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Author Topic: HRT not working  (Read 16142 times)

Turtle45

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HRT not working
« on: February 24, 2025, 06:17:06 PM »

Hi

Has anyone else found that HRT did not help with their symptoms, especially the psychological ones?
I started to get mood swings in December 2023 and various other symptoms. Then I became severely anxious about 4 months later. I had had PMDD for years but not suffered massively from anxiety before.
I was tried on a variety of HRT but nothing helped with their symptoms, especially the anxiety so my Dr had completely dismissed it having anything to do with menopause. 
I just wondered if anyone else knew their symptoms were menopausal but they had found that HRT didn’t seem to work for them?
Would really appreciate any insights! I’m quite frankly a mess. I’ve gone from having a good job, home, friends and being really healthy to being a husk of the woman I was.
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Fizwhizz

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Re: HRT not working
« Reply #1 on: February 24, 2025, 06:25:44 PM »

I found it took a long time to improve my menopause psychological symptoms and in the end it turns out it was both menopause and hypothyroidism that needed addressing with hormone replacement treatment. Things have improved a great deal but I still struggle with things and I’m definitely a very different version of myself now and will never be the person I used to be. What symptoms are you experiencing? Is it mainly anxiety that you’re struggling with? Mine was more low mood, flatness, lack of motivation.
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SundayGirl

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Re: HRT not working
« Reply #2 on: February 24, 2025, 06:51:18 PM »

As Fizwhizz said, just because you're a certain age, please don't put everything down to menopause.

HRT made me anxious and before that, anxiety, depression, moodiness were only relieved by appropriate thyroid meds and getting my core vitamins to a decent level for me.

When was the last time you had a full health MOT?
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Turtle45

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Re: HRT not working
« Reply #3 on: February 24, 2025, 07:10:59 PM »

Thanks for the responses.  It’s nice just to not feel alone. I have always struggled with my hormones having PMDD most of my life but I started to get the low mood and sobbing everyday rather than cyclically. The. The anxiety kicked in.
 I also had sweats, brain fog, bladder issues, tinnitus and a range of other things. I’ve had lots of tests and they haven’t shown anything.
There were other factors affecting me emotionally but I struggle to believe I went from being really good at my job and having a friendly, confident  personality to  the other end of the spectrum without it being to do with my hormones.
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Kathleen

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Re: HRT not working
« Reply #4 on: February 24, 2025, 07:57:41 PM »

Hello Starfish


A GP told me that HRT is very good at treating the physical symptoms but not the psychological ones and that has certainly been my experience.

I never had PMDD and I didn't suffer any issues post natally but I am much less stable emotionally now that I am post menopausal.

I am continuing with my HRT and looking at life style changes to help myself but I think the level headed person I used to be had gone  forever.


I am sorry that I can't be more helpful but you are not alone and I definitely think our hormones are to blame.

Wishing you well and take care.

K.
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Turtle45

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Re: HRT not working
« Reply #5 on: February 24, 2025, 08:43:05 PM »

Thank you Kathleen. I genuinely think I am going mad with the anxiety and memory issues. HRT and antidepressants haven’t helped so at a bit of a loss as what to do.
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Jopurpose

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Re: HRT not working
« Reply #6 on: February 24, 2025, 10:40:57 PM »

I think my HRT has stopped working too so I’m currently undergoing investigations.
I asked my GP how I was supposed to continue coping with the panicky-like anxiety and tearfulness in the meantime and she has given me Propanolol to take as and when necessary. It’s really helped me.
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Epona52

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Re: HRT not working
« Reply #7 on: February 25, 2025, 06:36:18 PM »

Hi starfish,
I can absolutely feel your pain, and everything you have said feels as though your telling my story,
I was a happy outgoing person who has health issues, but at 52 anxiety hit me head on and I have struggled ever since, gp upped my oestrogen gel to four pumps but I feel I'm not a good absorber, I wake every morning with raging anxiety that's there for no reason, I have depression on and off and now suffering with bladder issues, I struggle to go out sometimes to the point the anxiety controls me and I can't get out of the door, I've also given up driving through anxiety and panic attacks,
I always loved to get out and be independent but not now, my confidence has gone and I feel I will never be the same as I once was, gp's are pushed these days and when you phone for an appointment and message says your number 83 in a queue it just makes you
Give up, if it wasn't for this site I would feel so alone in this journey,
Take care and best wishes
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bombsh3ll

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Re: HRT not working
« Reply #8 on: February 25, 2025, 07:29:32 PM »

When you say you have tried HRT, what are/were you taking?

Often when people think their treatment isn't working it turns out they are on a very small dose, or a preparation that isn't the most suitable for them.

Psychological symptoms, particularly on a background of reproductive mood disorders such as PMDD often require higher doses of estrogen than it takes to simply suppress hot flushes, and testosterone can also be extremely helpful.

It may be that you are sensitive to either some or all progestogens and need an individualised approach here too.

Others find tibolone a great option where standard HRT preparations haven't suited.

I would suggest seeking help from a specialist given that primary care treatment hasn't helped.

Whilst nobody can promise that any particular treatment will be a silver bullet for what can be really complex and challenging issues, it would be premature to write off hormone therapy until someone with the appropriate skill level has been involved.
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joziel

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Re: HRT not working
« Reply #9 on: February 26, 2025, 06:51:33 PM »

I echo what bombshell says. My experience is that people are not being given anywhere near enough estrogen to help them. Doctors are obsessed with the dosage prescribed and not how much you are absorbing or serum levels. And everyone is an individual and needs varying amounts, with the amount needed for PMDD and neurological issues being known to be much higher.

If you haven't taken enough estrogen to get up to 800-1000pmol, I would strongly recommend you try that. There's nothing to lose, if it doesn't work, you can just come off it if you want to, or reduce. But at least you will have trialled it.

To be able to do that, you might need to go to a private clinic like Newson Health. That's where I go. I need to have estrogen around 800pmol+ for my neurological symptoms.

For more information, look up Dr Felice Gersh on YouTube or join the Bio-identical Hormone Replacement Therapy group on FB. It's in the US so you need to convert from pmol to pg using an online calculator, but the ranges they are dosing in are absolutely what I need and their info on progesterone is spot on as well.
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DottyD68

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Re: HRT not working
« Reply #10 on: February 26, 2025, 07:36:45 PM »

Hi Starfish43,

I tried several different combinations and regimes of HRT over a 3.5 year period after having struggled with perimenopause symptoms for 7 years. I really wanted it to work but it never gave me the relief I had hoped for. Some symptoms disappeared temporarily whilst new ones appeared, the worst one was anxiety which I had never previously experienced in my life. It was worse when I was on 4 pumps of gel. As I reduced the gel, the anxiety eased along with the huge sore tender boobs. The less I had, the more my symptoms reduced.

I found I was unable to get a balance between my dose of HRT and my own wildly fluctuating hormones.

I have recently stopped HRT as a trial to see where my own body is at. I am willing to retry HRT if my symptoms come back. But so far I have felt the best I have in years and my weight has dropped to near normal levels. Maybe it is a temporary relief or maybe I have finally got over the worst and things are starting to settle naturally as a lot of ladies say it does. Time will tell.

What I have learnt is that HRT is not a one size fits all and it has to be tweaked until you find what is right for you individually.

I hope you start to feel better soon with whatever you find helps X
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Turtle45

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Re: HRT not working
« Reply #11 on: February 26, 2025, 08:07:10 PM »

@joziel - how can you find out if your serum levels are high? I’ve been told my blood test show normal oestrogen levels when I’ve had them done. Haven’t had any for a while. Dr is reluctant.
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Mary G

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Re: HRT not working
« Reply #12 on: February 26, 2025, 08:54:29 PM »

joziel, I completely agree about meddling doctors constantly badgering women to reduce their oestrogen dose.  It really fouled things up for me years ago when I was settled on an HRT regime and I stupidly allowed a doctor to persuade me to reduce my dose - never again.

You are right, the menopause unleashes a complicated set of health events and in my case it's migraines which can only be prevented by a decent, stable dose of oestrogen.  If I go too low, I'm plagued with migraine auras.  Different medical conditions require different doses of oestrogen but generally speaking, women with depression and anxiety need to go high.
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joziel

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Re: HRT not working
« Reply #13 on: February 26, 2025, 09:10:57 PM »

@Dotty - things can be much more complicated because we are really in the dark ages with all this, in fact we are all pioneers thanks to the WHI putting the brakes on this for decades.

In my own case, anxiety (as with you) got worse initially with each increase in estrogen. So of course I assumed it was being caused by the estrogen and I stopped it. All my low estrogen symptoms returned and the anxiety didn't go away. So I restarted HRT and, this time, felt no worse with each increase. I have no idea why. Since I had explored no HRT, low dose HRT and average dose HRT, I decided the only unexplored thing remaining was getting levels up. So I increased... and hey presto, all my anxiety went away. If you try to reason it, it makes no sense - why was anxiety not a symptom for me UNTIL I started HRT? But stopping HRT didn't stop the anxiety? And then getting levels HIGH got rid of it??

This is exactly what I mean. We can't reason this stuff yet, because we don't have the research. There is only trial and error and working through different combinations of things, systematically. Best not to assume things, because they can be wrong and we might not try the one combo which works. And one thing many women don't even get to explore, is those higher E doses.

@Starfish - don't accept being told that you have 'normal' estrogen levels, because that is completely meaningless. Request all the actual results of your blood tests - which you are legally entitled to ask for copies of - from your doctor. Look at all the results. Anything under 270pmol is LOW, by anyone's standards. An average-ly acceptable level for many women is between 400-650pmol. And some women need to be between 650-1000pmol to get relief. It is very individual and involves trial and error.

Personally, I had inner tremors through the night which would feel like the bed was moving under me, hypnic jerks every time I began to fall asleep and my heart would beat incredibly hard and fast in my chest through the night - even when my estrogen was around 450pmol. NHS doctors would all tell me my symptoms most definitely could not be due to menopause or estrogen with levels like that. Only Newson Health told me they wanted me to get my estrogen up and see what I felt like with it much higher. As soon as I got to around 600 I noticed a huge improvement and even more around 800pmol. I now sleep about 7 hours a night and get 1 hour of deep sleep (according to my Apple Watch). Previously I was getting about 2 hours of dozing and I was a zombie every day. The NHS would have put me on pregabalin or gabapentin or SSRIs. I take nothing other than hormones at the moment (including for my thyroid). I am still not 100% perfect, in terms of sleep - I should be getting over 8 hours, I still have very faint tremors and I wake many times a night but I am able to go back to sleep now. I will be trying to get slightly higher to 1000pmol - except now there's an Estradot shortage so I might have to wait...
« Last Edit: February 26, 2025, 09:12:46 PM by joziel »
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DottyD68

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Re: HRT not working
« Reply #14 on: February 26, 2025, 10:16:30 PM »

Hi Joziel

Sorry the anxiety didn't go away for you when you reduced your HRT but glad you were able to feel better on the increased dose.

Our situations appear to differ in that for me reducing the dose definitely reduced/eliminated several symptoms for me that I didn't have prior to starting HRT. Anxiety was only one of them. I tried several different combinations of HRT which did not eliminate the new HRT symptoms. It was a no brainer for me to reduce, then try stopping HRT, as being on it made me feel much worse than being on a very reduced dose (or off it).

What is apparent is that we all react differently to HRT. Starfish43 asked if anyone else found HRT didn't work for them and my post was in response to her question.
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