ anxiety. I'm already on an antidepressant but was hopeful that hrt would ease the remaining symptoms. However, if anything it's caused these to escalate. The ultrageston makes me incredibly anxious and I'm waking after a few hours broken sleep flooded with anxiety and feeling wired with surges of adrenaline. The next day I feel utterly depressed and hopeless. I'm ready to give up entirely. Has this happened to anyone else and does it get better, or should I just give up now?

Thank you for the advice. Although I've decided to stop it all for the next few weeks, I DO really want it to work so will consider this approach next time ( hopefully!). I think Dr put me on the continuous cycle to alleviate pms symptoms?! Can't remember the reasoning now, but something like that. At least with the sequential, I'd get to see if it's the ultragestan causing me the problems as I suspect.

A little update: didn't take the progesterone tablet last night, so only had the 2 pumps of oestrogel in my system, and wow what a difference! I slept ok and wasn't woken by the flood of adrenaline in my system,internal jitters, anxiety and the panic. Today is the first time I haven't woken with a headache and without feeling desperately depressed. I think I can conclude utrageston just doesn't suit me. I obviously can't just take the oestrogen part but I don't know what to do about the progesterone. Are there alternatives?

The Mirena is an excellent option for progesterone. (Utrogestan didn't suit me either, so I switched to Mirena, which has been transformative.)

Thank you. I do worry about the mirena causing the same response, and then having to go through the palaver of having it out. I will put it on my list though to discuss with the gp at some point.

You could try Norethisterone which you can take as a tablet.

The Mirena, or patches with estrogen + Norethisterone.

However, you should be on sequential HRT as you're not over 54 or post menopause yet, so whatever you are on will be for 12 days a month.

Thank you, you've been an excellent source of information over this thread. I'm going to come off all hrt until I next see my gp and discuss these alternatives. Or if I simply can't tolerate any progesterone, will have to get my head round going through menopause without any. I'm really leaning towards being progesterone intolerant; the pill never suited years ago and the second half of my cycle up until the last few months where there's been no periods at all, have been painful with daily cramping, sore breasts, anxiety, insomnia etc.

How are you getting on?

I tried two pumps of oestrogel and also felt wired later that evening. My anxiety ramped right up and I could barely sleep.

Ive worked hard to manage my anxiety through lifestyle changes (cutting booze, eating better, therapy, mindfulness, journaling etc) so I wasn’t prepared to continue either.

Also had a difficult experience on the pill when I was younger and had a bad reaction to Sertraline a couple of years ago.

its really hard as I want to feel like my old self again but I also feel it’s an accumulation of difficult life experiences surfacing now I have the stability for them too x

My own estrogen surges on top of the patch make me feel jittery and nauseous but have to keep at it as low oestrogen and progesterone are hammering my muscle strength.

Why don't you try what other people have suggested before stopping? So utrogestan vaginally as that massively reduces side effects and introduce oestrogel slower so half a pump for a week then one pump and build up.

It's worth trouble shooting first before getting a GP phone consult. Any meds will cause some issues until the body adapt and adjusts.

It is absolutely fine to skip one utrogestan tablet to see if that's what is causing you the problem! It's just very much not OK to do that long term. You might find skipping a tablet brings on your period though - I wouldn't skip More than one.

Lots of women use cyclical HRT and accidentally miss a tablet. If you have a stomach bug and can't keep anything down you don't suddenly end up with a thickened endometrium.

I was told to just start on estrogen before adding utrogestan so I could see how each made me feel. It's quite difficult to work out.

Just the estrogen made me feel how you are feeling because it's just the sudden fluctuation in hormones. I felt that way again when I increased the dose, doing it incrementally is best.

You have to give it a chance to settle down because the point of HRT is to try and stabalise your hormones - but what you've done at the start is completely stir things up. It does take a while to stabilize. In a way what you've discovered is that HRT is very much working, just not stabilised yet so hasn't provided symptom relief.

If you quit now you won't really know if it would have worked if it had stabilised. that's why they say give it 3 months to settle. It is really common to feel worse before you feel better.

I think you could skip a utrogestan to see if that's the problem (you can't know it's progesterone intolerance if you started them together). If it's not then it's the estrogen and you could try reducing it ever so slightly and build up more gradually, but honestly in your shoes I just saw it through. I figured more change just meant more to get used to.

I was going to reply to this but has OP been back since the first few posts?

Oh no doesn’t look like it.

All the best op if you pop back and hope you are doing well.