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[Ljp]

Hi,
I'm coming to the end of my first three months on HRT (mirena coil, estring, and oestrogel)
I'm seeing my GP on Thursday to discuss things, especially local oestrogen.

I'm not feeling great to be honest 😟 I started with one pump oestrogel in December, felt good, anxiety improved, mood swings and flushes improved, libido improved, all good. Then after a few weeks, the night sweats returned, albeit not as bad.
Went to see my HP in January, for six week check on coil, and dus used things, she suggested trying two pumps oestrogel, which I did. Within a week I felt moody, withdrawn, lethargic, anxious.
I continued on the two pumps for another week or so, but reduced back to one pump as hated how I felt.

Within days I felt brighter agin, but thus last week, I'm back to struggling with anxiety, lethargy, Night swears (not as bad as pre HRT)… I'm just not feeling like I felt initially, and am questioning whether to persevere or not, and if I do, how much oestrogel to use?

I feel a bit stuck with it to be honest as had the mirena on the advice of gynae as she felt the local oestrogen (estriole cream) I had been using since last May, had possibly caused my post menopause bleed in October last year.
She suggested the mirena to protect my uterus, so I could safely use estring or vagifem with no worries.
It was only when reading and posting here, that I felt I should add some systemic oestrogen too, to prevent atrophy of my uterus lining.

And YES it did help me feel loads better at first, but now I'm just not feeling good at all, in fact apart from reduction in flushes, my mental state is rubbish, feeling cloudy, and anxious, and worrying about everything ( all pre HRT symptoms) also feeling exhausted and low.

Just don't know what to do, and not sure my GP will offer much guidance, she seems to go Ali g with most of what I suggest as a result of reading and researching.
I know I need to help my bladder.
I would like to feel how I felt when I first started using the one pump of oestrogel, but although that's what I'm using, I am feeling rubbish 😟😟😟

[Dancinggirl]

What about trying just an extra half dose of Oestrogel each day? HRT is not a cure all and the anxiety and fatigue you are feeling could be nothing to do with hormones. Maybe you are low on Vitamin D, B12 and Iron?
Some women need an SRRI alongside HRT as well. 
Have you tried Mindful Meditation - my GP suggested I do this and with regular practise I find it really helpful.  I started Mindful Meditation about 2 years ago and to start with I found it difficult but now I use it all the time and whenever I find myself dwelling on negative things I just slip into my 'good zone' mentally and can feel my body relax. We really can't expect to feel good all the time and learning to relax and take life at a different pace is important. 
I know you feel you were dragged down this road my the gynae (who put in the Mirena) but if your bladder is improving, your flushes are better and generally most of your meno symptoms are under control, then by working on some relaxation you could really improve your quality of life.
Have a look at your diet and exercise regime - get out for some brisk walks, take some Vitamin D3 and Omega Oils and with spring round the corner you will probably feel better.  DG x

[Clovie]

Hi Lisa, the GP I saw  recently also went along with what I suggested as he had little knowledge of HRT, and seemed to take my lead as I said I'd read about oestrogel and it's use. 

I am also new to using oestrogelafter swaping from Elleste Solo 2mg, and also wondering if I'm using too much/not enough, and not sure how long I need to wait until I ascertain its full effect on me. A week? A month? 3 months?

I will be following this thread.

Sorry you're experiencing difficulties and uncertainty. I have been there, still am, and have bought that Tshirt! x 

[Ljp]

I know what you mean Clovie, re how long to leave things before trying more or less gel.
I guess one and a half pumps might be worth a try in my case, although not sure how accurate one can dispense a half pump?

DG, I exercise plenty that's for sure, I teach 5 hours of dancing every Monday, the an hour of Dance fitness classes one morning, and three evenings a week.
Maybe I do need to take some b vitamins, and omega 3,6,9

Re mindful meditation, I wish I could learn how X

[Dancinggirl]

Clovie - With Oestrogel, 2 pumps per day is the recommended dose but we are all different.  One should give it at least 4 weeks to take effect - the oestrogen builds up over time and as the body welcomes and adjusts to the hormones there may be side effects like sore breasts, tingling around the lady bits and possibly the odd headache but these things should settle.  Finding the right balance is about being patient and not expecting HRT to solve everything. If you have had a hyster and just using oestrogel then 2-3 pumps per day is probably a good dose - especially if you are in your 50s or younger. Dg x

[Clovie]

Thanks so much for this DG   
 I'll give it longer then.
(I'm 52, no hysterectomy, am in peri with still regular but scant periods.)

[Dancinggirl]

Lisajp - sorry, I forgot you were a dance teacher - maybe you are overdoing it a bit - 5 hours of teaching dance is really full on!!!!! You've got a really heavy schedule - no wonder you are tired!!!! The problem is this is indoors and there is nothing like fresh air and sunshine to lift the mood.  Re: Mindful Meditation - there are some great books - my GP recommended: Mindfulness: A practical guide to finding peace in a frantic world by Mark Williams & Dr Danny Penman - it comes with CDs which take you through the sessions. You might end up using it as part of your dance classes?? It's really good for the 'wind down'.

Don't worry about exact amounts with the Oestrogel - I just squirt out an approximate amount if I want a half dose. I still think it's not the HRT that you need to adjust but maybe build more relaxation into your regime - sadly HRT won't necessarily sort your anxiety - learning to relax is very difficult.  I've just turned 60 and it's taken me 2 years of the meditation to find a calmer me - with or without HRT. 
Do research Vitamin D3 deficiency - you will be amazed at the impact of being low in this vital vitamin can have and the only good source in sunshine!! The fatigue, low mood etc you are suffering from are classic signs of lacking Vit D. My brother-in-law is a consultant gastroenterologist and he insists everyone should be taking Vitamin D throughout the winter. As an ex dancer myself, I always take Omega 3 or my joints really give me trouble. DG x

[Dancinggirl]

Clovie
What are you using for progesterone? Dg x

[Clovie]

DG, I'm using utrogestan, and I'm prog intolerant.
I've only been using it every 2, sometimes 3 months though, I based my decision on the fact that my old GP told me I could use the progesterone element of my HRT on such a long cycle as this because I'm so intolerant. Weighing any potential risk against my need for quality of life.

(Sorry for hijacking, Lisa!  x)

[Clovie]

Sorry, forgot to add, on the months I'm not taking the utrogestan I do have a quite regular period for 5 days duration, as is 'normal' for me, but it is scantier these days.

[Mary G]

Lisajp, I don't want to put the spanner in the works here but do you know if you are intolerant to synthetic progestins?  I know you were in two minds about having the Mirena fitted and I am now wondering, bearing in mind you have had it a few months now, if you are not tolerating it well.

How well did you do on the BCP for example?  Have you every taken any other form of HRT with synthetic progestins in them?  Do you have a history of PMS? 

The Mirena is supposed to stay mainly in the womb but enough of it gets into your system to cause problems if you are intolerant to synthetic progestins.  I had a Mirena coil for several years leading up to the menopause but it only set off my silent migraines (migraine aura without headache) when my own hormone levels dropped.  Synthetic progestins are the sole cause of my migraines, nothing else, so this is proof enough for me that a significant amount of it gets into your overall system. 

A lot of women get on extremely well with the Mirena coil and the last thing I would want to do is put them off but I always had enlarged, painful breasts, low mood, vaginal irritation and low libido - I have never suffered with PMS.  I took it all in my stride at the time because I had it fitted for contraceptive purposes but looking back, I was never really very happy with it.

[Dancinggirl]

lisajp - on your original post on this thread you described feeling: "rubbish, feeling cloudy, and anxious, and worrying about everything" - I don't think this is anything to do with the Mirena or the amount of Oestrogen you are using - I think you are over thinking things, over doing things (you have a very heavy schedule) and are in that 'end of winter blues' state that probably a lovely holiday in the sun would sort out.

Can you give yourself a break - even a weekend away, have some fun - I do think you sound a bit depressed and hormones are not going to make this better.  BE kind to yourself.   Sadly GPs rarely have the time to listen and certainly don't have the expertise to know whether a bit more oestrogen will make a difference - your GP is more likely to offer antidepressants. Do enjoy the fact you are more comfortable and not struggling with flushes.  Keep us posted.  Dg x

[Ljp]

Thank you for the replies, Mary G I was awful on the bop, I remember once driving to the doctors in desperation but not having the courage to go in. I did take it for 6 years before coming off it to have children.
I also used to suffer with PMS moody, and sore breasts etc, not nice.

DG, I think I do need to do some kind of self help to cope with my anxiety and worry. I just though, I have a S.A.D lite box, not used it much this year, need to start tomorrow, as I know from previous, it helps during this time of the year for me.

I hate the way my anxiety will creep up on me and send me into an out of control spiral, but need to find coping mechanism.

I gave a weekend away with hubby booked for next weekend, but find that a bit stressful,as I know he'll want a bit of the other, and not feeling any inclination towards that these days!
The joys of menopause and hirmonal change 😟

Re my HRT I feel I might be best to stick with it for another few months using estring ( or perhaps vagifem a couple of times a week?) and one and a half pumps oestrogel. Then try and find some self help for coping with my anxiety and worry, and use my light box.

[Dancinggirl]

Do try some Vitamin D3 as this is known to help with SAD. - Spring is round the corner.  The libido will probably return a bit when you are truly feeling more comfortable around your 'lady bits'. DG xxx