Have I made a mistake going on HRT

[Dobie54]

I'm 39 and have posted about starting HRT. I'm on my second Evorell 24 patch and honestly feel worse than ever. I'm not sleeping more than two hours a night now, laying awake and buzzing despite being tired. My anxiety is truly off the scale, I feel paranoid, disassociated and too scared to leave the house. Brain fog I thought had cleared and I'm a writer so this was great, but today I could barely proofread a sentence. I'm a mum to two small children and I'm freaking out that this is the new status quo. I cannot go on like this. I still have the addition of progesterone to contend with before my period and worried how my mood might decline even further. I'm not sure if I should push on through as posts suggest it will settle, or just give up. My symptoms were life inhibiting, hence why I plucked up the courage to try something.

I've no great advice as I'm attempting my third try on hrt, which have all proven problematic this far. This time round though, I've started the oestrogen with half a pump of gel each day as like you, my anxiety was uncontrollable on two pumps. It's been less than a week and I feel somewhat jittery so we'll see. Would you be able to request the gel instead of patches, as it's much easier to move up and down with dosing?

This is a good suggestion, I’ve recently started on gel and specifically wanted it instead of a patch in case I needed to adjust the dose

I think we need to know more about why you're on HRT at 39.
It's very young because the average age of menopause is 51/52 and although peri can start years before that, 39 is still young.

Evorell 24 patch What is this? Most patches last for 3-4 days.

What symptoms did you have?

Sorry, Evorell 25 and yes, changed twice a week. My symptoms were extreme irritability, brain fog, aching legs at night, anxiety, complete loss of libido after my daughter was born which has not recovered and loss of interest in life. My mum went through menopause at 40, so my GP thought it wasn't that far away from being a possibility.

Thanks for this, maybe I'll request this instead x

It's worth a try? Have you done much reading around the impact of different hormones during peri? Up til this point I hadn't realised that oestrogen is not always the anxiety reducing saviour it's made out to be. And it's progesterone which naturally declines first and is actually the calming, soothing hormone. I think peri is especially tricky as we have our own oestrogen spiking in the background and if we add in more estrogen it can lead to waves of anxiety.

I've probably done too much reading 🤣 but I was desperate so thought it might be worth a try. I'm close to just stopping but the only up side is my rage has calmed down significantly and I'm able to parent my two small children without raging at them constantly, which was my main impetus for the GP trip. I've been tested for everything under the sun so I just don't know where I'll turn next if I can't make this work. I've had some dark thoughts about the idea this might just be me now forever 😔

Have they checked your ferritin levels? My brain fog is terrible when its resources low. Hrt won’t help that though as it’s iron that’s needed for low ferritin.

I know what you mean, it's a bloody nightmare and especially when you don't respond like the majority of people, who report feelings of wonderful euphoria and blissful serenity within two weeks of hrt! Hold in there and see how you get on with the progesterone phase; you might be pleasantly surprised. That's what I'm telling myself anyway

Yes, ferritin was fine on my last test 🫤 I take Spatone as part of my supplements as well. My grandma had dementia and I know it is unlikely at 39, but the level of my brain fog and my inability to do tasks I was flying through last summer has freaked me out so much.

@Dobie54 I'd say the patch is far far too low. The symptoms are probably not from HRT at all but your own lack of hormones hitting you hard.

25mcg is the lowest dose available.
For younger women, many settle on 50mgs or even 75 or 100.

You should see your GP but as an experiment, you could try using 2 patches at once and see how that feels.

I'm not a medic so please don't do this if are unsure but certainly with gel it's possible to increase the dose by yourself from as low as half a pump to 1 pump up to 3 or 4.

That's interesting! I've requested the gel today so I'll see what they say and maybe I can experiment with it. Feels scary to add more but I understand what you're saying about symptoms probably being from hormones not the patch.

I started getting symptoms at 39 and my mum was the same and finished at 44. I have had anxiety and disassociation type feelings which correlate to when estrogen is rising, feels like someone has the foot on my internal accelerator.

Research suggests progesterone dips first overall and then oestrogen but everything is swinging up and down at first. You’re not alone, I found it hard to leave the house.

Maybe ask for a review. Only things that helped me were keeping a really good diary for the gp and so that I could correlate issues.

Exercise even in bite size chunks, fresh air even if only the garden, sleep, nutrition all the usual.

After 3 months on hrt it has begun to even out but the swings are hard and we are all different.

Also keep an eye on thyroid function too if you have fatigue and anxiety. Good luck op.

Thank you so much, this sounds so similar. From what I have read, 39 is not too young. I'm massively anxious about health and medications so I must have been desperate to try it. Weirdly I feel much calmer every evening, but the morning cortisol and ratty feelings are so overwhelming. I have messaged my GP with my symptoms x

Hi all oh I feel so bad today….headache brain fog and crippling anxiety- this all started a few months ago. I have dry eye too unknown if linked but my god I feel so MISERABLE- like I’m living in someone else’s body
I only started HRT today and came on to find some hopeful success stories but I’m so scared
i have other stresses going on in life at the moment not helping but I want this feeling to go away 😭I know I’ve only just started today but I was so worried about starting but decided it’s worth a go when I feel so dreadful but scared of feeling worse ! I can barely function as it is 😩

Don't worry, give it a try and you might be pleasantly surprised. Although my post was very negative I do have moments of the day where I suddenly feel a bit more normal and I can laugh again, I wonder if these moments become more frequent after a while. You can do this!

Have you had your B12 tested?

Have you actually had blood tests to see if you are actually oestrogen deficient or have obviously raised FSH. You should have 2 blood tests if under 45? It is normally a hoop to jump through, but sometimes it is a safety measure.

@Dobie54thank you that’s true….we shall see
ams yes maybe it will just take time to adjust
fingers crossed for you

And it's progesterone which naturally declines first and is actually the calming, soothing hormone

But many women feel moody, irritable and bloated in the 2nd half of their cycles.
Progesterone is the cause of PMS and moods in the 2nd half of a cycle.

Progesterone only dips if there is no ovulation.
Post menopause women don't ovulate. And they have no progesterone at all.
HRT supplements estrogen (it's low estrogen that causes the symptoms.)
Progesterone as part of HRT is only included to prevent overgrowth of the womb lining.

@Dobie54 Maybe you ought to ask your GP to refer you to a gynaecologist who deals with early menopause. You're having a lot of symptoms at an early age and your GP may not be familiar with all the types and doses of HRT.

My first fortnight on oestrogel was an emotional rollercoaster, I felt worse than ever! I levelled out soon after and feel much better now, 12 weeks on

Good luck, you are not alone

I get the poor slerp, early morning cortisol and buzzing when I switch doses, it takes over a month of stability on a dose to subside. I was worse on the gel, I don't think my body liked the small fluctuation in dosing.

@Dobie54 How are you doing now? I pretty much could have written your post.

I feel bad when taking nothing, hence trying the HRT, feel bad on 1 pump AND now feel bad on 2 pumps. By bad, I mean complete and utter despair and dark thoughts. If I could know for sure 2 pumps is going to be great and the side effects, as bad as they are, are going to be temporary, I could bear it. It's the fear I'm doing damage and maybe shouldn't even be on HRT - even though I know some symptoms have improved and some gone away entirely. Unfortunately, the ones that have improved/gone away were the least bothersome ones!

I feel totally stuck and not sure what to do next.

Hey, so yes, the good news is that things did improve for me. I am now on .50 and my rage has levelled out. I have however had a strange nervous system response to HRT as a whole, which triggered ectopic heartbeats. I have. had to cut out caffeine entirely. My periods have gone from being every 50 days to every 19 days :/ and I have really bad weepy PMS around my period. I would say overall I am better than I was before HRT, I mean the bar is LOW, but it hasn't yet answered all my questions. Progesterone was an issue for me on 200 mg cyclical, so I now take 100mg every day vaginally.

How long has it been? I would give it the full three months to settle and see how you feel. Also consider if Progesterone is causing any of the symptoms you describe. When I increased my E dose, I had some more racing thoughts, anxiety etc, but now know they do settle.

Sending solidarity!

@Dobie54

Oh I'm so pleased to hear overall you're doing well - that definitely gives me hope - but sorry to hear it's triggered something else!

My GP told me continuous HRT would mess with my cycles too much and advised me against that. I wonder if that could be what's causing your 19-day cycles? It doesn't sound pleasant - I was at my wit's end when they went from 28-30 to mostly being every 24-26 days!

I have taken progesterone vaginally from the get-go just as I had a feeling it would affect me as the progesterone-only pill did, and anything I could do to modify that risk was worth doing! I don't think urogestan actually affects me too much. I seem to be better in luteal than I was pre-HRT except for around CD25, when I haven't had enough urogestan to stop taking it yet but where I can feel my natural cycle is probably trying to start having a period, so it's probably less urogestan and more my own cycles wreaking havoc underneath, as I suspect may be at the heart of my entire issue.

I started HRT on 1 Feb, 1 pump estrogen, and switched to 2 pumps at the 3-month mark. I think that's now the equivalent dose you're on?

I've been (not consistently) keeping a diary, and I've just read my entries from this time last month and it's almost identical to how I feel now, despite upping my dose this month and despite being at the end of the 3-month adjustment period last month. I'm not sure what to make of it all. I think I'll try and hang in there for at least one more cycle, as hard as it may be (understatement!). I hope things continue to improve for you!