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[Butterfly22]

Evening ladies, I've not been on for a while but really finding my emotions hard now.

[babyjane]

Lila hello, I would like to reply to your post but I have to get ready for my aqua therapy class just now so I will be back later to talk to you.  I didn't want to just read your post and move on without saying something.  I have experience with a lot of what you say although I don't use systemic HRT.

See you later 

Right, I am back with a bit more time.  as I said above, I have no experience of HRT so hopefully one or more of the other members will post about that for you. However I have recently been started on Citalopram for a depression that I didn't even realise I had and also propranolol for anxiety.

I had a hysterectomy aged 38 and although my ovaries were left no one advised me that they could atrophy and slowly stop working properly as there was no point of reference from the womb.  When I was about 44 I started to have random strange symptoms and my GP tried me on SSRIs and HRT, neither of which I could tolerate.  I spent a lot of money on alternative therapists and, to cut a long story short, in 2004 I was diagnosed with ME at the National ME Centre in Romford after my GP surgery refused to refer me as there were no services for ME in our area back then.  I, too, have chemical sensitivity and also alcohol and certain foods.  I am a nightmare to medicate (my doctor's words said kindly) and don't use any air fresheners, bio washing powder or toiletries or household cleaners with chemicals as I react strongly to a lot of things.

When I hit the menopause my ME, which had been stabilised, became unstbale, as did my underactive thyroid.  the hormonal turmoil upset everything and the last 5 years have been quite difficult.  this forum has helped a lot as it has taught me that what I have experienced is normal for this stage of my life.  I do believe I have Chronic Fatigue Syndrome and so does my endocrinologist as I tick all the boxes for it, but I am not sure I ever had full blown ME.  Maybe I did and I am fortunate enough to have had a degree of recovery and improvement, but I also think my hormonal turmoil had something to do with the early severity of it. I am 58 now and a lot better than I was 10 years ago.

It is my belief that ME, menopause and depression are closely linked and a lot to do with hormonal instability whatever age we are.

[Butterfly22]

Lila hello, I would like to reply to your post but I have to get ready for my aqua therapy class just now so I will be back later to talk to you.  I didn't want to just read your post and move on without saying something.  I have experience with a lot of what you say although I don't use systemic HRT.

See you later 

Right, I am back with a bit more time.  as I said above, I have no experience of HRT so hopefully one or more of the other members will post about that for you. However I have recently been started on Citalopram for a depression that I didn't even realise I had and also propranolol for anxiety.

I had a hysterectomy aged 38 and although my ovaries were left no one advised me that they could atrophy and slowly stop working properly as there was no point of reference from the womb.  When I was about 44 I started to have random strange symptoms and my GP tried me on SSRIs and HRT, neither of which I could tolerate.  I spent a lot of money on alternative therapists and, to cut a long story short, in 2004 I was diagnosed with ME at the National ME Centre in Romford after my GP surgery refused to refer me as there were no services for ME in our area back then.  I, too, have chemical sensitivity and also alcohol and certain foods.  I am a nightmare to medicate (my doctor's words said kindly) and don't use any air fresheners, bio washing powder or toiletries or household cleaners with chemicals as I react strongly to a lot of things.

When I hit the menopause my ME, which had been stabilised, became unstbale, as did my underactive thyroid.  the hormonal turmoil upset everything and the last 5 years have been quite difficult.  this forum has helped a lot as it has taught me that what I have experienced is normal for this stage of my life.  I do believe I have Chronic Fatigue Syndrome and so does my endocrinologist as I tick all the boxes for it, but I am not sure I ever had full blown ME.  Maybe I did and I am fortunate enough to have had a degree of recovery and improvement, but I also think my hormonal turmoil had something to do with the early severity of it. I am 58 now and a lot better than I was 10 years ago.

It is my belief that ME, menopause and depression are closely linked and a lot to do with hormonal instability whatever age we are.

Hi babyjane
Wow thank you for all the information, I feel like crying as I no you have suffered to, I went to the doctors today and she thinks it's more then likely the depression so I'm now trying floroxidene.
She said take 20mg but still 10mg citalapram for two weeks then go back.
Im the same as you don't use air freshners ect and gave up drink seven years ago.
It's so hard trying to get on with things just when I thought HRT sorted my citalapram stop working
Thank you so much for sharing your experience and taking the time to write it all down.
Fingers crossed I'm on the right path xxxxx

[MIS71MUM]

Hello Lila
I'm 44 - and feel exactly the same as you.  I'm crying all the time, I'm peri-menopausal too.  I just wanted you to know that you're not alone.
I take an AD and have stopped taking HRT as was worried it was effecting my mood, or at least giving me pmt which I didn't have before.

[CLKD]

Sounds like depression ………..

[babyjane]

Glad I could help if just a little bit.  All the very best to you 

[Hurdity]

Hi lila

I know we have talked before about your situation and trying to find the right HRT and I am sorry to hear you are still feeling rough.

What I'm going to say is controversial to some extent and I'm coming at it from a different angle than babyjane - but I believe it is no coincidence that mostly women are diagnosed with conditions whose symptoms include a lot of fatigue, aches and pains, anxiety, low mood, depression - leading up to and after the menopause. These conditions are fibromyalgia, ME and CFS which share a lot of symptoms. Women on here have been given the diagnosis (or it has been suggested) when in fact the symptoms have been due to a hormone imbalance - which include hypothyroid, menopause - oestrogen deficiency, and testosterone deficiency (which is not tested).  I myself was going to be referred for possilbe fibromyalgia by my GP because of my symptoms. Some women are so much more sensitive to changes and deficiencies in these hormones - even when they are within normal range - if indeed they are actually tested.

One woman on here was referred for one of these conditions and reported that the gynae refused to diagnose her on the basis that she was experiencing and suffering these unpleasant symptoms (rather than having a medical disease) - and put her on hormone treatment and her symptoms improved.

I am in no way wishing to minimise the suffering endured by women who have been diagnosed with these conditions, but that the medical profession could do more to find out the real cause - rather than condemning a woman to a life of pain,  exhaustion etc with very little help - apart from painkillers and anti-depressants. It may not be the answer for everyone but it might help a huge number of women, and then the medical profession can concentrate on finding out the cause for those women/people for whom a hormone solution is not the answer.

Re your situation - I wonder how many of your symptoms are due to your homone imbalance and early menopause, and maybe not having the right type/dose of HRT from the start, as you were so young? I see that Nuvelle is still available but on continuous combined basis - did you take yours on a cycle? My view would be that you should feel better with the right dose/type of HRT - which means some form of estradiol ( perhpas try a transdermal one if you haven't already) together with progesterone (Utrogestan). I would do this on a cyclical basis until you found the right progestogen that you could tolerate - or even permanently stay on a cycle. Taking them separately would enable you to take a higher dose of oestrogen if necessary rather than a combi product.

Alternatively as you are young, some women are trying/have tried the birth control pill Qlaira which has the bio-identical (body identical) estradiol in it, but about half the month you also take high doses of a synthetic progestogen but crucially not all the time. Continuous synthetic progestogens such as you are taking can have negative side effects for many women and if you have been taking them for years - this could have contributed to some of your problems. I am sure I would end up depressed/with permanent low mood if I took progestogens all the time.

Also babyjane mentioned thyroid - and again this starts to play up for many women and can gives rise to the symptoms of fibromyalgia syndrome (thyroid UK discuss this on their website) - even for some people who are in the normal range. Have you had this tested?

Also testosterone deficiency - I know this is not tested but in your case with early menopause - could you ask for a referral to a menopause clinic?

If it were me I would resist as long as possible a diagnosis of depression in your situation (and associated medication) until you were absolutely sure you were taking the most effective hormone preparation.

This probably isn't what you wanted to hear, but did ask the question in your title and I presume you were looking for thoughts from all angles?

Do have a look at Prof Studd's website and especially what he says about hormones and depression. http://www.studd.co.uk/ . There are tabs down the left and then sub tabs appear on the right.

I hope this is helpful even if it does not explain your situation

Hurdity x

[Butterfly22]

Hello Lila
I'm 44 - and feel exactly the same as you.  I'm crying all the time, I'm peri-menopausal too.  I just wanted you to know that you're not alone.
I take an AD and have stopped taking HRT as was worried it was effecting my mood, or at least giving me pmt which I didn't have before.

It's so hard to no what's what, would you maybe try another HRT see if it helped your emotions, thank you for letting me no I'm not on my own xxxx

[Butterfly22]

Sounds like depression ………..

I feel like it is to, my HRT seems to have settled so maybe my AD were not working as well as taken for so long xxxx

[Butterfly22]

Hi lila

I know we have talked before about your situation and trying to find the right HRT and I am sorry to hear you are still feeling rough.

What I'm going to say is controversial to some extent and I'm coming at it from a different angle than babyjane - but I believe it is no coincidence that mostly women are diagnosed with conditions whose symptoms include a lot of fatigue, aches and pains, anxiety, low mood, depression - leading up to and after the menopause. These conditions are fibromyalgia, ME and CFS which share a lot of symptoms. Women on here have been given the diagnosis (or it has been suggested) when in fact the symptoms have been due to a hormone imbalance - which include hypothyroid, menopause - oestrogen deficiency, and testosterone deficiency (which is not tested).  I myself was going to be referred for possilbe fibromyalgia by my GP because of my symptoms. Some women are so much more sensitive to changes and deficiencies in these hormones - even when they are within normal range - if indeed they are actually tested.

One woman on here was referred for one of these conditions and reported that the gynae refused to diagnose her on the basis that she was experiencing and suffering these unpleasant symptoms (rather than having a medical disease) - and put her on hormone treatment and her symptoms improved.

I am in no way wishing to minimise the suffering endured by women who have been diagnosed with these conditions, but that the medical profession could do more to find out the real cause - rather than condemning a woman to a life of pain,  exhaustion etc with very little help - apart from painkillers and anti-depressants. It may not be the answer for everyone but it might help a huge number of women, and then the medical profession can concentrate on finding out the cause for those women/people for whom a hormone solution is not the answer.

Re your situation - I wonder how many of your symptoms are due to your homone imbalance and early menopause, and maybe not having the right type/dose of HRT from the start, as you were so young? I see that Nuvelle is still available but on continuous combined basis - did you take yours on a cycle? My view would be that you should feel better with the right dose/type of HRT - which means some form of estradiol ( perhpas try a transdermal one if you haven't already) together with progesterone (Utrogestan). I would do this on a cyclical basis until you found the right progestogen that you could tolerate - or even permanently stay on a cycle. Taking them separately would enable you to take a higher dose of oestrogen if necessary rather than a combi product.

Alternatively as you are young, some women are trying/have tried the birth control pill Qlaira which has the bio-identical (body identical) estradiol in it, but about half the month you also take high doses of a synthetic progestogen but crucially not all the time. Continuous synthetic progestogens such as you are taking can have negative side effects for many women and if you have been taking them for years - this could have contributed to some of your problems. I am sure I would end up depressed/with permanent low mood if I took progestogens all the time.

Also babyjane mentioned thyroid - and again this starts to play up for many women and can gives rise to the symptoms of fibromyalgia syndrome (thyroid UK discuss this on their website) - even for some people who are in the normal range. Have you had this tested?

Also testosterone deficiency - I know this is not tested but in your case with early menopause - could you ask for a referral to a menopause clinic?

If it were me I would resist as long as possible a diagnosis of depression in your situation (and associated medication) until you were absolutely sure you were taking the most effective hormone preparation.

This probably isn't what you wanted to hear, but did ask the question in your title and I presume you were looking for thoughts from all angles?

Do have a look at Prof Studd's website and especially what he says about hormones and depression. http://www.studd.co.uk/ . There are tabs down the left and then sub tabs appear on the right.

I hope this is helpful even if it does not explain your situation

Hurdity x

Hi Hurdity,
You have helped so much in the past so always value your opinion.
It's weird as both (ME and menopause)came on after the birth of my daughter, as I was on a period for seven months and had to have a d&c to stop it in the end, I was told it was afterbirth then when started asking more questions was told it was inconclusive what it was.
I think this brought on my problems.
At 13 I started my periods and it was horrendous and at 21 had a laparoscopy and found out I had endrometrosis.
So I have always suffered with hormones and have also suffered very low moods.
It took two years to find out it was the menopause and four provinces to find out the ME.
I've had a lot of tests done as they do everything they can to rule out other problems before they diagnose ME.
I guess it would be helpful to dig deeper on the hormone side, I was going to a menopause clinic in Newcastle and they did test me for a number of things and checked my hormones ect but not sure exactly what tests were done.
I moved to Richmond North Yorkshire three years ago so just see my local doctor who dose not think I need to go back to a clinic.
It's so hard to no what to do and when your tired it's like a mountain to climb.
I will look at the link posted and you have given me a few ideas.
Thank you for taking the time to reply xxxx

[MIS71MUM]

Hi Lila

Yes I agree, it's so hard to tell what makes us feel like we do. I've started CBT over the last 2 weeks because I know I'm being really negative and my thoughts also aren't helping me at the moment. For now, I am sticking with the AD's as I need to try and get myself back to work. I've been off sick just over 3 months.  As I'm still quite young in terms of menopause, I will consider HRT at a later time, but first I really need to get my mental health on an even keel.

Keep posting, I'd be happy to be a shoulder to cry if needed. I really know what you're going through, just wish there was a miracle cure out there, but sadly for depression, there isn't.

[Greenfields]

Just to say there is a link between menopause hormonal changes and women's vulnerability to depression - it happened to me this year and I looked into the academic research as i was getting better. For some women the hormonal changes at menopause place them at risk of depression.  Any stressful events you are going through tend to exacerbate hormonal changes and imbalances (from what I've read).  I was going through a very stressful time when my hormones got seriously out of whack. 

I was put on HRT (I'm 52) - and once I was put on one that worked for me, I started slowly to get better. I was on Nuvelle Continuous initially but it made me ill - strange highs followed by crashing fatigue. My current Dr switched me to Utrogestan (100mg) and a patch (Evorel 50) - and I'm now, finally back to my normal self (I went down with depression in March/April and I think I fully recovered from my depression in November).

I have beta blockers to take if I get any weird adrenalin surges (still occasionally get them). I exercise more and have considerably cut down on my caffiene intake (at one point I gave up tea completely - I'm not a coffee drinker - but I've recently gone back to drinking 2 cups of earl grey a day and I'm okay so far!).

I think the suggestions made by Hurdity merit futher investigation.  The first Dr I saw had me on Nuvelle Continuous and then slapped me on Sertraline - I took the latter for 2 days and had every single side effect and then some (I'm sensitive to meds).  So I came off it and switched Dr's with the help of a friend (I was very very ill at the time).

I know some women take Citalopram and I'm told that that has less side effects than Sertraline ... but I found, once I'd got on a different HRT that the anxiety and fatigue and things slowly went away.  But having a "nervous breakdown" /clinical depression took a long time to recover from.

Sending hugs. Don't give up. If your current Dr isn't helpful, change Dr's. I think if I had stuck with my original Dr I would still be ill. Menopause is a really challenging time and for many women it's psychological effects come completely out of the blue  - I know I was completely unprepared for the impact of it on my life. 

[Butterfly22]

Hi Lila

Yes I agree, it's so hard to tell what makes us feel like we do. I've started CBT over the last 2 weeks because I know I'm being really negative and my thoughts also aren't helping me at the moment. For now, I am sticking with the AD's as I need to try and get myself back to work. I've been off sick just over 3 months.  As I'm still quite young in terms of menopause, I will consider HRT at a later time, but first I really need to get my mental health on an even keel.

Keep posting, I'd be happy to be a shoulder to cry if needed. I really know what you're going through, just wish there was a miracle cure out there, but sadly for depression, there isn't.

Hi sorry to hear yo to are struggling, sometimes just to know others are there is a great help so thank you xxxx

[GypsyRoseLee]

I am.so glad to hear you have made a good recovery Greenfields. It's always lovely to hear of a happy ending on here.

I totally agree with you that hormonal imbalances in Perimenopause can leave you very vulnerable to anxiety and depression.

Bit like you, I had been through an incredibly stressful time during the couple of years before my perimenopause symptoms suddenly kicked in. I think all the cumulative stress left me wide open and totally vulnerable to hormonal anxiety and depression, and I went down under the onslaught.

I spent last night making notes from the mood diary I have and to my surprise quite a clear pattern emerged. Generally I would suffer with extreme low mood and anxiety for a few days midcycle. Followed by another dip on days 21-26ish of my cycle, which would disappear when my period arrived. Or if I didn't have a severe dip on days 21-26ish I would often get it instead when my period arrived and I would be very low and anxious until roughly day 6ish.

And on two separate months when I had a longer cycke and didn't bleed until days 28-30 I was virtually symptom free for the whole month with just a very minor dip just before period was due.

Plus, I think the only reason I didn't feel 100% symptom free between these dips is because I felt slightly apprehensive about experiencing the next severe dip because they really were very horrible. And as time went on and I still kept getting these dips each month I worried more and more about them, and the fact they weren't fading despite finally taking HRT.

Between these times I was virtually symptom free.

[Trufflecat]

I hope that more GPs get their heads round hormone imbalances causing symptoms of ME etc in some women.
Greenfield's, may I ask how many days a cycle you take the Utrogestan for? I ask because your symptoms are very like mine and I have started on 25 days a cycle even though I am 52 and only in peri.