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[Yvie]

Hi
I'm new to forum to provide brief history re peri-menopause I first started noticing my mood lowering when I was on cerazette Gp advised to come off this in Oct 2016. What happened thereafter has left me feeling rather traumatized as I didn't understand or link my symptoms with menopause. I started feeling extremely tired, joint pain, memory loss and then bouts of anxiety with moments of sheer fear!! Did have some day and night flushes and then severe headaches and visual disturbances I really thought I was going mad!! 3 months off work last year whilst Gp commenced ellestte duet 1mg however had to change this at the end of last year due to increase headaches to femoston 1/10. Been on this for the last 5 months and then last night had another fear attack and feeling really emotional today. Unsure whether I should go back to doctors to increase my dose to 2/10 or would I be best sticking with low dose!! Don't want another attack like that as it makes you feel as if your losing your mind. My husband has been great as he is dragged out at all hours of the night to walk off these feelings. My main fear is if I increase estrogen level then my dips with hormone levels will be worse and I'm only 44 don't know if this will get worse with age anyone else been in this predicament. Had to phone in at short notice to take annual leave today as mood so erratic Any advice greatly received.

[Dancinggirl]

Hi and welcome to MM Yvie
Firstly, you are young so HRT is absolutely right for you and you should take this till your mid 50s at least - to protect your heart and bones for the long term.
The menopause really does ‘mess with the head' so you are not alone with getting this anxiety.

You could try increasing the HRT dose but, having read so many posts on this forum with women trying to control their mood and anxiety with higher doses of hormones and actually finding things are worse, I am not convinced that this is the answer. Many women do have to take some anti anxiety medication alongside HRT to really control things.

I personally think it is a range of strategies that will help - so perhaps consider CBT, Mindfulness and other relaxation techniques, some changes with your diet and increase exercise etc. Do write down what you are experiencing and talk to your GP about this.  IF your flushes are returning then a higher dose of HRT would be appropriate. Also if you are finding these anxiety attacks occur at a particularly time in the HRT cycle then a different HRT might be appropriate.  Some find having a Mirena fitted, which gives a lower and more consistent amount of progesterone which can stabilise things more and you simply add oestrogen as patch or gel once the Mirena is fitted.  Some find using transdermal HRT e.g. Oestrogel or oestrogen patches with Utrogestan (micronised progesterone) can work better.  It will be trial and error I'm afraid but you can't expect HRT alone to solve this problem.  DG x

[dangermouse]

I suspect the Cerazette was keeping your progesterone levels high enough but then you needed more. You then were taken off if it and given HRT which, unless you take a very high dose to suppress your cycle, may have made things worse by upping your oestrogen enough but not your progesterone.

Are you still having periods?

[Dancinggirl]

Yvie - when you had this panic attack, where were you in your cycle?  Did this happen soon after you had finished the progesterone phase of your cycle? I do not think that this HRT is the issue, as you have been on it for 5 months with no issues. If you are still peri menopausal then you own hormones may well be fluctuating in the background and you may have experienced a spike or dip in oestrogen and unfortunately this would be difficult to avoid until your own hormones have bottomed out roughly 2 years after your last natural period.

Progesterone can sometimes increase anxiety and low mood yet some women feel really good on progesterone but get a bad reaction just after finishing the progesterone phase of the HRT cycle. Dangerous is a rare lady that really loves being on progesterone and feels very good on it!!
As dangerous has suggested, if you are getting panic attacks just after finishing the progesterone then having progesterone continuously can really help.  However, if you are sensitive to progesterone and this panic attack happened during the progesterone phase of the cycle, then it may be worth considering a different type of HRT.
Increasing progesterone can bring all sorts of side effects and unless you are in post menopause your only option would be the Mirena or problematic bleeding could be an issue.

I think you need to discuss everything with you GP as a beta blocker might be a good idea but this panic attack may have been a one off.
Keep us posted. DG x

[dangermouse]

I think the Cerazette is progesterone only so if going from that to oestrogen created such mayhem, it would seem going back to that or a higher dose progesterone would make more sense?

I'm not sure I'm that rare, as there seems to be many progesterone only users on other forums but I agree this one doesn't talk about as much for some reason.

Dangerous Dangermouse. I like! 

[Dancinggirl]

Dangermouse - if you read Yvie's post you will see that she has been fine for 5 months on Femoston with no problems. She has had one panic and attack so I would not deem her move from cerrazette to the Femoston as ‘mayhem' and to suggest she increase progesterone as the cure fir this one panic attact. Without looking at the whole picture we cannot get to the bottom of the problem and advice accordingly.
Where possible I like to take a holistic approach when offering advice, especially when we know so little about what is involved - so to suggest just one option ie ‘just increase progesterone and all will be fine', is perhaps not that helpful. I know you have a strong opinion regarding the benefits of progesterone but there are many women who find progesterone very challenging.
She has not told us where in the cycle she had this panic attack and this attack may not have had anything to do with HRT.
Hopefully she will respond to my queries for more information so we can all offer more balanced support. DG x

[Yvie]

Hi
When doc suggested to come off cerazette my periods were practically none existent, I had a massive fear and anxiety attack and the Gp recommended with other symptoms described to start HRT which was around 8 months since stopping cerazette as I felt everything crashed at this point.
This attack has started on day 26 of my tablets on the combined progesterone and estrogen tablet, I'm also experiencing painful boobs. I had been on cerazette for a number of years without any concerns it was only when I discussed flushes, low mood and joint pain that the Gp thought I was too high on progesterone  the doc briefly mentioned at this clinic menopause and HRT or anti d's but I didn't really understand so declined medication and thought I could handle this on my own (wish now I had started meds  back then and could've saved myself a whole lot of trauma)
Just feel that when looking symptoms on-line can be very confusing and conflicting and my last doc appt he was unsure himself and previous doc stated that anxiety wasn't related to menopause! I've never suffered from anxiety before now and nothing has changed in my personal or work life.

[Hurdity]

Hi Yvie

  from me too

Just a quick comment

Firstly - Cerazette is known to depress oestrogen levels to that of the early follicular phase from what I recall. This means that you were consistently not achieving the oestrogen levels you should be having which could have led to your symptoms. This is not a good pill to take when leading up to menopause for this reason. It also suppresses ovulation - hence its use a a contraceptive. 

Once you stopped the cerazette then you began to experience the hormonal fluctuations - either from the normal menstrual cycle or from peri-menopause, and also low mood due to the possible further dips in oestrogen - depending on what your cycle was doing.

Did your periods resume after stopping the Cerazette and before you started the HRT, and how long did you wait before starting the HRT?

Without knowing what stage you are at in the menopause it is difficult to advise but your initial problems will have stemmed from the cerazette combined with starting peri-menopause - I presume?

Dancinggirl's suggestion of  Mirena combined with low dose oestrogen ( to start with) is a good one. Also another possibility more suitable for women in your position is one of the gentler CCP types - there is one called QLAIRA  which contains oestrogen the same as in HRT, but there are only 2 tablet free days which is good - avoids the pill free week. This will suppress your cycle and prevent the extreme hormonal surges that cause many of the unpleasant symptoms, but at the same time will maintain your oestrogen levels - which the cerazette does not do.

In haste, and hope this helps

Hurdity x

[Yvie]

Hi
Had been on cerazette for around 8 years when I was advised to stop this my period resumed straight away but over the 8 months prior to starting HRT my periods were getting lighter to the point that they lasted one day with very little bleeding. I do think my symptoms are possible dips or spikes with my own hormones but which ones is the problem they can be quite debilitating when it happens and no matter what I try to control it I end up believing that I'm losing my mind.
My mum stated that she completed her menopause by age 49, I also started my periods early at just before age 11 and the Gp didn't think I was early in commencing peri-menopause stage. I have noticed that the week leading up to my period now has me feeling either jittery or full blown melt down. Periods since starting HRT has increased the bleed to around 3-4 days however this fluctuates had two periods one month. Unsure but can I miss a period even when on HRT as the doc stated that he didn't want me to commence a continuous HRT as he feared that I may spot and this would end up needing investigated!
Unsure about the mirena coil as I had that fitted once and for months afterwards I felt that my body was trying to reject it as I had extreme cramps for around 4 months every period time. I will make an appt with Gp as he stated that he might arrange for a referral to menopause clinic.
Thanks everyone for their advice I feel a lot better than this morning and trying to get through this each day.