Depressed on progesterone does it get better ?

[Vintageroses]

I’ve gone from taking it 12 days a month to continuous. Since starting continuous 2 weeks ago I’ve been bursting into tears left right and centre. Feel very down about myself and paranoid that everyone thinks I’m shit.
i am supposed to be speaking to the doctor in 3 months. Has anyone experienced this and it’s got better ?
I’ve gone on continuous to try to stop migraines.

Yes I felt the same and eventually have given up and stopped HRT.

Me too. I switched to continuous in the hope that's I'd feel better but it just made me feel dreadful all the time.

Now my "withdrawal" has settled (and my periods have stopped) I feel much better without it.

Depression is a known side-effect of progesterone-containing contraceptives. (But men gotta get their dicks wet, right?) It stands to reason that non-contraceptive uses of the same hormone would cause depression.

I started continuous around 3 months ago for the same reason as you - try to stop migraine.

It has really really improved* *migraines, but I take 200mg a day and have found it's effected my mood much more than when I was on sequential, when it wasn't a problem.

I'm more irritable than depressed, just very PMS type feelings.

It is starting to improve a bit, but it's still an issue. My GP gave me SSRIs to try, but I'm holding off for now as I want to see if it settles.

I have found that obtaining my progesterone via the mirena coil is the only form of it that does not make me depressed. But equally it might not be so helpful for migraines. Speak to your GP op.

I was hoping that it might settle down. Weirdly, I didn’t notice it when I took it for 12 days a month.
would the mirena coil be the same or is my only option to stop hrt altogether ?

I think how hormones affect people is very individual. I took utrogestan cyclically for 2 years and my mood was fine but had to stop as it gave me reflux. Switched to mirena and had horrible side effects for first 4 months (heart palpitations, raised resting heart rate, insomnia). These have now settled but feel a little flat and have started to gain weight (I think it is meant to affect some peoples level of activity/motivation) which is probably a factor.

I found exactly the same. I had no issue with it for 14 days a month.

It is improving, but it's still a lot of feelings!

I think it will get better still, you're supposed to give continuous 3-6 months.

I have a review in 2 months with my GP. I'm going to ask her if more estrogen might help.

My alternative to try is to try Zoley. But my migraines are so much better I'm reluctant to switch. I'm not very keen on taking the SSRI, but my GP felt it would work, she said they're very good for PMS.

PS - everyone is different, but I found I had significant mood issues on the mirena. I tried two of them for several years each when I was younger and concluded it wasn't for me

There are lots of alternative progesterones though. They are all different.

What?

@101trees i thought the pill was a no no for migraine sufferers?. Might depend on the type of migraine though.
i’m wondering if it’s the estrogen that causes my migraine as I’ve been ok the week before a period which I think is when it’s at its lowest. But then , my mood was bad. Can’t win !

Usually it is estrogen fluctuations which cause migraines. Did you get migraines before HRT?

I find it's any fluctuations in hormones which make my migraines worse, so it was also start/stopping utrogestan and it has . But the most normal is for it to be estrogen fluctuations.

Were you on sequential HRT before? Or did you start with continuous?

I have migraine without aura so the combined pill is OK-ish. They're still not madly enthusiastic about me taking it, but as contraceptive pills go it's not bad, similar risk profile to using oral HRT I think.

Estrogen is a no-go for women over 30 with simple migraine, or at all ages for those who have migraine with aura. You can take the "minipill" because it has no estrogen in it.

Progestogen in contraceptives makes women depressed. It is a known side-effect. Apparently, expecting women to put up with this is preferable to telling men to wear condoms.

Progestogen in HRT is likely to also make women depressed. It's the same hormone.

@101trees i started with migraine about 10 years ago. I didn’t think it was migraine myself as it really didn’t fit what I’d heard/ read. I was told it was ‘silent migraine’ i was only ok in the second week of my cycle.

Then peri started and it was all the time.
I now get headaches aswell and I’m only free of it for about 10 days before each period , The rest of the time I’ve got various head pressure , dizziness , tinnitus, lightheadedness, headache etc so it’s having a big impact.
Different pattern but just as long lasting. This pattern emerged after starting evorel sequi.

It's not an issue to use the combined pill after age 30 (or up to 45) if you have migraine without an aura and no other risk factors for stroke (non-smoker, not overweight, no high blood pressure).

Migraine without aura does not increase stroke risk in the same way migraine with an aura does. It just needs individual evaluation of overall risk factors.

The COC was suggested to me by a specialist neurologist on the NHS as a possible alternative to HRT which might help control menstral migraine if HRT made it worse. I'm 41. I was already under the neurologist for migraine before the issue of HRT came up.

It's used in lots of women between 40-50 who have endometriosis.

GPs are sometimes uncomfortable providing it without input from a neurologist, but my menopause specialist also suggested it because it provides a stable dose of estrogen and progesterone which can improve menstral migraine and give better control of menopause symptoms to women earlier in perimenopause.

It's not supposed to be used as a first line response to migraine, but if you have menopause symptoms too then it can be very effective at managing migraine and is a known pathway.

I guess maybe the answer for OP is that some specialist input is needed if the continuous utrogestan doesn't work out. Migraine is a complication for HRT, you can request to see a specialist because of the migraine.

It's absolutely not a case of either transdermal estrogen + utrogestan works or come off HRT and lump it. But you might need some specialist input to be able to access some of the alternatives. Someone who can really evaluate the real risk/benefit profile of the alternatives and feels comfortable prescribing them, instead of jumping to the stock answer.

There are different progesterones if you feel that might be the issue (it probably is behind the mood issues, it is a known side-effect)

Transdermal estrogen patches are considered to be the most stable release of estrogen to help migraine, but maybe you don't have enough of it to control the fluctuations? Or the COC absolutely is an option for some younger women with migraine without an aura and no other risk factors.

You don't just have to put up with it or give up because the easy solution doesn't fit you, but you do need the full information to make decisions.

My sister was borderline suicidal in progesterone orally. She's on mirena now and has no issues.

I think a lot of women find migraine gets worse with peri because of the fluctuating estrogen.

I have bog standard migraine without aura, but I went from 5 a month to 15 when peri started, then almost every day on sequential HRT. I'm back to 5 on continuous HRT, but the mood issues got worse.

If the evorel sequi was making migraine worse then it sounds like it was increasing the fluctuations rather than stabilising them.

Have the migraines improved on the conti but mood worse? Or is it both worse ?

You're not quite correct: migraine without aura does increase stroke risk, but not as much as migraine with aura. Hence doctors don't like giving COC to women over 30 who have migraine without aura. When I was thrown off COC 25 years ago, migraine without aura made for a blanket COC ban if you were over 30. As it was, I get migraine with aura, so it's a blanket ban for me at any age.

@101trees migraine the same so far but I’ve only done about two weeks on continuous so too early to say if it’s going to help I think.
I have had mood issues with periods all my life and then more so with peri. This month I’ve been awful with my period and then it hasn’t picked up much afterwards hence suspecting the continuous progesterone is to blame.
I think I need my periods to stop !

I had the same issue as you, and I changed to using progesterone vaginally , as this gives you the protection you need but without the side effects. Check with your GP/ nurse practitioner regarding this. Also I didn’t tolerate mirena coil which would have given me the progesterone part of my HRT

Exactly the same op and it got worse rather than better. Where I felt suicidal. It was the worst 3 months of my life. Too scared to try any variation of progesterone now. Have patches of combined HRT in my bedside drawer. Can’t face them. Took specialist advice from a private menopause dr- £400- and was advised to try progesterone vaginally. Didn’t.

Have also been offered synthetic progesterone via the pill as that’s what I had as contraception when younger with no ill effects that I can recall. Also been offered the coil. oh and SSRIs.

Am now on nothing except a couple of supplements and I have quit alcohol. Was never a big drinker anyway. Sleep and mood are both better. Mood and PMS are a bit frought before my period. Night sweats are my biggest symptom. But it all feels manageable than how I felt before- paranoid, so low, boughts of crying for no reason, insomnia, racing negative thoughts.

Sorry to be so negative. But I feel totally fine now! One third of women need HRT, one third do not and one third will need it and find mixed intolerances and have to play around with dose and type.

I started HRT early but I think that was a mistake. And actually i am in the third who doesn’t need it. Well that’s what i keep telling myself!!

Good luck to you. It’s brutal.

I'm about 3 / 4 months in and feel my mood is levelling out more now. I still have periods and have significant PMS beforehand, more than before. But it's manageable now where it was absolutely awful when I first started continuous, for about the first 6-weeks. Rage then crying, like being a teenager ! I'm just a bit snappy now, short fuse.

The migraines reduced pretty quickly. By the end of the first month I could tell they were a lot better. That has really been my motivation for keeping going in-spite of the problems with mood.

I've also really struggled with mood issues around periods my whole life, migraines too. I think I'm just very sensitive to hormones, which is why a stable dose of something is a good idea.

I also found migraines were worse until I was on a high dose of estrogen to level out the fluctuations more.

It's not perfect, the week before my period I still get hot flushes, migraines and PMS. But it is all a lot more stable than it was. Better than before using HRT, when on sequential and first starting continuous. So this is the best it has been.

Menstral migraine is just very hard to manage in peri. I had some really great advice from a migraine specialist neurologist (NHS) and menopause specialist (non-NHS) They both actually suggested trying COC over continuous HRT, but didn't want a big change and I liked utrogestan when I only took it for half the month so I went with their Plan B.

I don't think I would have continued if the migraines hadn't improved so much, but I am glad now that I have.

I think give it a bit more of a chance if it's only been a couple of weeks. I did find it truly awful to start with - but I react really extremely to changes in hormones and it sounds like maybe you do too?

I was bad enough to request SSRIs from my GP. But I haven't used them, it just levelled out with a bit more time (she says, optimistically hoping that doesn't change again!)

thanks @101trees nice to hear from someone in a similar situation although I wouldn’t wish it on anyone!
yes, I am also very sensitive to hormones I think. It’s so debilitating. Are you able to work ?
I will keep going, at least for the three months as planned as I really need to know if there’s a change to the migraines.
i just hope dh doesn’t leave before then on account of the rage and tears. i’m already taking an SSRI, I started that when peri first started and I had anxiety every morning.
Hope things continue to improve for you.

I do work, but I'm part time in a very flexible job with a very understanding employer. I can't work through a migraine, so I have found it difficult and had a lot of time off in odd days. I have tried very hard not to let it become longer periods off.

I also have a very young child, so that has been hard too.

Have you found the SSRI helps? Could you increase the dose?

If you really think your husband might leave, then that does feel too higher price to pay for giving it some more time. Perhaps you should discuss it with your GP again? There are lots of alternatives.

I knew early on the migraines were improving, I wouldn't have waited 3 months to check. The mood took 2.5 months to improve, but not the migraines. That was much quicker. But if you don't have the estrogen right then settling in on the utrogestan might not help them?

The first 2/3/4 weeks I was a crazy lady all the time. Then there were phases of feeling really settled and some crazy bits around ovulation & pre-period. Now I'm more settled overall, with some bad PMS, which is ok with meme I can deal with 4 days a month.

I think the problem with being sensitive to hormones is you can't tell if you just don't get along with it at all, or whether the change in hormones is what's caused the increase in problems. It's hard to know whether to stick it out or just switch and save yourself a miserable experience. It has taken me a year to figure mine out, and it's still not perfect.