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[hormonalee]

I'm 45 years old, peri and started HRT around two and half weeks ago. It's not going well so I'm considering stopping and looking for advice about how/when/whether to do this.

My symptoms - for around 18 months or so - some hot flashes but mostly brain fog, period cycle length irregularity but still monthly and most impactful of all: mood swings - I pretty much lose it every month for around a week.

Always had pretty awful PMT symptoms which have worsened over past several years (have wondered if PMDD?).

Anyway, GP was very happy to prescribe - I'm on 100mg utrogestan, days 1-25 of cycle, and estradiol transdermal gel 2 pumps (=1.5 mcg I think?!). GP sought pharmacist advice for that combo based on migraine risk (a lifelong sufferer).

So, after a few days of estrogen gel only, feeling sick but okay, upon starting progesterone have felt ridiculously fatigued, like wading through treacle, and verging on depressed. Aware that I always find the slide into autumn/winter tricky so that might be at play, but fatigue familiar to thyroid imbalance (have hypothyroidism too!) so feels hormonal.

GP is not at all discursive so feel I can't turn to her. Have seen several posts on here suggesting to give HRT a try for three months but the prospect of that is pretty daunting.

I pursued trying HRT to help feel more balanced in life, with more energy even (the dream!) but this is - currently - worse than before. I can't really get out of bed in the morning which is having a whole host of knock-on effects.

So: should I just cut my losses now, as it were? Or see it through at least one cycle? And, if I were to stop now mid-cycle does anyone know what kind of impact that might have? i.e induce a bleed? cause a hormone plummet? Should I at least see one cycle through?

Should add: have tried a bit of acupuncture, high-protein diet (which does help some), and take magnesium, evening primrose oil, and was taking agnus castus but not sure I thought it helped.

Any help or advice would be so welcome. Thank you x (also, sorry for long message!)

[Turkish delight]

Hia,

Welcome to the group, you have come to the right place for support.

So are you taking the Utro pill at night just before bed? This way it doesn't slow you down in the day.
That's an easy fix if you weren't already doing so.

The other things are more tricky. HRT isn't an overnight or 2-week wonder. You will want to commit to taking it for longer
if you want to give it a fighting chance of helping you. There isn't a quicker way I'm afraid.
Just take baby steps as you say, get to the end of your cycle and see if you can commit a bit longer each time.

We are all in this together so stick around, others will be online to help you better soon.

TD

[joziel]

If you're someone who's going to give up after 2 weeks you may as well not get started. The benefits of HRT will come if you get the dosage and products right for you and that can take some thinking and trial and error at first.

If you are experiencing side effects from the progesterone, you might want to try the Mirena coil or one of the synthetic progestins.

These are all the options: https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

[K45]

Hi, it's really frustrating I know but you need to be patient and give it time. It's not an overnight fix that's why they usually recommend 3 months and then reassess where you're at...my experience was I felt like my head was in a tumble dryer the first few weeks, dizzy, tired and very low but after a while I started to feel a bit better and my joints started aching less and the night sweats eased. What has helped me is keeping a diary of physical/mental health symptoms so I can see that things are improving and where in my cycle I need to take extra magnesium to help mood/sleep. If after 2-3 months you aren't seeing any improvement then go back to the GP and see if there's anything that can be tweaked. If HRT is not right for you there are other options that might work instead.

[DottyD68]

Sorry to hear you are struggling at the moment hormonalee.

I think expectations of HRT can be that it is the magic bullet that will alleviate all the horrible symptoms that the menopause presents us with...overnight. For some it maybe, but for others it is not. I have been perimenopausal for 10 years and struggled for over 3 years on HRT to get it right. I am no expert but I think it is even harder during peri as our own hormones are fluctuating all over the place so adding in extra stuff is bound to cause issues at different times of the month.

Personally I would try to stick with it as long as possible - 3 months if you can bear it - because it does take time to settle when you start it. Also you will be able to see if any patterns emerge throughout the month which will help you identify what does and doesn't suit you.

What I found was that some symptoms settled but then new ones appeared so it is a case of deciding which ones you can tolerate and then "tweak" HRT accordingly. Personally I find too much oestrogen causes me problems so trying to find the sweet spot of "just enough" is my ongoing challenge.

My advice is to take one day at a time and keep a diary to record how you feel each day. Hang in there x

[CLKD]

   unless symptoms are unbearable then do continue with a regime. Some find the progesterone part difficult, others manage by altering the type of replacement used.  Think about which symptom U would like to ease first?

Browse round.  Make notes.

[sheila99]

Utrogestan has the same effect on me. You could try a sequi regime which most people in peri start on, 2x100mg for 12 days per cycle (days 15-26) then you bleed on day 1 (at least in theory). This will tell you if it's the utrogestan that's the problem. If it is you can then try other options for progesterone and hopefully find something that suits you better. I'm staying on long cycle sequi in meno so I have more time on oestrogen only. It can take a bit of trial and error to find what's best for you, whether you want to spend the time trying it really depends how bad your symptoms are without it.

[hormonalee]

Thank you all so much for the warm welcome and encouragement x

I've just read the messages (just woken from a 24-hr migraine, brought on the stress-y state I had gotten into I think) and now feel determined to keep going!

Have been taking it at night (though thank you for the tip Turkish Delight!) but am going to try sequi regime next cycle (thank you shella99!), interesting to hear most peri people start on. There was no discussion of options, cycles etc with my doctor, she just prescribed and said all would be explained when I picked it up. I think I might have been expecting a leaflet or similar.

This is part of the reason I have felt despairing this week and willing to give up (agree seems premature, joziel ). I was not prepared at all for what might happen/to expect. She only said it might not work straight away, not it might be bumpy! Didn't realise other symptoms/challenges, on top of existing peri stuff, might appear as part of trying it out.

Almost everyone I know is either not peri yet or is post and breezed through, and no friends/family with experience of her HRT, so I'm so glad I found this forum.

Will keep reading, and start diary - excellent idea, thank you DottyD68, CLKD & K45!

[joziel]

Well, it's taken me about 4 years to get to where I am now with HRT  and I don't know if I'm optimal yet.

Constantly trying and changing things, struggling with really bad symptoms and difficulty working out if they are due to too much or too little E. (The latter, it seems.)

For some lucky people, they do just start it and feel great. For others, this is very tricky for various reasons. However, who knows... Perhaps those people who feel okay are actually not 'ok' in terms of optimal levels for bone, brain, heart etc protection. Perhaps us folks who have to test bloods and really think about all this end up getting levels which are more protective and better for us. Silver lining maybe...