Just some background: I went off Prozac at the end of January (weaned myself off it VERY slowly, according to dr's advice), after having been on it for seven years. My life has changed vastly and I felt I could go off it. It also affected my sex drive majorly and I am so glad to have my libido back.
I had no withdrawal effects.
However, suddenly, about five weeks ago, I was hit by dark moods and severe hot flushes. I was in Finland at the time and could do nothing about it. When I came back to South Africa, I went to my GP immediately and he said what I suspected - MENOPAUSE!! I am 50 years old. He also said that Prozac kept back many of the symptoms of menopause. My periods had already stopped when I was 42 and my then gynae forced me to go on oral HRT, which made me so depressed that I wanted to end my life. So I stopped using it and went to another gynae.
I apologise if my story sounds confusing. I didn't even consider menopausal symptoms when I was 42, and after that (silly me!) up till now. I have not had a hysterectomy.
I started using HRT patches. Estalis 40/150 (estradiol + norethisterone acetate). Two weeks ago. I have so many questions:
1. When will it start working for my mood? I do feel better, but some days I feel totally down again. I wake up with fear in the mornings, not knowing what the day will be like.
2. If it is not working for my mood, should I try a "stronger" version? I see there is an Estalis Sequi 50/250. How will I know that I am on the right patch?
3. I lost 30 kg when I started on what we call a "Banting" diet here - just Low Carb, High Fat. I started it in 2014 (after having gained weight due to taking about five different anti-depressants that finally sorted out my mood) and brought my weight down to 63kg. Last year (2017), I started gaining weight again, very very slowly, without my life style having changed. I now weigh 72kg and am very unhappy about that. Could that be menopausal weight gain? And will the patches sort that out?
4. I am also on lamotrogine, for unipolar (depression). Does that interact with the Estalis?
5. I also take thyroid medication. Will the Estalis interact with that? I had a thyroid test done a few months ago, and my thyroid levels were normal (being on the medication). I can't have another one done this year, my medical aid (like medical insurance in the USA) won't allow that.
6. Do I need testosterone? I have only read about that.
7. I also take Concerta (methylphenidate) as an anti-depressant (prescribed by my psychiatrist). Will the Estalis interact with that? Concerta has changed my life and made it possible for me to stop most of my other medications. It is not commonly used as an anti-depressant - I am aware of that. And I know that too high a dosage will make me anxious and make my menopausal anxiety worse. So I am regulating it very carefully.
8. When I was on the contraceptive pill before, in my life, it worsened my vulvodynia terribly. So playing around with my hormones is a scary thing for me. I have not had serious and chronic vulvodynia pain the last few years. Could the Estalis bring this back? Only people who have had vulvodynia know about the terrible terrible pain it causes. It is as if you are being stabbed in your private parts (sorry to be vague - I am not sure which words this forum allows) all day and night long. The pain takes over your life.
I am just so totally confused. As you can see from my mail! My priorities are my mood and my weight. Will the HRT sort that out? I can't go back on Prozac.
Thanks so much for reading my long mail and thanks in advance if you can answer some of my questions. Should I wait a little longer to see the effect of the patches? Perhaps I am too hasty and working myself up into a premature frenzy. I want to enjoy my life that has just started properly a year ago (after starting on Concerta).