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[Smurph]

  Hi everyone. Been a rollercoaster 11 days! After not being able to get in touch with the specialist after she prescribed me Cerele to stop my cycle (she thought I could have PMDD, then was going to add in Estrogen after a couple of months) I had a really bad reaction to Cerele and stopped taking it but I then then couldn’t speak to my specialist as she went into hospital for an op. SO! I contacted my doc who then prescribed me Everol 25 and 200mg Utrogestan for days 15-27. I am perimenopausal and have regular-ish periods and recently been suffering terrible PMT and mood swings. PMT had gradually got worse as I’ve got older but lately felt like I had it constantly. Hence the specialist thinking it could be PMDD.

Anyway, so I started on Everol 25 on the Monday and then on the Utrogestan vaginally on the Friday which was the 15th day of my cycle. (My doc told me to take it orally but I think I’m progesterone intolerant after an awful that horrific time on Cerele.) Felt really tired the next day and have since felt more and more tired and anxious since then. I then got a call from the specialist this Monday who said I should be on Everol 50 and that the doc was wrong to give me 25, so I just stuck another patch on.

Yesterday and today I am having god awful palpitations and feel on the verge of a panic attack. My resting heart rate is usually around 68bpm but I today is in the 90’s. Feel very down and confused with it all.

Do you think the palpitations are caused by too much progesterone as I’m still having periods and my body is producing it’s own? Or do you think it could be thyroid related? Im trying to speak to my doc but that won’t be any time soon and I can’t afford another consultation with the menopause clinic ☹️ Thanks all x

[joziel]

Hi Smurph - Sounds like you are having the exact same estrogen-sensitivity issues I had. If you scroll down and look at other recent posts (or use the search box for 'palpitations'), you'll find my posts about my total nightmare where I even went to A&E  .

Basically, it seems that for some women, estrogen - starting it or increasing it - can cause heart palpitations, anxiety, jitters, feeling like you've had 8 Red Bulls and high blood pressure and a fast heart rate. That is what I'm going through anyway. The good news is that, the longer I stay on it, the more it seems to settle although it does still play up at night sometimes.

I can sometimes lie in bed and feel like I'm 'pulsing' against the bed and my heart is beating faster than usual. The palps are different to the ones I had before starting HRT (which were the classic 'skipped beat' palps). These ones are like light flutters which go on for ages and ages - hours. My GP had asked me to take my blood pressure twice a day for a week (because I have white coat syndrome) and my home blood pressure machine kept having the 'irregular pulse' icon coming on every time almost...

When I increased my estrogen, I got this pretty much every night at first and a couple times it lasted until lunch time the next day. (I went to A&E once - my ECG was normal apparently although my BP was v high. 158/something.) Now all this has reduced to perhaps a couple times a week, and the pulsing is much less too.

All this is not because my blood estrogen levels are too high, because they were only 233nmol - so still pretty low. It's just how my body is reacting to the estrogen.

I am not sure if I'm going to need cardiac tests etc, but I'm hoping not! My Newson doctor wasn't at all concerned and said I should increase estrogen vv slowly and remain at each increase for a good 8wks+ before increasing anymore. So I have to cut patches into smaller pieces. I'm currently at 62.5 (which is a 50 patch and half a 25 patch!) and next I'm supposed to do a 50 patch and 3 quarters of a 25 patch(!). I am aiming to get to a 75 patch and then re-test my estrogen levels.

Which is all to say - you could either stick at the 50mcg and see if it settles. In my experience, the worst time (most extreme symptoms happening most often) is the first 2 weeks after the increase. After that it does improve and happens less often until (I hope!) it eventually stops totally. Or you could reduce your increase, so you do a 25 patch and half the other 25 patch instead of a full one...

[Smurph]

Wow! Thanks so much for replying Joziel! I would never have thought it was the Estrogen but that makes total sense. I’m sorry you’ve had a nightmare with it and I’m not surprised you ended up in A&E. I got very scared earlier today and it probably doesn’t help that I can easily check my heart rate on my watch so got myself into a slight panic! It has calmed down a bit now but when I was in a meeting earlier I was nervous and that seemed to make the pounding feel even worse. I felt it in my throat too - almost like a tightening around it if you know what I mean?! I had the same as you before starting hrt - the skipped beat sensation which was a bit weird but nowhere near as bad as this! Do you think I’m ok to change the dose now after just a few days? I’m worried about confusing my poor tired body 😂

[joziel]

I think you can for sure reduce the dose to 25 plus half a patch. I was at 75 for about a week and a half, then I reduced to 62.5 and have been there about 4 weeks now. Going down doesn't seem to cause the same probs as going up 

Yes, I have had the heart beating harder and hearing it my ears some. There is an app called Breathwrk which is a 'breathing' app and it gives you various breathing exercises to do and I've found that to help if my mind starts to contribute to the anxiety as well. Because it's like your body is in a physiological state of anxiety which didn't start with your mind and your thoughts - it is physical. But then your mind starts to go 'what is this? what's happening?' and get anxious about it, which just further feeds into what your body is doing and then it becomes a sh*tshow mess 

The thing I find hard is that it starts in my sleep, when my mind can't reason and I can't focus on my breathing - instead I am dozing and half awake and I just get anxious because I can't think rationally. And if I wake up properly to calm myself and think rationally, I'll never get back to sleep.

Even on the nights it doesn't happen, I was still waking up at 4am. I've no idea why, I'm not anxious. I just wake like I'm used to getting up at that time and it's wake up time  Then it was 4.30am. Then it was 5am and the last few nights I've got to 6am  At this rate I might eventually get through the night  This waking up in the night thing is part of the estrogen as well, I can just tell. I never used to have problems with sleep - I'm a 'head hits the pillow and the next thing, it's time to get up' person who used to sleep 7-8hrs every night. Then I got night sweats before HRT, which would wake me up - but I didn't have problems sleeping besides that. This sleep thing is something to do with estrogen-at-night syndrome (for lack of anything else to call it!!).

[Smurph]

  The Estrogen of the Night! Like a horror film!  Must be awful waking up so early with it. I can still sleep for England thankfully… for now anyway.

You’re so right about the way the mind works against you with these things. Happily plodding along and then feel a flutter which descends into panic and then spending the next few hours having arguments with your own head while making the palps even worse!

Do you not feel any better now that you’re taking it more slowly? Do you use Utrogestan too? How can you tell whether it’s the Estrogen or the flippin progesterone causing problems?! Sorry for all the questions! Oooh it’s confusing 

Well, I have taken your advice and I’ve unstuck my second patch and cut it in half so we shall see! Thanks again! Xx

[joziel]

Now I'm thinking of Phantom of the Opera and 'the music of the night'....

Nighttime sharpens, heightens each sensation.
Darkness stirs and wakes imagination.
Silently the senses abandon their defences...

  OMG, it's exactly right 

Yes, I feel much better now - in that, instead of happening every single night and then most of the morning, it is happening just perhaps 1-2 nights a week in a much less extreme way. (Ie just the throbbing feeling sometimes, or my heart beating more heavily rather than palps.) It did happen a bit a couple of nights ago and it always gets me down because I just want to know it has stopped and is a thing of the past. Except I also have to increase my estrogen in a couple of weeks...

I do use utrogestan as well, 100mg continuous. I didn't get this on the 25 patch with the same utrogestan (and it sounds like you didn't either?) so for me it is associated with the estrogen increase. It happened when I went to 50mcg but I was pretty chilled about it all surprisingly, probably because I was distracted by thinking about my endo and whether that was going to get aggravated. And when I went up to 75, it was every single night.... So for me it's def the estrogen.

As far as I can tell, progesterone side effects are PMS, depression, feeling angry, irritable, feeling fatigued or sleepy - I am fortunate that I don't get any of those side effects and can take pretty much any progesterone - but the jitters and the anxiety are most often estrogen side effects. And I seem to be very sensitive to that.

[Smurph]

Hahaaa exactly! Everything feels worse in the night too doesn’t it. The creeping dread!!

Ah I’m so pleased you’re getting there now. Hopefully next time round will be easier for you. It’s never straight forward is it! Such is life!

That makes sense about the Estrogen rather than the progesterone. I’m still learning about all of this and it’s so hard to differentiate side effects when you already have anxiety issues. I’m trying really hard not to think about it too much and just let things take their course but I’m so sensitive to everything, it’s difficult.

 I do find that I am absolutely shattered on the Utrogestan and so spaced out as if I’m in a dream! I hope I’m ok taking it vaginally but I will probably need to get a scan at some point as I’m taking 100 rather than 200 as prescribed by the doc. I just can’t handle the 200 even vaginally! Gawd! I thought it would all be so easy 

[joziel]

Hey - one approach is to halve the amount of utrogestan if taking it vaginally because it’s thought that if you’re putting it right on the place concerned you need less of it. So you are probably just fine with 100 instead of 200. That’s what the Newson Clinic recommend doing anyway although I know other doctors will recommend using the same amount either way. 👍

[Smurph]

Thank you Joziel  This morning I woke up with NO palpitations! Hurray! Thank you so much for your help. I feel so much better and my heart rate is gradually decreasing back to my usual level. What would I do without this amazing forum!?  Xx

[Smurph]

And I hope you had a palp free night/morning! Xx

[joziel]

I did indeed have a good night last night. I think it’s going to happen less frequently and fade away till it stops altogether. That’s my hunch anyway. Until I increase estrogen again.

I’m now at the doctor’s, waiting to see this new GP who specialises in the menopause. I have 20mins to explain a long history of endo, the journey to getting HRT, the impact of estrogen on ENDO and what I’ve tried/done, heart palpitations and a trip to A&E, joint pain and the referral to rheumatology and blood tests and x-rays…. I feel daunted and I’ve not even gone in there yet. 

[Caz17]

Hi new on this forum so not sure Im in the right place. I tend to just look at others problems/issues and try to take any advice I can.

Ive been taking Evorel Conti 50 for 9 months and increased my estrogen with the Evorel 25mg in March.

For the last 3 months I have suffered terrible anxiety but put it down to unexpected life changes (breakup in my relationship) but recently have had bleeds like periods. Could this be related to the increased estrogen patch? I have been in such a terrible anxiety state, paliptations, feeling I cant go out doors for fear of panic attacks. Any advice would be appreciated. Thanks

[Smurph]

Joziel, I hope you got on ok at the docs? Glad you had a better night anyway 

[Smurph]

Hey Caz, I feel your pain. Palpitations are scary stuff. I wouldn’t have thought the Estrogen would be causing them as you should really be used to the new dose by this point. Im just learning too tho! Why don’t you start a new topic incase this message gets lost in this one. I hope you get some answers xx

[joziel]

Caz, I guess if you are taking more estrogen than you need, you could still get ongoing high estrogen side effects for 3 months and high estrogen could also cause bleeds. But it is also normal to bleed after you increase your estrogen. They say to give it at least 3 months, maybe 6 after an increase, before you expect all bleeding to stop again.

Have you had your bloods done, to see what your estrogen levels were, before you increased?