Hi Greene1
from me too.
Sorry to hear about your problems.
I just looked up Spironolactone as I haven't heard of it and as always the endocrinology of it looks complex! The info says it is structurally similar to the mineralocorticoid hormone aldosterone, from which the androgen hormones are eventually synthesised. All of these hormones are governed by complex feedback mechanisms so I can imagine that adding an oestrogen into the mix could complicate matters.
Oestrogen itself would not cause depression - the opposite should be the case, but I am wondering if adding it in tablet form to the synthetic hormone type substance you are taking could be causing problems. Those who have issues with Elleste would be during phase two ie the combi tabs, not the oestrogen only tabs, except sometimes immediately after progestogen withdrawal (ie just after changing from the second phase to the first phase tabs).
Have you been prescribed the Elleste by a specialist? It does sound like you need a gynae and endocrinologist to advise in this case because it doesn't sound like the sort of specialism a GP would know about.
It may be that if HRT is OK to have transdermal would be better (ie patches or gel) - because your body is not having to metabolise such a large amount as with tabs so interaction with the Spiro... may not be so great. I am by the way talking off the top of my head here as I don't know how these hormones feedback on each other, but just a thought that might help.
If you haven't been depressed before and the meds combined with your condition are causing this I would go back to the doc urgently and ask for a referral - and don't let them give you other drugs for the depression. It sounds like you really need to get the balance of the hormones/replacement sorted out.
The other thing is I wonder what would have happened if you had gone onto HRT with a non-androgenic progestogen instead of the Spironolactone? It may be that tweaking standard HRT could sort out the other issues - which is why an endocrinologist/gynae should help.
From what I understand during peri-menopause and through to post-menopause we experience excess androgens relative to oestrogen - but overall both decline. Testosterone declines gradually with age (thought to be responsible for decline in energy mood libido amongst other things), and oestrogen suddenly with menopause. Perhaps you should have been given HRT at the start?
Hope this helps and isn't too much of a ramble - thinking aloud again!
Hurdity x
