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[Oliver39]

Hello - I'm new to posting ... I've read this site with interest for the last 9 months or so.

At the age of 45 I was diagnosed as being Peri-menopasal after being told by a consultant gynae at the age of 43 he thought I was (due to a low Anit Mulerian test when I was 36).  At 43 I came off my pill had a blood test which was normal - thought he must have been wrong(!) then in November last year was hit like a train with no energy or interest in most things totally exhausted and bloods lead to my diagnosis.

I have an understanding GP and after patches which just didn't stick went onto two various types of tablets that I've just not got there with, I've always struggled with the Progesterone side.  And at first suffered with not enough Oestrogen.  In April I was referred to a Menopause clinic (which was really just a consultation with a rather unhelpful female Consultant who said my energy would slow down naturally as am I getting older!!!) she put me on 4 pumps of Estrogel and 200mg orally of Utrogestan  days 15-26 to have a bleed generally about days 3 days after stopping the prog.  I'm very down and emotional on the progesterone generally and then suffer a massive mood drop after ending the prog.  I feel after 3.5 months of Estorogel my brain fog and ability to function is so much better - I really did lose it for a while.  I do generally feel bloated tho and this isn't ideal - I'm of a slim frame and put the gel on my arms and thighs.

I have previously been diagnosed with endometriosis, I couldn't have children due to low fertility (age 36) and have particularly heavy periods and a small fibroid - diagnosed by scan in 2013.

All of the emotions associated with all of this has just become too much and my GP has suggested Citlapram 20mg - not because she thinks I'm depressed just needing something to aid all the little bits that are overwhelming me.

So ....  I have several questions which I thought you lovely bunch could help me with   Sorry for the long winded intro!

Prior to all of this I was't really a "tablet taker"  I also seemed to be pilling on the weight so I have also given up carbs as I just feel the weight was pilling on and trying to eat healthy.  I take an oral multi vit and also Macca daily.

Will the hpl reduce my 4 pumps down - I've read that big doses of Oestrogen cause more painful periods - and since being on the gel I have one day of my 5 day cycle where i have horrendous pain - general day 3.
I read you can use Urogestan vaginally - it's better if it's localised - I know they dont like to tell you to do this but are the benefits/side effects better and should that be the 200mg for 10 days that way? Again, avoiding the liver and it's congestion.
Do ladies take the HRT and the SSRI's?  I understand some ladies can get by with just the SSRI and as it's lower risk would this be of benefit (my maternal grandmother died of Breast Cancer).  I need something as I was just a former version of myself.  My confidence also took a knock last year.

So there are a few things to be going on with - fortunately I've not suffered any sweats and my sleep is okay after CBT last year.

Look forward to hearing back with any useful advice - and as a thank you to all the ladies that have posted and I've read over the last 9 months  - a huge thanks  ... I wasn't going bonkers - Just having a tough time

[Lizab]

Hi and welcome! I'm sure you've seen in reading the forum that everything you mention is common among most of us on here. I didn't understand your first question. You can take the progesterone vaginally if it's micronized progesterone as in Utrogestan or Prometrium rather than a synthetic progestin. I think some ladies do take the 200 for 10 days even when taking it vaginally, but the research seems to indicate that's an excessive dose and vaginally a lower dose is sufficient. I'm sure some others will be along with their experiences. Plenty of women take SSRI and hrt! Absolutely try it if the hrt alone isn't giving you satisfactory quality of life.

Now, to address the consultant's comment that our energy slows as we get older, I think there is a bit of truth to that. Personally, I hoped that going on hrt would return me to my old self as before this hormonal upheaval. Like you, it hit me like a train and I was losing it. What I've found is that it seems hrt is instead giving me a "normal" menopause. I still have my moments and more fatigue and even occasional sweats and flushes (and for this I'm debating another change in estrogen dose), but it's no longer debilitating fog and intense fatigue or flushes to where I can't cope and my confidence is returning. So I think when doctors say thing like that, they are being truthful, but they don't really grasp the severity of it for some of us.