Did anyone find HRT symptoms worsened before things settled down?

[TabbieMctatty]

Hello. I'm hoping some of you may be able to share your experiences with me or maybe just a place for me to vent!

Did anyone find things got worse with HRT before they got better? I'm 45 years old and on the second month of HRT I'm doing two pumps of the gel daily and taking the oral progesterone for the latter half of my cycle. I went on it mostly because my mental health was in tatters - terrible anxiety, mood swings and I was just horrid. Zero libido and feeling very hot and achy all the time.

In the first month I felt better within a couple of days of using the gel. I appreciate that it could have been psychological though. I felt a lot calmer, a lot less anxious and whilst not back to my old self a lot better. Fast forward to month two and all of a sudden I've got the most horrendous hot flashes. I am so uncomfortable and it's starting to impact my daily life, I've never experienced anything like this!! My anxiety and mood swings seem to be back again and on top of all of that my skin is breaking out like crazy and my face is bright red and covered in acne which is new (I suffer from rosacea but not had acne).

I've made an appointment to see the GP but they had nothing available for 3 weeks. So I just wondered if anyone else had experienced things getting worse before they got better and what this might mean. Is the dose incorrect? Is the delivery method wrong? Should I stop taking the HRT? I felt so positive last month and now I feel like I'm back to square one, if not worse because now I have these hot flushes to contend with, horrible sore skin and all the anxiety is back.

I just don't feel like me anymore. I feel like my poor patient husband might walk out on me at any second and I can't blame him! And my poor kids deserve a happy relaxed mum.

You probably need to increase the dose.
You can use up to 4 pumps of estrogel.
At 45 you're young (I didn't start hrt till early 50s and 2 pumps was fine but for younger women they often need more.)

You could try increasing to 3 pumps and see how that goes.
I don't know what your GP has said but there is supposed to be a review after 3 months to discuss the dose. As you can't get an appt for 3 weeks, it's worth upping the dose.( Obviously if you have any medical conditions that may be an issue, wait to see your GP.)

You can also try using it am and pm (the British Menopause Society suggest this for women on 3 or 4 pumps. Do 2 in the morning and 1 at the end of they day. )
Don't apply over sunscreen or body lotion and ideally not straight after a shower with shower gels.

If you go up to 4 any time, you may need to increase the progesterone too, to avoid breakthrough bleeds, but that's further down the line at the moment!

Thank you, that's really helpful. It's all such a minefield and trial error! My GP is thankfully great but it's just hard to get an appointment for non urgent. I might try 3 pumps and see how it goes until I see her in a few weeks.

I have been applying after my shower, hmmm that's something to think about then. I sometimes wonder if the patch might be easier as I'm struggling to find windows to apply the gel!

I apply mine in the morning after a shower but leave a gap of about 20 mins. The apply the next dose at bedtime again after a shower. (I only use 2 pumps max and sometimes just one but split the dose for 2.)