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[rebel2]

I have been taking progynova 1mg on and off for three years now.   Other than the hot flushes [which I could have borne] my main symptom is awful anxiety, although I also take the HRT for preventative reasons and feel it is a good route for me.  [had hysterectomy, kept ovaries].

But lately, my anxiety has gone sky high and I am now struggling with insomnia.   My GP is useless on the menopause and I wondered whether an increased dose of HRT might help?  Or should I try stopping and switching to ADs?   I tried citalopram two years ago and hated the flat feeling and the tiredness, but have recently been given a prescription of sertraline, but am too scared to take it.

Any thoughts?

[Hurdity]

Hi rebel2

How old are you and have you any idea where in menopause you are ( difficult without a bleed)? Wherever you are, 1 mg tablet HRT is a low dose (perhpas suitable for early peri-menopause) and depending on your age and stage your oestrogen levels could well be falling overall especially if you've been taking it for 3 years. The great Prof Studd has done research on reproductive depression and suggests that some women need much higher doses of oestrogen than the average across the menstrual cycle - in order to feel well. Not suggesting you are depressed but I wonder if you have thought of increasing the dose - either to the 2 mg dose or perhaps switch to transdermal oestrogen - as a patch or gel? Is this something you can discuss with your doctor?

Because it is such a low dose I would suggest it is better to try this (an increased oestrogen dose) before thinking about ADs. How are your flushes and sweats anyway?

As well as increasing your oestrogen dose, there are also various ways of dealing with anxiety other than medication such as ADs which you seem reluctant to take, and especially are not appropriate for menopausal anxiety in the absence of any particular reason for it (personal, financial etc). I'm sure you've thought of all of these and perhaps tried other strategies - is it you that takes a lot of exercise already? Sorry I can't remember everyone's story!

Hopefully you will find a solution soon to enable you to feel better 

Hurdity x

[rebel2]

Thanks Hurdity.  I'm 57 and think I'm well into my meno journey - hot flushes started about 7 years ago but didn't get unmanageable until 3 years ago, when anxiety hit big style and hasn't really gone since.

I've completely overhauled my lifestyle and can't really do any more to alleviate the anxiety - I eat well, avoid alcohol, gave up the fags, strayed running and do yoga every week.

Need to go to GP next week for new prescription so will discuss increase in dose and perhaps a switch to transdermal.   Flushes and sweats aren't an issue on the low dose, but anxiety has become a major problem and is starting to cause real physical issues.

Am I too old for a higher dose?

[Roseneath]

Hi Rebel 2. I wondered how you are getting on as your symptoms; anxiety / insomnia seem similar to mine. I had a bad patch last May but with my GP (and a short dose of benzoates) managed to come through it. The (health) anxiety has been off and on an I have tried a self help NPS course, CBT, Melatonin, Nitol etc.   Last week I had one bad nights sleep / no sleep and boom the insomnia has come back; I am so tired but can't sleep then worry about it. When I have no health worries on my mind like now I gravitate to sleep worries I think.  I have an unsubstanciated theory that it is high hormones that cause this and it is related to anxiety as it hasadefinate cycle to it.Have you found anything helps?

[rebel2]

I'm luckily going through a really good patch at the moment.  Fingers crossed it lasts a while.
To be honest I've come to the conclusion that I'm not sure mine is totally hormone related.   I'm not going back on ADs as they only mask the problem.  I run, do yoga and look after my health to rather an obsessive degree.

I was always a glass half empty person!   Am going to try forgetting about my anxiety for a while, which will probably mean less visits here as it just tends to fuel my issues when I'm down.

Good luck with your struggle.

[Yammy1]

Glad your feeling better rebel2. Just wondering, I'm two weeks taking citalopram tomorrow. My anxiety is worse since starting but I expected that, but like you I feel really flat, down and fed up. I am strongly thinking of going back to doc and giving hrt one more try. I feel my anxiety is hormonal

[Hurdity]

Thanks Hurdity.  I'm 57 and think I'm well into my meno journey - hot flushes started about 7 years ago but didn't get unmanageable until 3 years ago, when anxiety hit big style and hasn't really gone since.

I've completely overhauled my lifestyle and can't really do any more to alleviate the anxiety - I eat well, avoid alcohol, gave up the fags, strayed running and do yoga every week.

Need to go to GP next week for new prescription so will discuss increase in dose and perhaps a switch to transdermal.   Flushes and sweats aren't an issue on the low dose, but anxiety has become a major problem and is starting to cause real physical issues.

Am I too old for a higher dose?

rebel2 if you are only taking 1 mg then depdending on how much you are absorbing then this could well be too low. Some women just don't absorb well from tablets. I would suggest you are not too old at all. Progynova 1 mg is classed as low dose whears the standard post-menopausal oestrogen dose for transdermal oestrogen is medium dose ( 50 mcg). Obviously we absorb differently but your residual symptoms could well be due to the low dose.

If you don't have a womb then it is all so easy! I would really try a patch if you haven't done so already - I recommend these because they have worked so well for me from late perimenopause onwards and here I am in mid 60's (yes still with a womb so having to take prog) still on medium dose 50 mcg + a little bit. Estradot are so good but annoying that they are rationed (have to go back each month although you still get the 3 months for the one prescription).

I really would try this for a few months before thinking about ADs because in any case that low dose is not licesned for osteoporosis protection (although all added oestrogen does help to some extent).

Hurdity  x

[rebel2]

Thanks Hurdity - I will try the patch route when I next visit.  We are moving soon so hoping for a more sympathetic doctor.