Feeling flat

[Cherryblossom200]

Hello!

I’m 51 in a few weeks, no periods for over a year. So menopausal now. I’ve been on HRT for a number of years, estrogel and ultrogestan. The anxiety and depression feeling and largely gone, which feels good. However I feel very flat and have done for some time which seems to just get worse. Not get up and go or zest for life. A couple of years ago I had my testosterone tested and it was fine.

I normally take ultrogestan once every evening, I’ve not had any issues with it and liked the calming effect it had on me and helped me sleep. I also take two pumps of estrogel at night and recently introduced a further pump in the morning. I can’t take estrogen orally, so the gel is the only way I can take it.

I have no idea if maybe I have too much estrogen and that’s making me feel this way.

I have a lot of life stuff going on and a very sick dad who isn’t going to get better. So I think this is adding to it. But at the same time I feel it’s a lot to do with my hormones too.

Does the flat feeling ever improve?!

No idea @Cherryblossom200. I’m a similar age and feel exactly the same. Watching the responses with interest.

They usually recommend oestrogen in the morning, progesterone at night. Try taking your 3 pumps in the morning and see if it makes a difference. You may also need to increase your oestrogen dose, but try the morning dosing first

You may also need to increase your progesterone dose as you've increased from 2 to 3 pumps. Have a chat with the doctor about it

I can so relate. Flat sums it up. And annoyed!!! Everybody and everything gets on my nerves!!!

Testosterone changed this feeling for me.

Upping my Oestrogen resolved this for me and moving from gel to patches.

More oestrogen fixed this for me. Testosterone has also helped but in different ways.

@Cherryblossom200 Best thing to do is trying upping your gel to 3 pumps for a few weeks. Many women need a bit more once they are post meno.

If you want to split the dose morning and evening, that's something recommended by the BMS for women using 3 or 4 pumps. (There is no guidance about applying it in the morning being 'better' than evening @Lottapianos .)

You only usually need consider increasing the Utrogestan once you get up to 4 pumps (again, BMS guidance on endometrial protection.)

I'd not underestimate the impact of what's happening with your Dad etc.
Also, are you doing exercise? The endorphin boost from exercise can help as much or more than HRT. Brisk walks for an hour a day can help.

(My menopause consultant is very pro HRT but they are also very insistent that it's not a silver bullet on its own and exercise/lifestyle etc is also needed.)

Thanks everyone, most definitely it’s a combination of hormones and the feeling of grief.

I have a dog and walk a lot, normally over 10.000 steps a day and sometimes more if I use my walking pad. I’m going to start swimming soon as well I think.

I was using the gel every evening, two pumps and taking my progesterone then too. Since switching to taking in the morning and upping your three pumps I feel like utter crap. I literally feel like I’m not actually here if that makes sense, like I’m in someone else’s body. I have no emotion, no happiness no joy nothing. It’s very odd.

So I took no estrogen last night and feel actually a bit more normal this morning.

No idea what’s going on 🫣 But I want a break from it for a day or two to give my body a rest.

To be honest you won't see much difference that is linked to no estrogen in a day or two. I've stopped my HRT twice to see how I go on. The first time I was fine for a month , the second for 2 weeks. My consultant said give it 3 months without, but I had to tell them I couldn't!

Have you only just started using 3 pumps? Since you posted yesterday?

You can't expect an instant 'fix' .
Again, medical guidance is give any new dose 3 months. It's too soon after a day to expect anything to change. It takes time to build up in your system.
Feeling awful is more likely to be a sign you need more, not a reaction to 1 extra pump for a day. (If that's what you've done.)

I'd really suggest you keep to an increased dose for some time before deciding it's not working. Try 3 pumps and split the dose morning and evening.

I think you're describing disassociation?

https://my.clevelandclinic.org/health/diseases/9791-depersonalization-derealization-disorder

That link makes it sound like some kind of big mental health disorder, but mild disassociation is actually quite common.

A lesser version is just getting very caught up in something to the point you don't notice what's going on around you.

@Dingaling47I think you are right, I think I’ve linked it to recently taking powder collagen. I’ve done some research and it can lower seratonin levels and make you feel flat! Which is exactly what’s been happening. My skin in glowing though 🤣 But I need to reduce the dose or take it at night.

Today I feel fab and not taken my estrogel. I’m going to take two pumps in the evening again which worked nicely. And stick to that for the time being.

ah I’m sorry for wasting everyone’s time! x

Oh really ?! That's a bugger... I was literally just about to start taking collagen for some joint problems !

I don't think you've wasted anyone's time. I said a lesser version is quite normal because I felt that description of dissociation in my link sounds a bit extreme and didn't want to do internet-diagnosing you with some pathological condition.

Disassociation is also quite a common sign of depression, PTSD etc. it's the degree to which you are feeling it has an impact that's relevant.

I find it happens to me with big swings in hormones - it's like I'm suddenly not mentally participating in life anymore. I did find it quite panic inducing because it happens quite abruptly to me (usually when I've left a patch off), but now I understand a little more about it and how to manage it, it's receeded a bit.

It's most commonly associated with PTSD because your brain is separating you from overwhelming feelings, but there is a link to hormonal triggers because of the way changing hormones affect your brain chemistry.

It has never happened to me in a moment of upset, it is purely an effect of sudden increase or decrease of estrogen.

Thanks for sharing the thing about collagen - I will think twice !

The collagen powder has been amazing for my skin, but I’ve cut the dose in half and take it now morning and evening to spread it out which works now.

But I’ve reduced my oestrogel pumps to just two and night and none in the morning, and I feel great. No low mood, woke up feeling so much better.

I think I might have had too much estrogen, I was showing signs of estrogen dominance which felt horrible!

PP point about slow changes is right though - oestrogen builds and drops very slowly - 1 extra / 1 fewer pumps won’t make such a dramatic difference so quickly. It takes weeks for the change to take effect so I’d wager the correlation you’ve seen is coincidence / something else and nothing to do with oestrogen as there won’t have been any measurable increase during the few days of 1 extra pump!

@Cherryblossom200 you're not wasting anyone's time. I've never taken collagen and up until a few years ago my diet was horrendous, tesco meal deal for lunch and a ready meal was all I could do. My peri menopause symptoms started during lock down whilst I was dealing with a divorce and working throughout so I put it down to stress. I started HRT 4 years ago and did improve a lot of symptoms but I still lacked motivation and felt flat, so I'm on my second month of testosterone and it is getting a lot better. I'm hoping this is the final piece of the jigsaw. I have also worked on improving my diet and get out for a walk most days. I hope you feel better soon.

I think you’re right, the testosterone part is missing so I’m going to get my hormones tested again .