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[Vicky81]

sorry Crispy - No cyclical nature to the crying

[Vicky81]

I'd be careful switching Vicky. You are looking for stability and have had that with Yasmin for a while now. You're nearly there. You are having a run of good days. You weren't getting that months ago.

Whilst I get joziel's comments on bio identical versus synthetic, I think when we are having a hellish peri, it's about finding stability. You will have a more stable cycle on the pill.

I've tried all the pills going and could no longer get on with any of them. If you are getting cycle suppression, I'd stay put. You've said yourself you tried zoley before.

And. I also disagree about swapping your pill to only hrt. Hrt does not suppress the system. We can have huge swings in peri...and that extra E simply swings with us. I felt dire on extra E.

Just be careful in your choices. You've been through a lot. You are being told it is the antidepressant causing the crying. I'd consider looking at that first.

Is there a cyclical nature to the crying?

When you say Dire on extra Oestrogen - what do you mean? Where you on patch? What mg? and what bad effects did it give you?

[Vicky81]

Sorry Crispy - i probably did this wrong - but i asked on the quoting you - what bad effects did you get from too much Oestrogen? Was it the patch? What mg made you ill?

[CrispyChick]

I've only tried E once through my horrific peri. And basically, all the symptoms I was having were made 10x worse within days.

I think you're doing the right thing taking advice on the AD and adjusting the dose as recommended. They are powerful drugs and can absolutely cause issues like u describe.

Messing with the pill or hrt at the same time should be a no no.  . You're on high dose E and the pill. your bloods are in good range. I can't see how you could be low E. especially if there is no cyclical nature to your crying spells.

However, I'm just yet another person on a forum. So I'm glad you're getting expert advice.

That's why I've responded as I don't feel it will do you any good to swap your pill right now or go all over to HRT. Everyone has an opinion, bug we also all respond differently.

I hope the reduction in AD is the right move. Hold on in there. Xxx

[joziel]

It's not about suppression of the cycle, that's too simplistic. I tried taking desogestrel whilst on HRT to suppress my ovaries and cycle - and it did nothing to my symptoms. High dose HRT finally is helping overcome the fluctuations which were causing those symptoms. Shutting my ovaries down to try to stop fluctuations didn't help, because our brains also manufacture estrogen and get deficient in it...

You can't dose HRT using blood tests at all if you are also taking Yasmin (or any combined pill with synthetic estrogen in it). How are you going to know if you are on too much, too little estrogen and how much you are absorbing etc etc...

You can't compare bio-identical estrogen with synthetic estrogen in terms of the quantity, they are not comparable. They are 2 completely different drugs. You are not taking estradiol with synthetic estrogen.

You are going to be taken off the combined pill when you hit 52 anyway, because that's best practice advice. It increases the risk of blood clots. You are going to be forced to go in search of 'stability' via HRT anyway. What you are doing now isn't tenable for the long term so you may as well use this situation as an opportunity to sort things out. How much worse is it going to be if you reach nirvana and are symptom-free and then are forced to come off the combined pill anyway....??

To be honest I'm really surprised a doctor has approved you being on both HRT and the combined pill.... I've never heard of anyone else doing this. There are some women who prefer to stay on the combined pill as long as possible, but not alongside HRT. It would be very unusual anyway.

[Vicky81]

Hi Joziel - I have always gotten on really well with Yasmin, along side the patch - always worked well - stopped my anxiety/crying etc. GP agrees that as long as im ok and getting scans that i can stay on it. So am on HRT and the pill. So once off the pill at whatever age, i will still be on the patch so hopefully it wont be that distressing for me.

What has happened in May is i took a dip in oestrogen - as you say Joziel may i am further along. So now my patch has been upped. Maybe it needs upping again due to the severe crying? who knows? The Pharmacist a while back suggested i just put the 100mg on instead of cutting the patch to 80. Maybe 80 is too low?

Crispy - Thanks for the message, I shall keep on my regime with the hope that this reduced Duloxetine will cease the crying, i guess i have to now give it 4 - 6 weeks? is that right? to see if its going to be for me? xx

[CrispyChick]

Yes, I think 4 to 6 weeks for stability on an AD.

With all due respect joziel - I know u believe in high dose E. And if it works for you, amazing. But some of us have a harder time finding that sweet spot or indeed getting on it in the first place.

Please bare in mind Vicky has been through a lot of upheaval and the  best thing for her right now is stability. No, she can't stay on the pill forever, but at 48, I just had a meno specialist say that's what they would still recommend.

For some it is all about the fluctuations, not solely about low E levels. that can come later.

If the drop in AD doesn't help Vicky, maybe a different AD? I'd expect crying to disappear on an AD. Or try the E increase then. As you say, your specialist has approved pill and patch.

Good luck. Xx

[joziel]

Indeed - who knows if you should increase or reduce? My point exactly: If you can't use blood tests - and you really can't on synthetic estrogen - then you are just guessing whether to increase or reduce.

Bearing in mind some of us (like yours truly) can need very high doses of HRT estrogen, how would you ever know if you were in that situation if you couldn't rely on bloods?

Yes, when off the pill you will still be on the patch - but what dose? Presumably you will need to increase HRT because you will have stopped the synthetic estrogen. Or you will still have some ovarian function left at 52 (not all women are instantly menopausal at 52.... ) and your own ovaries will contribute varying amounts then, maybe requiring more to overcome those fluctuations.

Point being - it's just delaying the inevitable really. You will need to come off the combined pill at some point. And whilst you might have been stable on it for a while, you clearly aren't now - and it is making it difficult to determine what's really going on.

[CrispyChick]

But Vicky thinks it's the AD causing the crying. So surely she's better to start there, as she's had expert advice to that affect.

Delaying the inevitable? Not necessarily. For many woman the pill helps mask the fluctuations until post meno. My own sis has stopped the pill  at 50, has gone straight into meno and is doing absolutely fine. whereas me, in this peri hell of wild fluctuations, is not.

If I could, and god I've tried, I'd take the pill in a heart beat and take my chances post meno.

We're all very very different. And it is most definitely a course of action still recommended by specialists. That's because it does flatten the hormones, whereas hrt tops up. Pill is stronger.

[Vicky81]

Hi Crispy i agree, I would rather stay on Yasmin as every blood test i have had to check LH and FSH have always come back as 0.1  - even the Gynae told me when i asked - she said they are very supressed.
So i guess the dip in May must be what Joziel said earlier - maybe I've come a bit more far along in peri? and that the 65 patch needed upping.
But since the Duloxetine, the crying has been terrible and quite frequent.

i have also heard of women who come off the pill and are fine just carrying on with HRT so thats my plan really.

[CrispyChick]

It's good to thrash it out on here vicky - to see what is best course of action for you.

For me, you sum it up perfectly here: "since the Duloxetine, the crying has been terrible and quite frequent.". Since the duloxetine. I'd definitely start there. Xx

[Vicky81]

Crispy I can't thank you enough for understanding everything I've been through ...thank you so very much xxxx

[Kathleen]

Hello Vicky81


I am sorry to hear that you are suffering, especially as you are trying so hard to feel better.

I hope that the reduction in your Duloxetine dose does the trick.

Like many ladies I take an AD along with my HRT and  I have often wondered if this is really helping or even making matters worse. Would you mind reporting back on your progress so that we can learn from each other.

Wishing you well and take care.

K.

[Vicky81]

Awww Kathleen so nice to hear from you! And yes of course I will report back ..

I hope you are doing ok? Xxx

[StrideOrDie]

I was on the "am I absorbing?" merry-go-round at first with HRT. Turns out I was absorbing, my dose just wasn't high enough. My .05 patch knocked out my night sweats and hot flashes but I had to get to .075 for my mood to improve and the depression to go away.

It's hard to get the dosing right. Don't be afraid to go up a notch. Your body will tell you if it's too high! Good luck!