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[Emjay]

Hi,
I hope i am posting correctly.
I just wanted to ask if anyone here felt worse when increasing their estrogen dose but over time once it settles felt better?
I am finding this whole process so confusing.

I am only 43, have had pmdd for absolutely years(would say that I still have) so I know how it feels when hormones are involved.
The past 2 years(after having my last child) I have been all over the place hormonally.
I had pnd aswell, always felt this was connected to my hormones but also probably depletion after having my 1st(had 2 children 2 years apart)
I used to feel horrendous for the 2 weeks lutel and absolutely fine from day 1 of my period.
The past couple of years I still feel horrendous during those 2 weeks but it drags on until around day 7 of my cycle.
I was getting hot flushes randomly plus vertigo.
My gp recommended I try hrt.
Started at 25 patch, then 50 and now have upped to 75. I am taking Utrogestan from day 15 for 2 weeks although I only managed 10 days this month as my mood dropped severely.
The hot flushes are no longer an issue and vertigo did disappear then I had a few episodes last month which is why she though to go a bit higher.
Vertigo has gone again but I feel so anxious, like erratic. I had anxiety and low mood before I started, I don't think I am worse but I am no better in that respect.
I am struggling to understand what I need or don't need.
Maybe I need to take Utrogestan daily so I don't have these ups and downs with the hormones, so things are more even, also maybe the extra estrogen has knocked the balance out even more with the progesterone levels.
Almost feel like giving up, not quite sure where to go. Take an ssri for anxiety aswell.
Just feel I am going to be taking so many things and I don't want to end up in a mess.
Does anyone fine that they feel worse when they up their dose to start with but it levels out eventually or is this a bad sign?

I only started in February with the whole process.
I have definitely cried a lot more this month then last and had mega feelings of panic and that I am loosing my sanity.
Is it ok to just lower my dose to see how I feel or will that also wobble the boat?

I hope this makes sense.
Suppose looking for anyone who has struggled with pmdd aswell as perimenopause where hrt helped or maybe didn't help.
Also anyone else who feels worse with an estrogen increase.
I still have periods, my cycle has gotten longer since starting the hrt but I think that sounds pretty common with a sequential routine.

[bombsh3ll]

Hi I am sorry you're struggling.

I am on Zoely OCP for menstrual suppression which I take every day.

It keeps me completely bleed free and hormonally stable.

I didn't tolerate my own progesterone very well, luteal phase was miserable, and like you I also experienced vertigo around my periods when I lost access to my combined pill during the pandemic.

In my opinion cyclical HRT is not a good idea for those who have had PMDD or other symptoms aggravated by their natural menstrual cycle as we thrive with stable consistent hormone levels rather than swinging up and down.

[sheila99]

Whatever you decide about conti vs sequi I would go back to 50mcg. Anxiety can be a symptom of too much as well as too little oestrogen and usually ( though not always) the dose that controls flushes is the right dose for you. How long were you on 50 for before you increased? You need 3 months for the full effect. My insomnia and anxiety took the full 3 months to go completely.

[Emjay]

Hi bombsh3ll

Thanks so much for your reply.
I will look into the zoley ocp. I haven't really taken hormones until recently as anytime I tried the odd time in my 20's I felt loads worse.
Is the progesterone side in the zoley low?
Do you find this work fine for you?
Did you try the estrogen patches and Utrogestan first?
The dr has suggested the merina coil for me to try as an alternative along with the estrogen patches.
She is a good Dr as in, a very understanding one and willing to try things and not just give up but sometimes I feel it would he easier to see an actual specialist that has a lot more experience with it all.

[Emjay]

Hi Sheila99

Thanks for your reply.
I think I was on the 50 patch from the beginning of April until end of June so nearly 3 months
I wonder if it is too much for me, I think he theory was that maybe the Utrogestan side of things were making me feel worse because my estrogen was still low.
I think I started the increase from 50-75 about a month ago.
Actually felt pretty good from the day after I upped it (day 8 of cycle I belive) until day 15.
Infact I wish I didn't have to take the Utrogestan on day 15 because I felt so good. Then the next day after the Utrogestan I my mood just absolutely plummeted.
I wonder how long it takes for your body to adjust once stopping the Utrogestan side of things when taking cyclically 🤔
Although my mood went low with the Utrogestan I didn't have any rage feelings that I had been getting but within 2 days of stopping the Utrogestan part, my mood still stayed low but had full on rage feeling with it aswell.
Maybe it is the starting and stopping that is making it all worse.
Although slightly scared to take Utrogestan daily as my mood clearly plummeted the next day, don't want to feel depressed every single day of the month and give up the week where I feel pretty good.
Maybe your body gets used to the Utrogestan though if you take it daily instead of cyclically.
Dr has suggested merina to try instead as it is a lower consist dose.
So hard to know.
I wish there was just a clear test.
I take the Utrogestan vaginally by the way.
If I take it orally I actually get hot flushes from that and cannot sleep at all.
I think even at the 25mg dose patch my hot flushes subsided. I upped it to 50 then to 75 because my vertigo kept starting to come back and I was still getting severe anxiety and depression for nearly 3 weeks a month.
Am thinking of trying a low dose ssri if things don't improve but then might he hard to see whether the hormones are helping or whether it is just the ssri.
Things that have improved since starting hrt are hot flushes, vertigo, skin is better (was crazy dry), my face and whole body looked very dehydrated. I didn't think the hrt would have anything to do with that but I do believe it helped that aspect.
I don't think it has helped anxiety or mood
Sorry, long reply.
I'm probably sounding quote confusing.
We are all on this journey together but we are all so different that is makes it difficult to understand what's best.
I really appreciate you taking your time to even read and reply to my last message.

[joziel]

Have you had your ferritin tested? It's just that low iron can cause anxiety and heart palpitations and it's very common in women due to losing blood with periods...

Ferritin should be over 100, don't let a GP tell you that 30 is okay - it's not. There is a great Facebook group called 'the Iron Protocol' which you can join. Don't join the UK version because it doesn't have the helpful guides in it which you need to follow.

With estrogen, anxiety can be caused by it being either too low or too high or just by changes to it. Which really doesn't help. You could ask your GP for a blood test during your period which is when your own estrogen is likely to be low - so that you can see what you're getting from the HRT.

When I first began HRT I was all over the place with anxiety and heart beating fast and it's taken me literally years of experimentation to figure out what I need. I really don't see how the NHS can provide this level of help to 50% of the population - I had to go to a private menopause clinic.