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

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Author Topic: Help next step  (Read 1416 times)

alltheleaves

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Help next step
« on: August 11, 2024, 09:52:28 AM »

I will try not to make it too long , getting worse in 1/2 evorel sequi , since starting been nearly: months now.
I was struggling with low mood and sadness, sweating before starting, but i didn’t have the sleep as bad ,my other post explains about my cancer induced menopause.
Started beginning of june , same time i started back at work, managed to get to work the start , now i can’t get in ,my moods have been up and down , my sleep has progressively got worse to the point i am severely deprived, anxiety is horrendous had crisis team out when i tried to take antidepressants.
Feel fine on diazepam, but can’t take that long term , the crisis team said i need to sort out my menopause and take a diazepam at night because I need to sleep, last night i couldn’t sleep even with diazepam my heart was pounding,my insides shake and I am off food though I am trying to eat , I am worried about getting addicted to diazepam, probably going to call a clinic is the newson one still a recommended , i am wondering if hrt made me worse frightened to try anything new x
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CLKD

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Re: Help next step
« Reply #1 on: August 11, 2024, 11:22:32 AM »

How much Valium are U taking?  What has been suggested by your prescriber?  I was on 5 mg 3 times a day for 2 weeks followed by 5mg at night, then 'as necessary'.  The idea is to allow the drug, as with all others, 'to work' and not overthink that you may require 'more'.  Also, I would wake in the night to C whether I had been asleep  ::)
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alltheleaves

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Re: Help next step
« Reply #2 on: August 11, 2024, 11:25:30 AM »

Did you not get withdrawal from the valium ? when you stopped
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joziel

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Re: Help next step
« Reply #3 on: August 11, 2024, 11:38:03 AM »

alltheleaves, Newson would be a great choice if you can afford it in my experience (I'm with Newson).

You likely need a lot more estrogen than you are getting from Evorel Sequi, which has a pre-set dose of 50mcg. Why are you not on separate patch and utrogestan? Then you could increase your patch up to 100mcg which is the max licensed dose. That much should be available through your GP, without any bloods needed - just going by symptoms.

Ask your GP to switch you to a 75mcg patch (and then 100mcg patch) and utrogestan separately.
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CLKD

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Re: Help next step
« Reply #4 on: August 11, 2024, 11:53:41 AM »

If that's addressed to me, then nope.  Under GP supervision in that I had to see him B4 he would give me the next prescription and because I know that it works as designed, I had no problems.  I was taking it for high levels of anxiety so once the symptoms were relieved I relaxed.  4 me it lasted 3 days so completely relaxed.

I then used 5mg the night B4 an event that I was unable to get out : i.e. when we had to visit family ......... usually for birthday celebrations.  Knowing that I could: and never did require: another 5mg the next afternoon ....... I did however fall asleep after lunch, much to his mother's annoyance  ;).

I now have an emergency anti-anxiety drug. 

How much valium has been prescribed to take at night?  If U don't want the worry about becoming addicted then mayB try an anti-travel sickness drug, i.e. Kwells?  Make sure it's not the 'non drowsy' one though, same with anti-histamines.  I have used those years ago for 3 consecutive nights which got me back into a proper sleep pattern.  Some find that 'valerian' tea works, relaxation therapy or listening to music; to avert the brain from the 'what if I can't get to sleep'.
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alltheleaves

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Re: Help next step
« Reply #5 on: August 11, 2024, 12:08:25 PM »

I have 5 mg tablets , I have bad anxiety which is stopping me using a full patch , i do have evorel 50 and utrogestan but i tried one capsule vaginally and i felt like death the next day , my low mood and anxiety are hindering me x
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sheila99

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Re: Help next step
« Reply #6 on: August 11, 2024, 12:33:31 PM »

These are oestrogen deficiency symptoms so I agree you need a higher dose. My anxiety and insomnia took 3 months on hrt to go completely. Perhaps  night on utrogestan wasn't long enough for a fair test but if it isn't for you there are other options - provera, noresthisterone. 2xPOP, see the Treatments tab from the menu. Please see you gp, you don’t have to suffer like this.
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joziel

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Re: Help next step
« Reply #7 on: August 11, 2024, 01:04:40 PM »

alltheleaves, you might want to read this document and then print it out and take it to your GP. Ask to try other progestin options and to have separate estrogen patches: https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

All of those solutions are licensed (well, not the 2x desogestrel but the others are).

You need to get your estrogen up to at least 100mcg (probably, with 4-6wks at 75mcg first) and trial those variations of progestins in the meantime. Don't let the progestin situation stop you getting the estrogen you need. There is also the Mirena coil as an option. Usually the progestin in that stays local to the uterus and doesn't go systemic.
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bombsh3ll

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Re: Help next step
« Reply #8 on: August 11, 2024, 01:50:40 PM »

I'm sorry you're dealing with this.

Firstly don't panic about the diazepam. Whilst addiction can occur, the vast majority of people who are prescribed it do not become addicted, nor do they increase their dose. A large study which I think was done in Scandinavia confirmed this. There is a lot of mention of addiction in medical literature, however when you drill down this is virtually all based on opinion and anecdote.

Secondly, whilst I have no personal experience with Dr Newson, I have read and listened to a lot of her material and think that if you can afford it, this is likely the best option to get you feeling better from a hormonal point of view in the shortest period of time.

Whilst you may be able to get there on the NHS, eventually, it sounds like you are too unwell to wait months and wade through all the beaurocracy, especially if this means having to really assert yourself to get the treatment you need.

Additionally, those with severe psychological symptoms often need more individualised care such as higher estrogen doses and or non standard progesterone regimes that aren't supported by the NHS.
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CLKD

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Re: Help next step
« Reply #9 on: August 11, 2024, 01:56:43 PM »

It's awful to feel ill as we go through trialling various HRT regimes  :'( :-\.  It's the Trial and Error that can often be really tiring.

AllTheLeaves - what has happened if you use a full patch is this every day?  Some have found half a patch helps symptoms; others add half a patch a few nights a week as well a full patch nightly.  Once U find a regime that eases symptoms U will have more confidence with less what iffs!

:bighug:
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alltheleaves

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Re: Help next step
« Reply #10 on: August 11, 2024, 02:15:56 PM »

It's awful to feel ill as we go through trialling various HRT regimes  :'( :-\.  It's the Trial and Error that can often be really tiring.

AllTheLeaves - what has happened if you use a full patch is this every day?  Some have found half a patch helps symptoms; others add half a patch a few nights a week as well a full patch nightly.  Once U find a regime that eases symptoms U will have more confidence with less what iffs!

:bighug:

The thing is I don’t remember feeling this bad back end may , I was at my sisters though i was not myself I wasn’t anxious and i wasn’t as bad , I was thinking of decorating bits and bobs .
Started the hrt beginning of june , the full patch made me feel worse if i remember, so tried 1/2 my mood was up and down drastically , then the mornings got worse , a few weeks ago the days used to get better and I was doing stuff on evening , though i didn’t feel right 100 percent, now i can’t get to work, my anxiety is saying is it the hrt , but if my radiation was in march , i had no mental symptoms until april 23rd when i started the morphine taper . Would my hormones still be dropping now x
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CLKD

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Re: Help next step
« Reply #11 on: August 11, 2024, 02:21:33 PM »

Hormones can rise and fall for years ........... and chemotherapy and other treatments may well interfere with levels as well as HRT.  MayB speak to the oncologist [I may have suggested previously  :-\] to ask whether he is aware of such problems? 

How R U after stopping morphine?
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alltheleaves

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Re: Help next step
« Reply #12 on: August 11, 2024, 02:28:18 PM »

Hormones can rise and fall for years ........... and chemotherapy and other treatments may well interfere with levels as well as HRT.  MayB speak to the oncologist [I may have suggested previously  :-\] to ask whether he is aware of such problems? 

How R U after stopping morphine?
Oncologist has just said see gp , the morphine withdrawal started all this i was fine prior to this , day before taper normal , after felt low
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CLKD

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Re: Help next step
« Reply #13 on: August 11, 2024, 04:55:03 PM »

MayB time to ask your GP to refer you to another oncologist with knowledge?

There are many thoughts that despite cancer treatment women should be able to take HRT.  After all, quality of Life for however long for any of us important.   

I would be contacting some1 with knowledge about morphine withdrawal, because patients aren't usually allowed to 'go it alone'.  If you have had morphine certainly don't worry about the odd diazepam!
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ElkWarning

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Re: Help next step
« Reply #14 on: August 11, 2024, 09:52:15 PM »

Hormones can rise and fall for years ........... and chemotherapy and other treatments may well interfere with levels as well as HRT.  MayB speak to the oncologist [I may have suggested previously  :-\] to ask whether he is aware of such problems? 

How R U after stopping morphine?
Oncologist has just said see gp , the morphine withdrawal started all this i was fine prior to this , day before taper normal , after felt low

You need to speak to someone ASAP about morphine withdrawal.
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