Before HRT, I had:
- Joint pain, especially on waking in the mornings or if I stayed in a position any length of time (knelt on the floor and then got up, for eg). I had pain in hips, knees, just felt stiff when I woke up. I had trigger finger in my little fingers when I woke (little finger would jerk up and down and wouldn't move smoothly) which is apparently a sign of arthritis. I had bloods done for arthritis which were all negative and I was referred to rheumtatology. They told me to see if HRT would help and come back if it didn't. GP was useless and said I was hypermobile and it must be because of that. (But I've been flexible all my life, that hasn't changed, so why would I suddenly get these symptoms?) I suggested it was peri-menopause but he said I was too young (at 42??). He did estrogen and FSH tests and told me they were fine so it couldn't be peri. I knew otherwise and just went to other doctors.
- Vaginal dryness. I actually thought this was thrush at first and treated twice for thrush, with no luck. Felt scratchy and burn-y and sore. I also had incredibly thick sticky/gluelike vaginal discharge a couple times which was like a mucous plug, it was gross. And at other times I would have a gush of runny watery stuff. Apparently this is all the cervix trying to lubricate itself, it goes either way. I had swabs done which were all normal and was given local estrogen, Vagifem and got Ovestin from Newson Health so I could have both and a ton of local moisturisers. I don't need any of that anymore, now my systemic estrogen is up. Which is good because it was a faff applying it all multiple times a day and my vag was taking over my life.
- Brain fog. I couldn't read and retain info. I would read and re-read the same sentence over and over again because I'd forget the start of it and the point of it by the time I got to the end. I'm pretty academic and a big reader so this was a problem. I couldn't think properly, my brain felt like it wasn't working.
- Constipation and gas/flatulence. Like humongous massive old people farts....
- Not wanting to do anything. Just wanting to sit around and wait, I had no idea what for. I wasn't depressed, just couldn't feel there was anything I 'wanted' or got excited about.
- Zero libido.
- Dry eye. I'd actually had this for years, my optician had told me about it - but I hadn't realised it was a low estrogen symptom until I started estrogen and it went away. It was associated with a watery/tearing eye as well, which would ruin any eye make-up and was really embarrassing. (I guess like the cervix, it goes both ways with all mucous-y things!)
- Migraines. I do still get these at times when I have a big sudden surge in estrogen, or if I drive and stare at the road for ages or am extra-tired. But the hormonal triggers are much reduced now.
I had no sleep problems, before though. I was always a very good sleeper my entire life. Head would hit the pillow and I'd be out for 8 hours or more. Self-employed so wouldn't need to set the alarm clock, just got up when I woke up. If I tried to stay awake lying on the sofa and watching a film, I was incapable of staying awake past 11pm. Just couldn't, no matter how much I tried. I would 'just rest' my eyes - and I'd be gone.
As for - has any doctor been able to tell me why this other set of symptoms appeared... There are thoughts and theories but not anything definitive. One is that they are due to the brain wanting extra estrogen (neurological symptoms) because the communication between brain and ovaries is going haywire.
One is that they are more due to a time of great fluctuations, hormonally, rather than simply high or low - when I started HRT, I also stopped the desogestrel POP which I'd been on for about 10 years. That suppresses your ovaries and keeps your estrogen quite low (and progesterone non-existent and testosterone low as well). So I went from a state of very low hormones, to adding all 3 hormones at once. My ovaries woke up because I'd stopped the desogestrel and started firing sharp shocks across my abdomen for a few months - they were doing weird things and probably increasing the fluctuations of hormones. (Stupid doctor question 'but how do you know it's your ovaries?' me: 'I can feel them.'. Doctor 'you can feel your ovaries?'.
And another theory is that there was no pattern to the rise and fall of hormones going on either. Our bodies are used to different hormone levels but across a cycle, which is predictable and has a pattern. They are not used to wild highs and lows lasting a few hours which have nothing to do with what time of the month it is. And that this causes the neurological stuff. So beforehand, the desogestrel was keeping everything low but constant - but it was too low. When I stopped it, I unleashed all the fluctuations.
With progesterone, I don't think 'addicted' is the right word. But there are people who say you need to take a break from it to reset the receptors, so that they can work again. But I do take a 5 day break and haven't noticed it working well again when I restart so not sure about that one! Maybe if I took it sequentially, I would really notice it when I started it - but I can't do that due to endo. I do find that if I take it with a little food, I absorb it even more and it hits me better (makes me sleepier). You could try that. It has to be a small amount of food and the same thing every night. (I usually have a coconut nibble healthy thing, I think the fat helps it absorb.)
Anyway, hope that helps! Really there is only experimentation. Keep trying things, dosages, products, keep experimenting until you find what works best for you. Because we are soooooooo far behind with women's health, that's the best we can do.
studies show you absolutely can have tolerance/withdrawal
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031054/?fbclid=IwY2xjawFBRwhleHRuA2FlbQIxMQABHartZNtxZcpZcKERQ35znnplbP58D6P5kpHZXMt3v4UYRWY4BTWPNOJdlA_aem_BlY-88SZpgVmbR630ptuUwSome excerpts from the "Screaming To Be Heard' book by Elizabeth Lee Vliet, MD.
'Many women have told me over the years that they have become depressed when they take progesterone or use the ‘wild yam’ progesterone creams. This is to be expected due to progesterone’s effects on the brain, since several metabolic breakdown products of the nature human progesterone molecule are very potent depressants of brain (CNS) function. One of the metabolites of progesterone (3-alpha-OH-DHP) has been found to be about eight times more potent as a CNS depressant producing antianxiety, sedative effects than the most potent barbiturate known today, methohexital. Studies looking at the anti-convulsant actions of 3-alpha-OH-DHP have found it to be more potent than clonazepam (Klonopin), a high-potency benzodiazepine used for epilepsy and panic disorder. Depressed mood occurring with progesterone is similar to the depressant effects on some women when taking Klonopin or Valium.
The neuroendocrine studies that have identified these progesterone metabolic products and their effects at brain receptors go back several decades, but much of this literature has not made its way into general clinical settings, particularly in the fields of psychiatry and gynecology. The progesterone metabolites above actually attach to GABA receptors, the same ones that bind the benzodiazepine drugs. At higher levels, progesterone actually acts very much like these anti-anxiety medications by attaching to the GABA receptor sites and causing release of the inhibitory neurotransmitter GABA, just as Klonpin, Valium, and the others in this group of medicines do. Inhibitory action at the GABA receptor complex causes decreased anxiety, decrease in seizures, increased sedation, delay in word recall and verbal responses, and potential increase in depression. The depressant effects seem to occur at higher doses than are needed for anti-anxiety effects, again similar to those effects we see with benzodiazepines. The depressant effects of progesterone are now thought to primarily occur from one of its metabolites, 3-alpha, 5-alpha-THP and allopregnanolone. Levels of allopregnanolone have been shown to correlate well with circulating levels of progesterone in the bloodstream.
An interesting observation in several studies is that progesterone given to either men or women produces effects like Valium (and other benzodiazepines) on such measurable variables as heart rate, blood pressure, respiratory rate, and the electrocardiogram patterns. It also causes quite pronounced daytime sleepiness for many, male or female. The flip side of this effect is that progesterone produces withdrawal effects similar to other medications that act at the GABA receptor, such as benzodiazepines and barbituates. This effect has been shown in men and women. This withdrawal syndrome increases anxiety, restlessness, insomnia, tearfulness, and other effects.
The binding of progesterone metabolites to the GABA receptor complex appears to be one of the primary reasons that high doses of progesterone help decrease anxiety in some women with severe PMS. The doses typically used for PMS treatment may run anywhere from 400-1600mg a day and produce blood levels actually higher than the levels of progesterone seen in the third trimester of pregnancy. Such high doses are actually providing a pharmacologic effect on the brain, similar to benzodiazepine medicines, rather than a physiologic one mimicking the levels and functions of a normal menstrual cycle. At these higher doses, the anxiety-relieving metabolites of progesterone are found to be depressogenic, much like what happens to some people when taking higher doses of Valium or Ativan over a period of time. The brain actions are essentially the same, but then over time, it can make depressed, dysphoric moods worse.
Frye and Duncan (1994) showed that, in rats, diminished pain sensitivity correlated well with the relative binding actions of various progesterone metabolites at the GABA receptor complex. They looked at several different compounds, and those that were strongly bound to GABA receptors showed he greatest reduction in pain, while the GABA antagonist compounds such as DHEA-S did not improve pain sensitivity.'