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[Riley04]

Hi
I started on HRT a number of weeks ago (Kliofem), managed 11 days and had to stop because my moods and emotions were in tatters.  I was diagnosed peri 6 years ago so I suppose it was a shock to the system having all those hormones rushing round.  Spoke to Dr and we agreed to come off the HRT.  About 5 days later I started feeling really anxious (nervous like you are about to sit your driving test).  It's worse first thing in the morning - I must add that I have suffered with anxiety in the past so my mind is worrying all the time that I'm going to feel worse.  I thought it was starting to ease, but today has been a bit rough.
Is it in my head or could it possibly be a result of stopping the hrt?

xxxx

[dangermouse]

It's probably the sudden hit of hormones and then stopping them that has caused your brain to chuck out so much adrenaline. It will likely calm back down to how it was before you went on the HRT soon.

11 days isn't enough time to know if the HRT will suit you as can take a while for your body to adjust to the new hormones, or the dose may have been too high for your needs.

[Riley04]

Do you think I should go back and ask for a lower dose hrt? I'm starting to lose the plot with it now it's really frustrating me and I'm frightened of it getting worse.
My other choice is to ask doctor for ADs, equivalent of citalopram (had this in the past but when I've tried it again it gave me chronic d)
Xxx

[dangermouse]

Perhaps you could just let this all calm down first before you try HRT again. It can be very hit and miss until you get the dose/type right but it depends how bad you felt before you tried the HRT to know if you will be better on or off of it, compared to how you feel now.

Adrenal surges can throw you into a feeing of panic but just try to ride them out knowing it's nothing to be concerned about.

[Riley04]

I was ok before I tried hrt just tired and moody! I'm going to talk to the dr and see if she thinks I should try a low dose hrt or need ADs again. My biggest concern is the worry of it getting worse and losing the ability to function..... Damn anxiety it just makes you worry about everything!
Thank you for your kind responses xxxx

[Taz2]

Whatever you do decide it's important to try each HRT for the three month recommended time. It can take a while for your body to adjust. It can take some time to find the right one but it's worth persevering.  You might prefer a sequential HRT which will give you a short monthly bleed. This means that you would be able to discover whether it is the oestrogen or the progesterone (which is added into the last part of the HRT each month) causing any side effects.

Taz x

[Dana]

I don't know much about Kliofem specifically, but looking at the green section above it appears to be a continuous HRT where you are having a small dose of norethisterone (progestin) everyday. This would be the first thing I would be looking at as causing a problem. Norethisterone is a progestin that a lot of women don't get on with very well, so the fact that after 11 days you started to feel unwell could be the clue here.

My advice, for what it's worth, is to go back to the doctor and ask for a separate estrogen and a separate progestogen. You can try different types of estrogen delivery (tablets, gel, patches) and different types of progestogens (progestins or progesterone).

What you would then do is take the estrogen constantly and take the progestin or progesterone for 10-14 days a month which would result in a period. You might have side effects from the progestogen while you're taking it, but the upside is that you know that when you stop it the side effects should go away.

Once you're established a routine that is working for you, you could then experiment with different cycles. A lot of women opt for a 2 monthly cycle where they only take the progestogen every other month, to lessen the side effects even more.

It will be up to you to experiment with different types of progestogens and there is no right or wrong type. A lot of women prefer to use a natural progesterone (Utrogestan) while others prefer to use a progestin (a synthetic progesterone - norethisterone or medroxyprogesterone). I personally prefer medroxyprogesterone (Provera), but it always comes down to what works best for you.

[Riley04]

Thank you so much for your comments.
I went to the drs and had a chat, we agreed that I should give the fliofem another go, as you have said, I didn't give it a chance.  I know now that you shouldn't just stopped hrt and that is probably what has kicked off the anxiety/feeling panic......I need to learn to be patient!  2 days in and not feeling any different, it;s first thing in the morning as soon as I open my eyes that a wave of panic comes over me.  I am hoping that this starts to subside but I am so scared of it getting worse, which is going round and round in my head, which makes me panic - it's just a never ending cycle I feel stuck in at the moment (I wish I could turn my brain off).
I have another appointment at the end of next week, so if the panic is still there we will look at what else could be done (ADs I suppose).
I honestly wish I hadn't started any of this, the mood swings and tiredness were bearable compared to this.
xxxx

[Riley04]

Today hasn't been a particularly good day.  Had the nervousness all day long from the minute I opened my eyes.  I've had tears and stamping feet.  I keep telling myself that I WILL get through it but the physical sensation in my stomach and feeling my heart in my chest just wouldn't go away.  I took the dog for a good long walk and tried so hard to take my mind off it.
I've been having a good read of the posts on here about anxiety and my symptoms are so mild in comparison.  I'm going to use this to keep telling myself this is just a blip.  Hopefully the hormones in the hrt will start taking effect in the next day or so, I've had 3 days now, but I do have another appointment at the dr on Thursday, so if the panic is still there I will be honest and try other routes.
I spoke to my mum (who was on hrt for years and was a nurse) and she agreed that stopping the hrt all of a sudden has probably caused this reaction, so I've promised to give this hrt a decent try and not spit my dummy out if it makes me feel emotional etc.  Obviously if after a few months I'm still not getting on with it I will try something else.  It's typical me to just throw my teddies out of the cot, really need to learn to be patient.
Hope you don't mind me posting on here, it helps to write things down and put it into perspective

xx

[Dana]

I still think you should be trialing separate estrogen and progesterone. If it is the progestin component in the HRT that is causing the problems you won't really know until you isolate each hormone.

[Taz2]

I agree with Dana on this plus as has been mentioned the norethisterone in kliofem does cause problems in many women as regards depression, low mood, irritability - it's a bit like having constant PMT.

Taz x

[Hurdity]

Hi Riley04

Sorry that you are still feeling rough.

I looked back at your previous threads and see we have given you various advice on different types of HRT already. I agree with Dana and Taz2 and we also said before - it may well be the norethisterone causing this. Also a sudden surge of oestrogen in tablet form when your body has been without it.

Personally I would go for a cyclical HRT and start low and build up to a decent dose which is what you should be having at your young age to protect your heart and bones. Either a combi one like Femoston - if you want tablets, or separates (oestrogen and progesterone) as has already been suggested several times. You will get a withdrawal bleed but as said you will then be able to find out whether you can tolerate the progestogen and increase your oestrogen dose if needed.

You don't need ADs so do not accept these from the doc - if the feelings are hormonal - you just need to find the right product and the right combo!

Keep going and hope you feel better soon

Hurdity x