Positive hrt in peri?

[AnxietyCam]

Hi. I’m 42, recently been prescribed HRT for my handful of symptoms the worst being anxiety and night sweats/panic. Started on Evorel 50 patch, lasted 6 days and my panic skyrocketed. GP advised removing and has now prescribed Evorel 25 patch and Utrogesten. Any positive stories for this type of HRT? Seems to be lots of negatives which are frightening. Desperate to get this under control, currently signed off work too 😔

I'd try to ignore any negatives. Women who get on well with their HRT tend not to post.

Your GP is doing the right thing to reduce the estrogen. It's best to start low and work up if needed.

You might also want to think about using estrogen gel in the future as it's easier to change the dose compared to a patch- you just use less or more and don't need a new prescription. (Obviously you don't change the dose day to day, but after a few weeks or months.) For reference, 1 pump of gel = 25mcg patch.

Be aware there is also a negative 'placebo' effect with any drugs and if you are already anxious, the anxiety may increase because of your mindset, not the actual drugs.

I'd suggest ignoring any negatives you may have heard and see how you go.
To give the other side, I've used estrogen gel and Utrogestan for over 15 years. Yes, there are some minor side effects from the progesterone but all drugs have some so it's balancing the benefits with those.

All the best!

I started with Evorel 25 and after a few months went to 50. With cyclical ultrogestan.

I've had zero negative side effects from the Evorel. I find the ultrogestan makes me a bit sluggish, although taking them as a pessary almost completely alleviates that.

For reference, I often don't get on with prescription drugs and am very sensitive to drugs in general. I prefer to try and alter my lifestyle before taking medication but hrt has been brilliant for me. I also have several friends starting out on it in various forms. Literally no negative feedback yet?

It's really easy to get in a perpetual loop with panic. Your thought patterns affect your breathing, which in turn affects your physiological state, leaving you in a state of fight/flight, which feeds right back into panicked thinking. In the short term I'd really recommend the free meditation app "insight timer" for some basic breathing exercises.

Good luck!

Thankyou both - i appreciate your reassurance!

Im on the elleste tablets.Never had a problem in 1 yr and 2 months

I am on the evorel 25 patches and cyclical ultrogestan almost a year now and it’s been life changing. I did find the ultrgestan made me a bit constipatited initially but it settled down. Anxiety, mood, sleep, skin, digestion, energy, brain fog, all so so much better.

One thing I also discovered along the way was I was low in folic acid, which can cause anxiety. Supplements helped with that.

HRT has been great for me, but I have twice daily gel and then capsules for the last 2 weeks of the cycle. The patches weren’t as good for me. I also take it in combination with 20mg Citalopram. I’m the same age as you.
I would recommend looking into a low dose of Citalopram or other SSRI along side the HRT.
It took a little while for me to find the right combination with the help of a private specialist (GP knew nothing tbh) but it has been life changing.

Another thing is that, while the medication has massively helped my symptoms, a holistic approach is best. Lots of water, fresh air, exercise, diet which is low in sugar and high in fresh fruit, veg and protein, good sleep. All of the stuff we already know is good for us. I am miles from perfect on that front but when I eat and sleep well and move around I feel better, as we all do.
I also discovered alcohol makes me anxious so tend to avoid now.

Another thing is that, while the medication has massively helped my symptoms, a holistic approach is best. Lots of water, fresh air, exercise, diet which is low in sugar and high in fresh fruit, veg and protein, good sleep. All of the stuff we already know is good for us. I am miles from perfect on that front but when I eat and sleep well and move around I feel better, as we all do.
I also discovered alcohol makes me anxious so tend to avoid now.

Sorry one more thing - magnesium!! Helps so much with sleep and calmness.

@GRCP There has been a huge drive for several years now to educate GPs so they stop offering ADs for peri menopause.

It's unusual for a specialist to go down that route.

They don't often work and they make it hard to know what dose of estrogen is needed.

NICE guidance from 2015 says do not routinely offer SSRIs- the route is to adjust (increase) estrogen and maybe change the type of progesterone.

Long term, SSRIs are not the answer whereas HRT can be used forever if it's helping with symptoms.

Lurking. I went today due to panic attacks/anxiety and I’m 41. They’ve prescribed micronised progesterone and oestrogen gel, I have a mirena too
need to pick it up tomorrow but a bit nervous of starting it!

Swapping from patches to estrogen gel and oral progesterone has helped a lot with anxiety. Patches were taking my oestrogen too high and not giving me enough progesterone. I've found oral progesterone to be v calming.

Hi, I started on hrt 2 years ago, after the crippling anxiety, night sweats and mood swings became too much and I just didn’t recognise myself anymore!
I was originally put on hrt patches (25) & progesterone 2 weeks of the month.
Moved up to patches (50).
Now on the gel (75) I find the gel suits me a lot better, still on the progesterone.
I also take Magnesium and Passionflower from Holland and Barrett.
I find that sleep is key for me, when I don’t sleep well for a few days the anxiety rockets.
I hope the Hrt helps you 🙂

I was just thinking this morning about how much better I am now than I was when I started HRT about 5 months ago, so definitely a positive experience here- though not necessarily a smooth path.
I started with sequential- gel and micronised progesterone. The gel meant I could start really low and build up gradually- as I was worried about side effects. It’s also good to be able to tweak the dose a bit and see if symptoms are alleviated. I’m now taking the progesterone continually and am finding that works for me much better (even though im peri and still having periods).
I was also super anxious, waking up in the night in complete panics and that has been alleviated- whether it is improved sleep that has reduced the panic or the reduced panic has improved the sleep I don’t know, but both have improved immeasurably. Had a blip over Christmas where I started waking again but had slipped on vitamins and magnesium, and been having a little more to drink. I’ve added a tiny bit more gel and got back into the good habits and the sleep and panic is sorted again. Definitely worth thinking of nutrition etc as a foundation to have in place, but get the HRT right and you’ll be flying. Good luck 🤞