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[Catsjulieanne]

Hi, I am 46 and today have started on Prempak.  I also take Mirtazapine anti depressant and currently the doctor has given me a weeks worth of sleeping tablets (not much effect).  I was fobbed off a lot at my GP when I kept querying why I was still so depressed and anxious despite taking anti depressant for more than 3 months....so changed GP.  She did blood tests (I asked to check thyroid too and that came back OK) but showed peri-menopause (haven't had period for 7 months).  My symptoms besides the bleakest depression and debilitating anxiety include insomnia, shaking, hot flush of face and chest, confusion, aches in legs, dry skin and hair, and increased hair on the side of my face.  I would like to know if others are taking Prempak perhaps also with Mirtazapine and could advise their experiences....side effects, how long it took to see a difference for the better (or worse).  Thanking you in advance, just want some reassurance that the way I've been feeling this last few months is not what I have to accept from now on  The old me has gone.  Terrible depressions/weeping/exhaustion.  Used to have a great sense of humour and could talk to anyone...now I am paranoid and self conscious and would happily hit an off switch if I had one. 

[CLKD]

Have a     

I am sure that someone will be along who takes HRT.  Have a look at the search button and maybe type in the HRT you have been prescribed?

[Dancinggirl]

Hi and welcome to MM Catsjulieanne
You are not alone in feeling this way.  Do browse around this site to get clued up.  Prempak is one of the old fashioned types of HRT but is still very popular with many women. It tends to be trial and error when finding the right HRT that works for you. What a shame you were put on an AD first!!!  Some women need both HRt and an AD/SRRI to really help with low mood and anxiety - you don't say how long you have been on your AD?  - If it isn't helping then you may need a different one.  See how you get on with Prempak but if you find you get too much PMT type symptoms on the progesterone phase of Prempak, it's worth switching to a different one with a kinder progesterone e.g. Femoston 1/10.  There are plenty of options, so do persevere.  At your age HRT is the right treatment to protect your heart and bones for the long term - you are now getting the right treatment so it's just going to be a bit of trial and error.
Keep us posted.  Dg x

[Daisygirl]

I too have had similar symptoms, I was put on mirtazpine and added a morning dose of cymbalta, the combination really helped the mood symptoms, I am currently taking 40 mg cymbalta am and 30mg mirzaipine. Side effects are sweating, feeling much better!

Tried different HRTs and none helped my symptoms, considering trying again at a low dose,
You have to keep trying and finding what's right for you, you'll get there!

[Hurdity]

Hi Catsjulieanne and Daisygirl

  to you both!

I agree with Dancinggirl - what a pity you have both been put on anti-depressants first! The current menopause guidelines state that HRT should be used in the first instance for menopausal symptoms of hot flushes and sweats - and not anti-depressants (unless of course you are taking them for lifelong depression not cyclical/reproductive depression).

Catsjulieanne - I agree try Femoston 1/10 not Prempak as it is better tolerated. Then increase to 2/10 if it doesn't work. Then try to wean off those ADs and sleeping tablets - how dreadful to be given all these pills, when HRT alone may well have been sufficient! Your doc needs an update! Also at your young age - you are probably nearly post-menopause then you do need a decent dose of HRT (oestrogen) to help protect heart and bones until at least the natural average age of menopause which is approx 51/52.

Daisygirl - you haven't said how old you are and where in menopause? If your periods have become erratic along with your symptoms then again HRT is the first treatment which should be given, as peri-menopause is assumed. If you are under 45 then sometimes the doc will do blood tests and if you are under 40 this is essential. Which different HRTs did you try and for how long?

Hurdity x

[Nita5691]

Hiya Catsjulieanne/ladies

I'm just coming to the end of month 4 of taking Prempak-c. It did take 3 months to feel any benefit. Side effects - bloating is the main one but even that seems to be settling down. You describe how you feel "the old me has gone & paranoid" it's a horrible feeling, like your body has been taken over by someone else,  the stage where hormone havoc takes control, and we definitely feel out of control. Taking Prempak-c has helped the sweats, insomnia and mood swings, though symptoms do still
sneak through. I can honestly say, taking HRT has been a positive 😀

Hope you feel better soon,  give the Prempak a few months, if results
aren't bringing any positive, ask to try something else. As others have said, it's definitely trial and error, until you find one that suits

[Catsjulieanne]

Thanks all for your responses and advice.  3 weeks in and after just a few days on Prempak the hot flushes stopped.  No other positive things to report, except I don't know if somehow related but my nails are strong and long having been broken and brittle for a couple of years.  The sleep situation is still as dire but I have been able to grab an hour during the day this weekend which is something I had given up doing in the fear it would affect the paltry amount at night.  When I originally posted I'd just started phased return to work and have only this week done the full 18 hours and I have to say I feel so wiped out this weekend.  I still have had no bleed since December and am hoping they don't return.  Have noticed since starting the Prempak that my legs and back feel quite achy as the day wears on and my eyes feel dry, sore and heavy. Thanks again for the responses.

[Dancinggirl]

Catsjullieanne - it takes a few weeks to really feel the full benefits of HRT.  I think Prempak is a sequential HRT so you should get a bleed after you finish the progesterone phase - so the bleed should start 1-3 days into the next pack of pills.  This should be a light bleed and is just making sure your womb lining stays thin.
You have had a tough time and it is going to take time to get yourself back in the the routine of working etc. - better sleep will gradually return I'm sure. General aches, pains, fatigue etc should all settle - especially if you get to be more active again.
Here is the link to the page on this site that shows all the HRT types for the peri meno stage - you will see Prempak on this list. I would see who the next 3 months go - you may find the Prempak works fine for you - but it is trial  error till one finds the right combination.  Keep us posted.  DG x