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[racjen]

Aaaargh, why do most doctors find it so difficult to accept that depression can be a symptom of the menopause and therefore treatable with HRT? I've just been for my regular post-breast cancer check with my oncologist, and ended up feeling like I'm making all this up, I should just shut up and go on anti-depressants. Similar reaction from my GP when I went to request HRT originally - 'there's no evidence that depression is linked to the menopause, you can try HRT is you like but...'(dubious expression on face). Feeling really undermined now and worried that I'm always going to feel this crap .

[CLKD]

However - some ladies find that HRT doesn't work!  What does your oncologist suggest?  HRT is often a no-no if one has undergone breast surgery.

[dazned]

Hrt doesn't always help with anxiety and depression,it didn't me for example. So don't despair there are other options out there for you to try. Hope your check up went ok otherwise.

[racjen]

But I have to wonder if some ladies find HRT doesn't work because they don't get enough support to stick with it until it does. My research indicates that it takes much higher levels of estrogen (not to mention testosterone) to improve mood symptoms than it does hot flushes and other physical stuff. My hot flushes stopped within a few days of starting Evorel 25 patches, at which point my estrogen level was <44, but my specialist says that the level probably needs to be at least 300 to start improving the depression. If I listen to the doctors who want to give me anti-depressants I'll have given up on HRT long before then. Plus anti-depressants don't work for everyone,me included, so I'm afraid there aren't always lots of other options.

My oncologist has no detailed knowledge of HRT and has no suggestions - I had to tell him what I've been able to piece together from my own research and the private specialist I've been to. To be honest even if my cancer had been hormone driven I think I'd be pushing for HRT right now - sometimes it's a question of quality of life being more important. And the check-up was fine thanks x

[racjen]

And in any case CLKD, you've already said that you had been suffering from depression and anxiety for years before the menopause, so if in your case HRT didn't make any difference, it would be because your depression wasn't hormonal. I've only suffered with these problems since being menopausal so I think it's much more likely there's a connection.

[jmj]

Thank you racjen for starting this thread. After reading so many personal stories here I started to ask myself exactly the same question...

After watching my own mother for so many years suffering in silence, cannot not to think that there was a (simple?) solution to that but nobody realized it?

[dazned]

I was under a private menopause consultant so I was fortunate enough to have plenty of support and many different HRT regimes but still to no avail sadly. I can only tell you of my personal experience ,everyone else will be different. Hope you find something to address your issues soon .

[racjen]

I'm really sorry to hear that dazned. Out of interest, did you try testosterone? And what have you found that does work for you?

[lesley998]

Racjen
....have you had a look at Prof Studd website? His findings on reproductive depression are very interesting.  Did you have PMT?  Did you sail through a happy pregnancy mentally...then have PMD?

http://www.studd.co.uk/reproductivedepression.php

http://www.studd.co.uk/depression.php

[racjen]

Yes, If I had the money I'd go and see Prof. Studd. I did have quite bad PMT but not PND, also I had an initial episode of depression and anxiety in my mid 40s when I would've been peri-menopausal, so I'm pretty convinced about the hormonal link. But sometimes when I'm already down it only takes one person to contradict what I thought I knew, and suddenly I feel completely at sea again. Maybe HRT won't work for me, but I want to give it a good go and not feel that I'm surrounded by people telling me I'm 'just depressed' and trying to force ADs on me  .

[Hurdity]

Hi racjen

Yes I agree totally with what you are saying and with SweetPea about the reproductive depression connection which is explained on the Studd website. This just is not recognised sufficiently by doctors. It was recognised by those who drew up the NICE Guidelines - so that HRT is the primary treatment for all menopausal symptoms that are new onset including low mood, anxiety and derpesssion (provided that the latter is not so extreme so that the woman is in danger - that goes without saying).

As has been said it is a personal decision but one that should be made in full possession of the evidence and the medical profession having given a woman the right support and treatment before rejecting HRT. Too often women are failed by the medical profession in this respect.

So yes I think you're right when you say this "But I have to wonder if some ladies find HRT doesn't work because they don't get enough support to stick with it until it does". Also I think the fault lies partly in some of the preparations available - which is a frequent mantra on here - there needs to be more variety! Too often women are given one  oral preparation in place of another or then a combi patch - but all these products are fixed dose preparations which may not suit everyone and it is not possible to tweak the dose. Any thoughts of increasing oestrogen is often met with horror and stories of cancer etc. The range of progestogens available is very limited (dydorgesterone for example would probably suit many more women and may well result in more women staying on HRT when given along with oestrogen patches or gel - as it is better suited to progesterone sensitive women.).

In your position (having been treated for cancer) it is understandable that those looking after you may feel that you are depressed  - but you know your body and your mind and what you feel and the hormone connection!! There have been others here who are extremely sensitive to hormonal changes and whose depression/extreme low mood is governed by their menstrual cycle.(GypsyRoseLee comes to mind - hope that's OK?).

Please hang in there - and fight for the right treatment if you can and if you don't want to take ADs - then don't - at least as you say not after trying to get the right HRT regime and giving it a good trial.

Have you thought of contacting Dr Currie - only costs £25 (home page). Also there is Women's Health Concern (patient arm of british Menopause Society) who do a telephone and e-mail service for varying (low!)prices - so you can print off the results and take to your doctor?
https://www.womens-health-concern.org/help-and-advice/email-advice/
https://www.womens-health-concern.org/help-and-advice/telephone-advisory-service/

If in the end you do feel you are getting nowhere and want a private consultation - there will be others who are cheaper than John Studd...he may well do an e-mail consultation too?

Hope this helps and you succeed in your quest for the right treatment for you. Do keep us updated along the way and we are here for you

Hurdity x

[peri]

Good thread ladies

[Nasil41]

Good thread ladies

Yes im very interested in this thread
X

[CLKD]

However: if someone tries a medication that makes them feel worse then isn't the instinct to stop it?  I know from reading on here that GPs are inclined to swap and change various methods of HRT when a lady presents saying that what has been prescribed isn't helping.  Which is why making a double appt and taking a list along might give both GP and patient time to consider options.

Does your oncologist agree with HRT in your case?  I believe in Quality of Life, after all, that bus might be along .......

Let us know how you get on?

[Mary G]

racjen, I know £300 is a lot of money but with your medical background, a private consultation with Professor Studd would be really worthwhile.  Apart from anything else it will speed things up and you may find it will be the best £300 you ever spent, particularly if it drastically improves your quality of life.  He does telephone consultations which could help to keep the costs down and it means you don't have to travel.  He will write to your GP with his preferred prescription and you should be able to get your HRT on the NHS thereafter. 

I was completely lost when I consulted Professor Studd - my GP had virtually told me to sod off - and I desperately needed two issues resolved (a) getting enough oestrogen into my system to stop endless and debilitating sweating and (b) finding a way to stop artificial progesterone (never had a problem with my own) induced silent migraines.  What else could I do?  I didn't have the luxury of that wonderful thing called 'choice' I was desperate.  He was the only medic who helped me and I will always remember that.

racjen, you have two things to address here, a history of breast cancer and what may turn out to be hormonal depression and I can tell you that Professor Studd prescribes HRT for women in both those categories.  For hormonal depression, he prescribes high doses of Oestrogel/low doses of progesterone and likes his patients to hit 800 pmol oestrogen at the very least.  Have a look at Gypsy Rose Lee's posts, she is an inspiration to anyone suffering with hormonal anxiety and depression.  My understanding is that you try the hormonal option first and then if you still feel depressed, you add in ADs - many women do well on both.

Here is link from the DM (not my kind of newspaper but sometimes useful) about HRT and breast cancer:

http://www.dailymail.co.uk/femail/article-3568584/Who-knew-HRT-saucy-dreams-CHRISTA-D-SOUZA-feared-taking-hormones-bring-breast-cancer-bizarre-symptom-sent-doctor.html

So don't necessary rule out HRT if you have had BC in the past.  However,
there is a new HRT called Duavive which I think will revolutionise HRT.  It is oestrogen coupled with a SERM (bazedoxifene) that effectively diverts oestrogen away from the breasts and the womb thus reducing cancer risk. Bazedoxifene is prescribed to prevent oesteoporosis but it is also given to women who have had breast cancer.  Here is another link which might interest you:

http://www.dailymail.co.uk/health/article-2466651/New-HRT-drug-help-PREVENT-breast-cancer.html

I am currently trialling 2 pumps of Oestrogel every day and 20mg baxedoxifene and so far so good, no side effects and no bleeding.

I hope that helps.