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[WildOtter]

I'm honestly feeling suicidal, I feel so low, and I've been feeling so low for so long. And I know it's hormonal because I'm flushed red as a beetroot but I just don't see an end to this

[Flossieteacake]

WildOtter I am so sorry to hear you are feeling this way. Yes, they do say to give a treatment 3 months to see if it works but I would not recommend waiting if it is causing you to feel suicidal. Do you think this feeling is hormonal?

You said you tapered off the antidepressant and your psychiatrist thinks your depression is related to hormones. I wonder how many antidepressants you have tried because it can take time to find the right one and if it helps slightly then I would say it is worth taking.

You have been through so much and it is totally understandable you are feeling the way you are. Is the HRT causing the depersonalisation or have you had this feeling before? I know this can be a reaction to medication as well as a mental health condition.

I am very concerned you are feeling suicidal. Have you told anybody how you are feeling? Have you had any support after your surgery?

[WildOtter]

Hi flossieteacake, I think that what I'm experiencing right now is hormonal because it's come on the same time I started the gel.

The rest of it is probably partially down to the SSRI which I had a really bad reaction to and a lot of trouble tapering off, but I've been off it for 12 weeks now and still not feeling any better.  My psychologist doesn't think everything I've experienced is hormonal but wondered if there was an element. 

I don't really know what to think now. The gel is certainly giving me hot flushes and heightened anxiety which weren't there on the patches. Whether that's because the patches actually were working, but the gel isn't, so I'm experiencing the absence of oestrogen now. Or because the patches weren't working, but the gel is, and I'm reacting this way because I suddenly have oestrogen in my system after a long absence.

The reason I haven't just thrown the gel at the wall and given up is firstly my libido seems to be starting to reappear which makes me hopeful I'm experiencing an oestrogen increase. And I do feel a bit less detached from myself, and in between the anxiety I'm getting just small flashes of actually feeling more positive.

So I don't know. The SSRI certainly did a number on my brain chemistry. I'm just a mess now and trying to figure out what's normal for me so I can begin to find a solution.

[WildOtter]

Thank you for your kind words also

[Flossieteacake]

Hi flossieteacake, I think that what I'm experiencing right now is hormonal because it's come on the same time I started the gel.

The rest of it is probably partially down to the SSRI which I had a really bad reaction to and a lot of trouble tapering off, but I've been off it for 12 weeks now and still not feeling any better.  My psychologist doesn't think everything I've experienced is hormonal but wondered if there was an element. 

I don't really know what to think now. The gel is certainly giving me hot flushes and heightened anxiety which weren't there on the patches. Whether that's because the patches actually were working, but the gel isn't, so I'm experiencing the absence of oestrogen now. Or because the patches weren't working, but the gel is, and I'm reacting this way because I suddenly have oestrogen in my system after a long absence.

The reason I haven't just thrown the gel at the wall and given up is firstly my libido seems to be starting to reappear which makes me hopeful I'm experiencing an oestrogen increase. And I do feel a bit less detached from myself, and in between the anxiety I'm getting just small flashes of actually feeling more positive.

So I don't know. The SSRI certainly did a number on my brain chemistry. I'm just a mess now and trying to figure out what's normal for me so I can begin to find a solution.

It sounds like you had a very bad reaction to the antidepressant. Thankfully you seem to be experiencing some positive signs now. I am glad you are not feeling as detached as you were. It sounded to me like you were feeling quite numb and I wondered if it was your brains way of coping with the trauma you have experienced.

Getting your libido back is a great sign. For me, it took me a long time to get used to having oestrogen and as you had a surgical menopause, I am guessing it may be more of a shock for your body. I have no experience in this so I could be totally wrong and I apologise if I have got that wrong.

[WildOtter]

Thank you for talking to me.

This level of anxiety is intolerable. I think I'm going to have to shift back to the patches at least until I see GP, I didn't feel good on them but I didn't feel this urgently bad.

[Gnatty]

Hi there, you are very young and are in surgical menopause. I was 55 when I had the operation and had a tough time getting sorted so I can only imagine it will be more of a shock to a 41 year old who would have been making much more of her own oestrogen. I would say it highly unlikely that two pumps of gel will be enough for you in the long run. If your libido is returning that is a positive sign you are starting to absorb. The anxiety may well settle down, could it be that it's more to do with coming off the anti depressant? One thing that I am more sensitive to now anxiety wise is caffeine so maybe watch that. Raising oestrogen levels can give a feeling of anxiety, so too can being on too high a dose but that won't be you on such a small dose.
A suggestion for you would be to join the surgical Menopause UK Facebook group. Everyone on there is super helpful and you will meet other younger women like you who will be able to help.
One thing you will notice, a lot of us have only felt finally well when we have introduced utrogestan. We are told we don't need it as we have no womb but I'm afraid the evidence doesn't concur. It seems to balance everything out and I feel much calmer and wonderfully no anxiety. So that might be something to think about. As an example, I take three pumps of gel in the morning, half a pump in the evening and I take a utrogestan every other night. And I have forgotten to mention testosterone. This is really really important as you have no ovaries! Ovaries make I think 50% of a woman's testosterone so again a big drop for you. It is great for energy levels and can help too with anxiety. But I would try and get settled on the gel first. It might equally be that a stronger patch would suit you better. But I'm afraid it is a bit trial and error and the important thing is not to chop and change too quickly. I speak from experience!
Please do join that Facebook group. They will get you sorted. Good luck, you will get there. xx

[Gnatty]

Sorry, I just thought of something else! Do you think to help you through this really difficult patch that you might benefit from maybe something like a low dose beta blocker? Obviously I am not a doctor and it may be you have had them before. I'm just trying to think back to what helped me when I was struggling. I found if I was really suffering a beta blocker in the morning really took the edge off things. Anxiety is so awful and I remember how ill I was so please keep messaging to us. xx

[Ermin2trude]

Gnatty has given you brilliant advice.

Progesterone is really important systemically. One of its many functions is on the GABA receptors in the brain which create calming feelings and lessen anxiety.

I would follow everything Gnatty has advised. There will be a balance of HRT to suit you, but it is trial and error (sadly) and there is definitely light at the end of the tunnel.

Best wishes.

[sheila99]

On the other hand there are many more women (I'm one of them) who feel much worse with progesterone - just take a look at all the posts about it. So I would get your oestrogen sorted out first before you add anything else into the mix, the more you change the harder it is to work out which product caused what improvements/side effect. Agree you will need testosterone. GPs won't usually prescribe it so I would ask for a referral to an nhs menopause clinic but it can be a long wait.
 I agree your oestrogen is probably too low. Flushes are a symptom of oestrogen deficiency and as they started after you switched to gel I think you are absorbing less from the gel than you did from the patch. On this basis I would increase to 3 pumps and may find you need 4. Most people start on 2 pumps or 50mcg patch in peri when they are still producing their own oestrogen so this is a low dose, probably too low, after surgical meno. Anxiety can also be a symptom of low oestrogen but also of too much oestrogen and can have other non meno causes too.
 Is there another gp you could see who is more knowledgeable about hrt? If there isn't I would increase the gel slowly until you flushes go then stay on that dose for 3 months and see if the anxiety resolves, mine took the full 3 months. I'm so sorry you're struggling and hope you see some improvement soon. I hate suggest it but if you can afford it going private may get you there quicker, the wait for a meno clinic for testosterone in my area is a year. They will test your oestrogen levels so may increase faster than the 'trial and error' way. You could test your levels yourself (medichecks do it, I'm sure there are others) but then you also need a gp to prescribe appropriately.

[Gnatty]

I agree Sheila women in normal menopause feel worse often with progesterone but somehow for those in surgical menopause the balance swings the other way - a higher proportion seem to prefer it. But agree absolutely to sort out oestrogen is first job.

[WildOtter]

Thank you everyone.  That is really helpful and reassuring. It just feels like such a long road - straight after surgery I was having chemo, as soon as I finished chemo I was put on an SSRI which definitely had a significant negative effect on me.  I was actually doing ok mood wise on everol 50 prior to that, even with everything else going on. 

This morning I slapped on two everol 50 patches and I'm not touching the gel again until I can speak to my GP (unfortunately not for a couple of weeks). I do really want testosterone but I don't know if that's possible for me.  Unfortunately private treatment is out of my budget right now.

I'm sorry for sounding so low. I just can say with absolute honesty that I haven't had a single genuine positive emotion since Christmas. I think a big part of that is the SSRI but I've been off that nearly 3 months now and not returning to anything resembling normal. It's negatively effecting everything in my life, from my relationship to my job. I'm just so sick of feeling sad and poorly and nothing whatsoever picks me up - I exercise and meditate and do all the things you're supposed to do. 

Thank you for your help and kindness. I will speak to my GP about some of the things you've suggested.

[Kathleen]

Hello again ladies.

I just wanted to add that the private clinic Newson Health have always promoted increasing Oestrogen over progesterone. I am post meno so this may be a reason.

On the contrary an NHS consultant told me that ' less is more' regarding Oestrogen and then told me to increase my progesterone to every night to achieve a better balance.

I think my experience highlights the need to personalise treatment. Although the trial and error approach is beyond frustrating it is all we have at the moment. Hopefully there will be more information and research into the menopause in the future.

Wishing you well ladies.

K.

[Flossieteacake]

Thank you everyone.  That is really helpful and reassuring. It just feels like such a long road - straight after surgery I was having chemo, as soon as I finished chemo I was put on an SSRI which definitely had a significant negative effect on me.  I was actually doing ok mood wise on everol 50 prior to that, even with everything else going on. 

This morning I slapped on two everol 50 patches and I'm not touching the gel again until I can speak to my GP (unfortunately not for a couple of weeks). I do really want testosterone but I don't know if that's possible for me.  Unfortunately private treatment is out of my budget right now.

I'm sorry for sounding so low. I just can say with absolute honesty that I haven't had a single genuine positive emotion since Christmas. I think a big part of that is the SSRI but I've been off that nearly 3 months now and not returning to anything resembling normal. It's negatively effecting everything in my life, from my relationship to my job. I'm just so sick of feeling sad and poorly and nothing whatsoever picks me up - I exercise and meditate and do all the things you're supposed to do. 

Thank you for your help and kindness. I will speak to my GP about some of the things you've suggested.

You do not need to apologise for being low. You cannot help how you feel and I think you are brave to reach out and speak so honestly about how you are feeling. That takes a lot of courage.

[sheila99]

Just a word of caution - increasing to 100mcg is a very big increase especially as you were OKish on 50 not too long ago. I appreciate how desperate you are to feel better (we've all been there) but it may be better to cut the second one in half so you get a 75mcg dose. The symptoms of too much and too little oestrogen can be very similar and with a big jump like this you may not be able to tell which it is.