Menopause Matters Forum
General Discussion => New Members => Topic started by: Barefoot on November 17, 2016, 10:00:14 AM
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I'm new on here and just started reading through a few posts. What a mine of info.
I've never suffered from any hormonal problems until now but suddenly in the menopause I'm having a horrible time. The main problem has been night sweats and accompanying poor quality sleep and hot flushes during the day. Any slightly stressful thought would bring one on.
Desperate, I went to the gp who prescribed sertraline, an SSRI antidepressant, not because I am depressed but because it has been shown to reduce sweating in menopause. I took my first dose yesterday and the effect was immediate. No sweats since, previously would have had 8-10 a day. And no night sweats. It was bliss.
But I have a headache, nausea, dry mouth and although I had no sweats in the night I woke several times and didn't easily fall back to sleep. I feel generally drugged. And I'm a bit concerned about AD drug for non depressed. I know all drugs have side effects. It's only day 2 today so I will give it time.
I'll be around reading your thoughts.
Barefoot x
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Hiya Barefoot,
I am on an AD for similar reasons and my GP did tell me "you are not depressed". They are used for many things other than depression. Hope the side effects pass soon ::)
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Barefoot - welcome to MM
How old are you? Are you still getting periods?
I believe your GP has given you the wrong treatment - HRT is the front line treatment for peri and post menopause symptoms such as you are experiencing.
Do read up all the info on this site to get clued up. Also look up the NICE guidelines on treatment for menopause and hot foot back to the GP and ask to try a low dose of HRT - this will reduce the flushes etc. and allow you to sleep.
The sedative and other side effects of SRRIs can settle but it you are in the your early 50s then HRT will actually protect your heart and bones for the long term which an SRRI won't do.
SRRIs are mainly for depression or for those who can't take HRT for health reasons - you don't sound depressed and if you are a non smoker and are not over weight then HRT is the right treatment for you.!!!
DG xxx
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Hi Barefoot
:welcomemm:
Absolutely as Dancinggirl says - you should NOT be given a drug for menopause that is usually given for depression if you are not depressed!!! The doctor is completely out of order here (well, out of date) - unless you are medically contraindicated for HRT which as Dancinggirl has said is the first line of treatment for menopausal symptoms. The problem with these is that once you start you may well find it difficult to stop - it seems that many women are dished out these and stay on them for years - as a nation we (not me) are "hooked on happy pills" as one newspaper article headline said a couple of years ago. They have their place - but docs are far to free to dish them out because it's easier and cheaper than anything else.
Please please go back to the doc and ask for HRT. We can help suggest which one if you tell us a bit more as Dancinggirl has asked.
Information about the NICE Guidelines can be found on the homepage of this website (not the forum) and follow the links.
Hurdity x
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Hi Barefoot if you are in the UK most GPs tend to give out antidepressants when faced with a menopausal women. Most of my friends that are menopausal have been given antidepressants instead of HRT. The side effects you are experiencing I had when I tried those tablets last year for anxiety. I had to come off them after 3 days as they didn't suit me, most antidepressants don't. I have several friends on those tablets ok. Have you asked to be referred to a consultant gynacologist to be assessed, you can ask for this. :)
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Thanks all for your replies.
I'm 53, my last period was in June. The GP seemed to think HRT would just delay the inevitable. Se said the SSRI would not be addictive. She was very young (another symptom of age, doctors and police officers are so young!). I her defence, she did recommend I looked on this website.
I haven't taken any drugs in decades apart from paracetamol so I'm not used to this drugged feeling. I have a phone review with the GP in 4 weeks. Maybe I should try and get to see her before then. I suppose I'm the generation who were brought up to defer to the doctor as the expert. Those times have changed.
I'm not depressed, no panic attacks or anything but I do get anxious easily. It's one of the things my husband loves about me. I care so much about everything. And the in the past couple of years I do worry about stuff more. But I think that's because at this age women have a lot to worry about, young adult children, ageing parents, responsibilities at work. And I'm used to feeling like that, I'd rather be worried than this foggy fuzzy feeling.
I need to educate myself and get back to the doctors.
Barefoot x
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Hi Barefoot, most antidepressants take 8 weeks to work properly. If I remember correctly the ones you have been given are part of the citalapram family. These type of antidepressants are the ones used now and are deemed better than previous ones such as valium and Prozac. The way you are feeling is your body getting use to them. Anxiety feelings can be caused by the menopause. Do a search of this site and look at posts of ladies who are post menopause. Your GP should offer you HRT treatments for being post menopausal. HRT doesn't delay anything it helps your symptoms, so your GP's comment is wrong. I hope you get sorted.
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Worrying and caring about things is normal!!! - I have always been like that but would never ever consider that I "suffer" with anxiety. It's just how I am. It doesn't stop me doing things - and I have often put myself outside my comfort zone even while being terrified!!!
I would not stay on those tablets for 4 weeks - I would go straight back to the doc and ask for something else. Fine if you find you cannot cope after you have got the right type of HRT and stayed on it for some months - and other methods haven't worked but I urge you to stop taking them well at least not for that long!
As for delaying the inevitable - that is a rubbish argument!!! We have demolished that frequently on this forum!!! For a start if you take HRT while you are peri-menopausal and your hormones are fluctuating, even if you stopped after 5 years and were post-menopause - your hormones will no longer be fluctuating because ovarian function will have ceased and your body will have gone through the menopause. You don't go through it twice.
Some women do react to reduction in oestrogen levels whenever they stop - whether it be 55 or 65 - but that is certainly no reason not to take it in the first place!! What about the years of improved quality of life you have gained all the years you have been taking it? You can't take those away - so even if you did feel rotten for a few months after stopping - you have felt good while you are still young rather than lying about on a sofa mopping your brow and expecting to be waited on ;D (I do always say this - I know it's a bit extreme!).
You cannot say in your case how long your symptoms will last if you don't take HRT - some women find they stop after a couple of years or hardly get them, but for some women they last into their 70's. In any case the long term effects of oestrogen deficiency can't be measured by the intensity of flushes and sweats and even taking oestrogen for a short time will confer additional protection to your heart and bones and especially if you are younger than the average age of menopause of around 51.
Hurdity x
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Thank you for your replies. I have booked another GP appointment, I have to wait 10 days though. I will print off and take with me some notes form the NICE guidelines on this site. I'm going to ask for HRT.
I'm still undecided whether to carry on with the sertraline. It has solved the night sweats and hot flushes. I've gone from 10 a day to zero. But I feel hungover and that's not fair as I haven't had a drink in weeks! And today my back muscles went into spasm which means I miss my favourite gym class. I'm gutted. I'm hoping the side effects will be less strong tomorrow, but then will I have withdrawal to go through if I do change meds. Maybe I should put up with the hot flushes until I can get back in to see the GP. Dilemmas.
At least now I feel a little more informed about all of this.
Barefoot
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Hi Barefoot depending how long and how many mgs you are on you may have to taper the antidepressants off to wean off them, ask your GPs advice. When I was on them I only took 75mg over 3 days but because I had such a bad reaction to them I came off them. It then took 3 weeks for the side effects to leave my system. Good luck x
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Hi Teresa I've taken 50mg a day for 3 days. Do you mind if I ask what side effects you had? x
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Hi, I took them for anxiety and ended up having full blown panick attacks. They magnified everything bad by about 100 times. I can't take several types of antidepressants becuase I react badly to them.I've never taken illegal drugs but taking these tablets felt like the worse drug trip you could imagine. They weren't for me.x
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I think if you continue with the AD your 'hung over' feeling will ease. Or maybe take the drug on alternate days? I have taken various ADs since the late 1980s, maybe a lot longer than many others who post here. It has never been a cure and there have been 'hung over' feelings, but that is far better than not being able to get out of bed due to depression; and Propranolol helps ease anxiety surges ……..
Also, my GP agrees that I can self medicate when necessary. So if my bowel becomes slow then I miss a dose, if I need to up my AD for example, that's OK too.
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Oh dear Teresa that sounds terrible. My side effects are nowhere near as bad, in fact today just a headache but that could be due to an 11 hour day at work.
I wake in the night a few times, but feel well rested by morning, I think my sleep is better quality that before. And to wake up not covered in freezing sweat is brilliant, I lie awake in bed just enjoying the feeling.
I haven't had a single hot flush since the moment I started these tablets. I can do normal things like drink hot drinks and drive to work without having all the windows down in the car. I will keep on with the tablets a few days more and hope I continue to adjust to them. I definitely don't want to go back to all that flushing and sweating!
Thank you all for your advice and for sharing your knowledge and personal experience.
Barefoot x
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Glad to hear you are getting relief. It makes so much difference doesnt it to feel on a more even keel. ;)
Hrt didnt help me ,and I tried most of them,that's not to say hrt wont help you. Once you have settled down you can have a review on which route you want to go . Hope you continue to improve.
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CKLD - ADs/SRRIs are appropriate treatment if prescribed for the right reasons. If you read my posts, I often suggest to ladies suffering with terrible anxiety, that HRT alone is often not enough to control this and an SRRI alongside HRT may be appropriate.
Too many women go to their GPs in a terrible state due to lack of sleep, burst into tears and the GPs will often jump to the conclusion they are depressed without going through the proper diagnosis procedures. A 10 min appointment is not enough to really get to the bottom of why a women is feeling so anxious or possibly depressed but lack of sleep and constant flushes are highly likely to be the cause when meno symptoms hit. If GPs were given a list of key questions to ascertain whether ADs and/or HRT are appropriate this might help matters. A history of anxiety or depression should also be taken into account, however, if a women says she cannot sleep because of night sweats and gets numerous flushes throughout the day that trigger anxious feelings, then setting out the clear options of HRT or possibly ADs/SRRIs should be offered, highlighting the benefits, side effects and risks of both treatments, then she can make a better informed choice. The days of routinely offering ADs/SRRIs should be behind us now - these drugs should be offered with caution.
If you read the original post on this thread, Barefoot is getting some rather nasty side effects from the ADs she has been given. My response in suggesting she has been given the wrong treatment for her meno symptoms is based on the clear advice on the NICE guidelines. Did Barefoot's GP tell her that there would be some nasty side effects that may effect her ability to function well and that coming off this AD would involve a slow withdrawal and possibly a return of symptoms? Did the GP explain that meno symptoms should normally be treated with HRT unless there are medical reasons for not doing so? Also, if HRT doesn't suit you can easily stop it - whereas ADs should not be stopped cold turkey.
When I was prescribed ADs back in my 30s when I was peri meno and got very depressed due to problems in my life at the time, my lovely local pharmacist took time to print off the info on side effects and advised me to really think carefully about whether to take them - I had young children and he knew I needed to drive and be functioning at a reasonable level. There have been many cases of people reacting very badly to ADs and in fact the side effects tipping them over the edge. I think I can actually give a very good example:
A man in my street became very anxious to a degree that his wife took him to casualty. He was given something to help - I assume some AD of some sort and sent home. In the middle of the night he woke, became extremely agitated, chased his wife around the house, grabbed a hammer and on the doorstep of their house struck her on the head and killed her. Now we will never truly know what tipped him over the edge - it had been a happy marriage and she was a calm and rational women, however, he got off with manslaughter on the basis that he was not of sound mind and I do wonder if he had had a bad reaction to the drug he had been given.
There was also a case on the news recently about a women who had just started an SRRI and suddenly went missing in the night, her husband and friends explaining this was completely out of character.
I feel very strongly that we should keep an open mind about any treatment and also keep in mind that GPs are under a great deal of pressure so simply cannot keep up to date on treatments or give the time to each patient to always give appropriate treatment.
CKLD - I know you are a great advocate of pharmacists; I went to see my favourite pharmacist yesterday for advice about the headaches I have been getting. He took my blood pressure and gave me so much time to talk through my options. We were interrupted by a phone call from an elderly lady, he supplies her regular prescriptions so knows her well, and she was clearly questioning something the GP had given her - I heard him tell her to get back in the touch with the GPs as they had given her the wrong type of drugs.
We are hear to share our experiences and views, so we should all respect this.
Barefoot - I would seriously consider HRT - read up all the info on this site to get clued up. The ADs you have been given may be OK for a short fix but they won't do any good for your bones and heart but HRT certainly can - HRT is not just for flushes and night sweats. The dry mouth and feeling of being ‘spaced out' can often linger with this AD which is not a good thing in the long term.
DG xxx
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Well said Dancinggirl :thankyou:
I am so glad you are feeling better Barefoot - but I also stand by what I said - that unfortunately you have been given the wrong prescription by an ignorant doctor! As you yourself said you are not a drug-taker - and HRT -especially the types that are bio-identical to our own hormones (estradiol, progesterone - readily available) is not a drug - it is what it says - hormone replacement, the first line of treatment for menopausal symptoms. ADs should only be given (for menopausal symptoms) to women who are unable to take HRT for medical reasons or who are adamant they don't want to take it! Your doctor should not decide this for you nor try to persuade you not to due to their own prejudices or misinformation!!
Good luck with your GP appointment and if we can help answer any questions about HRT in advance of this or help you with any of the arguments in its favour then please use us as a sounding board :)
Hurdity x
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Does this particular AD need supervised withdrawal and why is there a problem with this? It took me 9 weeks to withdraw from an AD years ago, still here >wave<. Other ADs I've stopped without withdrawal and started a new drug within 24 hours.
We don't know whether all your comments were offered up by Barefoot's GP during consultations. You will need to ask her directly.
These drugs remain offered with caution. But when a patient presents with depression or anxiety, regardless of the cause, then there is no reason not to offer them. Sorry, am repeating myself a bit ::)
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Yikes! I did not realise this would provoke such controversy.
True that I did not properly discuss side effects, withdrawal or how long I might be taking the ADs. And no it was not made clear that HRT and not ADs should be used to treat menopausal symptoms. But I don't want to engage in GP bashing. I will go back to my GP and I hope to have a mature and informed discussion, which is possible now I'm not having a hot flush at the slightest bit of excitement.
I'm certainly not angry with her for giving me sertraline and she did not have to persuade me. I agreed to try it. I went into that consultation without much information and feeling desperate and was happy to try anything suggested.
The drug has done its job and the hot flushes are gone. The side effects are diminishing and no longer that bad although they were a shock at first. But I don't feel my personality is altered.
Maybe I will change to another line of treatment in the future and I will consider HRT, but the ADs are doing the job for now. I eat well and workout regularly at the gym to keep bones and heart healthy. From what I can gather reading around, HRT is not side effect free either and not everyone gets on with it.
It has been good to have the NICE guidelines brought to my attention and I appreciate the views that have been shared.
Barefoot x
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Barefoot - I do hope the somewhat heated exchanges have not put you off posting on MM - these things happen occasionally when there are misunderstandings etc.
HRT is a personal choice - and the type of treatment you wish to use is a personal choice. We just tend to get a bit outraged that GPs don't offer the choice.
Most of us enter the menopause with little or no knowledge of what to expect and rarely have any idea of how to deal with the symptoms. If you are happy with the Sertraline and it's doing what you need then thats great. HRT doesn't suit everyone but it is worth giving it consideration in the future. Do keep posting
All the best DG x
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Dont worry you haven't caused controversy.
We're like a family here and as such we sometimes have occasional misunderstandings and little sqabbles ! ;)
Glad you seem to be getting good results. Its your choice what route you wish to choose ,at least you know more options now.
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This is a very old thread but I'm resurrecting it because I wanted to let people know how I got on with the (controversial) SSRI I had been prescribed...
I took it for about 12 months. It helped the hot flushes. It didn't help anything else. It made insomnia worse and I felt drugged and unmotivated. So I stopped.
Two weeks after stopping I felt much better emotionally, really much more energetic, got a great new job and went back to the gym but the hot flushes were still a problem. I decided to learn to live with it. So I did for around 12 months.
I tried everything. Sleep hygiene, sensible food, no drinking, no caffeine in the afternoon, exercise. The only thing I hadn't tried was HRT. So last week I saw a doctor, got myself some patches and woah amazing what a difference!!!! Already. It is no exaggeration to say it has changed my life. Why on earth didn't I get this first time round?
You did try to tell me - I wish I'd listened.. I've since read the NICE guidelines and I should never have been given Sertraline. I should have been on HRT the last 2 years. It has taken me 3 attempts to get this HRT. First I was given a prescription for anti depressants, 2nd visit a pamphlet on alternative therapies. 3rd time I have to say I was not in the mood for discussing anything else and I went in and said I wanted hrt. I'm cross I lost out on 2 years of quality of life but at least I know now. And because this time it has been over 12 months since my last period, I can have the period free option.
Sadly I've been prescribed a patch which is discontinued (I've just read on another thread). I have only a 4 week supply. I nearly cried when the pharmacist told me they couldn't get any more. I've put up with these symptoms for 2 years and now the thing that has sorted them is unavailable. But I'm going to go back and get that sorted.
So if anyone is new, and wondering about trying HRT, I'd say go for it. Don't let them fob you off with alternatives. And to those who tried to tell me - you were right. The first GP was wrong. The second GP was wrong. You can't assume the GP knows what she's talking about. Do your homework and know what you want.
Barefoot x
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:thankyou: