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[lovesflorida]

Hi! Would appreciate some advice! Have felt rough for last 6 years but mood swings, flushes , anxiety , depression all getting worse! Have resisted HRT route as was so concerned about long term side effects etc but feel so awful I've decided to see GP and ask for HRT but so many on market am very confused!i think I will need a continuous combined one but don't want animal products! Can anyone help? 😳😔

[Dancinggirl]

Hi lovesflorida - I'm afraid it is a trial and error process when it comes to finding the right HRT. What long term side effects are you worried about?  Don't believe all the negative stuff in the press. The long term benefits can be great e.g.  5 years of HRT can protect you heart and bones for the long term.
Most HRTs have bio identical oestrogen these days (so no equine hormones) and many progesterones are simply synthetic so not derived from animals.  There is a bio identical progesterone called Utrogestan which is becoming very popular.
Do look under TREATMENTS on this site to get clued up - print stuff off to show your GP as this will help with your decision about what to choose.    I would suggest you don't use a continuous HRT to start with, even if you are post menopause,  as it's better to try a sequential HRT so you can tell if the progesterone suits you or not.  You can move to a continuous HRt after 3-6 months if you find the progesterone is OK.
I found Utrogestan very problematic in terms of side effects while many women love it. If you want to try HRT pills then Femston 1/10 would be a good start as this has a gentler progesterone that suits many women very well.  If you want to go transdermal, then you could have the combined patches (these come as sequi and conic) OR,  better still, have oestrogen as patches or gel and then use either Utrogestan or Provera as the progesterone part of a regime.
If you are just suffering with low mood and anxiety, I must warn you that these meno symptoms are the toughest to treat and it can take time for HRT to work.  You will need to use a range of strategies that involve not just HRt but also changes in diet, exercise and relaxation techniques to really feel the full benefit of HRT. 
If you have flushes and night sweats, then these can be helped quite quickly with HRT, so you can start to feel better within 2-3 months.
Your GP will probably offer Elleste, which has a harsher progesterone, so I would push for Femoston 1/10 first as he/she is more likely to prescribe this.  GPs are seldom familiar with Utrogestan so it can be a struggle to get them to let you try this. It's often a matter of leading GPs gently toward the various options and if need be ask fi there is a meno clinician near you fro more specialist advice. Good luck DG x

[lovesflorida]

Thanks DancingGirl! I have been looking at all the different types of HRT and thought the conti ones would be best as I don't want a bleed- that's the only thing I like about the menopause 😊 I have taken norethisterone before on its own to stop bleeding whilst on holiday and don't remember any side effects - but that was about 4 years ago as haven't had a period since then! Didn't know if I would be better trying patches first or if they would be strong enough? Thanks for your advice xx

[Dancinggirl]

If you were fine on  norethesterone before, then you'll probably be fine with Elleste. Norithesterine is a strong progesterone so good at protecting the womb lining but most conti hrts will bring some bleeding and spotting in the first few months.
I assume you are post meno? So no period for at least one year or you are over 54?
A good non bleed option is to have a Mirena fitted and use oestrigen patches or Oestrogel alongside.  the Mirena offers a bleed free regime (some spotting at first though) and allows you to use as much oestrogen as you need.
As I said, low mood and anxiety are difficult to control without other measures to improve things - HRT is not a cure all - but HRT is definitely worth a try as if your flushes are reduced it can make you feel so much better. DG x

[Dotty]

I would ask for Oestrogel and utrogestan. It's the most natural form of hrt.

[lovesflorida]

Went to see GP this morning and after telling her how awful I've been feeling she was going to prescribe ‘premarin'? Or something like that- then I mentioned I had been researching them and that Femoston conti seemed popular - she prescribed 0.5 / 2.5 and I'm not sure what time of day to take it- any suggestions? BTW she's given me a 3 month supply x

[Dancinggirl]

lovesflorida - good that you were assertive with what you wanted.  Premarin would not have been a good choice.
Just start it whenever you like - take it at the same time each day whenever is convenient for and you likely to remember to take it. Morning with breakfast or evening with dinner are probably the best times.
Femoston 0.5/2.5 is actually a good one to start with - it is the ultra low dose so if you are starting from a low hormone base line then it may take a few weeks to really feel positive effects, (nothing is going to be a quick fix) however, it is a good idea to start low as this allows the body to adjust gradually as higher doses can bring quite startling side effects at first with no real benefits.  You may find this is enough to stabilise things for you without too many side effects generally. If it is suiting you but after 3 months you feel that you need a higher dose, then you can simple move to the Femoston 1/5.   
Do try to eat small meals regularly, get out for brisk walks every day and engage in positive activities that you find enjoyable. When I feel low, I make myself go out for a walk or do a job around the house (do the filing, clear out and clean a cupboard) that will make me feel I've achieved something.  Do read ‘Mindfulness' by Mark Williams and Danny Penman - this is an excellent book that gives you strategies to help with low mood and anxiety - I now practise this all the time and it's helped me a lot.  Good luck, Do let us know how you get on. Dg x

[lovesflorida]

Thanks so much DG for the advice- feeling extra tearful today so need the little pep talk- will certainly look into that book you recommended! I walk to work everyday ( approx 1.5 miles) and try to eat healthy but you know what it's like-when you feel so low it's hard to focus on any positives but am determined to try!! Thanks again 😊

[Dancinggirl]

lovesflorida - I know it's hard - I've had quite bad depression in the past. Hopefully the Femoston will give you a bit of a boost - be patient.  DG x

[Mary G]

lovesflorida, well done, it just shows that it pays to be assertive.  Good luck with the Femoston and please let us know how you get on. 

[lovesflorida]

Thanks for your support! Took first tablet this evening - I know it takes at least a week to start feeling better so fingers crossed x

[Emerald2017]

Hi! I was on cyclo progynova and on femoston 2/10 now with no problems at all! Maybe just try and see what suits you better!

[lovesflorida]

😘

[Hurdity]

Hi lovesflorida - you've had fantastic and comprehensive advice from Dancginggirl and glad you;ve managed to get Femoston. However I would say that is a very low dose indeed, and although it is often good to start low and increase - don't be worried if you don't feel any benefits from this one after  a few weeks - not necessarily waiting for 3 months. I would see how you feel after  say a month or 6 weeks max and if nothing is happening then either ask for the higher one or try doubling up yourself (or alternate days 1 tab with 2 tabs)- although you will run out pretty quickly!

You haven't said how far into menopause you are eg periods and age but I presume you are well past menopause ie more than 12 months without a period? if you are under 50/51 and post-menopause then a higher dose would be advisable anyway to give better protection for your bones.

Hope you feel better soon and do let us know how you get on

Hurdity x

[lovesflorida]

Hi Hurdity!
Thanks for the advice- everyone is being so helpful 😀. I'm 54 this year and haven't had a period for 4 years now so think I'm well and truly into menopause! I'm going to see how I go with the Femoston as my GP said to start off with it to see how my body tolerates it. I've been looking at posts re the estradol gel and then a progesterone tablet? Apparently the liver stops the full amount of oestrogen getting into bloodstream? All very confusing so will keep you posted and welcome any advice xx