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[Tracey]

Hoping someone can give me some advice!

I am 49 and have had a partial Hysterectomy - ovaries remaining. Over the past 18 months I have been really struggling to understand what on earth is happening to me. I feel so far removed from who I once was. I have had 3 anxiety breakdowns, the last one being severe and was unable to function or work for 2 months. Other symptoms during this time on and off have been headaches, night sweats, hives, my skin tone is horrid, hair shedding, insomnia and have no sex drive what so ever! as well as the most debilitating ache in my hips and upper arms. I have been seeing my GP who such a great support and has helped me get some control of my life back. Because I have not had periods due to my hysterectomy over 13 years ago, I am unable to say if all what has happened over the last 18 months is due to menopause or not. My GP says could be, but will not do blood tests as she said they are not reliable. Kind of doesn't give me any definite answers. In some ways I feel I could accept things better if she could say 'yes this is menopause' rather than me thinking I have some kind of other disease!!

I have been put on sertraline 50mg a day and I must say this has helped me get a bit of my sense of humour back but has not helped with the other symptoms. Some side affects but they out weigh my low mood.

My GP has mentioned HRT (oestrogen only) but am unsure as to what to expect from HRT. I would be so grateful if anyone on here could give me some advice or identify with what's happening to me.

Many Thaks Tracey

[CLKD]

Welcome!  Sounds like it.  What baffles me is why Consultants don't discuss HRT requirements with their patients PRIOR to any surgical intervention  , writing to the lady's GP telling him/her what may be needed!  If I were you I would be ringing the Consultant and ranting at him/her ........

In the mean time have a browse round, make notes.  Hormone blood tests are reliably un-reliable, my Gynae prefers to go on symptoms.  Some find it better to keep a mood/food/symptom diary for 3-4 months to see if there is a pattern.  Is there a Practice Nurse who might be more helpful or is this particular GP interested in womens' problems?  It should say on the Surgery web-site.

As oestrogen levels drop muscles may become lax = aches and pains as well as drying out the body,  inside and out: i.e. nostrils, deep in the ears, vagina, skin 

[Tracey]

Hi,

Thanks for your reply. I'm not sure if my GP specialises in women's problems but she is the only GP I have seen since my Anxiety hit. It has been a bit of battle getting that under control which is now a lot better, this is what she has concentrated on more than anything.  The discussion about Menopause has been in the last few visits and it is me who is suggesting it rather than her.

I am new to the site and  have found many of the threads informative and can certainly identify with what many of the ladies are saying. So glad I came across this community and the wealth of information on here.

[CLKD]

You are very welcome. It's about sharing experiences and taking from them what suits personal requirements.

Anxiety - regardless of what causes it - should be treated first so that one can see the other options for HRT etc. with a clearer mind.

[Hurdity]

Hi Tracey

 

Oh dear - yet another doctor who hands out anti-depressants rather than HRT - and not willing to consider menopause. ADs are not the first line of treatment for menopausal symptoms (including low mood) and just because you don't have periods due to hysterectomy, this is no excuse for your doctor to hesitate! If she considers that blood tests are unreliable ( which they are) then how would she propose to diagnose you with menopause. Given your age and those symptoms, approaching ovary failure and menopause is extremely likely! For women aged under 40 with menopausal symptoms doctors do two blood tests 4-6 weeks apart as a diagnosis so no reason not to do this in your case. On the other hand you could easily be given an oestrogen only HRT eg a patch and see how you fared.

I would ask for oestrogen only HRT - you are in such a good position to take this as it is the progestogen part of HRT which usually causes the most problems, and then hopefully wean off the ADs

This is quoted from the Menopause Matters Facebook page last Monday (they have a series called mythbusting Mondays:

**Antidepressants are not recommended for first-line treatment of menopausal symptoms such as flushes and low mood, yet are often offered by some GPs. Some antidepressants can be used if HRT is unable to be taken for medical reasons, but only after full discussion and after ruling out the use of HRT.**

HRT is what you need to help with your symptoms and mood!

Good luck and do ask if there is anything else we can help you with

Hurdity x

[Tracey]

Hello Hurdity,

Thank you for your post and the info. I fought off taking anti-depressants for well over a year, but as things seemed to get progressively worse I gave in as I felt there was not other option for me. I insisted that I stay on the lowest dose as for the shortest time possible. I also feel I have been as proactive as possible, I started Yoga for relaxation and exercise, tried various vitamin supplements, menopace even hair loss shampoo

I can honestly say I was in no way prepared for this huge change, and certainly didn't realise just how menopause can affect every aspect of who you are as a woman. I am now trying to educate myself in order to have some control over its effects - if that's possible!!

I have a review with my GP next week, HRT was discussed at my last review but they wanted the sertraline to settle into my system first. I have given HRT a lot of thought and the decision to go down this route. A little respite off of the steam train of doom would be welcomed  Do you know where I can access good advice/information on the types of Oestrogen only HRT that can be prescribed?

Thanks again

Tracey

[Tracey]

Hi,

Even though I resisted Sertraline, it has defiantly made positive difference. I was at a point where I felt stuck in a place, couldn't move forward, everything felt hopeless and I was totally lost. I don't even think I had smiled in months, just tears! But I am back at work, laughing with my colleagues, back working on my allotment and garden and I am so very grateful for that. For me its been about accepting help and accepting that no matter how hard I tried I wasn't going to be able to cope with this without medication.

Its now about getting the right combination of medication in place to deal with this phase of my life, so that I have a life!

Also grateful for all advice - having people to talk to really helps

Thanks Ladies 

[Elizabethrose]

Hi Tracey     lovely to have you join us!

I have to agree with CLKD, many ladies need both HRT and ADs, unfortunately HRT is not a cure all for everyone. Of course we are aware that ADs should not be the first line of treatment for menopausal symptoms, however, for some women ADs are necessary and give them the chance to mentally repair before the benefits of the HRT kick in. I'm really pleased that the Sertraline has helped you so much Tracey and now hopefully you'll soon also experience the benefits of some added oestrogen!

Wishing you well x
 

[Mbrown001]

Oh how I wish that HRT helped my anxiety, that would be so good. I was on HRT before anxiety started to become troublesome so for me like many others HRT has not helped that aspect at all.

Now you are settled on your AD then perhaps you will be in a better position to make the desicion as to whether you want to try HRT.

Please remember what works for one woman may not work for another and also please don't be pushed into thinking that you or your GP has made the wrong choice by starting an AD.

There are some that just see HRT as the only option when in actual fact other things may be needed to help.
It's all about quality in my eyes.


If you look at the top of the page you will be able to access a link to the different HRT's that are available to you.

If you do decide that this will be your choice then the general consensus is that either a patch or gel is the best way to go.



Mrs  Brown

[Hurdity]

Hello Hurdity,

Thank you for your post and the info. I fought off taking anti-depressants for well over a year, but as things seemed to get progressively worse I gave in as I felt there was not other option for me. I insisted that I stay on the lowest dose as for the shortest time possible. I also feel I have been as proactive as possible, I started Yoga for relaxation and exercise, tried various vitamin supplements, menopace even hair loss shampoo

I can honestly say I was in no way prepared for this huge change, and certainly didn't realise just how menopause can affect every aspect of who you are as a woman. I am now trying to educate myself in order to have some control over its effects - if that's possible!!

I have a review with my GP next week, HRT was discussed at my last review but they wanted the sertraline to settle into my system first. I have given HRT a lot of thought and the decision to go down this route. A little respite off of the steam train of doom would be welcomed  Do you know where I can access good advice/information on the types of Oestrogen only HRT that can be prescribed?

Thanks again

Tracey

Your post says it all Tracey and especially your comment that you fought against ADs because you felt there was no other option. It was your doctor's duty to offer you that option - ie HRT! We do have to help women who feel strong enough, to keep challenging their doctors because change happens from the bottom up as well as top down!

By the way I am of course very pleased that you are feeling better but sorry that you had to start on a course of treatment that the medical profession should not have prescribed initially especially after you resisted for so long and without any treatment! Had the doctor considered menopause initially and offered you oestrogen - you might not have got to the position where you were desperate.

What the enlightened medical profession and gynaecologists are striving to do through Menopause Guidelines (NICE), position statements and recommendations on HRT ( British Menopause Society and Women's Health Concern) and especially this website ( Dr Heather Currie as well as other pioneering doctors), is to educate GPs and others to try to get them to depart from their entrenched views – whereby they reach for anti-depressants the moment the word anxiety is mentioned, rather than look at the whole picture taking into account a woman's age and stage, and any other symptoms she is complaining of. It is precisely the opposite of what you are defending CLKD – there is no excuse of appointments being too short and what the woman presents with! It is the job of GPs to THINK MENOPAUSE and entertain the possibility of a hormone link! That is what all of this is about! I'd love to see that up in all their consulting rooms – a bit like the road signs you see THINK BIKE!

I deliberately quoted the myth-busting Monday post to demonstrate that it is not my view I am expounding here – it is the current view from menopause experts! Nowhere has anyone said they are opposed to ADs per se not even that some women may need both – it is as the MM FB post said – HRT should be considered first. Of course there will be exceptions and if a woman is in danger or absolutely cannot cope then a different approach might be needed.

Women's experiences of ADs in their previous life (before menopause) for whatever reasons is not relevant to the discussion about their use to treat menopause – and is not a reason to suggest the doctor is right to offer them!!

Also  - oestrogen replacement in any case is advised for women who reach menopause before the average age which is 51/52 – to protect heart and bones – although you don't know quite what your ovaries are doing at this point!

Tracey if you want to try oestrogen – you need to decide between tablet, patch or gel – but I would recommend transdermal HRT as being the most direct route. I have used patches (mostly changed twice weekly) for 10 years and swear by them – but others prefer gel (applied daily). The different preparations are listed here:
https://www.menopausematters.co.uk/treatafter.php

I do hope this is helpful and you are not disheartened – the main point is you can go forward with the knowledge that you should be offered HRT and then you might actually be able to withdraw from the ADs as you hopefully feel better and better.

If there is anything else we can help with please ask and do let us know what you decide and how you get on!

Hurdity x

[Tracey]

Hi Everyone,

It defiantly is all so very confusing. At this point I have no idea what treatment is going to be right for me. I know very little about options available or even how I will respond to them, if I go down that route. But I am learning.

I came to the forum to gain a better understanding from women who have been experiencing menopause symptoms for many years and how it can affect them but also experience of medications and how it has helped them. I do understand that everyone is different and what works for one may not work for another and so on. Before taking the Anti-depressants I don't think I was in a position to make any decisions about anything. I really didn't know what was happening to me.

I have faith that my GP prescribed Sertraline in order to get me out of a real crisis point, one where I am able to think more clearly. I was being told it was anxiety but I wasn't being told that the cause of the anxiety could have been because of menopause and hormone levels. I now know this to be the case.

I will continue to learn from you all

Tracey

[dazned]

Tracey hi

As you can see hormones have a lot to answer for especially psychological symptoms,ie pms,post natal depression all caused by hormone imbalance. Unfortunately there is no one size fits all. I was doing well for years on hrt then anxiety kicked in big time ! When no hrt helped me at all I started ADs and that is worked for me and at that point I couldn't care less what caused it I just wanted it stopped ! Some find relief with hrt,some with both hrt/ADs and some just use ADs it really is all down to the individual and what works for you. Also what relationship you have with your gp as we can quote the new NICE guidelines til we blue in the face the truth is gps are not under any obligations to prescribe if they don't feel the need,much as we would like them to.
Possibly book a double appointment and whilst waiting for it keep a simple diary spreadsheet with a few symptoms on any given day,don't get too obsessive though  see if a pattern emerges. Discuss with gp,try to get them on-board with which route you want try first. Hrt can take awhile to work in the short term ADs could ease the way for you to have some clarity.

[Tapnut45]

Hi Tracy, I agree all this information is a lot to take in, and I've been doing some reading up and looking around the site as suggested too.

From what I've read, estradiol is the natural estrogen and people seem to get on better with this. Personally I don't like the idea of equine estrogen as it comes from horse urine! But I know it works and I just don't like the idea of it!
Here's an article on HRT and Risks and Benefits https://patient.info/doctor/hormone-replacement-therapy-including-benefits-and-risks
As others have already said, you can find information and articles on this site at the top via the green bar, which are very helpful. These two might answer your question "am I going through the menopause?" https://www.menopausematters.co.uk/physical.php - info about physical symptoms, and this one https://www.menopausematters.co.uk/psychological.php about psychological symptoms - it certainly sounds like it with what you described. (I told you I'd been exploring the info!)

 I saw my GP in about Feb as I was having the anxiety problem and other psychological symptoms (very snappy and irritable, just wanted everyone to p*** off and leave me alone as they were all so annoying.......), not being able to settle in an evening and wandering around aimlessly being stressed. Lovely. So when I went to see the doc, it was those symptoms I wanted most of all to be sorted, and I was given the choice of ADs, HRT or wait and see. I know a little more now after finding this forum, so if I went back in time to February I may have chosen the HRT, but at the time, it was my choice, it was what I wanted, and it has worked for me too. I feel a lot better in myself, and can now think more rationally and understand what my other symptoms are ie menopausal, so now thinking of HRT. I've not had a hysterectomy so will have to be combined HRT for me, and I'm hoping the GP will explain some of my choices. I want to avoid norethisterone as I think it affected me with sweats, but apart from that I just want something easy to use that I won't forget.
Good luck Tracy, hope your doc is helpful and willing to take the time to answer your questions carefully. 

[Tracey]

I just thought I would let you know how I am getting on. I had my review with my GP yesterday and I must say she was brilliant, she went way over the allotted appointment time to really listen and ask questions about where I am now with regards to everything that's happened over the past two years.  We talked about how I had settled on the sertraline. I have been taking it for over two months now and only really have one side affect which is slight restless legs in the evening (not major). AD's have definitely got me to a better place and as I have said before the anxiety is pretty much under control. We talked about what symptoms continue to be an issue for me. Aching bones, hot flushes and constant vaginal itching still cause me a lot of discomfort

I had taken the advice from everyone who replied to my initial post and did some research on HRT so I knew what was out there and what all the possible side affects were, also what the pro's were. My GP said that she felt now was a good time to think about introducing Oestrogel and prescribed one pump per day for the next 3 months to see how I get on and then have another review to discuss if has made a difference. I must say I left the GP surgery feeling like I was holding a golden ticket to Willy Wonkers chocolate factory!!

I had my shower last night opened the pump bottle, looked at it for 20 minutes and then put it back in its box  ........... What is that all about? I'll sleep on it was my next thought. This morning I did exactly the same thing. Is it the apprehension of what it may or may not do for me. Is it because of possible side affects? What will happen when I have to come off it? Is it because its the start of another type of journey in this ever changing period of my life? Will I grow horns?

Has anyone else got to this point and felt the same way?

Tracey

[Emma]

I'm locking this thread as it had a lot of off-topic heated posts which have been removed.

Emma