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[joybean]

Dear All, following removal of my fallopian tubes, I was on HRT for 5 years until December 2016. I'd tried all the cutting down to half patches but it just became too chaotic, so with advice from my doctor I thought it best to pack in altogether. Since then things have got steadily worse and as well as hot flushes, sweat dripping down my face and the hideous night sweats I'm also getting heart palpitations. My doctor has prescribed Fluoxitine (prozac) and I am now really confused and a bit frightened. The sweats have a stress element but that isn't the whole story and the idea of taking an anti-depressant when I'm not depressed feels like I've woken up in another decade. Will it cure my  palpitations or will I just not care about them so much. Any experiences?

[babyjane]

Hi, you are very welcome. I am just off out but will return later.  There are many members who can comment on your question and hopefully they will be along soon.  Meanwhile why not type 'anti depressants' into the search box, there are many threads about these 

[Butterfly22]

I don't no much but could he not try more HRT as so many combos to try. Xxx

[Samade]

antidepressants aren't just for depression, they can work on sweats but you'll know within a few weeks if they work for you. I found fluoxetine good for night sweats after the first fortnight, my doctor said to me you are not depressed.

[br350]

My sister has been on antidepressants (an SSRI similar to Prozac) for a number of years for a diagnosed anxiety disorder.  She has, interestingly enough, had a very smooth and uneventful menopause with only the mildest of hot flashes - she said she cannot even truly call them a flash but more a sense of overheating.  The SSRI's have been shown to help and in smaller doses (I believe) than clinically indicated for relief of depression or anxiety.  No one knows exactly how or why they work to combat flashes, but they do seem to help some people.

[samweller161]

Hi Joy

I take HRT (Elleste Duet) and also AD's as I suffered with anxiety/depression before the menopause.  I mainly started HRT for the night sweats - as I work full time, I was having trouble concentrating through tiredness and they did help.  They are not a miracle cure but I don't have as much brain fog as I used to (I could sometimes forget my name even - lol).  A lot of docs prescribe AD's even before HRT which I don't think is the right way personally but you can take both without any problem.  Another example is a friend of mine in Scotland who cannot take HRT but does take 20mg Fluoxitine and she has gone through the menopause without too many issues.  Let us know how you get on?

SP x

[CLKD]

Many medicines World Wide have been found to ease symptoms that they were not initially designed for.  What's to lose?  If this AD helps with the sweats then you get some relief, if not you know to cross it off the list and ask for HRT.

In the meantime, have browse round: make notes. 

[Taz2]

Hi Joybean - welcome!

Can I ask why you stopped using HRT if it had been successful for you? There is an old way of thinking that five years is the maximum time allowed on HRT but this is no longer the case.

Fluoxetine (Prozac) can be prescribed for prevention of hot flushes but this is in a smaller dose than if it is used as an anti depressant. However, it doesn't help with other meno symptoms such as vaginal dryness.

Taz x 

[joybean]

Hi Taz
My doctor wasn't keen to give me HRT beyond 5 years. She showed me the figures and there does seem to be a dramatic rise in breast cancer risk beyond 5 years.

[CLKD]

Which figures?  Do you have a familial history of cancer  .  Decide what quality of Life you want!

[Hurdity]

Hi joybean

 

Notwithstanding the other members' experiences of anti-depressants, as Taz says your doc is out of date in terms of blanket refusal to prescribe HRT beyond 5 years. Anti-depressants should not be prescribed instead of HRT for menopausal symptoms if there is no reason why you should not be given HRT and you are not depressed.

All this information has been updated recently and sounds like your doc is looking at out of date information and stats. In any case the absolute risk of breast cancer is low and especially if you make sure you are not at risk from cancer through other life-style factors ( being overweight, smoking, drinking too much alcohol).

There is a lot of information on this site:
https://www.menopausematters.co.uk/risks.php
https://www.menopausematters.co.uk/balance.php

Here also is a blog by Dr Heather Currie (gynae founder of this site):
http://wwwmenopausematters.blogspot.co.uk/2016/04/hrt-and-breast-cancer.html

I've just posted the updated British Menopause Societies recommendations on HRT on another thread so will just post the link here:
https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/

You haven't said how old you are? Taking it up until the average age of menopause ( 51/52) doesn't count in terms of risk (and years of taking HRT) anyway as you would have been having much higher oestrogen levels naturally.

I would urge you not to take the Fluoxetine if you are not depressed and to go back onto HRT - as it sounds like you want to do - if there is no medical reason why you personally should stop.

Hurdity x

[Taz2]

Really informative post Hurdity - thank you. 

Taz x

[nearly50]

You haven't said how old you are? Taking it up until the average age of menopause ( 51/52) doesn't count in terms of risk (and years of taking HRT) anyway as you would have been having much higher oestrogen levels naturally.

Hi Hurdity, off topic slightly I know, but I was wondering why you say 51/52? If the average age of menopause is 51 in the UK, surely only up to the age of 50 (average final menstrual period) doesn't count? This is what I've read elsewhere and I just wondered if your source was more up to date than mine? Thanks.

[Hurdity]

Hi nearly50 - yes a bit off topic but good point. The actual average age in developed countries according to what I have read is 51.4 (not sure if that is 51 and 4 months or actually 0.4 of a year) hence 51/52. Most articles etc say just 51.   This date will be based on a study of a given population of women (sorry haven't time to look it up now but you can google it!) - and will obviously exclude all those who started HRT before menopause as these women would not know - so the sample on which this has all been calculated could actually be biased. Menopause is the date of the last period - only determined in retrospect ie after 12 months without a period has passed.

However it is not a precision thing - not the exact age of menopause nor the risk data - I mean it is not a question of being OK for 5 years and then suddenly not OK. Also with all the stats on risk - women are/were classified according to the arbitrary but convenient divisions of decade - but this does not have a precise biological basis - just approximately! Therefore the stats do talk about risk after 50 - but I think this is more to do with how the data were classified than any actual significance of 50.

If HRT is commenced at a young age because of premature menopause, then the use of HRT up to the age of 50 does not increase breast cancer risk any more than in women who continue to have periods up to the age of 50. Additional risk from HRT only applies if it is then taken for more than 5 years after 50.

https://www.menopausematters.co.uk/risks.php

I have always assumed this to mean approx age 50 because this is approx the average age of menopause and when the stats were calculated.

Sorry I'm repeating myself - hope it's not too garbled and you get what I'm saying!

Hurdity x

[nearly50]

Thanks Hurdity, I always thought menopause started one year after the final period, but that does of course make more sense. You'd think by this stage I'd have got my head round it all