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[Indigojo]

Hello Ladies,
I've always found this forum and those on it to offer invaluable advice so any help would be greatly appreciated.
My story... I started HRT at the beginning of 2016 having had 2 periods in 2 years, I was 48. My symptoms were night sweats and being a bit flighty/irrational and I was put on patches (Everol Conti then Everol Sequi) which caused me to have a lot of breakthrough bleeding and low moods. In July 2016 I was changed to Estelle Duet 2mg which I took for 7 months however, as time went on my low moods became increasingly dark from around day 10 - 14 when taking the estradiol only tablets. Having discussed this with the doctor, she reduced my dose to 1mg, her thinking being that I might still be producing oestrogen and therefore the 2mg dose maybe too high resulting in me getting down. So from March 2017 until 1 week ago I had been taking Estelle Duet 1mg and although I still got down on occasion it wasn't as bad however, for the past few months my night sweats had begun to return; I also hadn't had a period for 2-3 months despite having all the symptoms. Having discussed this with the GP, she decided to increase my does from 1mg to 3mg which worried me slightly as my mood hadn't been great on 2mg previously but she mentioned new thinking coming to light so I went with it.... Mistake!  Having taken the higher does for 7 days my mood has plummeted. I've been apathetic, tired and low with an inability to make decisions or concentrate... I've even had palpitations and joint pain so I know it's not right. This morning I was set to forget hrt all together as I'm 4 months in to a highly responsible job where I need to be able to function and lead a big team but, I went back to the doctors again and in my gps absence, I saw another doctor who advised going down to 2mg and returning next week to discuss reducing back down to 1mg but adding in Fluoxetine with my gp on her return.  Please, has anyone got an opinion on this? Should I just try a different hrt? Or should I try  adding in fluoxetine... I've heard both good and bad things. Any help, guidance or opinions would be gratefully received...  Thank you !!!!

[Dancinggirl]

Why not try Oestrogel with a seperate progesterone as pills and use a sequential regime for a few months so you don't get too many side effects frimthe progesterone.
Oestrogel allows you to adjust your dose - so start low on one pump per day for 3-4 weeks and then gradually increase, by maybe half a pump at a time, over several weeks, till you find the ideal amount to control your flushes.
I would try Provera progesterone as this is a gentler progesterone and often suits many women very well. Many love using Utrogestan but this can make you feel sedated.
I'd hold off from ADs at this stage - you are young and you need to get the HRT right to protect your heart and bones for the long term.
If HRT alone doesn't sort the low mood, then it maybe worth trying Cytalopram with the HRT.
You could also have a Mirena fitted and then use Oestrogel or oestrogen patches alongside.
You clearly don't do well on a high dose of oestrogen - I never did- you have just got to find the right balance. DG x

[Peroxideblader]

Hi there you've suggested starting low on one pump of oestrogel but I've been told on nhs I have to start 2 pumps and 200mg utrogestan?? Can I  start on one pump with that high dose of utrogestan as it's the oestrigen that made me ill on femoston ?

[Dancinggirl]

Yes, my gynae told me to start on one pump and then build to 2 pumps per day over 2-6 weeks. I Never actually used a full 2 pumps per day and felt best on just one pump per day - and that was even in post meno. I believe some women simply don't need a high dose.
Whether you need 100 or 200mg of  Utrogestan for 10-12 days per month, will depend on how much your womb lining builds, regardless of how much oestrogen you use.  I found that Utrogestan didn't control my bleed well so I got spotting and erratic bleeding - that's why I suggest that Provera might be a better option. Women who use Utrogestan vaginally seem to tolerate it better - I couldn't use it vaginally, so got more side effects.  DG x
DG x

[Hurdity]

Hi Indigojo - you've got two threads going and I answered on your other one  !

If you take a high enough dose of oestrogen it will suppress your cycle and then you should feel well but without the fluctuations - this would need advice from your doc or specialist as it's usually 4 pumps of gel or 100 mcg patch or more depending on your individual absorption.

Hurdity x