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[EnglishRose]

I know this is controversial but here are my thoughts.

I never used to hsve pms believe it or not, nope, until I hit 40 pms was something I used to laugh about when men joked about it. Doctors would ask me when my last period was and I never knew bc it had such a low impact in my life.. it didn't matter to me. No period pain perhaps a few more zits but that was it,

When I turned 40 I had an episode of insomnia anxiety and depression. Out of no where but this followed the breakdown of my 12 year relationship and three years of the build up to that breakdown so, the doctor put me on ADs.
I did mention hormones but he told me I was too young for menopause.
I've been on those ADs ever since and a low dose too. Probably not doing anything for me anymore in terms of brain chemicals but they do help me sleep under less turbulent times. They never stop the hormonal insomnia when it happens but when it doesnt, I sleep 10 hours or more and for me that's worth me taking them .

I've been using high doses of progesterone transdermal for years too, was 500 mg now down to 400mg. Used to buy the cream then learned about Cyclogest on the nhs so asked my doctor if she'd prescribe to save me the money, she said “Sure! It's only a hormone

My Oestrogen I've recently learned is now deficient in the minus range. I have high FHS at 70. So I'm within the menopause range but still having cycles.

I'm now in another episode presumably this is the end of peri and meno on the horizon so in a low place the first time since I hit peri actually.

That's me. But I wanted to touch on why women prefer HRT over ADs or the other way around.

I've just been replying to a PM here from a lady who is struggling with anxiety and trying HRT but as we all know it's a bumpy road often getting worse before better can take months or longer before you find the right one and\or the right dose.

Knowing our hormones have a direct effect on the brain chemicals seretonin and dopamine explains our anxiety and depression when the hormones are out of whack.

So if the quality of your life has become so bad your not living and dragging yourself through the day then to me at least it seems illogical to try HRT knowing all the ups and downs and the symptoms getting worse before better, trying to find the right type then the right dose and alll the Hell that comes with that.
When ADs tend to get to the heart of the matter faster, they balance the brain chemicals directly at a steady dose
As opposed to HRT which effects the brain chemicals but all that up and down on one type taking off to try another...all the while your brain chemicals are being effected...as the HRTs are upped downed swapped stopped started as we try and find one that suits.

Of course there is some of that with ADs too but not to the same extent as HRT.

To me quality of life comes before anything and it would seem HRT is very much the long and difficult route to get relief compared to ADs.

I do not condone anxiety meds. They're awful things to get addicted to and long term leave you far worse off.

With all that said I myself and currently using Vagifem and about to see a menopause doctor to get my hormones balanced due to some truly awful symptoms that I can only attribute to the lack of oestrogen and too much Progesterone and possibly too much testosterone. I'm not looking forward to what lies ahead.. I've read enough on here to see the struggles women go through when they're constantly adjusting their dose or swapping their HRT type. But for me, my symptoms are physical so Increasing thr AD won't make them go away, but had I just been dealing with anxiety and depression I'd take the AD route anytime as it seems faster and more direct to the heart of the matter.
I realise that forums by their very nature tend to be filled with stories from people in a crisis or a low point, after all that's why we come here. And then if they get better they vanish by and large and get on with their lives so we rarely see the happy endings to someone with a successful HRT story.

Perhaps that's why I'm so afraid to start it and expect the worst,

Thoughts?

[Dotty]

Hrt has worked brilliantly for me. This time last year I was very ill . The guidance is that if symptoms are caused by menopause then ladies should be offered hrt and not anti depressants . However, some ladies will need both. At the end of the day you need to do what's right for you. X

[EnglishRose]

Hrt has worked brilliantly for me. This time last year I was very ill . The guidance is that if symptoms are caused by menopause then ladies should be offered hrt and not anti depressants . However, some ladies will need both. At the end of the day you need to do what's right for you. X

Hi Dotty

Glad your better 😊
I see fatigue was a feature for you just had a quick glance at your first posts.. not so much anxiety or depression so ADs may not have been considered as your issue was mainly physical (?)

Did  you stick to the same HRT and it came good in the end?

Ever since I turned 40 I have episodes were my legs and back ache and feel restless
I'm fatigued can't get out of bed, walking makes me breathless and I shake from exhaustion. These episodes could last 2 to 6 weeks and I'm bed ridden
I am self employed so I could juggle my work around my health but I felt like I was always sick or catching up on work. Never have got to the bottom of it.

I wondered if it was thyroid but always comes back within the normal range.

 Strange how the illness  started at the same time my peri menopause symptoms which were more classic anxiety insomnia depression two weeks before my period

[Blot]

Very interesting post Roseenglish. It's very difficult to know what to do in these situations. How do you even know if  anxiety is hormonal? In your case your anxiety and depression could well have been just be a reaction to the traumas in your personal life and antidepressants would have been logical but I see you also have other symptoms which may well be hormonal.. My episodes have always been a reaction to something that I just get overwhelmed with.

In my case, I don't think the anxiety and low mood are hormonal, although some may say they can be made worse by the menopause.
I've suffered with anxiety for many years, long before I entered peri/menopause. I'm 8 years post menopause. I never suffered with pms and I had some menopausal flushing which I just coped with myself, not much else until I was hit with this vaginal atrophy out of the blue.

 I always have a reason to be anxious and in the past suffered quite badly with health anxiety where I misinterpreted physical symptoms and imagined the worst outcome, usually cancer. I then moved onto just worrying excessively about life situations, kids, family etc and my worries were disproportionate to the actual reality.
So I am not sure if hrt would be beneficial to me. However if I need it to overcome this awful VA then I would seriously consider it. Otherwise, if I don't sort myself out I will have no choice other than antidepressants.

[Dotty]

Hi roseenglish......I had many symptoms and I was very ill both physically and mentally.  My GP wanted to give me anti depressants but couldn't explain how they were going to help me.  I couldn't face throwing another medication into the mix as I felt so bad.  I tried a lot of different Hrts but a private consultant finally helped me by putting me on Oetsrogel, Utrogestan and Testosterone.  My GP asked me to ask him what he suggested regarding anti depressants and he said that I should give the hrt 3 months to work before considering anti depressants as otherwise I wouldn't know what was working.  Deep down I felt that once my oestrogen levels were right then the terrible depression, constant crying, anxiety would go.....and they did.  But that's just me.  I'm not saying it's the same for everyone. xx

[EnglishRose]

Hi roseenglish......I had many symptoms and I was very ill both physically and mentally.  My GP wanted to give me anti depressants but couldn't explain how they were going to help me.  I couldn't face throwing another medication into the mix as I felt so bad.  I tried a lot of different Hrts but a private consultant finally helped me by putting me on Oetsrogel, Utrogestan and Testosterone.  My GP asked me to ask him what he suggested regarding anti depressants and he said that I should give the hrt 3 months to work before considering anti depressants as otherwise I wouldn't know what was working.  Deep down I felt that once my oestrogen levels were right then the terrible depression, constant crying, anxiety would go.....and they did.  But that's just me.  I'm not saying it's the same for everyone. xx

Yes I agree Doctors are more anxious about prescribing HRT than they are about sleeping tablets or ADs.
General Practitioners have a tiny bit of knowledge about the most common ailments and they have a quick fix method of writing up a prescription to get you out of their office ASAP due to the queue of patients sat waiting
The nhs is on its ass.

My own prescripted Tibolone which should onky be given 12 months post meno no periods. It produces progesterone (which I already use) Oestrogen and androgen. One of my new symptoms is increased libido or something like that I'm not sure yet I only know it's very unsettling not something I'm comfortable with and is purely physical, so giving me anything with an androgen was totally the wrong thing to do.
I stopped after 3 days and when I saw her again and explained why I'd stopped it she said Its Oestrogen! and got her book out to check as she was certain it was Oestrogen only, then she put her book away in silence and moved on with the conversation to another subject.

I'm seeing a private menopause doctor on Tuesday. I'm scared. We are all so different and trying to juggle hormones to resolve our own unique body chemistry and symptoms seems almost like rolling a dice...

I've been using Progesterone for years which has been wonderful for sleep but now I'm officially oestrogen deficient things aren't right and I need to get that back within range.

I will try to adhere to the three month rule as reading your early posts shows it took a long time and you had doubts and insecurities that it was working at all which is a common theme here and perhaps why I feel worried 😟

One things for sure, I can't go on as I am. I'm miserable

[Dotty]

roseenglish.....try not to worry.  I was on oral hrt and it didn't help me at all.  I knew I needed more oestrogen but my GPs wouldn't prescribe anymore and just told me that I'd have to put up with it.  I couldn't put up with it as I was very ill and desperate for help.  I finally got the help I needed and it took a while to get sorted on the new regime, but it has worked for me. x

[Blot]

How do you know you are oestrogen deficient? Is this via a blood test and is it just private doctors who measure this?

I agree about gps. They know a little bit about lots of things but are not experts in menopause. The first gp I went to was clueless and looked in her little book which doesn't inspire confidence.

I hope you feel better after seeing your menopause doctor on Tuesday. It's crap that we have to pay privately to get a half decent service and if you can't afford it what do you do? Also I'm in the north eat of England and there seems to be no experts up here.

[Nik2502]

Hi Blot
I too am in the North East and struggling to get the right care. Nearest private specialist is Leeds!
My GP has insisted on referring me to secondary mental health services but I'm not sure this is the answer!
Lack of education in medical professionals is frightening! Xx

[Dancing Queen]

For me it was HRT which did the trick. I just knew my problems were hormonal and after being really ill trying ADs I asked for HRT and it worked. No idea why some Drs are so reluctant to prescribe hrt
 but I got my own way in the end! 😀

[SueLW]

AD's are not recommended as first line approach for menopausal symptoms.  If you never had any anxiety or depression in your fertile years (just like me) but suddenly got hit with it at some point in your 40's or early 50's then it's hormonal.  It's quite obvious when you think about it.  It was horrible.  I messed about with private compounded bioidentical hormones for 3 years and felt a little better sometimes but not consistently and not much better.  However, in July this year I switched doctors and she put me on Oestrogel and Utrogestan and a low dose of testosterone and I have been so much better from day one and improving all the time.  I have physical exhaustion issues still, but I am also inadequately dosed on thyroid meds and that could be the missing link now.  The depression and anxiety have gone and I have more clarity of thinking again, which probably comes from the testosterone.  Finding someone who actually knows what they are doing is amazing.  It's all available on the NHS, just most GP's can't be bothered to find out about it.

I didn't want to do AD's although they were suggested.  I knew it was hormonal because I'd been completely even and unbothered by periods all my life.  I am so glad I declined them. They may have helped but they wouldn't have cured the problem and they wouldn't help protect bones, heart and vaginal health either.

[Katejo]

AD's are not recommended as first line approach for menopausal symptoms.  If you never had any anxiety or depression in your fertile years (just like me) but suddenly got hit with it at some point in your 40's or early 50's then it's hormonal.  It's quite obvious when you think about it.  It was horrible.  I messed about with private compounded bioidentical hormones for 3 years and felt a little better sometimes but not consistently and not much better.  However, in July this year I switched doctors and she put me on Oestrogel and Utrogestan and a low dose of testosterone and I have been so much better from day one and improving all the time.  I have physical exhaustion issues still, but I am also inadequately dosed on thyroid meds and that could be the missing link now.  The depression and anxiety have gone and I have more clarity of thinking again, which probably comes from the testosterone.  Finding someone who actually knows what they are doing is amazing.  It's all available on the NHS, just most GP's can't be bothered to find out about it.

I didn't want to do AD's although they were suggested.  I knew it was hormonal because I'd been completely even and unbothered by periods all my life.  I am so glad I declined them. They may have helped but they wouldn't have cured the problem and they wouldn't help protect bones, heart and vaginal health either.

I have been fortunate to not experience depression during peri/menopause but,  had I done so, I would not have been happy to try antidepressants first. I would have felt that I was being fobbed off. I am not happy with the way in which many GP's seem happier to prescribe AB's with their many side effects to HRT
I also take thyroid medication and have wondered whether any of my symptoms have been connected with that. I think my dosage is ok at the moment but have had some issues before now.

[EnglishRose]

Very interesting post Roseenglish. It's very difficult to know what to do in these situations. How do you even know if  anxiety is hormonal? In your case your anxiety and depression could well have been just be a reaction to the traumas in your personal life and antidepressants would have been logical but I see you also have other symptoms which may well be hormonal.. My episodes have always been a reaction to something that I just get overwhelmed with.

In my case, I don't think the anxiety and low mood are hormonal, although some may say they can be made worse by the menopause.
I've suffered with anxiety for many years, long before I entered peri/menopause. I'm 8 years post menopause. I never suffered with pms and I had some menopausal flushing which I just coped with myself, not much else until I was hit with this vaginal atrophy out of the blue.

 I always have a reason to be anxious and in the past suffered quite badly with health anxiety where I misinterpreted physical symptoms and imagined the worst outcome, usually cancer. I then moved onto just worrying excessively about life situations, kids, family etc and my worries were disproportionate to the actual reality.
So I am not sure if hrt would be beneficial to me. However if I need it to overcome this awful VA then I would seriously consider it. Otherwise, if I don't sort myself out I will have no choice other than antidepressants.

How are you doing with the Vagifem? Any relief ? I guess in the early stages I'd be happy if it didn't make symptoms worse ...

[racjen]

I don't disagree - I'd happily take ADs if they worked for me, but unfortunately I'm super-sensitive to them and end up feeling far worse when I try them. So I don't really have any choice, have to keep trying with the HRT.

[Rosie63]

Morning ladies.  I've been trying to find the right hrt for me for over a year now. I've never suffered with what I could call real anxiety and depression apart from feeling really down when I've felt so ill and can't see a light at the end of the tunnel.  However, at last, I think I may have found a regime that might be working for me which is Estradot patches and Utrogestan on a sequi basis.  My problem is that I always seem to suffer with very uncomfortable digestive issues and this has been the case on whichever HRT I've tried and not only the prog part but oestrogen as well.  I have read and was also told by a consultant when I had camera tests, that a low dose ad can help with digestive issues.  At the time of being offered these, some 10 years ago, I declined as felt I could manage with diet etc. but I'm very tempted to give them a go now, alongside the hrt to see if they help with stomach pain.  I have an appointment with gp next Monday and will speaking to him about this to see if he will at least let me give it a go.

Wishing you all well.

Rosie63 x