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[Emjay]

I have been on hrt (e & p) for just over 18 month's.
Whilst some of the physical symptoms did improve my anxiety and other mental issues have not and infact I have been feeling a lot worse since I have gone higher with the estrogen dose.
Had testosterone tests twice in the past 6 months and both times it has been low, the 1st test showed my testosterone was below range.
My g.p has not let me try testosterone to see if it would help, I feel like a 90 year old, no energy, insane fatigue, muscle weakness, plus anxiety and a whole other symptoms. And no libido whatsoever for a couple of years.
They just keep upping my estrogen and obviously I have to take progesterone which also makes me feel severely insane.
I used to have pmdd (prob still do) so I am used to the hormonal feeling and the way it happens isn't the same as just anxiety or depression (have had the odd bouts in the past)
I decided to go private because I can't continue like this, I have 2 young children to take care of and they deserve a happy balanced mum.  I also work but am feeling like I am going to have to stop working as I am severely struggling as I have no energy, exhausted, weak plus anxiety then panic attacks randomly (again, this is not me)
The private consultant thinks I should stay on the 100mcg patch then re test my estrogen and testosterone in 2 months time, if testosterone is still low then will prescribe but in the meantime to take escitaloprám when I am at my worse, which used to be ovulation until a couple of days into a period..
Since upping estrogen I didn't have a window of feeling good at all, felt erratic and on the verge of a break down by day 9 of my "cycle" I felt it was my estrogen so I started progesterone early, the next day I felt calmer and it was like that for a couple of days, then as usual when I start with progesterone the joint pain started, insomnia, depression, emotional, head aches, fatigue to the point I want to just be in bed all day (have never been a day time napper, even when my kids were newborns)
I personally don't feel an ssri is the right way forward, I already feel so exhausted and when I have tried ssri's in the past, fatigue was always a side effect I experienced
Has anyone been in this situation?
Did they feel better after taking an ssri? Or did you feel better after trying testosterone?
My instincts is that I need testosterone, I have felt this all along.
Have read so much about other women's experiences, I have a friend who felt like me and feels so much better after starting testosterone, I have listened to heaps of drs, consultants talking about this.
What I am worried about is that I start an ssri to mask side effects from being on the wrong dose of hormones.
Maybe it will help, or maybe I will feel worse.
I want to just feel better now.
I feel I need less estrogen, possibly less progesterone (more of an individual dose plus scans to make sure my endometrial lining stays thin) and some testosterone.

[bombsh3ll]

I think at the moment you are getting the worst of both worlds shelling out for private consultations and still being offered antidepressants and no testosterone.

This is no better than what you were getting on the NHS.

I would question the private provider's level of knowledge and expertise - unfortunately a lot of GPs and others have jumped on the lucrative menopause bandwagon but have little experience or training in this area.

If your testosterone has already been tested and is low, which is only done to exclude prescribing it to someone who already has high levels and not for diagnostic purposes, why would this specialist expect the result to be different in two months time without any treatment?

This is just stalling for time as they probably lack confidence prescribing it and also will generate additional costs for inappropriate duplication of blood tests and further consultation.

If you are happy with the level of estrogen you are getting from the NHS but cannot obtain testosterone, why not use Superdrug's testosterone only service or Louise Newson's testosterone only service.

Finally I would always suggest decoupling the two issues - one is access to beneficial treatment, the other is being pressured or encouraged to take a treatment that is not indicated and has the potential to cause harm.

Whilst you may have to jump through various hoops or pay privately to obtain the treatment you need, you always have agency to decline inappropriate treatment.

Too many women end up taking antidepressants because they have asked for and been refused either estrogen and/or testosterone, which to me is illogical.

[sheila99]

Testosterone should help you fatigue, energy, muscle weakness and libido so I agree that this is what you should be having now. It is unlikely to help your anxiety though. Anxiety can be a symptom of both too little and too much oestrogen so I wonder if you passed your sweet spot and now have too much? Did your anxiety arrived with peri? As you know it has many possible causes and hrt is only going to help if it's caused by oestrogen deficiency. Peri is so difficult because of your own peaks and troughs so you're pretty much guaranteed to have too much or too little if something at some point in your cycle.