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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Depression and hrt  (Read 4206 times)

Latte21

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Depression and hrt
« on: November 10, 2020, 03:14:05 PM »

Hi everyone Ive never posted here before but feel at a loss at the moment. Im currently on Evorel 50 patch and started Citalopram 10mg 9 weeks ago increasing to 20 mg 5 weeks ago. Periods are very erratic feel major pmt but no period arrived this month. The worst part is the morning depression which doesn’t seem to lift until late afternoon. Is this menopause or Citalopram still kicking in does anyone know?  Also don’t know if I should be on higher dose hrt and my gp is no help. Just want to feel happy and have more enthusiasm to do normal things.   Thankyou for listening xx
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CLKD

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Re: Depression and hrt
« Reply #1 on: November 10, 2020, 03:28:32 PM »

 :welcomemm:   How long have you been on the patch?  Does it help your symptoms at all?

Citalopram usually gives benefit by about 3 months but that can depend on how depressed the brain might be as well as any hormonal effects.

MayB keep a mood/food/symptom diary.  To chart progress. 

How is your diet overall, as food intake can impact on depression.  My worst time is from 3.30 - 11.00 a.m., then I begin to improve.
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Latte21

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Re: Depression and hrt
« Reply #2 on: November 10, 2020, 03:37:03 PM »

Hi there. Been on the patch for over a year. It helps with almost all my menopause symptoms apart from the depression. Bone pain and hot flushes are much better. No night sweats either. Cannot seem to lift the mood though even when good things happen 😭.  I’m gluten and lactose intolerant so my diet is quite restricted anyway along with a few other weird intolerances that have sneaked in recently.  So is morning depression quite normal then and doesn’t mean that the antidepressants aren’t working? Xx
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CLKD

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Re: Depression and hrt
« Reply #3 on: November 10, 2020, 04:18:04 PM »

Early morning waking is a sign of depression which can persist into the day.  I suspect that your diet may not help if you are lacking certain elements.  The brain requires feeding but out of sight, out of mind  ::).

Do you get to see a dietician to handle the intolerances?
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Latte21

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Re: Depression and hrt
« Reply #4 on: November 10, 2020, 04:28:41 PM »

No gp basically said avoid any food/additives that affect me 🙄.  Have tried to find vitamin supplements for menopause but most of them contain fillers and sweeteners that I react to aswell. Need to look more into that as you’re probably right my diet is very basic and most probably lacks in nutrients that I need especially just now. Thankyou for even suggesting it it’s such a simple thing but I didn’t even think of it. My brain is mush xx
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CLKD

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Re: Depression and hrt
« Reply #5 on: November 10, 2020, 04:30:54 PM »

Probably due to not being nourished?

Get your GP to refer you to a dietician.  Have you been actually diagnosed with intolerances ?  If so you probably need a review and advice.  If we don't get enough minerals etc. we can soon feel poorly overall.  Something like this needs regular reviews to get the best out of your diet.
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Latte21

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Re: Depression and hrt
« Reply #6 on: November 10, 2020, 04:49:19 PM »

Yea been diagnosed but I will contact my gp again for a proper review and keep a food diary aswell I think. Thankyou xx
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CLKD

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Re: Depression and hrt
« Reply #7 on: November 10, 2020, 05:21:56 PM »

Let us know how you get on?
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Latte21

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Re: Depression and hrt
« Reply #8 on: November 10, 2020, 05:38:25 PM »

I will do thanks for your help 😘xx
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racjen

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Re: Depression and hrt
« Reply #9 on: November 10, 2020, 06:49:04 PM »

Hi, generally speaking mood problems like depression and anxiety require far higher levels of estrogen to resolve than physical ones like hot flushes and joint pains. Some experts recommend that you need to get your estrogen level up to 800 - 1000 pmol to have an effect on your mental health - that's far higher than most doctors would recognise as a reasonable level. But you won't get there on Evorel 50 - I'm on Evorel 125 and I'm averaging about 700 - 750 pmol. I don't know if that helps at all because your GP may not be willing to prescribe this level - you may need to see a private specialist to get it confirmed.
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Alicess

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Re: Depression and hrt
« Reply #10 on: November 10, 2020, 07:43:06 PM »

Hi Latti21,

I recognize the morning depression and feelings of utter doom. I still have a cycle and it happens on days when my estrogen is low. I think Racjen
is right, you need higher levels of estrogen.

Alicess
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CherrySG

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Re: Depression and hrt
« Reply #11 on: November 10, 2020, 08:36:50 PM »

I've been taking citalopram on and off since 2014 but it stopped working for me since I've been on hrt.

I did find an obscure medical paper online where they described an experiment on female monkeys using hrt after an ovarian ectomy. It was found that the hrt interfered with citalopram. This was the only thing I found online to support the idea that citalopram is rendered ineffective by hrt, so my issues may be due to the drug simply 'pooping out'.

Other ssris may work better. There are articles online suggesting hrt enhances Fluoxetine effects but I've never been on it. Maybe there is someone on here who has been on Fluoxetine and hrt who can answer.

I was in the middle of a contract role and nearly had another melt down so I took Escitalopram which is molecularly similar but twice as strong and I'm kind of OK. I would have expected your citalopram to have helped after 9 weeks, do you not feel even a little better? If not I'd ask the gp to suggest something else.
« Last Edit: November 10, 2020, 08:38:37 PM by CherrySG »
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Latte21

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Re: Depression and hrt
« Reply #12 on: November 10, 2020, 10:53:18 PM »

Hi yes I do definitely feel better with the Citalopram but it’s later on in the day I feel it. Morning is just awful. I’ve been on fluoxetine before but unfortunately it has too many additives and food colourings in it for me to tolerate and when I stopped that the adverse symptoms I got from them stopped. I don’t get those symptoms from Citalopram but the morning depression won’t shift. I take it at night as it makes me very tired
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Latte21

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Re: Depression and hrt
« Reply #13 on: November 10, 2020, 10:58:38 PM »

Also I’ll suggest to my gp about increasing my evorel maybe that will help although I don’t find my gp very helpful at all when it comes to menopause problems she seems to just smirk and expect me to accept it’s part of life. Which it is but it’s taking over my life. I’ve just been given the gift of a new granddaughter and still I feel so down 😭😭xx
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CherrySG

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Re: Depression and hrt
« Reply #14 on: November 11, 2020, 07:10:17 AM »

Mornings are always the worst for those of us with depression, and morning anxiety is the last to go! My MIL takes Fluoxetine as does well on it, but these things are so individual.

Your gp sounds quite annoying, maybe a different one would be more helpful? Depending on the system where you are. It's a lottery with my gp practice, you just get a random doctor. Maybe more oestrogen would help, like the others are saying. Escitalopram has fewer side effects i. e. less tiring but is more costly than citalopram so everyone gets given citalopram first but if you're experienced with ssris you probably know that anyway.

Congratulations on your granddaughter!!! 🎊 How lovely.
« Last Edit: November 11, 2020, 07:12:34 AM by CherrySG »
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