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[meno-mel]

Hi I need some advice,
I've been on Evorel 50 patches for almost 13 weeks and I still don't notice any improvement that makes it worth taking all month and the utrogestan half the time as well.

I expected to feel bad on the progesterone part, but feeling suicidal was a surprise, it was far worse than I expected.

I also expected to feel some relief of symptoms by now.
Hot flashes are still daily, night sweats unless I've a fan blowing all night and even then it happens a few times a week. Still running urgently for a wee all day long, plus I have periods with HRT, that is the only difference I can be sure of!

This month my period came the day before I was due to start the 12 days of utrogestan, so I didn't start it during my period thinking it might make that period last forever, although it's now six days and counting, it was lighter than usual, so longer doesn't worry me.

At what point do you conclude HRT isn't working and give up?

Or would my symptoms be even worse without HRT and I just don't realise how bad it would have got by now?

Has anyone tried tibolone? There aren't many results for it if I search this forum, nothing recent, is it still prescribed in the UK?

I've been trying my GP since Friday, not been quick enough in the queue yet to get a phone appointment, it's all they offer.
I've phoned the menopause clinic as well because this is their one day a week of being open, left a message for them to phone me back.
It's hard to know what is best to do, I want to feel better, HRT is making me feel like a total loser who can't even get basic medicines to work properly for me.

[Flossieteacake]

Hello meno mel. I am sorry to hear how difficult things have been. It can take time to find the right HRT. There are quite a few different options and it can be a matter of working through them until you find one that is suitable.

Feeling suicidal is very distressing and I am so sorry to hear this has happened to you. How are you feeling now with regards to this?

When you say you are needing the bathroom a lot this indicates you would benefit from some localised oestrogen. Ovestin cream or Vagifem pessary will help with this.

You are not a loser and I would not say HRT is something that is easy to take. It can take a while to find one that does not cause side effects and even when we find one, it can take time for our bodies to get used to it.

You are using ultrogestan and this can be quite difficult for people to tolerate. Some do report anxiety, low mood or feeling suicidal. One option would be for you to try this vaginally just to see if you find it better to tolerate. If this does not work then it may be an idea to try a different progesterone all together.

This is a link which will show you all the different HRT preparations.
https://www.menopausematters.co.uk/treatment.php

I am unsure about the other questions you have but I am sure somebody who knows will be able to reply soon.

[CLKD]

Hi! progesterone can throw up lots of difficulties.  Hopefully your suicidal feelings will lessen once that part of the HRT stops. 

How was your mental health prior to beginning HRT? 

Also, how is your diet overall?  PMT can cause suicidal thoughts, rages and anger in ladies that are usually calm.  Dr Dalton did a lot of research in the 1980s.  National Association for Pre-menstrual Syndrome. [NAPS]

[sheila99]

As you still have hot flushes I think you need to increase oestrogen. Do you have other symptoms and have any of them changed at all? I agree about the localised oestrogen, many women need both systemic and localised oestrogen. Have you tried utro vaginally? Side effects are less this way so worth a try imo, if that doesn't help I would try a different type. My anxiety and insomnia took 3 months to go but hot flushes usually only take a couple of weeks.

[joziel]

Sounds like you need more estrogen. 50mcg is really just the average starting point. Many women need 100mcg plus, especially if they are peri and still relatively young.

With the utrogestan, try it vaginally and see if that helps it not to affect your mood.

[meno-mel]

I have some vagirux tablets, but I've not bothered much with them, maybe I ought to try them again.

I told the menopause nurse they worked when I was taking them every day, but after the first 2 weeks I had a period so had none that week, then had to cut down to two a week and they just didn't work any more.

I think I need more than two a week and said so, but she wrote to my GP saying to keep me on two a week regardless. They don't work now because they sit in a drawer! Two a week is pointless imo, maybe save them up for a while then take every day.

I didn't have many meno symptoms really, I'm 53 and I wanted HRT for the other health benefits more than to solve hot flashes, but not if it makes me feel this dreadful. I thought utrogestan was fantastic the first couple of days, I was wide awake and buzzing, craving my next dose, then day 4 I suddenly crashed and found myself watching the tears splash onto my desk as I thought up excuses I could use to justify my suicide to my kids.

CLKD, my parents both dumped me when I was still a child, that was tough and I've been on antidepressants most of my life since, so I guess most people would consider my mental health to be delicate, not built on a firm foundation, but I pass for normal, lol. When I say I'm suicidal I very much mean it and have tried to get rid of myself before. It's a genuine fear, I wouldn't want my kids to have to deal with that but if my brain gets hijacked by hormones, anything could happen.

I felt better in my mental health after my periods stopped, before getting HRT. Hormones were always a depressing medicine for me to take. But more oestrogen might help?
I wonder would that cause more nausea? Something is giving me nausea since starting oestrogen patches, so it's my best guess.

Anyone know about tibolone? Maybe I'll start a new thread for that, someone must know about it.

[Flossieteacake]

Many of us have to take VA treatment daily in order to control our VA symptoms so I can understand why taking it twice a week was not enough. It seems it can be a fight to get a prescription for it daily but hopefully once this is explained to your GP they will issue it. VA only gets worse without treatment so please start taking the Vagirux again.

Have you called your GP and told them you are feeling suicidal again? Are you under the care of the mental health team or do you have access to the crisis team? Please reach out and do not keep this in. You are important and you deserve to be here.

Starting a new thread about tibolone is a good idea.

[meno-mel]

Thank you Flossieteacake (great name), I'll start taking the vagirux again.

My GP gives me antidepressants and a few years ago I got 8 sessions of CBT which only made me worse because he got me to trust him and open up and tell him stuff. I felt like an idiot when the last session came and he just said I had far to many issues for what they do in the GPs, sorry can't help you.

I told the GP three or four times I'm suicidal with various forms of HRT, I've even had a meltdown on the phone to her, but it falls on deaf ears, she says HRT doesn't do that to anyone, I'm just depressed for some other reason.

The thing is, I'm perfectly happy and not suicidal at all unless I have a hormonal imbalance, like pregnancy, that made me suicidal too even though it was a 100% happy event. The midwife told me I had that wrong as well. I sat and sobbed with a razor at my wrist while five months pregnant, I've no idea why these health professionals don't believe me.

I used to have this notion, from TV I guess, that if you threatened to kill yourself they will try to stop you. Of course they won't, why would they? They don't have the resources.

So right now I'm as sane as I ever am and I can't bring myself to take the pills that send me straight into the pits of hell and insanity. Was supposed to start them 5 days ago.

I don't think anyone is phoning me back today either, I'll try again tomorrow and wait to take the pills.

Now, a tibolone thread next

[CLKD]

You need to have support from the GP Mental Health Team or contact MIND Charity - they were v good when I had a crisis [long story short], keeping in touch via e-mail.

Do read the NAPS website.  Ask questions there.  It's all about how hormonal upheaval can interfere with mental health.

CBT never worked for me.  Too many issues that began when I was born.  The team should have referred you elsewhere at that time.  That doesn't mean that you shouldn't contact your GP Surgery etc., 1 has to be pro-active in order to get help.  My husband attended GP appts with me to make sure that I could get my problems across as occasionally, I was so depressed that I could hardly move.  With correct anti-depressant and anti-anxiety medication I am now well.

MayB make a list of your worries to discuss with the GP or Nurse Practitioner. 

[meno-mel]

You need to have support from the GP Mental Health Team or contact MIND Charity - they were v good when I had a crisis [long story short], keeping in touch via e-mail.

Do read the NAPS website.  Ask questions there.  It's all about how hormonal upheaval can interfere with mental health.

CBT never worked for me.  Too many issues that began when I was born.  The team should have referred you elsewhere at that time.  That doesn't mean that you shouldn't contact your GP Surgery etc., 1 has to be pro-active in order to get help.  My husband attended GP appts with me to make sure that I could get my problems across as occasionally, I was so depressed that I could hardly move.  With correct anti-depressant and anti-anxiety medication I am now well.

MayB make a list of your worries to discuss with the GP or Nurse Practitioner.

I'll check those websites, thank you CLKD.
I've not heard of a mental health team at our GPs. With the cuts I think they got rid of their CBT guy too, he was the mental health department!

[joziel]

If you're dealing with mood changes relating to fluctuating hormones, you probably need quite a high dose of estrogen (increased up to gradually and according to how your mood changes) and then a carefully chosen progesterone. This might mean continuous progesterone even if you are peri, because then you'd be getting a regular stable dose of it and only 100mg instead of the 200mg in the second half of the cycle. Or, as I said above, you can take the progesterone vaginally so it bypasses your system and doesn't affect your mood....

[Flossieteacake]

Thank you Flossieteacake (great name), I'll start taking the vagirux again.

My GP gives me antidepressants and a few years ago I got 8 sessions of CBT which only made me worse because he got me to trust him and open up and tell him stuff. I felt like an idiot when the last session came and he just said I had far to many issues for what they do in the GPs, sorry can't help you.

I told the GP three or four times I'm suicidal with various forms of HRT, I've even had a meltdown on the phone to her, but it falls on deaf ears, she says HRT doesn't do that to anyone, I'm just depressed for some other reason.

The thing is, I'm perfectly happy and not suicidal at all unless I have a hormonal imbalance, like pregnancy, that made me suicidal too even though it was a 100% happy event. The midwife told me I had that wrong as well. I sat and sobbed with a razor at my wrist while five months pregnant, I've no idea why these health professionals don't believe me.

I used to have this notion, from TV I guess, that if you threatened to kill yourself they will try to stop you. Of course they won't, why would they? They don't have the resources.

So right now I'm as sane as I ever am and I can't bring myself to take the pills that send me straight into the pits of hell and insanity. Was supposed to start them 5 days ago.

I don't think anyone is phoning me back today either, I'll try again tomorrow and wait to take the pills.

Now, a tibolone thread next

You are most welcome.

CBT is offered as it is cheap and it is never going to be of any use for anything more severe. It is terrible they did not refer you to the mental health department and just left you to get on with things. It is hard to get into mental health services but if you do decide to then pester your GP and explain your history. Antidepressants can take the edge of things but as you know, cannot do enough.

The medical professionals who are not listening to you and telling you that you cannot be suicidal on HRT or when pregnant really are neglectful. It is sad when opening up about how you feel is just dismissed. Yes, on TV they make out anybody suicidal will be whisked away into hospital which I have never heard of in real life.

If you are progesterone intolerant then there is the option to be on oestrogen alone and have regular scans to check the lining of your womb. This is usually only something a menopause clinic would offer but perhaps it is worth mentioning to the GP anyway.

There will be a mental health team but usually they are separate from the GP practice. The GP would need to refer you to them.

I really am sorry to hear how your GP and the CBT therapist have been so unsupportive. It can be a real fight to get support sometimes.

[Minusminnie]

Mental Health Matters is another organisation that have walk in centres in some parts of the country.

https://www.mhm.org.uk/Pages/Category/crisis-support

eg under York safe haven they mention that they are linked to community mental health teams. 

[meno-mel]

I'm on the list!
Today a doctor will phone back (so they say) and I can ask for Estradot50 instead of Evorel50.

I aready checked stock with the pharmacy, no problems locally, I just need a doctor to write the prescription and fingers crossed it has some effect I can feel 

In the meantime I want some mango, the doctor better not phone while I'm in Lidl!

[CLKD]

Pakistani mango ?  Sweet, runny, juicy ...........