Hi and Welcome SueSG8
You're in the right place for help and support.
It sounds as though you are getting quite good support from your GP. It is strongly recommended to take HRT until at least 50 if you have a hysterectomy or early meno as you need the oestrogen to protect your heart and bones. There are long term implications of not having enough oestrogen before 50 and there are very good reasons to stay on HRT beyond this provided you don't have health issues that prevent this. There are no real alternatives and I'm afraid the evidence is simply not there to support the view that herbs or remedies can replace oestrogen. These remedies only seem to help those lucky women who don't experience bad meno symptoms. I think there is still the view that HRT is somehow tampering with nature when in fact up to the age of 50-55 it is the most natural way to maintain the bodies hormone levels and reduce the often nasty meno symptoms. Kliofem is not listed on this site but I assume it is one of the natural oestrogens (Estradiol) - what strength are you using?
You say you are concerned about effects - what effects are you worried about? The risks of taking just oestrogen are extremely low - it is the combined HRT which includes progesterone that brings a very slight increased risk of breast cancer after the age of 55-60. The risk of osteoporosis and heart decease due to lack of oestrogen is far greater long term.
Anxiety is often one of the major symptoms of the meno and having the correct balance of oestrogen can alleviate this greatly, however, many women in peri and post meno do benefit from ADs.
If I was you I would not consider coming off HRT until you are at least 50 and then taper off very slowly (I think you GP wants you to go cold turkey so you really feel how bad things are without oestrogen - he/she knows how important it is you keep using HRT for the next few years)). You could try using Oestrogel which is a transdermal form of oestrogen and allows you to adjust the amount you use according to your symptoms - it will also allow you to eventually reduce the amount you use over months or possibly years before coming off and give your body time to adjust.
I am now 58, became peri meno in my mid 30s and was probably post meno from my early 40s so have used HRT most of this time. I came off HRT at 49 because of all the scares( these scares were based on flawed research!!!) and suffered terrible flushes etc for 3 years before going back on HRT for another 4 years. I lost 3 years of my life because of those scares!
Last autumn I was advised to have another break from HRT to see how things are and though I'm coping quite well my joints are giving terrible problems and the lack of sleep is making me very tired. I have also been suffering from vaginal atrophy so use local oestrogen treatment which I will probably need for the rest of my life to prevent chronic bladder problems. I am not ruling out going back on full systemic HRT.
I haven't read Marylin Glenvilles book recently - I think I read this when I was 49 and hoped her advice would help. I spent a fortune on remedies, herbs, vitamins and special diet etc - all a waste of money for me.
I believe you are more worried about the effects of the Citalopram. What I have found that helps me with my anxiety is 'Mindful Meditation' - there are some good books on this - perhaps give this a try. My GP recommended 'Mindfulness' by Mark Williams and Danny Penman - comes with a CD which is great.
Do keep us posted about your progress. DG xxx
