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[Krista]

Many GPs still believe that unless a woman reports flushes, she isn't peri or menopausal  .  For me it was more of an all over 'glow' after my evening bath  which lasted about 10 mins. each evening.  For about 6-9 months.  Then went.

Take a list to your GP perhaps: date of LMP; symptoms you have noticed int he last 3-4 months; the symptom you struggle with the most ..... then let us know?

My docs know all about my depression and just keep giving me different pills that don't work. If only they made the connection to my menopause and at least considered that may be the cause. I mean, it may not be but I'm quite annoyed after reading up on this that the doctors haven't made a connection to at least try HRT/Oestrogel cream. They know my anxiety started three years ago. I'm 52 - how come no mention of menopause. Sure I will calm down but I'm fuming at this moment. I will definitely let you know - never had so much help from a forum before. Thankyou.

[CLKD]

Did you make the connection?  For years my depression was cyclical .........

[Krista]

Krista, you might find GypsyRoseLee's posts interesting, she suffered with hormonal depression and anxiety and has had great success with Professor Studd's regime i.e. the same as Carol Volderman.  I am also using the same regime but at a different dose for different problems and have found it to be the best HRT regime by far.  My problem was endless sweating and poor thermostatic control and Oestrogel has completely eradicated the problem.   

As shortie says, you can obtain Professor Studd's preferred regime of Oestrogel (gel you rub on your skin) Utrogestan (micronised progesterone capsules best used vaginally) and testosterone gel from the NHS and you can even simply walk into a pharmacy in Spain while on holiday and buy Oestrogel and Utrogestan over the counter and without a prescription. 

However, my personal opinion, which is based on my own experience, is that the key to success for this regime is getting the dose of each product right and for that you often need expert advice, I know I did.  Obviously everyone absorbs each product differently and everyone has different tolerance levels of each product but as a general guide, women with hormonal depression and anxiety need very high doses of oestrogen to get relief.  For example, GypsyRoseLee is on 4 pumps of Oestrogel everyday but I am only on 2 pumps everyday so it's a case of different doses for different problems. 

Other factors also come into play i.e. how well do you tolerate progesterone?  This has a huge impact on the success of any HRT regime and too much of it can drown out the positive effects of the oetrogen and ruin your regime if you are either sensitive or intolerant to progesterone used in HRT preparations.  Again, how this part of your HRT is prescribed can make or break your regime. 

I take it you have read Professor Studd's website and in particular the part about hormonal depression? 

My advice would be to go straight for the Oestrogel/Utrogestan regime and specifically ask you doctor for it - you could also ask for testosterone but that might be more difficult.  To be blunt, if you are suffering from hormonal depression and anxiety, I doubt that a continuous combined oral form of HRT will cut it - I realise many women do well on these forms of HRT but that is probably because they are just trying to control straightforward symptoms. 

I think you need a regime with maximum flexibility allowing you to adjust the oestrogen dose quickly and easily which is why I would strongly recommend Oestrogel. 

I'm sorry I can't advise on ADs but I do know that many women use HRT and ADs and do very well.

This is just my own personal opinion based on my past experiences.  I hope that helps.

I went straight to Prof Studd's hormonal depression page yesterday. I have made a note to ask my doctor for Oestrogel and Utrogestan (and I might try my luck and ask for some Testo gel). If she's unsympathetic I will do as Shortie recommends and ask my doc to refer me to a meno clinic. This week I'm also going to look at GRL's posts.

Thing is, last month I asked them to test my hormones because in the back of my mind I was wondering if this is the issue. All my hormones came back as normal but from what I've read, this "normal" is for women of my age, but I could still be low. I'm wondering if I should ask for the numbers from my results and if they will help me work out if I am indeed low. I will look into that.

Thankyou very much indeed for your post (and all of you). I'm feeling a slight ray of hope here.

[Krista]

Did you make the connection?  For years my depression was cyclical .........

Yes it was me that made the connection. I remember throwing my sleeping tablets on the doc surgery floor and begging them to help me otherwise I'd take them all. Ha! I got more AD's. Still it may not be hormonal so I don't want to get too excited. The AD's haven't worked at all.

[CLKD]

HORMONES   

Blood tests are reliably un-reliable ........ several are required at different times of the month because hormone levels rise and fall naturally all the while anyway ........ and at peri they become erratic 

[Krista]

Hi Krista

  from me too.

I agree with all that's been said about hormones!

The other thing is - how long have you been taking an AD?  If you started before menopause or close to it and started taking it for anxiety rather than menopause ( because you and your doc didn't realise it was due to hormones) - it could have stopped you experiencing hot flushes. ADs are recognised as a prescribable non HRT for women who are medically contra-indicated for HRT eg have had breast cancer or a blood clot etc. If this is the case then the obvious signs of menopause (flushes and sweats) might be absent hence the delay in realising the cause?

If you have been taking an AD for years then the same reasoning applies and doc would not attribute your symptoms to menopause - which of course they should. HRT is the first line of treatment for menopause, not ADs - as recognised and recommended by NICE Guidelines, menopause societies and medical protocols.

Re the BHRT. The confusion arises due to the use of this term. BHRT is the name given to the treatment known as Bioidentical Hormone Replacement Therapy - which usually consists of compounded hormones available only privately and are unregulated and very expensive. This practice arose in US where the health care system is different ( but is not FDA approved there) and certainly not recommended in UK. BHRT as a therapy as described above must be distinguished from the use of bioidentical hormones for HRT which as has already been described, is available on NHS as the 3 hormones - as shortie said earlier. Unfortunately this confusion leads women up the wrong and expensive path. As already said oestrogen and progesterone are available easily on NHS ( though some GP practices are notoriously difficult and won't prescribed them!) but testosterone can be more difficult as the only preparation readily available (testosterone gel) is not licensed for women. I had to go privately for this - and have yet to test the system by getting it on NHS.

As shortie said - start the oestrogen and progesterone first until you settle on the right regime and hopefully you can introduce testosterone.

Hopefully you will then be able to come off your AD unless this is long standing since before menopause. Incidentally what sleeping tablet do you take - is it a benzo?

Also it is absolutely fine to post the link to the article - in fact would be helpful to have on this thread as it's relevant to your story. What we're not allowed to post are commercial links or names of websites selling menopausal products especially, or seeming to promote these.

Definitely read the links to Studd's work on reproductive depression. In fact here is a starter ( look down the tabs on lhs and rhs and you will see the stuff on depression). http://www.studd.co.uk/reproductivedepression.php

Hope this helps

Hurdity x

Been on Prozac for over 20 years and Amytriptiline (sp?) for around five years. I take Zopiclone sleeping tablets - just one or even half a tablet per night and I started taking them around three years ago when I got depressed. Lol! I don't think they are a benzo.

And thanks for the welcomes.

I will go and add the CV link to my post for anyone else browsing through the forums. I also read this Studd guy helped Denise Welch, plus I've read from "ordinary" women who have been to see him. Same stories: Being given AD's etc and nothing working.

[Krista]

Krista - I'm a patient of Prof Studd and whilst he is probably the most eminent gynaecologist in this country and possibly Europe, he is expensive and you can bet your shirt that he'll prescribe 3 pumps Oestrogel, small blob Testim and utrogestan for 7 days. He usually puts you on this regime for 3 months and then re-assesses where you are. He also takes a full set of bloods, does a breast exam and  a full X-ray for osteoporosis then and there. You wait around half an hour and all the results are in and he prescribes from there. That prescription will be sent to your GP and they won't refuse to re-prescribe when they have his recommendations.

Please don't be impressed by Z list celebrities being amongst his clients, there were a lot of 'normal' women in his waiting room when I was there.

I wouldn't usually say that private should be the first port of call for HRT as his regime is easily replicated on the NHS, however, as MaryG points out, he will eventually tailor your regime to suit you which the NHS probably won't, and given your current medication regime, I think a specialist would be a good idea for you. He will know exactly what the interactions are with each drug and how to best use them for your specific purposes.

Please bear in mind that you'll pay a lot of money for the initial consultation and will be required to visit him in London probably on a 3 monthly basis initially. He does do phone consultations but they're not as useful as face to face.

Sx

Oh God I'm not impressed by slebs he's seen. They are just the ones that have come up when I've Googled him. Couldn't care less.

I'm also not paying (yet) in excess of £700 for a consultation. Thanks to reading up on here and the great answers I've had, I'm going armed to my GP. If no luck there I might try private but cheaper and closer to home.

[Krista]

HORMONES   

Blood tests are reliably un-reliable ........ several are required at different times of the month because hormone levels rise and fall naturally all the while anyway ........ and at peri they become erratic 

Sorry to ask but if I go to see my doc this week and say I'd like Oestrogel is she likely to say no because my hormone tests all came back ok? If so, what should be my next move? Can I sort of demand them or will they need to do hormone tests again - but even so the results seem to be within their safe ranges.

Just taken a sleeping pill which makes me a bit high before zedding me out so hope this makes sense.

[daisysareyellow]

Hi Krista
Zopiclone is not recommended for long term use as it is addictive and dependence sets in. Can I ask why you take two types of AD? The reason I ask this is because my father was severely bi-polar most of his adult life and when he had a very bad attack in his senior years, they found that many of his medications were working against each other. He had to be made an involuntary patient for 6 months. My brothers (doctors) got involved in his treatment and his whole regime was looked at and tweaked until everything worked properly. He was given vitamins and the minimum amounts of drugs needed to stabilise him. The last 15 years of his life were the very best I ever saw him. He was happy and normal. You are taking three very powerful drugs. Do you feel as though they are helping?

[daisysareyellow]

Hi Shortie
Sometimes GP's are the best doctors because they deal with so much. One of my older brothers is an Emergency Medicine specialist, so he is a jack of all trades if you like. He was instrumental in getting dad's medication right when the psychiatrists and geriatric medical specialists were failing him quite badly. G.P's see everything and they hear about the side effects of all manner of medications. I was on an epilepsy medication for my migraines called Topamax. I tolerated it perfectly for 5 years and absolutely loved it. I developed a left hand tremor and all over body twitching 5 years down the track and it was my GP who picked the link, not my neurologist. I was absolutely petrified that I had developed a neurological disorder like MS or Parkinsons in my mid 40's. I was taken off the drug and all symptoms stopped within a week! 

[daisysareyellow]

That's great news for you but my point was that many GP's are not clued up on HRT and with alarming frequency prescribe the wrong type of HRT and as I understand it, there's an issue with oestrogen absorption and some drugs, therefore it might be prudent to speak to a specialist in HRT private or not, to ensure all the drugs and the HRT are working in harmony.

Sx

I think there is also a big difference in the standard of care between Australia and the UK from what I understand. The NHS has become quite difficult to navigate from what I read and hear. In Australia, we are far less regulated on what doctors and specialists we can see in the public system. I have private health cover along with the mandatory Medicare (public health), so I am covered every which way, but our public health system is still pretty good. I remember having a discussion with someone on an Interstitial Cystitis forum who was reliant on the NHS and I might be wrong about this but you must go to the specialist they nominate? I would love someone to clarify this for me and how your system works.

[daisysareyellow]

Hi ladies
I have never suffered anxiety or depression so I have some questions. Is the anxiety and depression generalised or do you have specific thoughts that bother you? It would be interesting to know if there is a pattern.

[Krista]

Hi all. I will reply later on but I have an appointment this morning with the doc. Will let you know the results.

[MicheleMaBelle]

Katia- good post from Mary G- you can get the bio identical hormones on the NHS- they may/ may not help with your depression so sometimes an AD is needed too.
If you have any issue with your GP you could go privately - you shouldn't have to but many of us are forced down this route.

Sorry you're feeling so rubbish- hopefully you'll get a regime that works for you x

[Hurdity]

Sorry to ask but if I go to see my doc this week and say I'd like Oestrogel is she likely to say no because my hormone tests all came back ok? If so, what should be my next move? Can I sort of demand them or will they need to do hormone tests again - but even so the results seem to be within their safe ranges.

Just taken a sleeping pill which makes me a bit high before zedding me out so hope this makes sense.

I don't think this has been answered and I expect you have been to the docs already?

Yes you should ask for the numbers and also depends what they tested. The thing is low oestrogen is normal for post-menopause and if you are experiencing symptoms which you feel are due to menopause then you are entitled to HRT.  Blood tests are absolutely not necessary - you are post-menopausal so your FSH will be high and your oestrogen low. However I can see you are on a cocktail of drugs - what were you given the Amitryp for as this in a nerve pain drug? Not sure why you would have been given this as well as Prozac. I agree with whoever said these drugs may well all be interacting with each other and you definitely need specialist advice and support as to how to maybe withdraw from some of these and replace them with HRT - if they were given for menopausal symptoms.

I presume you started Prozac for reasons other than hormonal or cyclical depression as you have been on it for that length of time, so I expect you would need to continue this? Additional new onset depression/anxiety and insomnia caused by menopause needs treatment with hormones in the first instance.

I hope you are successful and do keep us posted as to the outcome of your consultations and treatment.

Hurdity x