Testosterone or WLI? HRT weight gain and no mojo

[WeAreStillHere]

Would be interested in any advice / thoughts on what next for me. Thank you in advance!

I am 55 and have been on HRT since Jan (just upped to 3 pumps gel, continuous progesterone, stopped periods at 47).

I went on HRT cos fatigue, poor sleep, joint pain, loss of mojo, and family history of osteoporosis,

Sleep and joint pain better (but joints pain not completely resolved and it made me realise how much it was affecting my life). I have gained HRT weight (2 stone, BMI now 27) and have no mojo at all. Mojo drives healthy eating and exercise for me. I have stopped running because I can’t get out of bed to do it atm. Food noise has been a lifelong companion so these things are driving the weight gain.

i have a tendency to higher cholesterol (was 7.8; got it down to 4.9 pre HRT but is creeping up again now to 5.8). Family history of heart disease and I have some risk factors (pre-e). Blood pressure is ok but higher than it used to be.

i want my running mojo back, and my food mojo as it will (I think) fix everything else. Less/no joint pain would also be amazing.

Do I try testosterone next (fix mojo and therefore fix lifestyle stuff) or try WLI? (Fix food noise, extra weight on joints and maybe general inflammation therefore less joint pain).

WWYD? Money is a consideration but not the first one. What else should I be thinking about?

Thank you!

I'm not sure on your questions having never tried either, sorry.

But I did recently learn that low estrogen increases cholesterol xx

Not taken either myself but from friends’ experiences I would try testosterone first for the mojo/energy aspect which might drive other benefits.

I started androfeme 2 weeks ago and within 3 days I felt really calm, my brain fog had gone and I had more energy/mojo. Its sort of given me a 'can do' attitude. The other thing it's done is it's made my orgasms really fast and consistently stronger.

I had to say it was for low libido (even though I don't have a low libido) and have a baseline bloodtest. My baseline testosterone was 1.0 and I'm mid 50s so a bit older than you.

I started on the standard 5mg dose but I've reduced it to 2.5mg because I was permanently on heat which was inconvenient and I'm paranoid about hairloss.

I'm also on everol 50 and I utrogestan and vaginal oestrogen too.

Obviously, it might not affect you in the same way, but that's my experience of testosterone which so far has been very positive.

oh i've just been for a HRT review because I could have written your post. My other symptoms are pretty much ok apart from my mood and "get up and go". I'm on oestrogen & progesterone and still having periods. I think she thinks i'm depressed but we've agreed I'll increase my dose for a couple of months to see if it helps. Never thought about testosterone, does that only apply if you've stopped having periods??

Thanks for your thoughts.

@Additup I have zero sex drive but that is bothering me less than lack of mojo 😂. Thanks for sharing.

@MiddleAgedDread yes, I think my GP suspects depression but that doesn't feel right to me, and I would like to explore other options before considering SSRIs. She has put the oestrogen up (I was on two pumps) to see if that helps. Re testosterone -- yes, it can be prescribed as part of HRT while you are still having periods I believe; and in the UK it is only prescribed for "lack of sex drive" which annoys me (I mean, you don't want to have sex with your husband / partner? must fix with hormones. Oh, you have no energy and can't be bothered to exercise? tough shit.)

I have to say I am tending to trying testosterone next, but I can't figure out if that's me just being paranoid about WLI. I know for WLI to work you have to be organised / disciplined with your diet and actually it's the being arsed to be organised that I am currently struggling with.

I'm already on 3 pumps so she's suggested increasing it to 4 and the progesterone from 2 to 3 tablets. My other concern is that this is the max dose so no room to increase if other symptoms get worse (which they were on 2 pumps). Maybe I am depressed, I dunno, how do you know?? Everything just seems to be getting me down at the moment - I'm injured so it's impacting my exercise, I'm gaining weight (HRT, lack of exercise, too much "stress wine"??), work is crap and I don't enjoy going in the office, my OH is stressed about various issues (and ironically has lost his sex drive), parents are getting older and have been worryingly ill, best friends have stuff going on that's adding to my worries etc.

@MiddleAgedDread progesterone can cause depression like symptoms -- has your GP talked to you about mirena coil? There is now way in hell I am upping progesterone tabs so will do that if GP suggests me going up to four pumps next.

The "are you depressed" question is such a hard one. Yes, I am tired and low and finding life difficult but ... life is actually categorically quite difficult atm.

And I really feel you re being injured. That's the thing that always tips me over the edge. Sounds like you are in a tough place.

A friend of mine recently went to the GP about depression / anxiety (triggered by really seriously shit domestic life that she can't do anything about) and the GP was brilliant but said "let's work on getting the HRT in place and titrated as well as we can for you, and then see what symptoms are left that we might be able to help with" which I thought was 100% sound.

@WeAreStillHere i had a mirena years ago to supposedly help with the heavy bleeding caused by fibroids. Worst year of my life and definitely won't be having one again (most of it was probably due to the fibroids but it's not a risk I'm willing to take!)
That's basically the approach she's taking too, let's see what changing the HRT does and take it from there.

Testosterone was miraculous for my libido but did nothing for energy levels.

I'm still exhausted. And my ferritin is over 100 and my b12 levels are normal.

But I do eat well and even when I was at my worst hormonal crying state, I would exercise as I know it's the best thing for me.

So maybe wli would be more effective for you.

Food noise has been a lifelong companion so these things are driving the weight gain.

You talk about' food noise' so are you eating more?
Progesterone can increase appetite but it doesn't mean it has to be 'obeyed'.

I'm not sure from your post if you're overeating or not.

I'm one of the those on HRT long term (over 15 years) and put on no weight.
I have had to adjust what I eat though as I'm old!

You might want to reconsider being on continuous progesterone. It's perfectly fine to carry on with sequential HRT ( 12 days a month) long term if you can stand the withdrawal bleed. I know my appetite for sweet stuff increases on the progesterone part of the HRT cycle and it takes a lot not to give in to it.

I’m on both and reduced my oestrogen. You store oestrogen in fat cells, so when you lose weight it releases using WLI. I lost 3.5st then started on testosterone and it’s taken 3months to feel benefit on sex drive from zero to slight interest plus the topical oestrogen that you insert. Did testosterone via Superdrug doctors privately as struggled tp get GP moving at snails pace (by the time they invited me to see nurse for a blood test to even start to consider it I had done the blood test myself, got the results and had the drugs posted and been on it 2 weeks!)

@JinglingSpringbells ... so yes, weight gain because I am eating more, and yes that's because of the food noise combined with lack of drive to do the difficult things.

One of the joys of stopping my cycles was the food noise went away for the first time in my adult life. I lost the 3 extra stone I had been carrying with no difficulty and it made me realise how "cycle-related" my over-eating was.

HRT has been game changing for me in terms of sleep and joint pain, but the food noise is back. So my weight gain is clearly because I am eating more, but I also think the drive to eat more is part of how I'm responding to the hormones.

I am more concerned about my lack of drive to do the difficult things because I know they are good for me, which affects my desire to exercise and make the effort to ensure I'm eating healthily (I used to prep meals 24 hours in advance so I could just pull stuff out of the friedge when it was time to eat ... I do that every third day right now cos I CBA often). I could live with the extra weight but I really am not enjoying the loss of mojo and am missing the ease I used to get out of bed and go for a run.

Interesting that you have noticed a relationship between progesterone and wanting to eat sweet stuff.

@PunRunTea have either affected your general energy levels? (WLI or testosterone)? How did you know to reduce your oestrogen? Thanks for sharing.

This might sound a bit dismissive but are you able to afford a personal trainer? Seeing someone at the gym or coming to your house?
Finding a motivational 'coach' to help might help. Or joining a group of women runners? Being committed to something regular often helps.
And some distraction strategies for when you eat to replace something else going on in your head- comfort eating, boredom, unhappiness, whatever it is.

BTW I'm not sure that PP is on the right track about reducing estogen= reduced fat.

Fat helps the body to produce estrogen. Which is why being overweight adds to the risk of hormone-driven cancers.

But reducing estrogen doesn't equate to losing fat. In fact the opposite it the case. Post menopause, women's fat distribution changes and fat goes onto the abdomen which is a high risk for CVD etc.

Think about or look into going low carb. You can eat more, but appetite regulates quite quickly. Also, low carb is high fat, and women need fat in order to make hormones. If you add a home made bone broth every day your joints will improve too. It is also incredibly cheap and easy. I wouldn't worry about cholesterol in itself, as if you look into it, higher cholesterol IN WOMEN, associates with lower all cause mortality.
Best wishes, and all the best.

Yes loads more energy and clearer thinking the best bonus of WLI was reduced brain fog & inflammation in my joints from Day1. I exercise daily, run 3x a week, do some weights & walk lots I’m mid 50s.

To add, I was doing all the “right” things prior to WLI eating more protein, less carbs, exercising lots , fasting 14hrs+ daily, but just constantly craving carbs & sugar. I just could not break the cycle, would spend 3wks trying to lose a lb then gain back 2lbs in a week. I carried on doing all the other things but with mounjaro suddenly I was losing 1-2lbs per week every week and the weight just steady went down.

This isn't correct about fat/ estrogen/ heart health.

Fat (ie body fat) produces estrogen which is why being overweight is a risk factor for breast and endometrial cancer post menopause.

Women can't get away with having high cholesterol- heart disease is the 2nd highest cause of death in women in the UK (and was the 1st until dementia overtook that.)

Loss of estrogen post menopause is one of the factors because estrogen keeps arteries flexible and not so likely to narrow with plaque.

Women's heart health is around 10-15 years behind men'' as they have some protection up to the menopause. After that, they match men's risk.

Or do both! I did both at the same time. I've lost 3 and a half stone ( put on pre HRT) and got a lot of my mojo back. I feel normal.

It's a lack of oestrogen that causes weight gain. Fat cells contain oestrogen and so our bodies are desperate to create oestrogen ergo to create fat. My menopause specialist told me that.

You need to be on an optimal dose if oestrogen before you have testosterone, otherwise your body converts it to oestrogen. So you should try upping your oestrogen dose first- my symptoms weren't fully alleviated until I was on the highest dose. They only prescribe testosterone for lack of libido, so you have to tell them what they want to hear.

Thanks, all. Lots to think about.

I keep flipping between "mojo is down cos life is hard and I'm stressed and there's a lot going on and I need to give myself some grace" and "FFS WeAreStill, pull yourself together and do something about it, and accept you are not turning things round on your own and yes, life is hard, but it always has been, and that's not changing in the short term and you can't let your health go to hell in a hand basket at the same time as that will just make everything worse long term."

I've had a longish term family-related stress appear to turn a corner in the last week or so and I feel (physically in my own body) SO MUCH better. Being at this life stage has so many variables that impact how we feel it's hard to separate them out and figure out what the best next step is.

I'm not going to do anything for a little while, but appreciate the thoughts here and will think on them. Will consider both WLI and testosterone (or both!) as potentials for the future and will see how I go.

@JinglingSpringbells thank you for the suggestions: already do group PT and that's the only thing I've managed to keep going in the middle of all of this so at least I'm not losing muscle strength!

@Raccoonswillonedayrevolt have done low carb, and have done low carb and high fat and that ended up with my high cholesterol so I have stepped back from that. I follow a Zoe-ish diet most of the time (lots of variety of plants and grains, keep an eye on protein to keep it high, keep an eye on fibre to keep it high, try to focus on healthy fats) so what I eat is pretty good for the most part I just eat way more than I need.

@Bulbsbulbsbulbs -- how do you know if you are on enough oestrogen that your body wouldn't convert testosterone to oestrogen? Do you test both regularly? I've just upped my dose of oestrogen and (so far) feel exactly the same so it makes me wonder.

@WeAreStillHere regarding oestrogen levels, no, there's no point in testing as even on HRT oestrogen levels still fluctuate.

One of the things my GP did was check my vulval tissues, she said that gave her a good idea pre testosterone blood test.

Realistically there wasn't much more I could do as I was already on 100mcg patches!

Is HRT supposed to help this?

I've had low cholesterol until very recently when it suddenly shot up and I now have high cholesterol.

It's really taken me by surprise as I'm only 40, very slim, have always done lots of regular exercise and eat a really healthy balanced diet - although I do eat butter on toast, eggs etc. I'm not exactly eating cakes, takeaways and fry-ups.

The only thing that has changed is my periods are coming to an end. But I've been on HRT a couple of years now. I'd sort of assumed this would give some level of protection against the low estrogen related health risks...

@BellsAllTheTime I'm wondering why you are having your cholesterol tested. Is there a reason? (Many people never get a test on the NHS.)
Are you 'at risk' and is this part of being considered having an early menopause?

I'd be asking for a more specialist input. Some high cholesterol is genetic and food etc makes little difference.

What is your GP suggesting? Are you on statins or working on your diet?

HRT does supposedly create a more favourable lipid profile which means it can help cholesterol stay healthy with a higher ratio of HDL.

I think you need to talk it over with your GP and ask to be referred to someone for advice.

I am on estrogen and continuous progesterone after an ooperechtomy last year.
2 progesterone and 3 or 4 pumps of estrogen, I alternate the amount of pumps because 3 wasn't enough but 4 was too much.
I have a great GP and a few months ago went back as the exhaustion and lack of any emotions lead me to believe it was depression but the GP didn't agree and sent me for bloods. Ferritin was extremely low as was vit D so I've been taking prescription vit D and iron for the last 2 months and what a difference. My energy levels are so much better, I can stay awake past 9pm, I wake up and feel like I've actually slept and can now function rather than just exist.
I was given testosterone but haven't really been keen to start to so it's sitting there if I want it.
The weight gain has been horrendous though and I've applied for WLI and with a BMI currently at 33 I should get accepted.
I'm not sure how helpful any of that is but you're not alone in trying to navigate this new chapter and still try to retain who you are.

I actually only had it tested because it was part of a package deal of some blood tests in a private testing place, I actually wanted to check iron and thyroid (both of which I've always teetered on the edge of normal range for) because I'd suddenly been feeling really excessively fatigued. It was just cheaper to pay for the iron & thyroid as part of a package which included cholesterol than 2 separate tests.

The only reason I know my cholesterol was low before is because I participated in some medical research over a period of time, so I know at age 30 and 35 it was low in the normal range.

I certainly wasn't expecting the cholesterol blood test to say anything interesting. I'm yet to discuss the result with my GP.

Thanks for the info. I'll follow up with my GP.