Hi Jo
Welcome!
I had symptoms of anxiety and depression when I was peri-menopausal and was originally out on HRT tablets (Femoston 1/10) which worked okay for the first six months (this was five years ago) but over time didn't and for the past two years had horrible psychological symptoms but no hot sweats. I finally worked out it was probably low oestrogen levels as I had all the symptoms, asked my GP for an increase; she refused, saying I needed to be weaned off HRT, and wanted me to go on AD's which I didn't want to do. My oestrogen levels were 72, which is lower than most men's!
Long story short, I saw Professor John Studd privately in April this year and have done really well on his regime and feel better than I have done for years.
He prescribed oestrogen (Estrogel) gel continuously (transdermal oestrogen gels or patches are a far safer and far more effective option than HRT tablets), a very tiny daily dose of Testim (testosterone) and micronised progesterone (Utrogestan) tablets which I take at 100mg for 7 days each months (in order to get the necessary withdrawal bleed).
It cost me £300 to see him for the initial assessment and there is follow up at 3 months and then every 12 months after that. I got my hormone tests done on the NHS which he accepted so I did not need to pay for his private blood tests (which from memory, was about £300 and included everything from vitamins levels to hormones). I also get all my HRT prescribed on the NHS as he wrote to my GP, although his private prescription for 3 months of HRT is about £70 to £90 in total to get dispensed.
Studd also goes by symptoms and medical history, as well as hormone levels and he certainly did not insist on having unnecessary blood tests at additional expense to me
It's a shame I had to pay to see him, but I had no other option as clearly my GP wasn't interested.
I'm not entirely clear about what you mean by "bio-identical hormones" as that term seems to be used in different ways by different clinicians. Certainly from all the formal clinical research I have read, Studd's treatment regime is considered "bio-identical" and also the use of progesterone creams have limited, if any clinical efficacy. I think they and other alternatives seem to work because hormonal levels fluctuate when you are peri-menopausal so some women think they are effective when in fact it's their natural hormones kicking in, not the herb or cream.
He also suggests that peri-menopausal women with a history of what he calls "reproductive depression" (i.e. hormone responsive depression, such as history of depression being worse before a period, PMS, PND, feeling fine during pregnancy, PMS returning as periods return, recurrent cyclical depression, react badly to progesterone whether oral or depot, etc.) need HRT and not AD's as the latter as likely to be ineffective in treating the underlying hormonal cause
He argues that peri-menopausal women often recognise they have hormonal depression but because their oestradiol and FSH fall within a "normal range", GP's often brush them off and prescribe AD's. When AD's often fail, usually they will be given a second AD, at a higher dose and are often misdiagnosed as having conditions such as Bi-Polar Disorder, recurrent depressive disorder, generalised anxiety disorder, borderline personality disorder, etc.
He also says that diagnosis should be made on history, and not blood tests and that HRT is usually has a better response to depression/anxiety rather than AD's.
As you'll gather, I am a fan of Studd's treatment regime, as are many other women on here who have either seen him or got the same treatment via the NHS. Personally I've found his treatment regime to be life changing. I feel better now after 4 months than I have for years and for me it worth every penny to see him. Ideally it should be available on the NHS, whether via a GP or Menopause Clinic, but from many of the posts on here, sadly that is not always the case.
HRT should be the right hormones, at the right amount and the right format of delivery for the individual but often it's a "one size fits all" approach in the NHS, which I think leaves some women giving up on HRT as they are given the wrong treatment and feel worse on it as a result.
Look around on the forum and read previous posts and views to get as much info as possible.
I knew very little about HRT before deciding to see Studd and the whole range of options , but after lots (masses!) of research, feel I made the right choice.
If you want any more information and/or clinical articles do PM me and I'll be happy to forward them on.
Sorry for the long post!
Good luck.
Freckles x
