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[Teresa]

Hi, this is my very first post and am hoping please for some advice as just don’t know what to do for the best. I’m 55 and for the past 8 weeks have been suffering from severe bad Health Anxiety and panic attacks which had been building up for some time. It’s been awful. I have fibroids. Had no period for 18 months, post menopausal. That happened after I had my 2nd mirena coil removed, which had been there just over 6 years….due to a number of issues with obtaining hospital app to have to get it removed surgically after scan showed the fibroids. It was also dislodged and had moved. Saying that, I got in really well with the Mirena, no side effects and it stopped heavy periods for me for a number of years.

I also had pre cancerous cells removed from cervix 15 years ago… I mentioned that to my GP and he said it was ok as it wasn’t cancer. Have had loads of smears since all negative.

So 18 months after my mirena was removed, no periods and my anxiety worsened, and menopause symptoms worsened. My GP tried two different ADs, both had severe side effects, made anxiety far  worse, which isn’t great for someone with health anxiety, so I came off them quickly. Six weeks ago, GP put me on Elleste Duet conti tablets as my first HRT. They immediately stopped the flushes at night, but my anxiety wasn’t calmed, though my insomnia was helped. I experienced the usual side effects I think you seem to get, bloating, cramps, joint pain in knees, diarrhoea ( more recently) but also started getting twinges in chest now and again ( husband said he thought it was indigestion, but I did worry) but I seem to get a lot of broken capillaries on my face toowhich was odd and I didn’t really like that. Main thing was no real change to the anxiety, so after being on it five weeks, I spoke to another GP on Monday about coming off ( 6 days ago) who didn’t try and dissuade me or suggest an alternative. Told me just to stop.

My insomnia has returned and anxiety seems a bit worse even. 

I haven’t had a bleed, but I do have a little bit of darkened discharge….is that ok? Should I just monitor that, it’s not a lot? GP said I might get spotting or a bleed but have had nothing yet. They said to monitor for a bleed and if it goes on for longer tgat 2 weeks to let them know?

I am now thinking I’d like to try another HRT and patches as I wanted those originally but GP said tablets were more popular and said patches fall off, but I do want patches, What do you ladies think? I do wonder if I wasn’t suited to the progesterone in the tablets and after reading some posts here, I think from what I read ‘Femseven conti’ patches have a progesterone that is similar to the mirena? Is that correct? Are there different strengths? Or is there another patch that you think would be more suitable?

I appreciate any help that anyone could give me….Thankyou in anticipation.

[Dotty]

Hi Oestrogel or oestrogen only patches would be a good alternative. You would need to take a progesterone too in the form of Utrogestan or another Mirena coil . x

[Taz2]

Hi Theresa. Good advice from Dotty. Was it the discomfort of the fibroid which prevented you having another mirena? Oestrogen can cause fibroids to grow but I believe the mirena is used to help prevent this so could be a good choice along with a patch or gel HRT.

It is advisable to try each HRT for at least three months as it can take this long for any side effects to settle down and for the full benefits to take effect.

As for the anxiety and panic some women need both HRT and anti depressants to get this under control so don't feel you have exhausted all options.

Taz x

[Teresa]

Thanks Taz2 & Dotty for your replies,
MyDoctor said that they don’t do oestrogel or utrogestan when I originally asked as this is what I wanted. They said it ‘wasn’t on their books’? Both my friends use this so I was a bit surprised as they can get it from theirs. Shall I press perhaps for an oestrogen patch and utrogestan ? and can I take utrogestan  as an oral pill daily?  Should they be able to provide it for me….do all GPs provide it?

I have a very tilted womb and the mirena had badly dislodged, so with the fibroids was difficult to remove even surgically, so I’m very weary and not sure if they would think it a good idea to be honest.

I perhaps should have continued on the HRT Elleste and am sorry I stopped so soon and wish the different Gp I spoke to this week, suggested I continue….but My anxiety wasn’t helped and I was worried about the side effects that seem to be getting worse…would these have subsided? The boatedness, diarrhoea, headaches and chest pains? I feel much worse though as anxiety is hitting roof and I am not sleeping now I’ve stopped. I took a sleeping pilll last  night as still had some left….I hadn’t taken any for a month since the HRT kicked in. 

With health anxiety, side effects are so much worse and heightened and add to the worries I have, it’s awful. I can’t take anti depressants as I also have started to suffer from irregular  palpitations ( another thing) currently waiting for 24 ECG monitor thing but apparently which takes a few weeks. But I’ve had these on and off for years, but anxiety is making them worse I think.
The two ADs I tried, first ( after 4 days) made all my knees and legs swell with fluid  and I had bad tremors and high heart rate….GP said stop….2nd AD which was an SSRI had severe side effects, I tried for just under 2 weeks, but had to stop because of my health anxiety and insomnia making me feel so rough.

I have a telephone app with my GP Wed, so will ask if I could try another HRT….please is there a specific name for a oestrogen patch that is recommended?
If they still say they don’t do oestrogel or utrogestan, what progesterone pill would you recommend too ? ( ps  - my GPs are both male so far if that makes a difference) 
Sorry all, but really suffering today  ( and so are my son and husband, I feel so bad for them as they are struggling with how I am ) I feel so very low.
Thankyou x

[Teresa]

In desperation, I could resume my Elleste? It’s been six days….is it ok to start again? ( I realise that the brown discharge I have is possible spotting)…the GP I am speaking to on Wed is sympathetic and seems to want to try and help me get over this.,.the one I spoke to earlier this week, I think is anti HRT so didn’t persuade me to stay or try anything different….
I think I hoped my anxiety would have been better after 5 weeks and side effects had lessened….was I expecting too much too soon?

[Dotty]

Hi Elleste Duet Conti is used by many ladies but doesn’t suit everyone. I tried it twice and bled both times when I stopped ( I was told to expect this.) There wasn’t enough oestrogen in it for me. It removed some symptoms but not all of them.

There are various makes of patches .. Evorel, Estradot for example. Yes you can take Utrogestan every day alongside the patch …. You may get breakthrough bleeding for up to 6 months.

I don’t think I would restart the Elleste, I would wait to speak to your doctor this week. You should be able to get Oestrogel. It is available on the NHS.

Your palpitations might be caused by low oestrogen… I suffered terribly with them but they went once I was on the right type and dose of HRT.

[CLKD]

Ask for a referral to a Menopause Clinic.  Not a Gynaecologist as they don't know much more than GPs seem to.  In the mean time of course, a good GP will be looking up what is suitable for U to discuss at your next appt..  U could also ring your local pharmacist 2 C what is available in your area, don't know why a GP 'wouldn't do' HRT which is commonly prescribed!  It shouldn't make any difference which gender a GP might be, information remains the same.

Hormones can cause all kinds of upheavals, including bowel issues.  10 mins. prior to a bleed I would have 'the runs', even when a period wasn't due!  Do U keep a mood/food/symptom diary, to chart progress?

Which symptom would you like to ease first? 

[Teresa]

Thanks again Dotty and thanks CLKD,

I will wait until Wednesday as you suggest…I think I’m just panicking a bit right now. You are right, just because they’re male, they should be able to still provide same information…

I will press for the oestrogel gel and failing that a patch…but will press for the utrogestan pill. Our pharmacist is very good so will check they have it on stock as well.

I have been keeping a mood diary and I can see it’s all been getting worse this past week. I’ve lost 10 Lbs weight in past 8 weeks, as appetite so low too and I’ve given up alcohol as I was worried that was part of palpitations….I think sometimes a glass of wine may have helped me this week though 

Dotty, I’d like to ease the insomnia and the anxiety mainly first….

Please can I ask which HRT you take now Dotty? And CLKD?
I will also ask to be referred to a menopause clinic….I had no idea I can do this.

Thankyou in advance,

Teresa

[Dotty]

Hi I’m on Oestrogel and Utrogestan and have been on it for over 3 years.

Insomnia and anxiety were the last things to be cured for me. I’m afraid it’s a waiting game and you have to be patient. I kept a detailed diary of symptoms and slowly began to see changes .

NHS menopause clinics are very rare these days and I imagine the wait could be a long one…. maybe up to a year unfortunately. X

[Teresa]

Thanks Dotty,
It’s good to know that  works for you and I’ve noted it for Wednesday. It’s a bit of a minefield isn’t it? I need to start on something again ASAP….I read that ladies have issues with all sorts of combinations, but I know we are all very different. I think I will panic if I have bad effects.
Looking back on the Elleste duet conti…all in all, I am wondering if I should have persevered….though knee pain I had had completely gone and I thought I was getting arthritis in it. Chest pain also gone, but that’s about it…and it was only a twinge here and there. Still bad stomach, but that’s prob the anxiety. I never got sore breasts or bad headaches either. Perhaps a different progesterone is key for me…..or perhaps I should have just persevered….but the knee pain wasn’t getting better, but anxiety wasn’t as bad as now and I was sleeping too.  I am so confused.

I will suggest to GP as he seems open to what I suggest:
Oestrogen patch and utrogestan;
Femoston conti tabs ( though ideally I didn’t want tabs, but I know it’s a different progesterone )
Femseven conti patch….as prog same a Mirena, though I’ve read worrying side effects on here and the fact they don’t stick very well….

Thankyou Dotty,
Teresa

[Dotty]

Hi I’ve never had any side effects from HRT. All my problems were caused by low oestrogen . Sometimes symptoms are blamed as side effects when they’re not.

Femoston Conti only comes in ultra low and low dose so it may not be a high enough dosage for you.

As I said , Elleste Duet Conti relieved some of my symptoms but not all . Oestrogel has worked for me . I’m on 4 pumps and I’m 57. It’s a bit of a faff putting the gel on but you soon get used to it.

It can take 3 months for the hrt to work. I noticed improvements after about a month on Oestrogel. But it took 3-6 months to see the best improvements. X

[Taz2]

I used Evorel sequi patches for a few years then swapped to FemSeven as the progesterone in Evorel gave me PMT type symptoms. I've had a hysterectomy since then due to prolapse and am now back on Evorel 50 as I no longer need a progesterone. I think that tablet types of HRT do give more digestive side effects as these have to be metabolised by the liver whereas patch and gel delivered hormones don't.

My heart palpitations have always stopped while on HRT. They returned on the two occasions I had to come off it.

Health anxiety is so difficult to cope with as the more anxious we get the more health problems seem to emerge.

Taz x 

[CLKD]

So far I haven't required HRT other than to treat vaginal atrophy.  (read our 'bladder issues' and 'vaginal atrophy' threads.  4 warned is 4 armed ;-) )

[Teresa]

Thankyou, Dotty, CLKD & Taz2 again for your helpful replies, it has certainly given me a lot to think about and you’ve all made me feel better about what is on offer.
Apologies,for late reply but I was out all yesterday for a BBQ….first time out in about a year and I think it did me good 

I’m armed now with what I want to ask the Dr for on Wednesday and am ready. I’m going to check with our Pharmacy tomorrow that they have the gels, patches etc in stock n case I’m up against a fight for what I want  which I hope won’t be the case.

I’m going to ask for oestrogel or estradot patches and utrogestan. I’ve made my decision  my friend at the BBQ also has been using oestrogel and utrogestan and is very happy….she’s local so I know her GP does it. If i do end up with Estradot patches I notice they come in different strengths…..I don’t think my GP will know what to give me. I don’t think I should have the lowest strength….do you agree? I notice it goes up to 100 Mcg, but started at 25mcg….do you think I should ask for the 37.5 Mcg or 50 Mcg… & how do you ever know if you need to increase as time goes on, is it just trial and error?

Thankyou,

Teresa

[Dotty]

Hi Teresa you were on Elleste duet Conti I believe….the tough equivalent to that would be a 50 patch or two pumps of gel. However, if the Elleste didn’t get rid of all your symptoms you may need a bigger patch or more gel. I was on Elleste Duet Vonti but am now on 4 pumps of gel….a smaller dose of gel did nothing for me. But you might get better absorption from a patch or gel, so it’s trial and error. You’ll know if it’s not enough if your symptoms aren ‘t improving . x