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[DebJ]

Hi Everyone

I am 56 and having a difficult menopause. I am currently on HRT Kliovance and it helps but not that much. I can cope with night sweats, frequent waking up but its the anxiety & depression that I've had for so long now that I find so difficult. How do others cope? I don't want to take anti depressants but wondered if there is anything natural that I can take with the HRT that will help. I also wondered about testosterone. I did think that it would have been better by now but it seems to be worse. I do get plenty of exercise but where I used to get a buss from a big hike or a long walk and even my daily walk that's just not happening now. I constantly feel either flat & uninterested or depressed & anxious there is no let up.
Sorry I sound really negative but wondered is there a solution to this, sometimes it feels like there is no end to it, I know so many others have the same issues and its good to be able to ask on here
Debbie x

[Tiddles]

Hi DebJ

I'm far from knowledgable on this subject myself but just wanted to say hi and let you know you are not alone.  Anxiety and depression seem to be very common symptoms and many of us have been offered anti-depressants by our GPs in the first instance. Like you I didn't want to take them as I was convinced my symptoms were hormonal and battled the GP for HRT which I was finally given (tablets - Elleste Duet and then Femoston).  The anxiety and depression improved almost immediately - within days.  Before HRT I was having nightly anxiety attacks (massive adrenaline rushes) and nightmares, daytime anxiety about routine things like driving or making phonecalls, catastrophising and deep depression that even saw me contemplating checking myself out on a couple of occassions.  Now I sleep well all night and feel balanced and optimistic with very rare bad days.  Ive been on HRT for 5 months.

So I wonder if you simply need to try a different HRT? If you look under the 'Treatments' tab you can see what your options are, depending on your circumstances.  Best of luck to you x

[Mary G]

Debj, I'm 56 but soon to be 57!

My immediate thoughts are that you should look at changing your HRT regime.   You are taking a fairly low dose of oestrogen with a very strong form of progesterone and that is probably why you only have partial symptom relief and don't feel as good as you should -  you are stuck in what I call the HRT halfway house.  It could also be that you ovaries have finally packed up which won't help.

My advice would be to change to something like Femoston with a 2mg oestrogen dose or something similar.   Alternatively you could switch to Oestrogel (you rub it on your skin and it's very dose flexible) with a separate progesterone.   Have a look at the various options on this website and decide if you want a bleed free continuous combined  or a cyclical regime.   

You can certainly do much better than you are at the moment and you should not put up with night sweats.   

I hope that helps.

[Mustard1]

HI Debj,   Please know that you are not alone.  I am in work just now and battling with horrendous anxiety with a dread of the weekend and going to a concert that in my previous life I would have loved.  I am on Everol Conti (50 mgs) and 1/2 pump Estogel.  I don't understand why things are not improving but we have just to listen to all the others out there and know that somehow they will and perhaps the regime we are on is not right for us.  I am also on anti-depressants as initially my doctor diagnosed a breakdown before we realizing 2 months later it was hormone related.  Stay optimistic and know that it seems to be very common.  Hugs to you.  Mx

[DebJ]

Hi Everyone
Thanks so much for your reply's its so helpful. I am going to go back to my doctor and ask for something different and have a good read on here

Thanks again
Debbie

[DebJ]

Hi Tiddles

You mention 2 types of HRT that helped you a lot are you on both ? If not do you know which one helped with the depression & anxiety

Thanks Debbie

[Lisa1966]

Hi Debbie,I'm not going to offer any advice as I'm still struggling with anxiety and depression myself,so I'm still looking for the right balance,but I do know what u r going through,and I hope u find something that makes u feel better soon.
     Sending hugs
     Lisa xx

[Tiddles]

Hi Debbie

I started on Elleste Duet 1//10. My worst symptoms: anxiety, depression, nightmares, adrenaline rushes during the day, bad lapses of memory, forgetting the next word etc all cleared up completely within 3 days.  The hot flushes got fewer and fewer until I was having none at all after the first month on HRT.  Night sweats took 2 weeks to disappear. I haven't had one since. I kept a symptom diary and filled it in religiously every day to keep a track of what was happening and I'd recommend this.

During the second half of the first month on Elleste I experienced nausea, dizziness and bad, bad headache.  Also PMT but no worse than when I used to have regular periods.  These symptoms peaked for about a week and then faded off as I started a new pack of HRT and was back in the oestrogen phase. (Just to explain, with sequi HRT tablets like Elleste Duet and Femoston for the first 2 weeks of the months you are taking an oestrogen pill and the second 2 weeks you are taking progesterone which is what forces a period at the end of the month.)

So the good effects continued throughout the 3 months I was on Elleste but the bad side effects during the progesterone phase got worse and worse and following advice on here I went back to the GP after 3 months armed with my symptom diary and print outs of information from here and asked to change to Femoston 1/10.  They are similar to Elleste Duet in that you have 2 weeks of oestrogen tablets followed by 2 weeks of progesterone which gives you a period, but the progesterone is easier to tolerate for those who are sensitive.  I have been taking Femoston 1/10 for 2 months now.  The anxiety, depression, nightmares and other emotional symptoms have not returned nor have the hot flushes or night sweats.  I do still get a few headaches and some nausea during the 2nd half of the month but it is much less than on Elleste and it's bearable. I don't feel foggy brained either.  I still get period pains but I can cope with those.  The periods haven't been heavy, but then again they weren't very heavy before menopause for me.

Hope that helps? x

[CLKD]

its the anxiety & depression that I've had for so long now

Was this cyclical during your menstruating years?  How long have you had symptoms?

Sometimes ladies require anti-depressant and/or anti-anxiety medication along-side HRT in order to remain stable.   It really can be Trial and Error and sorting out HRT whilst feeling anxious and/or depressed drags it out a bit.

I have taken ADs since 1988 and have a beta-blocka to ease anxiety surges as well as an emergency anti-anxiety pill as necessary.

Maybe keep a mood/food/symptom diary?

[Tiddles]

Debj, I'm 56 but soon to be 57!

My advice would be to change to something like Femoston with a 2mg oestrogen dose or something similar.   

Hi again Debdie.  The Femoston Mary G is recommending above is the same brand of HRT that I'm on but the next strength up from the one I'm on - I'm on Femoston 1/10 which contains 1mg of oestrogen.  Mary is much more knowledgable than I am so that's sure to be sound advice :-)

[Hurdity]

Hi DebJ

Just to add that I agree with what the others have said especially Tiddles excellent post where she explained about the different types of HRT  - specifically the cyclical type that gives you a bleed.

You haven't said how long you have been taking HRT nor how long you had been without periods when you started the HRT.

The bottom line is - the oestrogen dose should be sufficient to stop night sweats. Full stop. If they are still occurring the dose isn't high enough ( or there is another reason for them - sometimes thyroid or blood sugar metabolism related). Also some women find that when on continuous combined HRt as you are the continuous ( strong) synthetic progestogen interferes with the beneficial effects of the oestrogen, and also sometimes has other negative side effects - which are worse if you are having it all the time. The one in that preparation (and Elleste) is called norethisterone and as Tiddles explained the one in Femoston is better tolerated (called dydrogesterone) because it is closer to our own natural progesterone.

If you want to keep with a patch you could either change to Evorel sequi and see if your night sweats disappear - or go for the tablet - Femoston, or go for separate oestrogen and a progestogen like Mary G suggested - so and oestrogen only patch ( or gel) together with something like Utrogestan (micronised progesterone) or even the Mirena coil. With separate oestrogen and progestogens you can tweak the doses until you have it right for you.

All the different HRT preparations are listed under treatments on the menu.

Far better to get the HRT dose right before even thinking about ADs - after all it could be that your oestrogen dose is too low, or that you are reacting to the continuous progestogen. Taking ADs will only muddy the waters and if you are not depressed due to life events but just have hormones out of whack - then they are not recommended - provided you can cope and not in any danger to yourself.

Mustard1 - if you were put on ADs incorrectly for the wrong reasons and due to hormonal upheavals as a result of peri-menopause, then now you are on HRT perhaps you could consider reducing them with a view to coming off them while you continue to tweak the HRT? You may also be sensitive to the continuous progestogen in the Evorel conti? It can cause pms symptoms like headaches and anxiety in some women.

Hurdity x

[DebJ]

Thankyou so much everyone, this has been a great help. I am sure the HRT needs changing will make an appointment to see my GP


Take care everyone

Debbie

[Mustard1]

HI Hurdity,  Thank you for your response.  I am not peri-menopause.  I am post menopause - I was started in Kliofem 2/1 when I was 44 (now 53 years) but my Menopause Doctor thought my receptors stopped working.  I will reduce my dose of ADs as I am very keen to get off these.  I will also talk the Meno doctor regarding the Everol Conti.  Mxx

[racjen]

I've also been suffering badly from menopausal anxiety and depression - the depression has been helped a lot by oestrogen, but the anxiety refuses to shift and I've had to resort to pregabalin (which does finally seem to be making a difference).

However, the two I would say are that 1) pretty much everyone on here makes out that progesterone is the out and out bad guy in all this and if we didn't have to take it we'd be much better off. Not my experience - I've noticed that after a couple of months on estrogen-only I start to get depressed again, and then within a couple of days of restarting progesterone I feel better. 2) I'm pretty convinced that testosterone deficiency is the cause of my anxiety - my levels are extremely low and anxiety is a classic symptom, but when I've tried to take it it's made me very depressed. A rare but not unknown side-effect apparently. So if you're suffering from depression and anxiety despite HRT get your testosterone level checked too.

[Wilks]

Hi, I agree that you should get your hormones sorted out first. HRT is the first-line treatment for low mood in menopause and perhaps that will be sufficient for you.
BUT- HRT (and testosterone) isn't necessarily enough for everyone. I've had severe depression and although getting the HRT right and taking testosterone has helped massively with numerous symptoms, I am also taking fluoxetine. I felt pressured to stop the fluoxetine (by various comments that we shouldn't be taking ADs) so I stopped it a month ago and my mood crashed so I've had to restart.

In a nutshell - get your hormones sorted first but if you are still suffering with low mood and/or anxiety despite that, an antidepressant can literally be a life saver. x