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[Dee46]

I have been on Oestrodose for 8 weeks now, first using 1 pump for 3 weeks then up to 2 pumps for the last 5 weeks, also Utrogestan from days 14-28 200mg vaginally, I have had 2 periods, the first month spotting on the progesterone part for a few days towards the end & then got my period on stopping which was heavy for 5 days, this month got my period 4 days after stopping the progesterone & it has lasted 3 days, felt sedated & flat on this part with anxiety.

I am suffering bad anxiety but one day I can feel calmer & the next all hell breaks lose & I am feeling rubbish again, I have been feeling flat now for a couple of weeks & cried twice this week at work as I am sick of this anxiety & dread when I wake up each morning, also feeling nauseous.

Is it still early days for the HRT regime to be doing anything? I know they say to give 3 months but is that to just start to see results? I am back at the consultant in 3 weeks for a review.

I am also on Citalopram 10mg which has done nothing for the anxiety at all, I am off to the doctors tomorrow to see if they will prescribe my regime on the NHS as I did go private for this, I am worried that as I am so emotional with this anxiety she will suggest another AD & I cannot bear the fact of starting something else whilst still struggling with this regime. Was put on Sertraline 18 months ago which started all this off which gave me bad anxiety & depression. I just want to feel a bit better as I have been feeling like this now almost 2 years.

Any advice would be helpful on the above.

[MicheleMaBelle]

Hi Dee- sorry you're having such a hard time. I've had exactly the same feelings. Now on my 4th HRT regime which includes utrogestan orally and have been up and down on it although I'm only a week into it. You wake up feeling sedated and with that sad heavy feeling in your chest...

I can only assume that you seem very sensitive to the progesterone and maybe you'll be one of the women who has to take it at a lower dose or less frequently that the prescribed amount. Under supervision and I think you may also need to have annual scans if this is the case, to check if the womb lining is thin enough. I don't know enough about it but I'm sure others can give you more information. I suspect quite strongly that I'm in the same category although I'm taking mine cyclically.

I'm also not sure if a mirena coil would be an option for you?My consultant has suggested one for me if the utrogestan and then Femeston doesn't work.

Sorry- not much help but just wanted to say hi and reassure you that you're not alone.x

[Dee46]

Michelemabelle It is awful isn't it, my doctors never suggested menopause to me & stuck me on an AD which I ended up having a breakdown & I don't want to end up like that again but feel I could go that way sometimes, I am also too scared to get off the AD now because of side effects. I am keeping a diary of how I feel everyday & think I was less anxious at the beginning of the regime, I get the dread, sedated feeling & like my head & heart are going to explode it is awful!
Maybe I am sensitive to the progesterone part then, hopefully the consultant will be able to tell me when I go for my 3 month check as to what she needs to tweak. I am not sure about all the lining of the womb stuff, all this meno stuff is still a learning curve!
Are you also on the gel? & do you take 200mg or 100mg? For how many days?
I have never really fancied the coil but I guess it will have to be an option if it helped with this anxiety, I was on Femoston 1/10  & then Femoston 2/10 for 7 months & it did nothing for me, I feel like I am losing the will to live when I have bad days like today, I just want to go to bed to tick another day off this horrendous meno calendar!
Without this forum I am not sure where I would be now without the advice provided as GP's havent got a clue!! Dreading going tomorrow to be fed more rubbish about an AD will help....

[MicheleMaBelle]

Hi Dee- it's pretty awful. I know exactly how you're feeling as I feel the same way. I first went to my doc almost 3 years ago. They have been pretty useless- putting me on 3 different HRT preps which contained the same type of progesterone ( notorious for really bad side effects) .I was backwards and forwards but they weren't listening/ didn't know enough. In the meantime I was getting increasingly worse. I had noticed that when I was taking the progesterone part of my combined HRT, that I became a lot worse with sleep, bad thoughts, low mood etc. So what did they do? Change me from sequential HRT to continuous so I was taking a smaller dose of progesterone but on a daily basis. It was horrendous- terrible headaches and very black moods. I was then changed to a combined patch- same thing. I ended up cutting the patches in half so only getting half dose. Lo and behold, I started to feel more like my old self although the flushes returned as I wasn't getting enough oestrogen.
I had then decided to see a consultant privately and he's put me on this new regime. Gel which I can tweak dosage wise and 100mg orally every day. I think it's this part that's causing the problems.So far, not so good but I will persevere for a while. Oh and I had forgotten to say- before the HRT I was prescribed ADs twice. Took Setraline the second time I was offered them. I didn't get along with them at all- shaking and hallucinating and I don't want to try them again but I may reluctantly have to if the hormonal depression doesn't settle. I know some women benefit greatly from them.
We are all different and some women are lucky to hit on a regime that suits them quickly and some don't I'm afraid. You are in the latter category. I'm not saying to come off the ADs but at this stage, you don't know what is the principal cause of how you're feeling - is it all hormonal related or do you have clinical depression. I do think if you can get the hormonal side sorted you will start to feel better. Did you suffer from pmt or have you had post natal depression in the past.? Did you ever struggle with mood if you took the contraceptive pill. These are all indicators that you are sensitive / intolerant of progesterone and if this is the case, maybe your doc can suggest some alternatives by way of taking it over a shorter period. It's not the prescribed basis though.
There is growing evidence that the contraceptive pill can cause depression in certain women. I was on it for years and I thought with mainly no side effects- however I do remember it being changed once and I turned into a complete nutter- crying and rocking back and forth.. So, there you have it. I'm utterly convinced that my issues with HRT are down to a progesterone intolerance and if you read the stories in this site, you'll understand that this seems to be a common theme. I don't like feeling this ill, you'll be the same. We all just want to feel relatively normal again and this might mean for some of us, moving away from the " prescribed " regimes and doing something a bit different, but under medical supervision.
Go speak with your consultant in a few weeks - take a list of symptoms with you and discuss your next steps. Moan away on here- we all understand and I do hope that you start to feel a bit better soon x

[GypsyRoseLee]

Hello Dee

I am so sorry you are suffering like this, and I can totally sympathise because I'm pretty much in the same boat. All my life I have suffered with quite bad PMS, and at university suffered with sudden onset depression (for absolutely no reason) within 4 weeks of going on the BCP. The depression lifted as soon as I stopped taking it. I then had severe PND after my first child was born, and suffered constant PMS for 9 months when I tried the Mirena coil. According to experts, this all means that I am highly intolerant to progesterone. You might think 'But it's just a hormones, how can it make me feel so awful?'. But it really, really can. And it bloody does.

I know exactly what you mean about the nasty feelings of dread/anxiety, and feeling so flat and hopeless at times. I get those too. A lot of women on here get them too, they seem quite specific to women in their 30s/40s who are peri menopausal. The only other times I have experienced anything similar was when I was on the BCP at university, and when I had PND. Coincidence? I think not.

Like you, I have tried various regimes. I also tried Femostan 1/10 and then 2/10, but the mood crash I experienced on the combined part of Femostan was so dreadful that it felt like I was having a breakdown, and I was signed off work with extreme anxiety. At times I felt suicidal. But, then it would all magically disappear for a day or two, and I would feel happy and calm.

I was interested to read that you tried Sertraline, when all this started, and you think it caused you to have a breakdown? Back when all this started for me, I also tried Sertraline and it had me climbing the walls, the anxiety was overwhelming, so after only 4 weeks I stopped. BUT, 2 years later, I went back on it + using 4 pumps of gel + 100mg of Utrogestan for 7 days a month + testim ( prescribed by Prof Studd) and I was FINE taking it. In fact it's from when I started it the 2nd time, that I began to really improve.

There are lots of connections between hormones and serotonin production, and I believe that when I tried it the first time, my hormones were so bad that adding sertraline to the mix just made things much worse because all my chemicals were all over the place. But the 2nd time I had begun to stabilise a bit on Studd's regime, so the sertraline was much more gentle.

You will see that I only take Utrogestan at 100mg, for 7 days each month. This is because I am intolerant, although actually I don't always feel too bad when taking it. It's when my OWN progesterone flares up that I seem to have real problems. Prof Studd is perfectly happy to have lots of women on this smaller dose, and he's perfectly happy for you to even miss the occasional month. He didn't even advise me to have regular scans, because I still have my own (very light) period each month. But for just £70 you can get a scan done at many Mothercare stores, for your own peace of mind.

Just like Michele says, it's likely that 200mg of Utro for half the month is not doing you any favours at all. People just don't GET how dreadful it can make you feel. You feel crappy while taking it, then even worse when you have the withdrawl crash.

When you see your consultant, I would ask about using less for a shorter period of time. I also wouldn't dismiss trying another AD again, or even increasing your citalopram while your HRT stabilises. I am so sorry that any of us have to suffer like this, it's like mental torture isn't it? But you will get it sorted out xxx

[GypsyRoseLee]

Oh, and I see you are using oestrodose. It's not as effective as Oestrogel, in my opinion. Have a read of my posts about trying oestrodose recently, and all my symptoms got much worse. The poster Tempest experienced the same too.

Oestrodose is cheaper, and the carrier gel isn't the same as in Oestrogel, so absorption can be reduced. Also, personally I wouldn't try the Mirena coil. Prof Studd thinks they're a bad idea if you are progesterone intolerant. Because the progesterone DOESN'T just stay total local, it does travel round your system.

[Dee46]

Michelemabelle – you sound like me I gave my gp one shot at the HRT after knowing they were reluctant to give me it in the first place I went private, maybe I should have gone last year instead of giving the gp the benefit of the doubt, as it happens they don't have a clue. Were you suffering bad anxiety on the progesterone part? I was good mood wise when I first started the gel, still had the anxiety but I felt better in myself, so maybe the progesterone is too strong for me, I was on POP pill & having periods although they got irregular I didn't connect menopause. I am also determined to give this the 3 months but in the meanwhile I will be back to specialist so she can advise then.
I feel like I am up & down, was down & flat for the couple of weeks on progesterone, but probably feeling teary & that this week as my period is coming to an end. Sertraline put me in this dark place over night & I was disconnected from everything, doctor told me to continue so I did for 3 weeks, came off them & had what I thought was a nervous breakdown, apparently I read us women think we have having a nervous breakdown when it is actually fluctuating hormones that are the problem.
Great thought I would be in the latter category!! I can see this menopause being a right nightmare & me suffering for years at this rate.
I have never suffered depression in my life, I never had PMT bad moods & never had PND after my 2 children so this is why it has hit me like a steam train, again I never had any problems being on the BCP only a few headaches now & again, have seemed to just get by on whatever I was given until now!
I read an article the other day on a link I receive about the POP pill  once you start the approach to the menopause, your oestrogen levels are going to start to fall, but your progesterone level is going to stay up here, and it's the gap between these two that can actually cause problems. When you're going through the menopause, it's not so much about how much hormone you have of each one, but it's about the relationship between oestrogen and progesterone. So if your progesterone levels are quite high and your oestrogen starts to fall, then you can end up experiencing low oestrogen symptoms. And the main ones will be things like anxiety, flushes, sleep problem, joint aches and pains, stress palpitations, mood swings and irritability.
This might explain my anxiety etc…this is a very good site I use but not sure I can mention on here?
I don't like feeling ill no, I am at my wits end sometimes with waking up & thinking oh how will I feel today, will I feel a bit like me & some days I am good & others I just want to be alone.
Like all of us we want a magic pill to take all this away but some days it feels like it is all too much & unfair.

[Dee46]

Gypsy Rose Lee I am sorry you have suffered most of your life with pms & the depression at university, this is why I am so devastated at what has happened, I have never suffered depression or anxiety in my life, I know my teenage hormonal years were a up & down with mood swings & crying sobbing so I can see the resemblance now of how I was then & what I am going through now, but didn't realise it could get this bad. Again I never suffered when I had my 2 children or if I did I never noticed, my mum is gobsmacked at how this has taken hold of me & was really worried about me, so just goes to show this is not like me at all.

It is good to hear that a lot of women suffer that dread/anxiety out of control feeling because that is what I hate the most, waking up thinking will I feel better today & if you do have a good day knowing that tomorrow could be a bad day again, but I recognize these now so try to deal with them but they get exhausting when you know that this is not actually you.

See what pushed me over the edge was the Sertraline, I was having these mood swings & crying, dizzy spells but I just felt a bit weird, within an hour of taking the Sertraline I was like a mental patient, I was crippled with anxiety that night in bed, heart coming out of my chest sweating, it was awful & then on put into this dark depression all because of that tablet, I lost 2 stone & doctors where not interested, I then went onto Citalopram thinking they would put me right but no carried on panic attacks all day, I was like a zombie. I feel suicidal a lot of the time so not sure if it is my hormones or the AD as I never felt like this beforehand, think it is hormones as have a relative going through the same who is not taking anything & feels suicidal.

It is good that you are back on Sertraline & it is working for you but I was speaking to someone & they said probably not a good idea to try it again if it gave me that reaction & maybe I am sensitive to AD's, hence the reason Citalopram does nothing for me. Out of interest how long did it take for you to feel better the 2nd time around on Sertraline? I am happy to try another AD but not sure I should whilst still trying to get the HRT sorted. I was on 30mg Citalopram last year, tapered down to 20mg & now down to 10mg & I can honestly say I do not feel any worse for coming down as they did nothing for me, I feel maybe I am taking them for no reason as they made me feel worse.

How long   have you been on this regime & how long did it take for you to feel the benefits? Also not sure if it is just me but when I apply at night I find that my anxiety increases for an hour or so, is this normal?

I am sure my specialist will tweak my hrt when I go back & she did say that anxiety is hard to control in the peri, she also did say that I shouldn't be getting anxiety with Citalopram so that also tells me that the tablet is doing nothing so it must be my hormones.
Think Michele is right maybe it is too much so I might get changed to 100mg when I go back, it did make me feel awful & yes afterwards too.

It is mental torture, but not sure the AD will help as the increase was no good & not sure which other AD to try without having all these side effects again when I start it, it is lovely to have such good advice from all the ladies on this forum.
Have read your Oestrogel  posts & will speak to the consultant about it, do you think that is what she prescribed but the pharmacy gave me the incorrect one? My private prescription says Oestrogel 0.06% 80g pump, maybe I am on the wrong one then? No I don't  fancy the Mirena coil as women seem to have problems with that, will have to battle on with this HRT & see if it kicks in!

[CLKD]

The AD dose may not be high enough.  Try not to worry about stopping it if that is your choice, ADs can either be weaned off under GP support or stopped without problems.  It took me 9 weeks to get off 1 [can't remember which  ] and once I realised that side effects didn't get any worse after 24 hours, I coped.  It wasn't easy so I rested when necessary until I felt better.  Which I did!

However, an AD is unlikely to 'give' someone anxiety or depression.  Depression can be caused by hormonal imbalance, I have both clinical and organic types which are eased by low-dose AD for Life.  If my brain feels low for more than 3 mornings I up my doseage until I feel better.  Anxiety can strike with menopause >sigh< - I have a beta-blocka to help ease sudden surges as well as an emergency pill on an 'as necessary' basis.

Don't despair.  It really can be Trial and Error at a time when we want answers and 'cures' but it is about managing how we feel.  Maybe make notes as to how you feel each day so that you have something to talk with your GP/Practice Nurse about?

[greenECLECtus28]

Hi
I was just reading your post and saw the bit regarding your AD's I have been going through a tough time myself recently I'm 54 and had my last period in December 2015. I was precscribed Fluoxetine but have been afraid to try it because of the potential side effects I'm a bit of a scardey cat there  however I had a panic attack and was back at the doc we had a chat as I had remembered when I was on an AD when my mum died that the first one I tried had made things ten times worse I had been worried it was Fluoxitine but when he checked it had been in fact Setraline which was changed to Citalopram which was then changed to escitalopram so I obviously hadnt settled on that either I guess what I'm trying to say is that if that drug doesn't suit you there are others that your doctor could try  just to say as well it was a good 3 months before the drug kicked in,also I think it's possibly not as straightforward for you as well as you are taking HRT in which our hormones do affect our mood as well so perhaps it's going to be a case of trying different things to get a balance between the HRT and the AD if you decide to take both. The people on this forum are wonderful and always there if you need a chat they have really helped me to try and take one day at a time and believe you will get there in the end because you will   

[Dee46]

CLKD I was put on 10mg Citalopram increasing up to 30mg & having really bad panic attacks all day, shaking constantly & just was not here it was like I was this zombie it was really scary in this dark place all I did was cry & breakdown so surely an AD should not make you feel like that? 9 months before that I was on Amitriptyline for back/thigh/heel pain that was in the January & then all this started in the May with the hormones & I didn't feel right, I kept crying & didn't know why, thought it was the AD so was put on Pregablin none of these caused me any side effects was told they were given to me to help me sleep, it was then I started to ‘not feel myself' & was put on Sertraline which caused all this heightened anxiety which then led to the depression, so I know you say that the AD cannot cause it, I think in this case it did along with hormonal upheaval, so can you see where I am coming from I was ok on 2 other AD's but not ssri which I must be sensitive to, so you can see why I am not happy on them as to me they are not helping me no matter what dose I am on. I have no objection from taking an AD as long as it makes me better not worse. I also have been taking the occasional beta blocker & they do not really do much just make me think they are. I will try anything to get through this jungle if it helps, just scared to try another ssri, saying that I think the problem arose when the gp    put me on ssri whilst still on pregablin & maybe it was too much for my body, who knows but I was ill & still suffering. I have been making notes everyday of how I feel to show the consultant when I see her so she can see the pattern.

greenELECtus28 I have considered Fluoxetine isn't that Prozac? I have read that gps put you on that to withdraw from Citalopram, but again I am scared to try that one in case I get bad side effects, so you were put on the same ones I had issues also with, just goes to show that some of  us do get bad effects from AD's, I also thought about Escitalopram but surely that is the same as Citalopram? I have been on Citalopram since end Dec 2015 so I am sure it should have kicked in, I was on 30mg for 8 months & no change, just panic all day long with negative thoughts. I agree although I feel the AD is not helping I am a bit reluctant to change yet until I give the HRT to work its stuff, also the consultant said to say on it until things settle. I totally agree this forum is so nice, everyone is there to hold our hands through this deliberating time of our lives, it is great to know we all have the support of one another, it does feel like a long journey already!

[GypsyRoseLee]

Hi Dee

I completely identify with what you'e going through. Have you read Prof Studd's website, where he talks about hormonal depression & anxiety. It's very enlightening, and I recognised myself straightaway + it really helped knowing that I wasn't just 'going crazy' and that there was a chemical/hormonal cause.

When I took sertraline a couple of years ago, after the very first tablet I didn't sleep a wink. Just lay in bed, feeling wired and jittery all night. Over the next few weeks I just got worse and worse. I thought I was having a breakdown. Like you, I lost a lot of weight, stopped sleeping and just felt dreadful. The odd thing was, that I had successfully taken sertraline years ago when I had PND. I didn't have any side effects back then.

But, 2 years ago I stopped taking it after 3.5 weeks because I just couldn't stand it anymore.

Over the next 18 months I experimented with various HRT regimes, but nothing really worked, and I was still very, very up and down. This time last year I tried Femoston 2/10 but the combined tablets just flipped me over the edge, and I just went to pieces on the synthetic progesterone. I experienced the most severe headache of my life, and couldn't stop crying. I saw Dr Annie Evans (a well known GP with a special interest in menopause) and she confirmed I was suffering with hormonal depression & anxiety, and prescribed me 3 sachets of sandrena gel + utrogestan, 100mg for 7 days a month.

But, I think I had left it too late, because eventhough I started her regime I just felt so dreadful, and ended up signed off work. After a week I convinced myself that the sandrena gel was too much for me, and cut it down to 2 sachets - I realise now, that this was the very worst thing I could have done, and that actually the 3 sachets wasn't enough! I went through Hell for the next 2 months, I really thought I was going to end up dead. I felt suicidal, so anxious, woke every morning at am filled with dread and panic. I hated leaving the house, and was scared to be left alone. In this time Dr Evans retired, so I couldn't seek her advice. My GP wasn't much use, just referred me to the Crisis Team and I ended up seeing various CPNs and even their psychiatrist. They started me on Trazadone, but it didn't work, so they just kept upping the dose. They couldn't understand why I wasn't responding to treatment? I was in a very dark place for 90% of the time, then it would magically just lift for a a few days. But I did some silly things, irrational stuff, and really scared my poor DH. It was just one long nightmare.

In desperation I went to see Prof Studd, and he said that he saw women like me all day, every day. Women at the end of their tether, suicidal, desperate etc, and he immediately started me on 3 pumps of oestrogel + 100mg utrogestan 7 days a month + testim gel. After 6 weeks I hadn't noticed any improvement so he increased me to 4 pumps of gel, because he said that to cure hormonal depression/anxiety you need 3-4 pumps of gel per day. At the same time I stopped taking the Trazadone and started Sertraline. Within 12 hours of the first 50mg tablet my mind felt clearer. After 3 days I felt very dreamy and a bit spaced out, but it felt so good. I felt very drained and exhausted, but I think that was just down to all the punishment my body/mind had been going through. I was in a bit of a Zen bubble for several weeks, but it was a huge improvement over how I had been. I still don't know if it was the higher dose of gel that caused this, or the sertraline? Maybe it was both?

But, every now and again (usually) every 2-3 weeks I would suddenly find myself back at square one - feeling suicidal, so flat, panicky etc, and it would last from several days up to a week. But, then it would suddenly lift. But, mercifully I had started sleeping normally again, and the early morning dread/anxiety had gone.

And, really that's where I am now. I feel pretty okay for upto 3.5 weeks, but then I always seem to crash back down for several days and feel really anxious/panicky again, and don't sleep properly.

I don't think your pharmacy gave you the wrong thing. The active ingredient in oestrodose and oestrogel is the same BUT the carrier gel is different (did you read dangermouse's very informative post about the differing carrier gels?). I strongly suspect that oestrodose is just a cheaper option. Plenty of women are fine on it, but I think that for some women we really need the proper, branded product.

[MicheleMaBelle]

GRL- very informative post. Thank you. I can identify completely with everything you've said. Glad to hear that your better most of them time. A hostage to Hormones. Sucks doesn't it?
Xxx

[Dee46]

GypsyRoseLee

You have been through the mill & this is exactly how I have been feeling for the last 18 months to 2 years just like you have been, I went to the GP today who has agreed on the regime the consultant prescribed me & we talked about my AD she said about a referral to a psychiatrist which I was not to sure about but I decide to go for it because of the Sertraline experience I don't want to try another AD until I know if the gel is working, I am back with the consultant in just over 2 weeks so I will mention you going up to 4 pumps for the anxiety & depressin & using the utrogestan 100mg for 7 days & testim gel, do you think I will also need an AD alongside this then? I am will try another AD if it makes me feel better, like you were I wake up everyday with the dread get these awful thoughts & just plod on in this little world of my own dizzy, panicky & ready to explode inside my body & head! I don't know who I am anymore, surely these are all lack of low oestrogen? My consultant will work with me & agreed some women struggle on the 2nd part of the hrt so we will discuss when I see her.
I am grateful for you explaining all below of what you have been through & where you are now, it is a long tunnel isn't it when you feel dreadful everyday but try to put a brave face on when really you just want this to be over with & someone wave that magic wand.
I spoke to the guy in Boots today regarding oestrodose & oestrogel, he said it has oestogel written on it & that it gets imported from the EU countries & has the sticker put on in the UK but they are all the same? Which pharmacy do you use? Is it a high street one?
Thanks for the great advice I really appreciate it