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Author Topic: Anxiety and mild depression - what are my options alongside HRT?  (Read 949 times)

Kai_63

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I've been on HRT (2.5 pumps oestrogel, sequential 12 day 200mcg Progesterone x 12 days, plus vagifem) for over two years. I'm mid 40s.

I was finding the sequential Prog was giving me a lot of side effects (migraines, teariness) so my gynaecologist moved me to 25 days Prog where the 3 day break would still allow for a bleed. Unfortunately my bleeds were erratic and I got spotting, even though I felt so much better on this cycle.

I've moved back to 12 day Prog 200mcg daily and feel awful in terms of high anxiety and mild depression (as confirmed by questionnaires).

I've got a lot of other stress in my life due to redundancy etc and I just need to feel better so I can job hunt. It's a 6 month wait for CBT with the GP. Should I try and manage it myself through meditation, exercise or add yet another med - sertraline - into the mix?

I had to take this for about 10 months previously due to a traumatic life event but I'm not generally prone to anxiety or depression.

Would be get views, I don't really want to be on medication but can't carry on like this (especially the wanting to cry all the time) while job hunting etc.
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CLKD

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Re: Anxiety and mild depression - what are my options alongside HRT?
« Reply #1 on: October 05, 2024, 07:53:03 PM »

Hi!  Did the GP send you for a womb scan to check the lining, if within 'normal limits' I don't see any reason not to continue on the 25 days with a 3 day break.  I'm sure that some1 will be along with sensible advice.  How inconvenient were the bleeds?

What was your cycle like prior to starting HRT and which symptom would you like to ease first?  Did u have anxiety/weepiness at any time in your menstrual cycle, I certainly did, it was regular so I knew it was hormones.

There is no reason not to take Sertraline to allow you to stabilise the mood which will help with the job hunting.  Some keep a mood/food/symptom diary to chart progress.

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sheila99

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Re: Anxiety and mild depression - what are my options alongside HRT?
« Reply #2 on: October 06, 2024, 09:31:53 AM »

Do you get the anxiety during thr estrogen only phase, the progesterone phase or all the time? If it's  the progesterone phase you could try a different  progestogen. If it's all the time you could try increasing oestrogen. Anxiety was one of my worst meno symptoms and I've had to increase twice as my own production fell and anxiety returned. If you had anxiety before peri and it isn't a meno symptom  you may need an ad.
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bombsh3ll

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Re: Anxiety and mild depression - what are my options alongside HRT?
« Reply #3 on: October 06, 2024, 01:21:05 PM »

I would try switching the progestogen in the first instance and also consider whether you would benefit from androgen replacement as well. This often helps with the mood and psychological symptoms.

Did you get any benefit from the antidepressant you took previously?
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Kai_63

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Re: Anxiety and mild depression - what are my options alongside HRT?
« Reply #4 on: October 06, 2024, 05:16:47 PM »

Thanks for all the helpful replies.

Waiting for my scan follow up meeting. I don't think it showed anything abnormal (some minor fybroids) but both the private gynaecologist and GP were very reluctant to keep me on the 25 day while still perimenopausal. The spotting was pretty inconvenient to be honest.

I only had mild PMT and no anxiety pre peri (aside from during high stress/traumatic events).

The challenge with the anxiety is that it could be due to general life but it seems to be month round at the moment so will try increasing oestrogel.

Is androgen synthetic? What other progesterone options are there? I don't know anything about it.

The sertraline helped me get back on track, yes.
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CLKD

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Re: Anxiety and mild depression - what are my options alongside HRT?
« Reply #5 on: October 06, 2024, 08:14:02 PM »

If it's cyclical then adjusting replacement may help, hopefully some1 with knowledge will be along.

When I had extreme PMT in my late 30s The national Association for Pre-menstrual Syndrome told me to eat every 3 hours, 24/7. [NAPS].  Even though the night ;-)
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