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[zen]

Hi

Has any one tried this combination?.  A menopause clinic is recommending it. I am currently on Prof Studs regime but only 2 1/2 pumps of estrogen, 1/8 tube of testim, cyclogest for a week every two months which has not been working re mood - really bad anxiety and depression.  The menopause clinic was not happy with that combination! She said I couldn't increase the estrogel to 4 pumps and am not taking enough progesterone. :-( They said to try 1.25 Premarin and provera. They also said my anxiety and depression is a separate issue as the HRT is not working. (although no hormone levels were measured).  I'm not completely convinced.  I have had it continuously since I started the menopause 9 years ago  and I wasn't previously a depressed/anxious person! Having to resort to diazepam:-(
 
The menopause also coincided with a diagnosis of an underactive thyroid. Have tried several AD's to no avail which does make me wonder if it's hormonal or a thyroid issue.

Am not sure what do. Any suggestions would be great! Am also wondering if HRT is not for me.

Thanks

zen

[Venetia]

I can't comment at all on your HRT experience but can say that, about 6 months after starting to take thyroxine, I realised that my mood, which had been characterised by bouts of gloom, had lifted and evened out.  Depression is recognised as a symptom of an underactive thyroid so it's definitely worth considering when you consider what to do next

[zen]

Thanks very much Venetia.  Yes I do really wonder if that is the root of it all - I still have all the underactive thyroid symptoms, really low basal temperature, hair falling out, aches and pains, really cold all the time, total exhaustion etc. Am only on 50mg of thyroxine and 10 mg of T3 but  am getting a full thyroid panel done privately to find out what is going on.

Am so glad the thyroxine is helping you. I know everyone is different but what dose are you on if you don't mind me asking?


Thanks again.


zen

[SueLW]

There is no such thing as a full replacement dose of thyroid medication.  It's like treating menopause, we are all different and require different levels.  I know of people taking 200mcg levothyroxine a day.  Many even out at around 150-175.  I'm still on 125 at the moment.  Bloods drawn yesterday.  I fully expect a dose increase as my numbers are not at all right yet.  Depression and anxiety are symptoms of hypothyroidism.  If you are still cold and tired etc then you need a dose increase. 

Why won't the clinic let you use more than 2 pumps a day of gel?  Perhaps because that is the recommended dose in the PIL.  And if they are still giving out horse urine HRT then they are hardly up with the times.  I didn't start to feel better until I used 3 pumps and I'm now on 3.5 and can go up to 4 if I wish.  I accompany this with 100 Utrogestan a night vaginally.  You could use a patch, or more gel and have a Mirena coil fitted if you wanted to do without the bother of the progesterone part.

You have been using gel a long time.  I'd not give it up that easily if it has suited in the past.  But you do need to convince a doctor that you can have 4 pumps to get the prescription. 

[zen]

Thanks very much for your replies Stellajane and SueLW. I have only been using Prof Studds regime for about a year and a half but its not working but have been suffering from the depression/anxiety for nine years.  I did read somewhere that you need 4 pumps of estrogel to help with anxiety/depression.  I do find the progesterone, cyclogest intolerable too.

 Yes I think the menopause clinic was sticking to certain guidelines and Proff Studds regime is controversial! I have tried Angelique in tablet form and evorel conti before which didn't help so I am not having much luck with HRT. The mirena coil is a consideration. It is complicated with the underactive thyroid and I have CFS too which has been soo much worse since the hypothyroidism and menopause.  All a bit of a nightmare really! I do think my thyroid is undertreated so my gut instinct too is to get that sorted out first once and for all and go from there. The blood tests are coming back in the 'low' normal range but I certain still have all the symptoms of an underactive thyroid.

I am desperate to feel back to my previous happy self with at least some energy.

Thanks again.
zen

[Venetia]

Hello zen, I take 50mcg of levothyroxine daily.  I've been retested twice and have been told that the results are 'satisfactory' so my dose hasn't changed - no idea of any numbers and I wouldn't know what they meant anyway!  Good luck with your next steps.

[zen]

Thanks very much. Stellajane and Venetia. Gosh Stellajane your GP sounds amazing. I know from any GPs/endocrinologists I have seen that they just go on at blood tests results for thyroid and totally ignore how awful you are feeling if your blood test in in the 'normal' range! Its crazy. In the olden days apparently they always diagnosed on symptoms.  I'm sorry thyroxine is not working for you. I feel the same. Apparently it only works for about 80% of people.  I might try NDT.

Thanks again

zen

[Hurdity]

Hi zen

Sorry to hear about your ongoing symptoms. Yes it does sound like a combination of insufficient oestrogen and undertreated underactive thyroid could be repsonsible for your symptoms. I hope you manage to avoid the diaezepam - there have been a number of threads and posts on this and it can be very addictive as some women report. Ditto the ADs - avoiding them if possible while you try to sort out the right hormone balance for you as by your own admission it is likely to be hormonal.

One point about the progesterone - I agree that is VERY low dose - one week every two months is way way below the recommended amount but if you are not getting much of a bleed, and no bleeding in between times then it might suggest you are not absorbing the oestrogen and therefore not building up much lining, in which case an increase is definitely in order as others have suggested. Also it depends on the dose of Cyclogest - this isn't licensed for hRT although I was prescribed it when I first started HRT - 400 mg for 11 days per month. As a matter of interest  - why Cyclogest rather than Utrogestan? You would not really want to increase oestrogen while on this extremely low dose of prog - you would need a higher dose - after first trying out a higher dose of estrogen gel to see how you felt after a few weeks.

I can't imagine why a menopausal clinic would want to change you from transdermal bio-identical HRT to old-fashioned synthetic products (well the oestrogen is anyway) except on the grounds of cost. The Provera would probably be more effective on clearing the womb lining but without blood tests and scans you don't know a) whether you are absorbing the oestrogen from the gel or  b) whether the Cyclogest really is protecting your lining.

Hurdity x

[zen]

Hi Hurdity

Thanks very much for your reply. I agree it is probably insufficient estrogen and my undertreated thyroid that is to blame.

With the progesterone I am getting a reasonable bleed after taking it and a very occassional breakthrough bleed.  I tried utrogestan which made me very depressed and I can't really tolerate the cyclogest either and it is only 200mg.  As it builds up over the 7 days I get more and more depressed until its almost intolerable. I agree it is probably not a good idea to increase the estrogen when taking so little progesterone but I think I am pretty much progesterone intolerant. Maybe I could try the provera with what I am taking to see if I can tolerate it better.

I was a bit surprised by the menopause clinic's suggestion too. I thought they were taking a stab in the dark when they don't know my hormone levels.  I did have a scan done about a year ago which was fine. I am wondering too if HRT is maybe not for me as I am sensitive to medications/side effects but I am a bit of a loss as to what to do as my anxiety and low mood is terrible and I was fine before the menopause/underactive thyroid diagnosis. I am getting private thyroid tests done so that might help.

Thanks again.

zen x