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[Victoria]

Hi there.  I have been a member for some time now but I have never introduced myself properly. 

I am 46 and my periods started going haywire about 6 years ago.  I have never had heavy periods and was regular every 24 days which lasted for 5 days.  I have had 3 periods this year.  I have always suffered with PMT (2 weeks of every month), together with postnatal depression and now seem to have constant PMT/anxiety which is getting worse.  My GP put me on antidepressants a short while after my first daughter was born and I carried on taking these for 13 years!  My daughters are now 13 and 14. 

Earlier this year I was told by my GP that I had to come off antidepressants.  I found they were not helping so much any more anyway.  Thanks to this super website/members, I was able to do some research and went to my GP in June as I could no longer deal with the hot flushes, night sweats, insomnia and anxiety.  I was given Femseven Sequi which was helpful for the hot flushes and night sweats but felt terrible on the progesterone stage. So I went back to my GP and asked for an oestrogen only patch together with Utrogestan.  My GP decided to refer me to my local Meno Clinic as he admitted he wasn't sure about HRT.  So I had a blood test (FSH 46) and was seen by a gynaecologist on 12 December.  He spoke about Professor Studd's research and decided to put in a Mirena coil for the progesterone and said he would give me a high dose oestrogen patch.  I said I didn't want a Mirena as it had made me go a bit crazy when I had it before but he said that was because I didn't have enough oestrogen and that I should "trust him".  He prescribed 75mg Estradot patch.

So, three weeks down the line and I still feel terrible.  I am constantly tired and moody and this festive period has put me over the edge.  I am at a loss as to what to do next.  The gynae has discharged me back to my GP.  Should I have the Mirena taken out, or should I ask GP for higher dose of Estradot?

I am so sorry for this long post but I didn't want to miss anything out. I am supposed to be going to a party tonight but just want to curl up in bed and sleep tbh.  My husband has had enough of my mood swings and family life is so tough atm.

I hope some of you lovely ladies can offer me some advice.  Thanking you so much in advance xxx

[CLKD]

  HORMONES 

Someone will be along about the hormone treatment.  How is your diet?  Mood swings can be caused by low blood sugar levels so eating every 3 hours is recommended by NAPS.  One doesn't eat more but spreads the diet across the 24 hours, even in the night; if a bathroom visit is required eat a biscuit before going back to sleep.  Or a piece of banana.  I had PMT badly and found that, so long as I ate regularly throughout the 24 hours and didn't forget, the moods and despearate nausea were controlled.  I carried biscuits, dried fruits and nuts, bananas with me everywhere ...........

[Taz2]

Hi Victoria - I find it strange that your consultant put you back on the very progesterone which gave you side effects before when you were using Femseven. I would think it is the type of progesterone which is at fault here. I too have dreadful mood swings and PMT symptoms while on the progesterone phase of HRT and was advised to use utrogestan. For me this didn't work because I am intolerant to soya which is in the capsule but I would think this definitely would be a better bet for you.

Someone else will be along soon who knows more about progesterone and it's effects. I'm not sure whether symptoms from the Mirena settle down after a while? I have a couple of friends who couldn't cope with the mood swings and had it removed but this was after three months of trying.

Taz x 

[Hurdity]

Hi Victoria

From your description it does sound as thoyugh you are one of the unfortunate ones who are progesterone intolerant - because you suffered from pmt for the whole two weeks of the month, rather than just the few days before a period that most of us got/get.

I also agree with Taz re the Mirena - the gynae has given you the same progestogen that caused problems before. Theoretically the Mirena is supposed only to act on the uterus with no side effects, but in practice there seems to be some systemic absorption which does affect some women - there are stories on the web about other women who have gone crazy when using the Mirena.

It's interesting you have read of Prof Studd's research and also your doctor could be partly right. You may well need more oestrogen (you are still young)- and especially as you suffered from PND which he remedies through oestrogen supplementation.

My suggestion would be the same as Taz - to try the Utrogestan. I would say if things haven't improved since 12 December then they are probably unlikely to as that is 3 weeks of progestogen. At the same time I would also suggest increasing the estrogen dose as well - as you may well not be getting enough, although I expect you still have some of your own?

With your progesterone intolerance you would be a good candidate for a shorter course of progesterone ( ie the utrogestan) but under supervision to check that the lining does not over thicken. I expect you have read that courses as short as 7 days can be given according to Prof Studd, but you would need regular scans.

You have my sympathies as there is no easy answer for you but hopefully you will be able to work out a regime that enables you to feel as well as you can for as long as you can.

Hurdity x

[Victoria]

Dear CLKD Taz2 thank you for your speedy replies.

CLKD, I do generally have had a good diet when I'm feeling "normal" but have completely lost my appetite at the moment so have been skipping meals.  I know you have said to others before how important it is to keep the blood sugar levels up by eating little and often and I will certainly try this.  I was really enjoying porridge/granola for breakfast, salad for lunch with fruit in between until this latest phase 'hit' me.  So thank you for reminding me and I will certainly try this.

Taz2, I had the first Mirena coil fitted by my GP about 8 years ago (for contraception) but had it removed after less than 6 weeks as I felt very tearful/moody with it.  I could not tolerate the contraceptive pill for the same reason.  A Consultant Gynaecologist at my local hospital fitted the coil this time.  I chose to to see him in particular as he specialises in HRT.  I told him I didn't want the Mirena because of last time but he said that I would would be okay as long as I had a high dose oestrogen.  He said "trust me I know what I am talking about" so I went ahead.  I am just not sure that the oestrogen dose (75mg Estradot) is high enough?

Maybe I should give it a little longer as it's only early days I know.  I think I was expecting a miracle.

Thanks again for your replies.

[Victoria]

Dear Hurdity, thank you very much for your response.  Indeed I think I am one of those unlucky ones who cannot tolerate the progesterone in the Mirena.  I said to the Gynae as I was leaving "what if it makes me go crazy again" and he said to "just have it taken out"! Apart from nightmare of the last 3 weeks it is such a waste of NHS money when I specifically asked for Utrogestan. 

It is through your posts, Hurdity, that I became aware of Professor Studd's website and was relieved to read about his research on women with PMT/PND and how they should be treated with high dose oestrogen instead of antidepressants.  This makes complete sense to me.

I am not sure how much oestrogen I have left in me, not a lot I suppose with FSH 46. I did not have a bleed after having the Mirena fitted.  Also, my mum's periods stopped when she was 43 and I understand early menopause can be hereditary.  My hips and other joints are so painful at times.  Luckily, I have been a gym member all my adult life and a regular workout makes me feel so much better.

I will go to see my GP next week and and ask for a higher dose Estrodot patch. If that doesn't improve after a couple of weeks I think I will have to have the Mirena removed and go down the Utrogestan route.  I am willing to have an email consultation with Dr Currie to give my GP some guidance if necessary.

Thank you once again for your post.  I will repost again when I have been to see my GP.

[ellie66]

Victoria, I was the same as you with the Mirena coil when I used it for contraception. 5 years of hell!

However I am feeling utterly fab on Oestrogel and Utogestan. I have zero side effects with Utogestan.

[Victoria]

Thanks Ellie66 for your reply. I keep thinking it's all in my mind as others swear by the Mirena. I have had such a bad day today with tiredness and anxiety. Seeing my GP on Tuesday and will ask to have it removed and hopefully get Utrogestan instead.

Really pleased you are feeling fab x

[ellie66]

Victoria, from my experience I would say that its the Mirena causing the problem. I would absolutely insist on Utrogestan on some GP computers its listed as "Micronised Progesterone" if your GP cannot find it.

I am on Oestrogel everyday 4 pumps (high dosage I was on Femston2/10 for 3/4 years and my meno symptoms where coming back) and Utrogestan from days 15-26 inclusively. Oestrogel you normally start on 2 pumps a day.

Even if I started to suffer from heavy bleeding in perimenopause as women do I would NEVER EVER agree to another Mirena. If you are sensitive or suffer side effects to progesterone they can be utterly dreadful things

Once you have this sorted out I would write to Consultant and tell he was wrong. Although perhaps I am gobby cow hehehehe I would do that if it were me 

I feel absolutely fab- best HRT ever.   

Do let us know how you get on 

[Victoria]

Thanks Ellie66. I didn't want the Mirena in the first place (had one before which sent me crazy then!) but the Consultant insisted and told me he knew what he was doing. I am so peed off as I have felt rubbish all over Christmas. Seeing GP Tuesday and will ask for Micronised Progesterone.  I will let you know how I get on x

[Victoria]

Hi Ladies, I thought I'd give you an update.  I went to see a locum GP last week to request Utrogestan for the progesterone part of my HRT.  On entering the room I burst into tears and told him that I could not cope with the Mirena Coil.  So I now have Utrogestan and Evorel 75mg.  This morning I had the Mirena Coil removed (and again burst into tears).  The nurse had warned the lady GP that I was upset/adamant so the GP removed the coil and didn't try and dissuade me!

I feel relieved but also very guilty for having felt so moody/tired/sad these last 5 weeks and I know my family have suffered. But I look forward, hopefully, to feeling better soon.

Whilst being seen this morning, the lady GP asked if I had ever considered going "cold turkey" and started telling me about the dangers of HRT. I said I was quite happy, thank you, being on HRT for the time being! She said I should consider using a much lower dose of Oestrogen (25mg).

Thank you all you lovely ladies out there who have helped and given advice.

[Hurdity]

Well done and hope you feel better soon.

Don't be fobbed off with the suggestion of the low dose! I am 60 and still on 50 mcg patch - they did suggest going lower, and I did try, but symptoms came back so not worth it! Glad you still have 75 mcg - you need it at your age

Hurdity x

[Victoria]

Thanks Hurdity. We only have the one lady GP at our practice. I find it frustrating she is so anti-HRT, so I am feeling quite lucky right now x

[ellie66]

Well done Victoria. What annoys me is it should be woman deciding what is acceptable to her not the GP. The GP is not taking the HRT! Makes me so cross. Victoria I am the same as you on the Mirena but I am fine on Utrogestan zero side effects.