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[Unhinged]

Hi Ladies,

I've been on HRT only for a short while, but I have not taken it today because it is making me so tired, I don't mean just weary, I mean literally fighting against zonking out unable to function tired. I think my anxiety has also increased. For  the first few days I felt a little better, it seemed to start working quickly, and it has also decreased the number of flushes, but this level of zombie-like fatigue is actually worse than my menopause symptoms. Has anyone else experienced this?

As I say it's only been a short while, but this is what I've tried so far:

1). Short spell on Femoston Conti Ultra Low Dose as patches I wanted were out of stock: stomach aches and general stomach upset.
2). Next was the Femseven patch: felt good on these but only short trial as simply would not stick!
3). Next was Evoril Conti patch: stuck nicely, felt better for 2 days, but then tore it off after sudden onset of the worst depressive feeling I've ever had!
4). Now, back on Femoston Conti Ultra Low Dose, which I intended giving the full trial of 3 - 6 months. Stomach aches cleared after a few days, only slight ocassional headache, all was going well, but now this unbearable sleepiness/tiredness/mind fog/crying.

I know it looks like I've chopped and changed, but I had wanted the patch all along, but what with Femseven not sticking, and the low mood so bad on Evoril (I mean not normal 'depression' or anxiety but strong suicidal thoughts which scared the living daylights out of me), I thought I was finally settled on Femoston for the long-haul.

I may try taking one every couple of days, but surely as they're ultra low dose they shouldn't be affecting me like this? Does anyone have any ideas of what else I could do? I'm 54 and 4 years post meno so really don't want to start a bleed on a sequi. Or do I accept that HRT is not going to be for me?

Thanks for any help if you can, I'm already half-mad with anxiety and obsessive thoughts, not impressed with level of knowledge at docs - I think there is better knowledge and advice on here! x

[Briony]

The worst fatigue I've had has been before I started HRT. It really scared me.  I've had it since in smaller doses and nearly always, it has coincided with either a dip in estrogen or rise in progesterone. When it strikes, it stops everything, doesn't it? Do you get anything else with it such as nausea or chills?  It could be worth you keeping a diary of when it strikes, if you dont already. That's how I real sued it was linked to my progesterone going up rather than too much estrogen.
Really hope you get things sorted soon x

[Briony]

Ps it took at least three months for the HRT to start making me feel better x

[Unhinged]

Hi Briony, thanks for replying, yes you're right it does stop everything. At first it was just evenings when I expected it really after a day at work for example, but now I am waking up like it - takes me ages to force myself to get up in the morning and stays with me most of the day. I don't get nausea with it, or the chills, so can only think it's the oestrogen or progesterone but as I'm on conti I have no chance of working out which!

I am going to do an experiment, I haven't taken my HRT pill today and my mind feels slightly sharper tonight, so I will see how I feel fatigue-wise tomorrow. If it starts going I may have to try to do without HRT as I have all the usual stuff like the flushes and generally feeling like rubbish, BUT I would cope with that. The worst part for me is the anxiety and as the HRT doesn't seem to have improved that I may as well abandon it.

What HRT are you on, do you have many side effects from it or has it been good for you?  x

[Dancinggirl]

Unhinged - you poor thing - you are having a rough time.
I actually don't think it is the Femoston giving you terrible fatigue. I do think you need to give it at least 3 months to see if it helps. Femoston ultra low dose would take longer to start working as it takes longer for the oestrogen to build up in your system.  In my experience high doses of progesterone can make one feel more fatigue but you aren't using a high dose. You say you only took the Femoston for a short while but you don't say how long? Taking erratically every other day won't do any good at all.
It sounds to me as though your anxiety is overriding everything.  Some women need an SRRI alongside HRT to really keep all symptoms under control. 
Femoston is a good one to try so do keep going - maybe your body is telling you that it needs some rest - I've suffered with awful fatigue at times and sometimes one needs to just give in and rest. Severe anxiety is exhausting.  Take care and keep posting.  DG x

[Unhinged]

Thanks Dancinggirl, gosh, sometimes you can't see the wood for the trees - I think you've hit the nail right on the head! The anxiety is absolutely exhausting, after a  bad spell I feel like I've got a hangover for a few days, I only said something similar myself on someone else's thread - why on earth didn't I realise that might be the cause?! Shows what a fog I'm in.

Thankyou, you might have saved the day, I will continue with the Femoston (only been on two weeks or so). Oh, that's another good point you made; if the oestrogen takes a while to build up and I'm on a very low dose anyway, does progesterone take effect more quickly? Could it be that until the oestrogen has built up I'm actually getting a higher ratio of progesterone to start with while I'm waiting for oestrogen to build? I hope you understand what I'm rambling on about - I know what I mean but don't think I'm explaining it clearly! x

[Briony]

I know just what you mean, and agree, if that makes sense? DG speaks very wisely about both the HRT and the anxiety. I had a similar response from another member when I was in your position and I am so glad she encouraged me not to give up! Hang in there if you can, so at least you can say you gave it a fair trial xxx

[Unhinged]

Thanks Briony, I'm glad that made sense and you agree, I'm going to persevere then, I note yours took 3 months and I've heard some say six, so I should at least try for the 3 months! xx

[Sunnydays]

Hi Unhinged, if its any help i chopped and changed when I first started hrt and it didn't do me any favours. Initially I tried femm seven conti and it did stick but gave me severe migraine headaches, I wanted an extra low dose and had a presecription for femsoston tablets but they are still in the drawer because I really wanted a patch. I now have evoril conti and I started on just a quarter patch and now 3 months later I'm on just under half a patch. I can't say it made me tired, although I did have low levels of anxiety, strange thoughts, tension headache and nausea, BUT, these have just about all gone, even with the higher dose of half a patch. If you're happy with the hrt route I would say give it 3 months. (I'v worked out that if a full patch is classed as medium dose, I must be on just about low dose)

[pepperminty]

Hi,

The dreadful feeling of being out of control with anxiety and depressive thoughts is very scary. Yesterday I actually asked a friend to text me this morning to check I was still conscious! As I was so scared at how ill I was feeling.

The ladies who have posted are right , you really do need to give it a good 3 months. That is how long it took me before I saw an improvement.

If your hormones are also still playing in the background it will take time for the HRT to stabilize them.

I would recommend asking your GP for counselling to help with the anxiety, there are courses such as CBT that the NHS run and they really help.

Zombie fatigue is the worst, I know I have had it and still get it.

I think that it is important to take some control if you can and knowledge is power.

But it is a bit of a roller coaster unfortunately.

Peppermintyxx

[Unhinged]

Thanks very much for your suggestions Sunnydays and Pepperminty, yes I think some sort of counselling may help. I need to make a decision on the HRT I know, the Evoril patch is out for sure, I only used a half patch and that low mood was worse than the anxiety attacks; it was sort of different, really really dark.

I am third day off of HRT, I'm still  tired but not so zombie-like and am able to shake myself awake and function. I suppose the only way to test is to go back on the Femoston and just see what happens!

Thanks again for all your suggestions and tips, and sorry to hear you are still suffering the anxiety too. I know that some ladies who have gone a few months on HRT have more control of the physical symptoms like flushes but still have the anxiety. I wonder how many ladies win with both physical and emotional on HRT? I know there is the option to add an AD though. I just wish that the medication didn't have potentially just as many side effects as the menopause itself! xx

[Dancinggirl]

All I know is that I feel far more in control and alert when on HRT but for me it has to be a lowish dose.  Off HRT I really don't sleep well, so I go through my days in headachy exhaustion. DG x

[Hurdity]

Hi Unhinged

The problem with all of the HRT types you have tried is that they are  continuous combined - meaning as you know you are taking oestrogen and progestogen every day. This is of course how HRT is prescribed for post-menopausal women - but it does mean that those who are senstivie to progestogens ( whether natural or synthetic) have a continuous dose and may suffer from continuous progestogenic side effects. Since progesterone is a sedative - the fatigue can be due to this - natural progesterone (Utrogestan) certainly affects me like this and the fatigue/hangover feeling is typical. Some of the synthetic progestogens also cause depression and anxiety.

Added to this low oestrogen also can lead to depression and tiredness. The Femseven and the Evorel would probably have given you a higher dose of oestrogen which you probably need - ultra low dose is very low!

Personally as you are post-menopausal - if you haven't suffered from depression in the past and don't feel that life events are causing you to feel like this - then you don't need an anti-depressant, if your problems are hormonal.

My suggestion would be firstly to give the HRT the 3 months as others have suggested and see if the side effects lessen and you feel better, but if not to bite the bullet and try separate oestrogen and progesterone - firstly on a cyclical basis (to see if it is the progestogen causing your fatigue/depression) and take it from there. It does mean you would have to have a withdrawal bleed but in the long term you would be able to decide what you can tolerate and then adjust your regime accordingly. You would be able to choose a dose of oestrogen which enabled you to feel fine.

You are still fairly young - I did not start HRT until I was about your age - but I was in late peri-menopause and started straight away on a cyclical HRT which has suited me ever since - now age 62 and still on it. It is worth getting it right and not give up as yet! I have only ever been on a dose of 50 mcg patch for my oestrogen and it has always suited me.

Hope this helps

Hurdity  x

[Unhinged]

Hi Hurdity,

Thanks very much for posting, and yes it does help, it all makes perfect sense. I think it is either low estrogen, or the progestogen causing the fatigue, simply because the fatigue feels 'unnatural' - as though I have been 'drugged'. No, I have never suffered depression before menopause - I was always the opposite, the 'let's go for it' type, usually chivvying everyone else and trying to cheer them up.

I've made up my mind, I've going to carry on with the femoston for 3 months as everyone has suggested, if I feel better great, but if not then I will try the separate, like you say it's only then that I can work out which of the two doesn't agree with me. I didn't want to go back to a monthly bleed as it's been 4 years or more since, but I would be very happy to have a bleed a longer intervals - I think I've read some of your other posts and you can do a 'long cycle'. I am assuming this is what you do, and even though the Utrogestan causes you fatigue, it's something you can handle if it's for a shorter period each cycle?

Thankyou Hurdity, I found your response very encouraging x

[Hurdity]

Absolutely - I get that drugged feeling on the utrogestan after it builds up. Yes I am on a long cycle - and there are several of us doing various longer cycles from 5 weeks to someone who I think does 3 months ( probably too long for me) - with the support of doctors. Yes I can cope with the side effects (because I am not severaly intolerant to progesterone) and often it doesn't build up until about the 5th day. I use it vaginally too so I don't get the nausea that some women experience.

I was just like you - lots of get up and go - still do some of the time - but feel lethargic and sluggish with heavy head during some of the time on the utrogestan. I feel perfectly all right on the oestrogen) not quite as zingy as when fertile - but as well as can be expected 

Of course the downside is a bleed - but this to me is the lesser of the evils given we have to take something - and partly why several older women such as me still have a bleed - because this gives fewer side effects than taking progesterone all the time!

Good luck and keep us posted with how you are!

Hurdity  x