Do I need to accept HRT is a series of trade offs rather than a total solution?

[Wonderbug81]

I was fine with Oestrogel 3 pumps (alongside Utrogestan sequential) for a couple of years. It was never perfect, still had a lack of motivation, loss of libido, fatigue etc.

Then I totally stopped absorbing the gel (lots of symptoms incl anxiety, cardiovascular issues and depression).

Moved to 75 Evorel patch (twice a week) and feeling much better but still spotting on and off after three months which is an issue on various levels.

I did originally try 50 evorel after gel and was OK but still not feeling great and had some anxiety.

I moved to continuous Utrogestan 100 mcg daily at the start of the year as it had been a few years and that has helped with side effects of that and there was no spotting etc. Blood tests via menopause doc also showed v low testosterone so I would like to try that.

Basically though whatever I do, it seems like there will be issues. It's all been verified by (private) menopause doctors but I need to speak to yet another one.

Do I go with 50 evorel patch so I at least don't have the spotting and hope testosterone helps with the rest?
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Yes, HRT like any medication can cause side effects.
Some of these have improved for me but some are still an issue months later.

@Piggles1979I've been on testosterone about 7 years. No side effects.

@Doodledoggle and @JinglingSpringbells thank you. I’ve requested an appointment with my GP to discuss Mirena and testosterone.

I've got a hairier neck - the part under my chin. But not like a man's hair. And I was always prone to the odd wiry face hair.

Feels like the goal posts are moving constantly.

I started on Evorel 50 / Utrogestan 100mg daily and that worked well for a year.

Then symptoms returned. Upped to 75 and symptoms much the same and spotting for 6 months.

Now on Everol 100 and 200mg Utrogestan for the last 4 weeks, spotting stopped, but waking up in the night hot and sweaty now every 2-3 days. Not sure what they will suggest next. 🤦🏻‍♀️ she did mention possibly swapping to gel if the 100 didn’t work.

I would definitely discuss higher dose with your doctor.

But if you've got low testosterone, that is the thing I'd focus on. For it to be low enough for them to actually NOTICE means it's pretty damn low. for me, going on testosterone did help with the libido, but actually, the main benefit seemed to be that overall my resilience just improved. Physical, mental etc. It's hard to explain but I wouldn't give it up.

The other game changer for me was when the menopause doctor insisted I try vaginal oestrogen alongside my regular one. That has helped a lot with sleep in particular.