Restarting HRT

[twig1234]

Hello, I have been on Evorel 50, mirena coil and Sertraline for 3 years. Two high FSH results age 40 years. I have various symptoms and increased my SSRI as anxiety with driving and work was worsening. I also had a break from the HRT as felt worse at times with mood.

I now do not recognise myself and feel very low and detached. I’m not sure I should be taking the sertraline anymore and should restart the patches. I cannot pin point anything that helps and just feel lost with it all.

If anyone has any advice? Thanks

I don't know that much but I do know that anti depressants are not necessarily effective if perimenopause and fluctuating hormones are driving mood changes.
Maybe talk to your GP or see it you can see a specialist. At the very least it would seem worth trying a different HRT regime and / or a different antidepressant. It can take a while to get the right medication on either count 🌻❤️🦋

If it's any help NICE does not recommend SSRIs for menopause and they said this as far back as 2015. The guidance says estrogen should be tweaked- usually up- and / or different form of progesterone offered and tried.

There is also some risk that using SSRIs clouds the correct dose of estrogen because it's impossible to know which of the 2 drugs is working or not.

GPs should not be prescribing SSRIs and the guidance is very clear on this.

You might be better on Oestrogel rather than a patch as you can adjust the dose yourself every few weeks (with GP okaying this at the start) so you get the right dose.

You might also want to reconsider the progesterone side unless you're happy with the Mirena. Many women now start on micronised progesterone.
If this is beyond your GP's expertise (which is very common) it's worth thinking of a private appt with a specialist to help you.

Are you 40 now or did you start HRT at 37 or 40?

If you needed to start HRT at 40, were you having an early menopause (no periods) or did you not know because you had a coil?

A 50mcg patch is quite low for someone as young as you. (I know much older women in their 60s and 70s on that dose.)

You may need 75 or even 100mcg patch.

If your periods had stopped at 40 (or 43) that is considered a premature or early menopause. Medical advice is this needs treating to protect bone and heart health with HRT at least to 51-52.

Thanks all. I started before 40 with long gaps between periods and then they only lasted one day. No mirena coil then and had lots of tests as also diagnosed with eosinophilia . Joint pain etc and mood changes.

I think I will arrange a private consult and look into the different types of progesterone. I started with conti and when I took the progesterone/oestrogen patch’s for last two weeks of cycle my mood plummeted even further. So moved to coil and the patch.

Thabka again for taking the time to reply to me

You seem to be almost in the premature menopause group so your GP really ought to refer you to a specialist gynae who deals with this.

Ask them?

Might be a very long wait so privately may be better.