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[racjen]

To those of you who've seen a private specialist for menopausal depression/anxiety and found it helpful, who would you recommend? I'm at my wits end - been struggling with awful depression and anxiety for several years, HRT has helped sporadically but not enough to give me back my life, and my GP, although sympathetic really isn't knowledgable enough about HRT to help. There's no NHS menopause provision where I live (the southwest) and I've got to the point where I'm prepared to pay to see a private specialist, but only if I feel they'll be knowledgable enough about the mental health side of menopause to suggest anything other than what I've already tried. Any ideas please? I'm desperate....

[Wrensong]

Hi racjen, so sorry to know you are feeling low & I hope you get some helpful responses to this question.  I can't offer any experience in that respect but noticed your other current thread asking about differences between Evorel & Estradot & didn't really know which to post on as what I wanted to say is something else entirely, but might just be relevant to help with the way you're feeling.  You don't mention testosterone as part of your current regimen, so I wondered whether you'd tried it for the mental health aspects of menopause?  I recently had it added to my HRT & it seems to have helped with mental wellbeing as well as the physical aspects it's renowned for.  I've had BSO so really felt the lack of T afterwards & just thought you might be interested if you've yet to try it. 

The following extract is from the paper in the link below.  The bottom line, frustratingly as so often, is that further research is needed but I think the evidence they've gathered here is promising  . . .

"While the clinical studies of testosterone therapy in women are more limited, some evidence supports anxiolytic and antidepressant roles for testosterone. Administration of a low dose of testosterone in women with treatment-resistant major depressive disorder significantly improved ratings of depression, compared to placebo-treated subjects (Miller et al., 2009). In addition, surgical removal of the ovaries increased mood disturbances and depression, compared to placebo-treated controls, an effect reversed by testosterone (Shifren et al., 2000). Another study in women found that a single administration of testosterone reduced anxiety in the fear-potentiated startle response, compared to placebo-treated controls (Hermans et al., 2006). Furthermore, transdermal application of testosterone in women experiencing age-related declines in androgens resulted in substantially improved mood and psychological well-being, compared to placebo-treated individuals (Goldstat et al., 2003). However, some reports have noted that too much testosterone can also negatively impact mood in women and can even contribute to the onset of major depressive disorder (Rohr, 2002). Additional clinical studies in women are necessary in order to reveal whether, and under what conditions, testosterone alleviates symptoms of anxiety and major depressive disorder."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946856/#R180

Wx

[racjen]

Hi Wrensong, thanks for your reply. I had chemotherapy for breast cancer  4 years ago, so my ovaries were knocked out completely and I was prescribed testosterone as part of my HRT. Unfortunately and paradoxically it made me more depressed - no-one seemed to have any idea why so I had to give up on it, which was very disappointing as at that point I did think it might be the missing link  x

[Wrensong]

Oh racjen, sorry you've found it no help  .  It can be so difficult trying to get HRT right without any ovarian function, I think.  I hope you get some helpful replies though.
Wx