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[DownDillie]

Hi all - when I joined here I posted in the New Members forum about my very low moods, anxiety and marriage woes. To recap, I am 52, had an easy peri but have been struggling for many months now with very low moods and an anxious fluttery heart. Original thread is here: http://www.menopausematters.co.uk/forum/index.php/topic,31576.0.html

For the past 3 months I have been on Utrogestan 100mg 25 days out of 28, and 1mg Sandrena gel. I am still struggling badly with low moods and anxiety. Today, I felt I was on high-alert all day, like something terrible was just about to happen or just had happened. I know I was releasing heavy sighs all day at work, not really sighs more like a big 'phew' to relieve the tension in my chest. I was close to tears several times for no particular reason. I kept getting those horrible sinking feelings you get when you realise something has gone badly wrong. Constant feelings of shame, uselessness and feeling I've let everyone down, I'm a terrible person etc.

I have lost interest in almost everything these days, I just want to be left alone and not asked to do anything. I don't feel I can cope. I am beginning to understand now how people can arrive at a point where they feel life is not worth living.

I am due to have an HRT review with my GP in early September. Anyone got any suggestions as to what I should try next - should I carry on with the current regime for another 3 months? I am asking here because I know my GP won't have any insights as I don't think she has much experience with treating menopausal women.

I don't know if it's the Utrogestan that's making me feel low or the oestrogen. If it's the oestrogen I don't know if I am having too much or too little. How earth does a body find out?

I have some good days - yesterday was reasonable. But I am beginning to despair. I have a lot to sort out in my life and I can't do it when actually I just want to hibernate in bed with endless episodes of Pointless to distract me from everything!

[CLKD]

Well I wouldn't choose 'Pointless' as a bed fellow, I'm more a 'tipping point' Girl 

Maybe think about why you began this medication regime, has it eased any symptoms and what would you like to sort first.  Make a list to take to your next appt..

Browse round.  Maybe someone will be alone with HRT advice …….  I hate that hi-alert feeling 

[Dancinggirl]

Hi DownDillie - I'm afraid I am not convinced that HRT will always improve low mood and anxiety  - in your case, your issues may not be hormone related.  You've been through a rough time generally and still going through the mill.  Your symptoms sound to me like a touch of clinical depression which would probably respond better to a few months on an AD/SRRI and some CBT to get you through.

I have a very dear friend who has had various health and family worries over the years and at one stage she was particularly low, couldn't sleep and her health was really suffering (one of her children was giving terrible problems). Anyway, her very good GP simply told her that she ‘needed a break from all the stress to allow her body to heal itself'.  He prescribed an AD/SRRI, assuring her this would just be for a few months so she could feel calmer, get some sleep and help her daughter through the current challenges. She did as she was told, took the ADs and then after 6months gradually weaned off them again. She recently told me that, when she looks back, her GP had advised her well and done her a big favour as it was the right approach at that time.

I have suffered with depression so know exactly what it is like - wading through life feeling horribly overwhelmed with everything. Back in my late 30s I had CBT counselling for a year which I found really helpful - I now practise meditation to control anxiety and low mood and do a lot of walking to clear the head.  I also keep life a lot more simple these days - I don't commit to anything unless I have to and I have learned to say ‘NO' a lot more.

Utrogestan did make me feel slightly sedated which I think could make one feel less able to cope with things.  Oestrogen is usually the ‘feel good' hormone so I doubt that is the issue.
Do discuss the option of trying an AD/SRRI - but be aware that they can make you feel a bit worse for the first 2-4 weeks before they do their magic.  I think there are drugs that can lift the mood immediately for short term use.
Do keep us posted.  DG x

[Mary G]

DownDillie, how disappointing that your regime has not gone as well as you hoped.

Having read your post, I do wonder if your low mood could be linked to the high level of Utrogestan you are taking?  That is an awful lot to be taking and I think many women (myself included) would really struggle to feel good on that regime.  I realise there are other life factors to take into consideration but if you are feeling depressed, too much progesterone will simply make matters worse.

Do you know why you were put on this particular dose of Utrogestan and how are you taking it, orally or vaginally?  That would make a difference.

[DownDillie]

Dancinggirl, thanks for the reply. I understand what you're saying but I don't think I am clinically depressed - I'm not sure obviously but it seems to me that my moods are too variable. I had a great day today, for example, with none of the horrible symptoms of yesterday. It's tough to separate out everything properly so it's really hard to know what's going on but I am usually pretty good at being able to 'centre' myself even when I am worried about something. This anxious high-alert feeling is very unusual for me and I don't think it's depression.

Certainly for now I will continue to try to gain some relief with HRT. If I can't find a combination that works, I will stop taking it completely because the whole point was to sort out the low moods and anxiety. Then I will look to see if anti-depressants might help. I am working on things like mindfulness and meditation. I have eliminated some junk from my diet but need to improve it further and I certainly need to get out walking and cycling again. I know I can do more to help myself but the high-alert thing is so weird, I genuinely think it's entirely physical in nature.

I will bear in mind what you've said. I think I asked about the oestrogen because I had heard that too much of it can make you jittery and anxious.

[DownDillie]

Do you know why you were put on this particular dose of Utrogestan and how are you taking it, orally or vaginally?  That would make a difference.

Hi MaryG - when I saw the GP (the second one as the first one clearly wasn't keen on HRT) I had to spell out the name Utrogestan to her (and the oestrogen gel as well). I suggested a 12-day per month regime but she said as I hadn't had a period for over 3 years, it would be easier to go on a continuous regime. She asked for time to look into it all properly and then phoned me a couple of days later to say she'd done me a prescription.

I am taking it orally. I did express concern about the continuous regime because I said that the main reason I wanted HRT was for the anxiety and low mood and I knew that progestogen can often make this worse. I much prefer the sound of the regime you are following with Prof Studd but of course that won't be possible unless I actually see him myself, get the scans etc.

Possibly less Utrogestan or maybe a different progestogen might help. I am also wondering if perhaps an oestrogen patch would suit me better as it would be a continuous supply rather than one application of gel every night.

I am aware that I have other things that might be complicating the way I feel, I might manage this whole thing a lot better if I were in a supportive loving relationship and everything else in my life was fine. It's tricky. But I do honestly feel the main issue is physical.

[DownDillie]

Well I wouldn't choose 'Pointless' as a bed fellow, I'm more a 'tipping point' Girl 

Maybe think about why you began this medication regime, has it eased any symptoms and what would you like to sort first.  Make a list to take to your next appt..

Browse round.  Maybe someone will be alone with HRT advice …….  I hate that hi-alert feeling 

It really is a horrible feeling isn't it and very hard to think your way out of it. I can rationalise things all I like but since I am not actually agitated over anything, I can't talk myself out of the agitation, it's just there for no reason.

I will do a list to take to my appt. I've been keeping a symptoms diary though have neglected it of late. The low mood / racing heart was the primary reason I wanted HRT as the physical symptoms were mild enough and didn't trouble me. I thought I was getting away very lightly  .

[clare663]

Downdillie I have really weird mood swings on HRT. I can go a while feeling really good and then I get mood swings, anxious, irritable etc. I then either stop the HRT or cut right down on what Im taking and it seems to work. I am 5 yrs post so I doubt if I am getting fluctuating hormones of my own to that extent but I really think the hormones we put in our bodies on a daily basis build up as it is always 3-6 wks before my meno symptoms reappear. I literally take it a day at a time and im getting used to how I feel if I have 'overdosed' on hormones and then take a break.

[Tempest]

Hi Claire 663! I'm very interested in your experiences of HRT, and I've read back on some of your other posts. Have you always used transdermal? I'm wondering if (like me), you are having problems with erratic absorption? I have just started oral HRT as my Menopause Consultant thinks this could be the problem for me (that, and I'm in surgical menopause so have no 'back up' hormones of my own to speak of, except what the adrenals produce).

I also notice that you up your dose quite quickly if you don't get symptom relief relatively quickly. I've done a lot of research into this, and this is why the 'go low, go slow' mantra is useful, I believe. It takes time for the hormones to build in your system, so to expect instant relief is not going to happen (I learned this the hard way)! If you bump the dose too quickly, you could end up with too much and this, I believe, is why you're having to stop or take a break. It's better to be patient and give it time, adding in if needed. It is much easier to add hormones than it is to clear an excess. It also doesn't do your body any good stopping and starting.

I've learned this the hard way, as I have said!

[CLKD]

Depression can feel like wading through treacle 

[linz57]

Clare, how long a break do you take if you cut down or leave off the hormones? I recently felt my patch wasn't working as well as it had for the first 12 months so I went cold turkey. That wasn't too successful so am now on half a patch but am wondering how long to stay like this before upping to a full one again.

[clare663]

Hi Tempest. I have tried with tablets also. The first lot I took made me suicidal after a week. Was too scared to try anything else for nearly 2 years. Then gave it another go for 6 months on a different brand of tablet. Made me bleed monthly and they got heavier and so painful! (Ihave never had problems with periods prior to this. I also ended up a crying wreck!! Went on the patches earlier this year for 6 weeks but again ended up an emotional wreck. Took 6 weeks for my symptoms to come back so tried the patch agaion and after 3 weeks my hot flushes were still present so change to the gel and utrogestan. Good results initially but then mood swings and anxiety came back. Been off all of it for over a week and feel much better and no return of flushes yet. I was told that the gel is instant and can be adjusted day to day and have personnally found this to be true.

Linz57 I would try going to the full patch and if you find this is too much cut it to maybe two thirds. i found that I was quite sensitive to any hormones I have taken and taking a break or stopping had quite a quick effect on me.

[SadLynda]

Hi DD, I dont get here as often as I would like, and only post on things I know about.  This is one of them.  One thing that stood out to me is your saying 'you are not depressed' I thought that too, but I could not cope with life and things did get bad before I went back to GP no. 3 for help, and with advice I received here.  I am now 9 months on my AD's which were increased in February and I now feel better than I did for years, I did not even realise I 'was' depressed.  I still have the 'odd' bite of anxiety but nowhere near as it was.  I can now go out, and can even do shopping without too much worry.

Not suggesting you do the same, but sharing experience of how I really do know how you are feeling right now and how good it is to come out the other side.  Take Care x

[CLKD]

   SadLynda - glad you have improved!