HRT alternatives

[Iamtarticus]

morning, I’m 49 and going through peri still having periods but symptoms getting soooo much worse now. Anxious off the scale, flooding, clots, anger, muscle pain, tiredness etc. I’m unable to have HRT due to medical issues. Does anyone have any suggestions? My doctor wants me to have citalipram and the coil,

I have found the mirena coil very good when I started to have a difficult time with periods. My periods pretty much stopped. It has been great for me.

Thank you, I’m concerned about the SSRI, I’m not depressed , but I’m very very anxious and it’s effecting everything. I have no confidence, I’m snappy and I’m so so tired.

I'm sorry to hear it. I hope someone can advise you about the SSRI. I hope you will start feeling better soon 💐

Can you say what the reasons are for no HRT?
It's quite unusual to be allowed the coil (which is hormonal) but not estrogen.
Only asking as some GPs If it is your GP) are often wrong on this.

Cardiac and cancer risks.

Have you had a heart attack or blood clot?

The only absolute no-no's are a heart attack or blood clot recently, or recent breast cancer (or the BRACa gene.)

And if either of those apply the same would possibly apply to the Mirena coil which is a synthetic progesterone.

My doctor has specifically advised against it. He said the risks are too high for me.

What are the reasons for your risks? Do you have existing conditions?

Some GPs are just very against HRT and come up with all kinds of reasons that are completely wrong.

Have you had a proper discussion or is your GP out of date with HRT?
In your position I'd be asking for a 2nd opinion from a specialist, as most GPs know nothing about HRT (as shown on this forum every day.)

Family history of cardiac issues are not counted .
The breast cancer risk applies only to women with the BRACa gene or a mum and sister who have had breast cancer. And even then it's not a 100% no-no.

The only absolute reasons not to prescribe HRT are as those I posted.
HRT protects against heart disease.
There is no cancer risk for at least 5 years with one type of progesterone.

I don’t really want to discuss HRT, I started this thread with a view to peoples experiences of alternatives please.

Okay

I’ve had citalopram OP, and it was helpful. It’s rough starting it, the first few weeks everything can feel worse. The first time they started me on 20mg but I’ve come off it and then gone back on twice and both times started on 10mg and then built up after a month or so, which was gentler.

I found it helped a lot with anxiety and low mood, I was a lot calmer, enjoyed things more. I had two main side effects which were the reason I stopped in the end, which were that it delayed orgasm during sex at 10mg and it just wasn’t possible to come at 20mg, which got me down in the end, plus I had put on weight (although this was also due to other factors) and I thought perhaps I was making me feel more hungry so I was eating more. If I hadn’t had those two things I’d still be on it, as I say, it was really helpful, even at 10mg.

Obviously everyone’s different, but might be worth a go. I have come off it very gradually each time and that’s been ok.

I should add that this was just in the last few years, and alongside HRT, so moods would have been menopause / perimenopause related, I’m pretty sure.

They're used to treat anxiety as well as depression. Main reason I went back on them

Should also add that if you decide to try it make sure you have check ins booked with your GP through the first few weeks so they can help you monitor your moods while you’re adjusting to it - that really helped me to stick with it and I felt someone was making sure I was ok.

They're for anxiety as well as depression, depression can present as extreme anxiety, in your shoes I'd give it a go ,you can always stop taking them if they're no good. I have no experience of the coil so can't comment on that.

My cardiologist recommended to speak with a Bupa menopause specialist, they do an annual plan , they do loads of hormone testing and will take into account pre existing conditions

As you can't have hrt then medication for anxiety and a coil to control the bleeding seems sensible, Everyone's experience on meds is very different so it might just be a case of give it a go and review in 3 months. Many if not most do feel rougher before any improvement on anxiety meds so choose a time when demands are low and no important work events pending.

I'm sure you have but make sure all bloods up to date as exhaustion can have many causes such as low thyroid, low vit D, low ferritin.

The best thing ime for fatigue is physical activity. No matter how drained i might feel an hour's brisk walk with the dog with playlist blaring is invigorating. Also headphones handy if you live in a noisy household and need to tune out for an hours calm/decompress!

Avoid caffeine and booze as that can cause sleep disturbances with knock on fatigue.

Hello Iamtarticus ·
Check with a menopause specialist, nutritionist who specialises in a natural, holistic approach and can advice on what foods to eat and how to deal with your symptoms. Also, ask your GP for blood tests, as others have suggested. Tranexamic acid can help reduce bleeding if you are allowed to take it or mirena coil. This was offered to me. You need to take iron and eat more iron-rich foods. Tiredness may be due to low levels of certain vitamins.
CBT,talking therapy can sometimes help with your mental health and emotional well-being.
I have some older colleagues and friends who have chosen the natural route. My ex-colleague had breast cancer in her 60s, and her specialist advised her not to take HRT, which she followed. Fast forward to today, she is nearly 80, quite fit, and appears young for her age.
Exercise, healthy eating, and sharing your journey with others are key factors in navigating menopause x