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Author Topic: HRT beginner, confused  (Read 823 times)

laszla

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HRT beginner, confused
« on: February 06, 2018, 11:25:05 PM »

Apologies if advice I'm seeking is covered already somewhere, in which case thanks for pointing me in the right direction.
Background: Age 51, perimenopausal (and suspect I have been for many years).
Gp started me on femoston 2/10 about 6 weeks ago at my request.
My symptoms that I linked to lowered hormones were/are: zero energy, anxiety, weepiness, depression, periods resembling someone bleeding to death, a cervical cyst (removed). No hot flushes or sweats, in fact I'm permanently freezing.
To complicate matters, a year ago I suffered the worst bereavment of my life and am still suffering terribly for this loss, had some counselling, trauma therapy etc., nothing really helped.
I mention this because obviously it makes distinguishing between the causes of some of my symptoms more difficult.
Gp was anxious for me to take anti-depressents for my bereavement which I'd rather not.
Strangely enough, because my loss has entailed a lot of crying, this has actually trained me to distinguish between what feel like very different types of crying - tears of suffering for my loss and what I would categorise as hormonal tears which are more like a tap being turned on.
I hoped the hrt could help at least with the hormonal type weepiness and just to clarify, all the other symptoms I mention pre-date my bereavement.

At 6 weeks in, so far the one concrete improvement was a much lighter, more bearable period. Otherwise perhaps a slight increase in energy but anxiety is atrocious Ė perhaps even worse than before. I also have some spots, not full blown acne but appearance is important for my work. No other side effects though bad headache today which I never have.
MY QUESTIONS: I would be grateful for advice on how long I should give it and how to manage my gp who is receptive but not particularly knowledgeable about hrt. Iím having a consultation with her tomorrow.
The chemist told me it takes 3 months to feel the effects Ė should I stick it out for now and if no improvement try some other kind, eg gels, might this make a difference?
I have had only 1 full pack and in a week finish the second one. Iíd say I feel worse in the progesterone half of the pack.
I also donít understand why estrogen and progesterone are given for 14 days each Ė I understand the private/Studd-type regime gives estrogen for most of the month and progesterone for just a week. Is this preferable and if so could I set this up with the gp?
Many thanks
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Nellie Noo

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Re: HRT beginner, confused
« Reply #1 on: February 07, 2018, 06:49:48 AM »

Welcome to the forum ! Im not as knowledgeable as some of the ladies here but yes I was told three months for the body to adjust. I initiallyteied femseven for three months but they weren't working for me so he changed me to gel and utrogestan . I was amazed when he said i could try the oestrogen for 4 weeks and then to introduce the progesterone... for 2 weeks ...so a longer cycle. Not quite what studded recommends but i was pleased that he suggested it . You could certainly ask . I was always worse on the prog x
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Bettythecat

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Re: HRT beginner, confused
« Reply #2 on: February 07, 2018, 07:11:48 AM »

Dear laszla
What a terrible time youíve been through, saying I feel sorry for what youíve suffered sounds like a platitude but I am sorry for your loss. And then the menopause comes along! Nature loves to save everything up for us just when we thought life was getting easier, doesnít it?!
Iíve learned from my short time on this excellent site that everyone has different experiences and reacts very differently to the multitude of treatments, but unless youíve had really bad side effects then it pays to stick with something for at least 3 months to give it chance to build up in your system and take effect. I also felt really bad with the progesterone weeks but 5 months in thatĒs settled down and now - touch wood - feeling calmer and very settled in my moods. The 6 week point was my lowest and I started to feel better at 3 months. I hope this helps a bit. And hopefully your GP is able to guide you but if he isnít then youíre definitely not alone and can check things with the very experienced and knowledgeable people on this site. Good luck xxx
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Dancinggirl

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Re: HRT beginner, confused
« Reply #3 on: February 07, 2018, 08:50:04 AM »

Hi and welcome laszla
It does take time for HRT to work - particularly for low mood if it is hormone related.
Controlling any symptoms in the peri meno stage is more tricky as your own hormones will be fluctuating. Starting on the higher dose may not have been the best option - itís always best to start low in peri and gradually build till you find the right balance but Iíd stick with things for now. The headaches might be too much oestrogen at times when your own oestrogen does a spike.
Progesterone is a vital part of HRT if you still have your uterus and the dose plus the number of days that are  prescribed with any HRT regime has been worked out to protect the uteral lining from building up and causing problematic bleeding and the risk of developing uterine cancer. Studd offers a regime for those that are severely intolerant to progesterone which does involve less use of progesterone but regular scans are required and the NHS wonít offer this.
In my 25 years of HRT use, there will always be some side effects with any progesterone and when I tried doing the Studd regime under the supervision of a private gynae, I actually got more side effects and problematic bleeding than any other regime I tried. Many women love Stidds regime but we are all different - that is why here are different HRT options but HRT is rarely a perfect treatment. It is about the most benefits with the least side effects.
Femoston is one of the best HRT to be on  (it has a gentler progesterone) so i would persevere if I were you.
You have been through terrible trauma and it sounds to me as though your body is begging for some peace from all this and HRT may not be enough.
A friend if mine went through a very traumatic time a few years ago it was seriously affecting her health. Her GP gently suggest trying an AD for a few months that would give her mind and body the Ďbreak it neededí to recover - my friend said it was the best thing she ever did as it got her life back on track. The stigma of ADs/ASRIs often puts people off and if low mood is hormone related then HRT is more appropriate but I do wonder in your case whether you need to add an AD with the HRT to really help you in the short term? Again, an AD would take a while to work - nothing is going to be a quite fix Iím afraid. Chopping and changing hrts is not a good idea really - you can end up worse off on the harsher progesterones in other HRTs. If you wanted an easy HRT regime, then having a Mirena fitted and using oestrogen as gel or patch would probably result in no bleeding at all, protect your uterus really well and avoids the ups and downs of a sequential HRT. Look under TREATMENTS on this site to find out more.
Keep an open mind - it sounds as though you have a good GP - let them help you as they think best.   DG x
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laszla

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Re: HRT beginner, confused
« Reply #4 on: February 07, 2018, 03:05:34 PM »

Thank you so much to all of you for your kind words and individual feedback. In view of what you all said, clearly it makes sense to give the femoston at least three months. Interesting to hear that 6 weeks was your low point Betty as that's where I am now and Nellie also reassuring to know that there is the option of gel and utrogestan where you can adjust the cycle length.
Dancing girl, the gp too is quite keen on the AD route and while I don't (consciously at least!) feel a stigma attached to them, I am worried about side effects reported by people close to me.
I forgot to mention that until starting the HRT I had been more or less permanently on St Johns Wort for low mood which, while not a miracle cure (what is), in my experience does give concrete, albeit moderate help. But I read that SJW interferes with estrogen so I decided to stop taking, also to 'test' how the hrt would affect my mood on its own. But perhaps in hindsight it was foolish to make two major changes at once. I will perhaps look into reinstating SJW, and definitely giving the femoston at least a month or two more.
Thanks again for all your help xx
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Dancinggirl

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Re: HRT beginner, confused
« Reply #5 on: February 07, 2018, 04:44:09 PM »

Donít use St. Johnís wort with HRT - it may affect absorbtion.
Why not try ding some Mindfulness or other relaxation techniques?
I suspect that if you continue with the Femoston your body will gradually settle and if you allow yourself more time to recover from all the trauma, you may find in 6 months time you will be back on track.
Nothing is going to solve this quickly.
If you are peri meno, I wouldnít be in a hurry to try doing longer cycles - the longer cycle is really when in post meno. Be patient. DG x
« Last Edit: February 08, 2018, 08:54:57 AM by Dancinggirl »
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Js

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Re: HRT beginner, confused
« Reply #6 on: February 07, 2018, 07:02:42 PM »

Laszia

Im Sorry you have gone through a bereavement that can take up to at least 2years to get back to some normality I know of this by experience myself sometimes you never get over it, but then you have the double burden of the dreaded menopause a double wammy so they say I agree with you about not going on anti depression tablets if you can manage it .i was offered bereavement counselling which is helpful but as for getting to,grips with the problems of meno yes it does take at least 3months for body to get used to hrt I was on patches which I found to suit me better and the hot sweats had gone within about 3 weeks I was on evorel conti so didnít have a break in between patches so no bleed . I didnít find I was moody on hrt the only thing I was hoping that it might have helped my migraines but alas it did not but Iím on a preventative now for them so hopefully I can cope better .

It does seem to be the progesterone part of hrt that can cause issues with women keep a note of symptoms you get to be reviewed when you next go to your memo nurse or doctor then she may be able to prescribe a different hrt if femoston does not agree with you

Take care and hope you feel better soon
Js
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laszla

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Re: HRT beginner, confused
« Reply #7 on: February 10, 2018, 11:12:16 AM »

Many thanks for your input JS. I fully expect the bereavement to be a long-term, possibly permanent process. I did not find counselling helpful for me though I know many are helped by it. Others have mentioned the interaction of St John's wort with hrt but I'll give the femoston another couple of months before looking into other options.
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