Dont know if i should give up on HRT

[potas]

Or keep on trying.

I stopped having periods over 4 years ago. Doctors at the time just kept saying I was too young (early forties) for menopause.
Symptoms including insomnia, bladder issues, lack of libido have been getting steadily worse so about 6 months ago I went back (new practice). They assessed me and told me that my original bloods 4+ years ago had shown testosterone already below a readable level. I was put on evorell patches (1 patch twice a week) and told I probably need testosterone but my oestrogen and progesterone need to be supplemented first. After 3 months bloods showed they were still low so the evorell dose was doubled. Since then I am piling on weight (almost half a stone in 6 weeks) and this week have been bleeding and have sore breasts although on continuous treatment. I feel awful. There's been no improvement in any symptoms.
I am due bloods again in 2 weeks then another review so potentially in 3 weeks time they may add in testosterone but I just feel like I'm done.

Sorry for the long post.
I don't know if I should persevere for another month but the changes in the last week or so are worrying me that I'm messing around with my body and I should just leave it alone and accept the downsides of menopause.

Has anyone been in a similar situation and come out the other side feeling better ?

First thing is that HRT is good for long term brain and bone health so given your relatively early menopause, I’d vote yes, worth persevering.

Is the everel a combined patch with estrogen & progesterone? I ask because you didn’t mention how you are taking progesterone, which you need if you have a womb. I think sore breasts is a sign of too much estrogen so I think the balance of HRT is not optimal for you. When they doubled your Evorel dose - from what to what? It can be a bit trial and error, but maybe post a bit more detail here.

I’d get estrogen & progesterone sorted before worrying about testosterone which for most of us is a maybe-nice-to-have.

Hi.
Yes it is a combined patch. Evorel Conti. And the dose is 100micrograms of oestrogen and 340micrograms of progesterone daily at the dose I am using.

@potas I think you should carry on. your periods stopped early 40s that's classed as early menopause and you will have been without estrogen for a good few years early= risk to your bones and heart health, longer term.

However....

if this is HRT from your GP they tend to prescribe 'bog standard' using GP guidance rules which don't allow for variations that you could be offered from a meno consultant or outside NHS prescribing.

You've been offered 'bog standard' for someone post menopause.

It's often better to start on sequential/cyclical HRT because this is only estrogen for a few weeks and you can get that dose right. I was much older than you when I started HRT . But I was started on estrogen gel only for 10 weeks to get that dose right, before adding in a progesterone. I was still in peri so there wasn't a risk to my womb to be without progesterone for those weeks.
I started low- half a pump- and worked up to 2 pumps (same as 50mcgs patch.)

I'm still in sequential, years later, out of choice.

I'd suggest you ask if you can try sequential for 6 months and see how that goes. your GP may be reluctant - going by the 'rules' on it must be continuous, but this isn't actually true. (I know women in their 70s still on HRT using it on a cycle, out of choice.)

You might also want to swap from patches to gel because you can change the dose yourself (up) without a new prescription (as with patches.)

And you'd take Utrogestan for 12 days per month. Yes, you'd have a light bleed each month but it may be better than weight gain and not feeling any better. The progesterone in patches is the old type, whereas Utrogestan (micronised progesterone) is body-identical. It's trial and error which suits you best.

if your GP isn't up to speed, can you stretch to a private consultation with a meno specialist?

I'd hang on for the testosterone. That was the one thing that really nailed it for me
But either way I found it all told a good few months to bed in

Thank you for taking the time to respond. The nurse actually suggested I go private at my last visit if I wanted to speed things up a bit. I feel a bit more positive today, probably cos the bleeding has stopped. Maybe I just need to accept it could take 6 months more to get it 'right'.

To give you some context, it took me a number of years to get it anywhere near right and now due to estradot not being available, I feel like I am starting again after 10 years of HRT, so you are very early on your journey. Yes it can be extremely challenging to find the right preparation and dose for you, but its worth persevering.

Depending on the private specialist, you may not find that things are speeded up as they will expect oestrogen to be optimised before starting you on testosterone. Even then you may, or may not find it to be helpful. I didn’t find it helpful at all.