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[alltheleaves]

March had pelvic radiation , they said would induce menopause.

no mental symptoms until april 23rd was very content considering happy treatment had ended positive about future,started tapering morphine, then had anxiety/low mood , typical withdrawal symptoms.

may was having a few flushes at night , completely off morphine by end may , was feeling a bit sad about stuff , little over worried, looking forward to getting back to work on 31st may .But was still seeing a bit of joy in things , was thinking of decorating house .

Started working, found motivation in morning a bit struggle starting at 6am but was kind of excited to get back to normal. It felt a bit odd not the same but I was in a bit low mood still .

Started the evorel sequi a beginning June a few days in to work . Tried full patch it made my head feel funny and worse so used half . Night sweats increased so sleeping was harder .
Found it harder to get to work first two weeks. Suffering mood swings , feeling worse on a morning .

Had to go off sick , as couldn’t motivate myself to get ready in morning, had wizzing anxiety early mornings, some days very depressed, some windows of feeling motivated and thinking about decorating etc . Can’t nap in day because of anxiety rushes.

example of mood swing ,july 2nd after a month of hrt  one day i felt really good thought go visit someone, was excited thinking about it booked tickets , packed . was ok on way when got there mood dropped spent two days anxious and low , had to use diazepam to sleep, train journey back was horrendous.

By 23rd July i though i need to try and get back to work so got sertraline , it put me in bed for two days no sleep, violently shaking , so stopped it .

Tried full patch on 27th july to see if the increase would help
28th July pushed myself into work at the later time of 9am , felt awful literally could see the point of doing it motivating was 0 , head foggy couldn’t concentrate, then at about 11.30 my head cleared , i could think straight was thinking about doing food shopping (i haven’t been able to do it because it causes me stress) it was almost like a high feeling . It lasted until 2pm then I went down again, worse than ever so I changed it to the half out of fear .

So still off work , anxiety is bad sleeping was horrendous, now the evening are not enjoying either as I was occasionally enjoying watching tv on a night before the sertraline incident.

My mother keeps saying i need hrt and not giving it a chance , i need to keep full patch on so I try again just before my results appointment and it sent my anxiety high on way in car , my mind was uncontrollably, so I took 1/2 diazepam , results good , first time in ages i felt great hopeful, confident later day , like normal. Next day totally down again serious anxiety all night needed crisis team . So dropped back down to half . Had half diazepam day crisis team  settled down a bit next day had a crappy morning but a great afternoon, was in garden centre, my brain even did online shopping which i haven’t been able to concentrate on.
But nights are torture they said i am sleep deprived. Next two days anxiety was bad , getting shaky heart . Called crisis team again and they said just take a diazepam.


So i decided to stop hrt Monday , few nights I slept better not as sweaty , felt a bit better maybe placebo effect , went swimming a few times morning anxiety wasn’t as bad . Wednesday was out and about and afternoon was quite good , did food planning, this is something i have struggled with , was feeling like the future was bright. It lasted 4 days then I had really bad night so bad even full diazepam didn’t settle it , shaking inside heart and mind racing .

So in desperation I have stuck full 50 patch on and trying to ride it out , but I feel detached and spaced out and I have been in bed or pacing the floor went out earlier and felt like I was on drugs and wanted to come home , I can’t eat much though J am forcing food down,I seriously don’t know what to do now , or what to try next .

[CLKD]

I think that your body is overwhelmed.  U have been through a lot of treatments along with morphine withdrawal.  Also the lack of support from the various depts when I underwent treatment sessions left me feeling deflated .  Although I knew that I could phone the Dept it wasn't the same as going in for radiation daily.

What does your GP suggest?  If HRT is causing so many side effects it may. not be the correct treatment at this time.

Have U had full blood count in the last 3 months as you may simply be lacking 'something', i.e. VitD or thyroid function may be out of kilter. 

[alltheleaves]

I had a full bloods done and they never said anything wrong , cancer consultant referred me to a psychotherapist and menopause specialist but how long who knows .
Gp just keeps giving me anti depressants, they said it’s trauma but it is serious mood swings unfortunately they are not swing up much these days and i am getting desperate, the anti depressants i tried sent me over the edge

[ElkWarning]

My therapist suggested a little book to me 'Trauma is Really Strange'.  I found it useful.

I can take 80mgs of diazepam and if my fight or flight (flop / freeze) has been activated, then it won't even touch the sides.  Dissociation, due to trauma, is a helluva powerful thing.  For me, I felt more in control, and less scared of going completely mad, once I knew what was happening in my brain - hence the book recommendation.

In one of your earlier posts I suggested speaking to someone ASAP re: morphine withdrawal.  The thing about morphine is that it anaesthetises most people to their feelings (that's why we have so many heroin addicts), but those feelings are probably going to happen at some point.  You know, Freud was big on the whole you can't repress it forever vibe.  In other words, delayed reaction and no parachute.

The good news is that if the diazepam doesn't work (and only take what you're prescribed by the way, I was prescribed 80mgs, don't take more, you don't want to go there), then there's other drugs.  You won't fall into a hole that you can't get out of.  It can be a rough ride for a bit, but you've got this.

Stay in touch with your crisis team - see if you can get a referral to your community mental health team, or see if you can get a named person at your surgery so all your appointments / questions go to one person for continuity of care.

It might take a bit of time for you to process what you've been through.  Any talking therapy you can access could be useful at this point.  Google what's in your local area.

I'm sorry you're going through this.  It sounds as if you're not being very well supported by health services.

[joziel]

You can't keep starting and stopping and increasing and reducing doses and taking psych meds and stopping them. This is only going to make all your symptoms worse. The body likes stability and consistency.

You probably need a lot more estrogen than a 50 patch. That is the basic low starting dose for women who are in a natural peri or post menopause, not women who have been thrown suddenly into menopause by something traumatic like surgery or radiation. You should stick to the 50 patch for at least a month but then very gradually increase - by cutting patches up if necessary.

Anxiety is hugely caused by low estrogen... Too high estrogen can also cause the jitters, but if you've just had radiation and been put into menopause by that, your estrogen is not going to be too high on a 50 patch... What is your serum estradiol? I'm assuming it's been tested?

You've been through a lot and want to feel better, so it's natural to keep trying different things - but this will only make things worse by creating constant flux.

[alltheleaves]

My level fsh was 94 , oestradiol 165 and progesterone was 0.43, that was mid July .I understand I need consistency, do you think I felt better end may before hrt because the radiation damage hadn’t kicked in as much ?

[alltheleaves]

My therapist suggested a little book to me 'Trauma is Really Strange'.  I found it useful.

I can take 80mgs of diazepam and if my fight or flight (flop / freeze) has been activated, then it won't even touch the sides.  Dissociation, due to trauma, is a helluva powerful thing.  For me, I felt more in control, and less scared of going completely mad, once I knew what was happening in my brain - hence the book recommendation.

In one of your earlier posts I suggested speaking to someone ASAP re: morphine withdrawal.  The thing about morphine is that it anaesthetises most people to their feelings (that's why we have so many heroin addicts), but those feelings are probably going to happen at some point.  You know, Freud was big on the whole you can't repress it forever vibe.  In other words, delayed reaction and no parachute.

The good news is that if the diazepam doesn't work (and only take what you're prescribed by the way, I was prescribed 80mgs, don't take more, you don't want to go there), then there's other drugs.  You won't fall into a hole that you can't get out of.  It can be a rough ride for a bit, but you've got this.

Stay in touch with your crisis team - see if you can get a referral to your community mental health team, or see if you can get a named person at your surgery so all your appointments / questions go to one person for continuity of care.

It might take a bit of time for you to process what you've been through.  Any talking therapy you can access could be useful at this point.  Google what's in your local area.

I'm sorry you're going through this.  It sounds as if you're not being very well supported by health services.

Thanks for the book recommendation will take a look at it x

[sheila99]

I'm not able to advise about ads but I agree with joziel. Your oestrogen levels are too low and probably you will need 100 not 50 but definitely don't go below 50. Whatever you do with the ads you need to use the 50 consistently. My advice would be the same, 50 for a month then increase probably to 75. If you can cope with 75 or 100 now then use that. Every time you reduce the dose you set yourself back.

[joziel]

Your FSH there is raised because your body is screaming for more estrogen. That's what FSH is, it's crying out to your ovaries to make more estrogen - only they can't.

Your estradiol is very low at 165, it is not even at levels protective for bone health - which should be at least 250pmol.

Many women feel best with estradiol between 450-650pmol, especially if they have been thrown suddenly into menopause.

Yes, it probably took a while for the effect of the radiation to set in. Please do commit to getting that estradiol up....  And also sometimes you don't notice any improvement until you get over a certain threshold. By that I mean, when you increase the estrogen in the right direction you might not notice anything until it goes over a threshold where it really makes a difference.

You need to keep testing your levels every 2-3 months and increasing in the meantime. If you get to 100mcg and have trouble getting a doctor to prescribe higher, you probably want to go to a private menopause clinic who will be very happy to prescribe higher. I am on 100mcg patch plus 12 pumps of gel at the moment. I am supposed to be heading higher on the patches to 200, 300 even 400mcg patches - and down on the gel because I'm not really absorbing more over 6 pumps. My serum level was 325pmol on 6 and also on 12 pumps of gel (before adding patches).

[Mary G]

That oestrogen level is verging on rock bottom and unlikely to be doing anything useful.  50 mcg patches didn't cut through for me and I found gel to be much stronger and more effective so you might want to try that.

[alltheleaves]

Your FSH there is raised because your body is screaming for more estrogen. That's what FSH is, it's crying out to your ovaries to make more estrogen - only they can't.

Your estradiol is very low at 165, it is not even at levels protective for bone health - which should be at least 250pmol.

Many women feel best with estradiol between 450-650pmol, especially if they have been thrown suddenly into menopause.

Yes, it probably took a while for the effect of the radiation to set in. Please do commit to getting that estradiol up....  And also sometimes you don't notice any improvement until you get over a certain threshold. By that I mean, when you increase the estrogen in the right direction you might not notice anything until it goes over a threshold where it really makes a difference.

You need to keep testing your levels every 2-3 months and increasing in the meantime. If you get to 100mcg and have trouble getting a doctor to prescribe higher, you probably want to go to a private menopause clinic who will be very happy to prescribe higher. I am on 100mcg patch plus 12 pumps of gel at the moment. I am supposed to be heading higher on the patches to 200, 300 even 400mcg patches - and down on the gel because I'm not really absorbing more over 6 pumps. My serum level was 325pmol on 6 and also on 12 pumps of gel (before adding patches).

Thank you , i am going to book a specialist, just scared of increasing as since putting on this patch i feel spaced out and more depressed and my ears are ringing, i did sleep better last night though , it seems it has helped my anxiety but made me feel lower .

[alltheleaves]

That oestrogen level is verging on rock bottom and unlikely to be doing anything useful.  50 mcg patches didn't cut through for me and I found gel to be much stronger and more effective so you might want to try that.

I was wondering what to try next , I have found it hard to increase as it makes my brain more foggy and buzzy , so frightened to try the utrogestan properly i tried one vaginally and i woke up in a thick fog , I was thinking of trying the femseven with the different progesterone, the evorel one isn’t very nice , but as i have depression maybe i am just sensitive to things that normally i would tolerate. I remember having the morning after pill with the same drug in as femseven years ago and no effects , i couldn’t have coil , friend had bad experience but also i have vagina stenosis i doubt they would get it in , i would be frightened it couldn’t be removed.
It’s weird how i have these normal moments, they were more often before the hrt , i seem to be getting more depressed, more numb than anything, but I tried being off  hrt and had a few normal ish days mood wise was planning on getting hair done , looking forward to stuff ,but my anxiety went crazy one day and night , heart was pounding all night , can’t win back on the evorel i seem to have lost my purpose again .

[CLKD]

Do U actually need any replacement at this moment in time?

MayB your body needs a rest, it's been a bit battered in the last 12 months. 

R the symptoms really difficult to tolerate?  Brain fog is 'usual' ..... I haven't had a clear head for years  .  I have tinnitus which I am beginning to think is due to statins  .

Your body doesn't need stop/start of any medication.  I don't know how long these various drugs stay in the body ........ 

[joziel]

Yes, she does need replacement. Her ovaries have just been switched off suddenly. It is going to be extremely rough if she doesn't get some estrogen on board.

alltheleaves, please stop self-medicating and thinking about now trying femseven.... that is just MORE changes. Honestly... You need to have separate estrogen and progesterone so you can adjust both separately. You will go down a rabbit hole if you now start on a combined product.

If you are not sure what symptoms are caused by estrogen and what by progesterone, use a sequential regime for now with utrogestan the second half of the month.

Utrogestan has a sedative effect - and if you suffer from anxiety, that's great. Take it last thing at night and take full advantage of that, it will help you sleep. You are very lucky if it has that effect, I wish it did for me.

It sounds like you really need specialist help and I hope you can get booked in with say the Newson Clinic or somewhere, the worst thing you can do is keep chopping and changing and trying different things.

[alltheleaves]

Yes, she does need replacement. Her ovaries have just been switched off suddenly. It is going to be extremely rough if she doesn't get some estrogen on board.

alltheleaves, please stop self-medicating and thinking about now trying femseven.... that is just MORE changes. Honestly... You need to have separate estrogen and progesterone so you can adjust both separately. You will go down a rabbit hole if you now start on a combined product.

If you are not sure what symptoms are caused by estrogen and what by progesterone, use a sequential regime for now with utrogestan the second half of the month.

Utrogestan has a sedative effect - and if you suffer from anxiety, that's great. Take it last thing at night and take full advantage of that, it will help you sleep. You are very lucky if it has that effect, I wish it did for me.

It sounds like you really need specialist help and I hope you can get booked in with say the Newson Clinic or somewhere, the worst thing you can do is keep chopping and changing and trying different things.

I agree it’s my anxiety that’s not helpful, i am going to book somewhere tomorrow, I just need someone to take charge and then stick with it , I feel hopeful as these little windows where my brain wakes up and i can function are still happening occasionally x