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[heljanejo]

Had an HRT review with GP this week, who suggested I consider coming off  current medication (Novofem) and trying anti depressants "in the interim", before being medication free.

I have been on HRT for 10 years (I'm now 55) and have a progesterone intolerance which has so far ruled out any continuous tablet regime as it makes me so depressed. I still get low mood on sequential but I know its only for a few days so i just get on with it. I tried coming off HRT two years ago but it was a disaster and symptoms (mainly hot flushes but everything else too) were intolerable so went back to HRT on low dose sequential combined which keeps me symptom free.

I requested trying the gel/utrogestan (vaginal) regime, but GP said she couldn't prescribe this without seeking advice from local specialist (which she said she would do but I'm not hopeful). Suggested Mirena and gel but I can't tolerate this (previously had one for contraception back in the day). GP just went on about the risks, but I'm healthy, not overweight, drink hardly at all, and have no close family history of breast cancer or heart disease (although my cholesterol is high- genetic rather than lifestyle as been on a diet for 25 years!) 

So.... Has any one had experience of the anti depressant route and whether this worked?  Should I just insist on trying the gel & utrogestan (and going private if needs be) as this seems a safer choice of HRT, or  just keep going as I am and refuse to stop??

I had such a terrible time when I tried to come off last time (and then a further 8 more difficult months trying various continuous regimes which I couldn't tolerate) the thought of trying anything new is filling me with dread !   

[CLKD]

Your GP is well out of date!  No one needs to be medication free, would she/he suggest this to a diabetic or someone with heart problems? 

Ask for a referral to a menopause clinic.  Not a gynaecologist 'cos they don't know much more than GPs.

If this HRT has worked for you, why stop?  Have you stopped?  Why fix if it ain't broke? 


Your GP is wrong to suggest Anti-depressant medication instead of.  Where on earth  ......... this may be due to ignorance on her part, or because they want to cut costs ...... but you don't have to stop.  Ever. 

I'm sure someone else will be along.  I would go back and tell this particular GP that after consideration "I would like to continue with my present regime."  That my mental health depends on it  .  55 is young.  Quality of Life is so important. 

[westie]

Hi

You don't even need a referral to a meno specialist. If you go into menopause doctor website and search NICE. Guidelines you can print these off and take with you to GP. There is loads of great info on that website and the NICE guidelines clearly spell out the guidelines for prescribing HRT. So much ignorance amongst GP's on this subject makes my blood boil.
 Good luck
W xx

[sheila99]

Antidepressants aren't a cure for low oestrogen, it can only be cured by adding oestrogen. Your gp is an ignorant pr***. Try the Nice guidelines but if you don't get anyway insist on a referral to a menopause clinic.

[CLKD]

It seems that this particular GP is trying to get ladies off HRT when it probably a) won't help them in the short term and b) wants to cut costs?

[CherrySG]

I was put on citalopram for what I now realise was peri-menopausal depression. I tried many times to come off and felt stigmatised as 'mentally ill' for years

It was only when I came off for a year recently that I have ever experienced any menopause issues at all, i. e. suddenly got a bunch of utis and galloping VA. So citalopram can work at solving some menopause issues, but I was always tired and unmotivated. I did, however, think I'd escaped any menopause symptoms until the age of 55, and thought I must be really lucky.

Now I take Provera and Oestrogel and am almost off citalopram. I couldn't take Utrogestan unless I wanted to sleep 20 hours a day and have acid reflux. Doing fine on Provera. And do not have the cluster of mh disorders I assumed I must have for the past 7 years 🤔

Just sharing my story, hope it's not too long. I agree that getting referral to menopause clinic is the way to go. Or could you see a different gp? It seems a shame to change your current regime if it works.

Update 4th July in case anyone searches Provera depression link, like I did 

After 3 months on Provera I got very depressed. Had to increase antidepressant (citalopram) and quit systemic Hrt. I also couldn't deal with the acid reflux from the oestrogel and constipation from Provera.

I just thought I'd update this for anyone who likes to compare what they have experienced with others, as this is what I prefer to do myself.

[CherrySG]

Actually your idea of utrogestan vaginally and oestrogel sounds excellent for you! If you see another gp maybe you could tell them you'd like to try utrogestan again. No need to tell them you're planning on taking it vaginally. Maybe they'll be more amenable to letting you continue on a different regime?

[CLKD]

Welcome CherrySG

[CherrySG]

Thanks CLKD