HRT - does it suit everyone?

[LittleTroubleGirl]

I’m 44 and getting increased perimenopause symptoms. Irritability, paranoia, anxiety and low mood. My biggest issue at the minute is recurrent bouts of insomnia which can last 2-3 days at a time. Sometimes this is predictable around my period but is also happening at random times of the month. I’ve suffered with hormone issues since being a teenager and would consider myself to have possible undiagnosed PMDD.I tried various contraceptive pills during my teens and 20s, including progesterone only pills but ended up with bad side effects ranging from suicidal thoughts, high anxiety to bleeding in between periods. After trying various types in my mid 20s I decided to get the copper coil, which felt like one of the only alternative option on offer at the time. That in itself caused physical side effects including heavy and painful periods. I was relieved of my hormonal ups and downs for a few years after kids, then breastfeeding which seemed to stabilise things, and I haven’t experienced as many fluctuations in my late 30s. However I’m now at a point where I’m managing less day to day, and thinking about booking an appointment with a GP to discuss HRT. My question is has anyone who has experienced similar sensitivities to synthetic hormonal contraception found HRT the same or have you found it works differently? I can just about ride the mood swings now but worry that meds might tip the balance in a negative way, just looking for experiences.

Hiya, well it's a bundle of fun isnt it!!!

Here's my experience tho...

I started on Menopace early which helped.

I found out that magnesium helps with 3am wake ups.

I started fasting to balance blood sugar and manage weight, lost a stone and a half.

But I did get driving anxiety, when I've never had a problem there. So I went onto hrt. Thought it was great.

But.......suddenly got lumps in lower pelvis. Did some reading and thought, fibroids. Saw gp, got a scan at hospital and yes, fibroids.

Immediately stopped hrt and they are shrinking. Someone said, yes cheap oestrogen in the hrt....

In your case, I would start Menopace and magnesium for the sleep.

I would also start journaling and therapy in case anything is pissing you off. We know that peri is a giant sorting out time in life, so don't be afraid to start things like 'not my circus, not my monkeys.'

Some women get on with hrt but not me, so I'm back to natural remedies, good healthcare and that's it.

One thing I'd say is that the criteria with some GPs for HRT is irregular periods and vasomotor symptoms (flushes and night sweats.) If 'all' you have so far are a couple of days on insomnia a month, they may be a bit reluctant.
That's not to say you can't push for it or at least discuss.

Do you find the insomnia is linked to getting hot at night around your period time? I had that for years but for me it was 'normal' and more peri symptoms didn't kick in for another 10 years or so.

I started HRT in my 50s when flushes, insomnia and night sweats were becoming a real issue and I've been on it for over 15 years.

I'd done everything else re. diet, exercise, lifestyle and was advised (private consultant) that there wasn't much more I could do.

All estrogen now is plant based and nothing like the old forms of HRT form 30 years ago and nothing like the contraceptive pill.The type of progesterone used now is also 'natural' and made from yams.

All it's doing is replacing your own hormones.

It's not a 1-way street. You can try it for 6 months and see how you go. No one can predict how you'll feel but it's easy enough to try it.

I was really hesitant to try HRT due to similar experiences to yourself in the past. I had heavy bleeding caused by fibroids (which were eventually treated but the NHS seem more intent on trying to treat the symptoms rather than cause first!), so was given the combined pill (gave me a migraine after 3 weeks), progesterone only pill (bled continuously for 12 weeks before deciding enough was enough), and mirena coil (made the bleeding heavier, longer, gave me cramps like i'd never had in my life before and eventually bled itself out after a year from hell). It felt like my body just didn't react to hormone treatment in the way it should but I've been absolutely fine on HRT, although I have "politely" declined another mirena as part of HRT package!

Only Utrogeston is made from Yams, this type of supposedly body identical progesterone sent me bonkers, PMT like effects. I like yourself struggled with the pill and the progesterone in it. After 3 years of trying all sorts of HRTs I finally found one that I can tolerate. It involves taking progesterone for 14 days after taking estrogen for 70 days, it was called Tridestra which has been discontinued 😵.

Fortunately my Dr is now prescribing the components of this regime which is wonderful. I warn my husband that I’m about to take the progesterone part, so for 3 weeks I’m a bit of a grump, two weeks of progesterone and one week of withdrawal bleed.

My main concern of the menopause was horrific vaginal atrophy and hot flushes, really low energy and NO LIBIDO at all 🥴. Vaginal estrogen just never cut it so I take it orally for the atrophy. After the initial 6 months of taking HRT my energy and libido we’re still non existent. Testosterone was introduced (Tostran) and after two weeks my life changed, it was as though someone had flicked a switch, amazing.

I’m very happy with my HRT regime, it’s given me my life back 🌼

@snippit Only Utrogeston is made from Yams.
That's right. It is body-identical but doesn't suit everyone.

I was on a 3-month cycle for years (private consultant) using estrogen and Norethisterone. I'm still doing a longer cycle but have regular scans.

There is a higher risk of hyperplasia with a longer cycle (which is I assume why Tridestra is no longer available.)

The BMS has some advice in their guide on HRT/progesterone - where progesterone can be reduced or cycle lengthened if women are intolerant - and advises 3-monthly scans for women on lower doses.

It’s reassuring to hear that the body identical progesterone might be better, and if not it sounds like there are many more options in terms of HRT treatment anyway compared to the pill. Reading replies has reminded me of some other symptoms, including hair loss which I’ve been experiencing for a couple of years now and over the last 6 months or so I’ve had increased urination, dryness and itching prior to my period. My libido is also pretty non existent apart from a couple of days a month. I do experience hot flushes anyway before my period, not every cycle though. I haven’t experienced many cognitive symptoms apart from some recent spatial awareness issues parking the car 😂 Again, I’ve experienced brain fog, forgetfulness and word finding issues before my period most of my life, but interestingly these seem to be less of an issue with age compared to other symptoms….

Hello

I had a very similar experience to you, both with struggling with hormones since I was a teenager, particularly the emotional side effects; and with negative experiences of hormonal contraception.

Negative experiences is such an understatement, I was actually a total mess.

I put off trying HRT for ages because I was terrified of making it worse because I was already struggling with hormones. I read all the negative experiences people had with utrogestan and was totally convinced it would be a disaster.

Pleased to report I feel much much better. I had one week of feeling like early pregnancy when I first started estrogen, bad nausea, headaches, sensitive, increased hot flushes.

Then I felt much better. I actually feel better still in the utrogestand phase, weirdly.

I'm on 50mg evrorel patches and 12/28 days of utrogestan a month. This is my 3rd cycle, at no point did I really tank or have any major issues, periods are shorter and heavier, but otherwise just felt gradually better in myself.

It's not perfect, I still get hot flushes around my period, but they're milder and less frequent. I'm still irritable and cranky during my period, but then I always was. It's the crazy perimenopause bit on top that improved.

Thank god.

I think everyone is different. I never expected it to work for me, but was pleasantly surprised.

PS - insomnia accompanied by anxiety was my biggest issue pre HRT. 4AM wake ups with crashing feelings of doom and anxiety.

This has really improved. Sometimes I still wake up, I'm just not anxious about it anymore so I go back to sleep.