Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: GypsyRoseLee on December 05, 2016, 05:19:04 PM
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I emailed Prof Studd and explained how I was still getting really severe, cyclical anxiety/depression right after ovulation - and that it's lasting for longer and longer each month.
He replied, suggesting Zoladex monthly injections to totally shut down my ovaries + Livial for 7 days per month.
This would mean I wouldn't have ANY oestrogen in my system, at all. Surely that would make me feel very low and anxious all the time?
I'm very confused. Am I missing something, or does that sound like a bad idea?
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Google livial (aka Tibolone)
I find it hard to explain but you'd be converting the livial to oestrogen , progesterone and testosterone
I can't say whether it's a good /bad thing
The adrenals will still produce a tiny bit I think
X
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Lival (Tibolone) might be good option for you but if taken for just 7 days per month that probably wouldn't do anything!!???
I find this reply very baffling. You'll need to ask him to explain how this combination is going to help. DG x
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I had zoladex for 18 months and what should happen is you no longer get the fluctuations but need something as you go into a medicine induced menopause. I would get clarification and give it careful thought x
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I have replied to Prof Studd, asking for clarification.
Donna, can I ask if the Zolodex injections helped? I seem to remember from your other posts that you also suffered terrible hormonal anxiety/depression, too?
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Hi there
I have had exactly your experience and have been on Lucrin (in same family as Zoladex) to suppress my ovulatory cycle. You are absolutely right in that Zoladex does wipe out your own (endogenous) production of estrogen (and progesterone/testosterone) but the idea is that you "add-back" hormones in a stable form, so whatever HRT regime you are currently on. It sounds as if, like me, it is the fluctuations following ovulation that you are very sensitive to - and so Zoladex is designed to suppress these disabling fluctuations. Overall, I am better on than off, Lucrin - I had a short period without Lucrin to see if I could do without but the time around ovulation almost toppled me (very bad anxiety/depression) so have had to go back on it. To be honest, it's still not perfect - (I am on 150 transdermal oestrogen patch), I find I am functioning pretty well when I have low stress in my life, but when I get busy and have lots on (including positive events), I have the sense that my estrogen levels are readily depleted. So the regime requires you to be pretty self-aware. For some women, this regime can be great so it sounds like it could be worth a try. Or the tibolone which I haven't yet tried - but might in due course!
Best of luck!
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Goodness, GRL! Yes, Livial for just 7 days would barely be giving you anything! He needs to clarify!! I wonder if he's getting awfully rushed these days? I remember a while back when I consulted him by email that he sent me a prescription for Utrogestan when I had clearly told him that I had had a full hysterectomy and oopherectomy. :o
Frankie, hi! Yes - as a lady in surgical menopause myself I can vouch that stress does indeed knock out your supply of estrogen (yes - even nice, exciting things too)! You're absolutely correct. You do indeed need to be 'on top of your game' when relying on add back hormones, as I'm just finding out nearly 20 months post surgery!
Annie - this may very well explain your added anxiety symptoms too when you do anything social. Even 'good' stress such as going to your works 'do' would put extra demands on you and you might have burned through your estrogen a bit faster than you normally would. I guess this is where the Estrogel is handy if you're a dab hand at adjusting accordingly (which I'm not)! I wonder if Livial has a bit of 'adjustment' built into its mechanism as it converts theoretically into the 3 hormones according to our needs (as I understand it)? I know it would still be limited by the dose, but I'm doing more and more research into this option..... it's about now I could do with some input from the lovely Menomale as she is very thorough with her research and I know she's been looking into the Livial too.
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Thank you Frankie, that's really helpful.
150mg patch is very high, but I do think that for hormonal anxiety/depression you need tonnes of oestrogen. I am using 4 pumps of oestrogel and I think my body could easily handle more.
Since starting the injections have you found the anxiety and depression have disappeared?
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Hi Tempest, yes I wondered if he'd got confused, or rushing? When I saw him for my consultation I had to repeat several times that I STILL had my own period, regardless of whether I took Utrogestan or not.
I think he doesn't listen carefully enough. I would love to hear what menomale has to say about Livial, too.
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That sounds really logical Tempest !
I can't handle stress since meno. Let me clarify I never liked stress but I was always SO laid back it think it aggravated my parents lol, these days the mere sniff of stress and I'm quickly thinking which way to turn and run
I think the testosterone is trying hard to help me as since I've been on it I look forward to events now but once I'm on the way I feel the stress/anxiety emerging
Livial has been reported on here to have really helped with lots of ladies anxiety
GRL, you need answers (and deserve) as to why only 7 days a month on livial . It does seem just as it'll be getting into your system you'll be off it again until the next time plus you may risk the unsettling symptoms some women talk of (think I'm remembering correctly, a little more anxiety initially) each time you restart
I agree Tempest about Menomale, I'm missing her presence here
X
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Thank you Frankie, that's really helpful.
150mg patch is very high, but I do think that for hormonal anxiety/depression you need tonnes of oestrogen. I am using 4 pumps of oestrogel and I think my body could easily handle more.
Since starting the injections have you found the anxiety and depression have disappeared?
GRL I don't fall into that category . I tried 100mcg estradot and I was a jittery wreck ! I think 50mcg would suit me better but adding in T I need a good amount of O for balance
It appears livial just knows what balance to get at. I hear many more success stories about it than bad reviews. It still is my plan B if this regime stops working or I start to not feel I'm getting anywhere
X
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I've just replied to another ovary-less lady in another thread who ideally only needs 25mcg of E because she feels rotten on anything higher! I see this a lot over at Hystersisters too. I think the gel if only I could get my flamin' head around it (and no rash) would allow me to adjust better in times of extra stress but conversely I would be feared of pushing myself into excess as I feel even right now that a 50 Estradot is a bit much (but the Hystersisters ladies tell me this might settle). I'd be a basket case right now on a 100 patch too, Annie! :o And Livial = less anxiety? GIVE ME IT NOW!!!!!!!! ;)
GRL, I think all that demonstrating of how to apply testosterone might be getting to the dear Prof! Maybe it's addling his poor brain..... ;D I hope Mrs. Studd can keep up with him (I heard that he likes to demonstrate on his arm how much Testim to use, so if you imagine he might be doing this several times a week)...... ;D
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:rofl: :rofl: :rofl:
Girl you have your sense of humour back !
I think sometimes when I write about Livial I am actually talking myself into trying it !
It's like describing a lovely roast dinner whilst eating a salad lol
X
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I definitely see a pattern emerging, Annie! ;) ;)
Well, I'm going to see how it goes until January and then I'm going to hit my Prof. with my thoughts about trying the Livial. We can hand hold if we try it together? Who knows, it could be roast beef and all the trimmings.......I haven't even got any flamin' croutons with my measly salad at the moment! :o ;)
I wish we could earburn Menomale - I think she'd be totally up to joining us (Brazilian pharmacy allowing)!
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GRL, I think all that demonstrating of how to apply testosterone might be getting to the dear Prof! Maybe it's addling his poor brain..... ;D I hope Mrs. Studd can keep up with him (I heard that he likes to demonstrate on his arm how much Testim to use, so if you imagine he might be doing this several times a week)...... ;D
;D ;D
Well that does sound very unorthodox - 7 days Livial per month :-\
Um I had a little look at Studd's website and he does not mention this on there - here is a relevant section:
There are now many studies showing that GnRH analogues remove the symptoms of PMS by suppressing ovulation and producing a medical menopause. An injection of Gonapeptyl, every month is ideal and 'add-back' HRT, will prevent vasomotor symptoms and bone demineralisation. The orthodox estrogen/progestogen preparations are useful but the PMS symptoms may recur with the cyclical progestogen. Livial seems to be an excellent alternative without bleeding or progestogenic side effects.
http://www.studd.co.uk/pms_various.php
Unless this is a very unorthodox new approach, it sounds like he is giving his usual prescription of Utrogestan for 7 days per month for progesterone intolerant women - whereas surely he should have been saying Livial every day?
I would be interested to hear the outcome....
Hurdity x
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I had no idea she was leaving otherwise I would've took her email 😢
I always get scared changing things with my hrt ..... it's like trying to work out the best time to possibly have a bad time and then I convince myself it's better the devil you know
I can't complain too much at the moment, have definitely been through a lot worse during this but been bloody better before all this . One thing meno hasn't stripped me of is my indecisiveness but then again meno can't take the libran out of Me can it !!!!!
X
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Oh no!!!! She's gone?!? I had no idea! Does anyone know why I wonder? I hope she's OK. I know she has a lot on with caring for her Dad. She always put a lot into the research, and had some really interesting and informative things to share. :'( :'(
I'm a Piscean. Yeah......says it all really, doesn't it?!? ;)
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I didn't do well on high estrogen levels and only in 50 mcg estradot. I was OK on zoladex but my system still was still occasionally breaking through even on the 3 monthly one. I got anxiety bad when my estrogen would rise. I'm now on a nasal spray still have dodgy days but managing to cope a lot of the time. Managing back at work. X
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Hi Donna
What is the nasal spray for ?
X
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Thanks Donna. Did you find the Zoladex pretty much stopped your anxiety?
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Hi Gypsy Lee,
My experience on the Lucrin (Zoladex equivalent) has been mixed - and to be frank, (ha!) I'm not sure I've found the optimal regime yet. Like Donna, I feel as if my own cycles do "break through" sometimes anyway (I'm on a 3 weekly injection), but I would say the somatic symptoms of anxiety are much less. Without it, I had horrendous bodily anxiety, a very tight chest (it felt like my lungs were in vices), stomach knots, headaches etc (I lost 3 kilos in 2 weeks) but on Lucrin, these symptoms are much abated. However, I would say the trade-off for me personally, is more depression - not always, but certainly a few days a month. It arises inexplicably - and gradually or even suddenly, disappears. I'm interested in peoples' discussion of livial here. I'm in NZ and not many women seem to be on it here - but I'm aware of a huge trial being conducted in Melbourne currently of Livial for perimenopausal depression - on the wire, I've heard results are mixed, but some women are getting excellent outcomes. Full results will be published early 2017 I think.
I really empathise with the cyclical nature of your symptoms Gypsy-Lee. In my own experience, I can feel really almost normal for a couple of weeks and so plan events etc, only to be knocked flat when I "cycle" - and have to cancel out of things, or grit my teeth and get on with them with little pleasure. I've heard in time these cycles diminish, but there's no real knowing when! I wonder how livial would affect the fluctuation aspect of things? Does anyone know? I might start a conversation with my endo...
Good luck and Best wishes to you all
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Donna,
Just a quick question - when you said you felt as if your own cycle broke through on the Zoladex, did you ever test to see if this was reflected in your bloodwork? ie. post ovulation, you would see expect to see a significant increase in progesterone. My experiences seem to have been purely subjective - ie increased anxiety/depression post "cycling" but no detectable increase in serum progesterone. Even more baffling!!
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Hi Frankie
I am desperate to feel some stability. Our symptoms sound very similar. Generally I have been getting about 2.5 good weeks, when I feel fine and happy. I feel optimistic and outgoing. But then it all comes crashing down and I revert to feeling panicky, despairing and hopeless. It just feels horrible. I can't enjoy anything, and just like you say, grit my teeth through social events (when I'm normally very sociable).
And again, just as you say it can suddenly lift in a matter of minutes. I often go to bed feeling fine, only to wake up feeling anxious and very low. If it wasn't happening to me, I don't think I would believe someone's mood could change so dramatically in just a few moments. It's so emotionally punishing, I can't tell you (though I expect you already know?).
But, I have read that this very quick cycling between moods is typical of peri Menopause? Though sometimes I really worry I might suddenly have developed bi polar, although when I feel fine I just feel normally happy, not manic or hyper.
If having Zoladex just gave me a few days of low mood per month, like you, then I could settle for that. Especially if it was fairly predictable. It's this awful unpredictability that is so disheartening.
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So relieved I am not the only person who had their own hormones break through the zoladex. I would feel fine and then suddenly massive anxiety tears and burning skin all the symptoms when I had high estrogen. The nasal spray is called buserelin and it shuts down the piturity gland so I have no natural estrogen. This seems ok a lot of the time but I need to take it 4 times a day and if I am late of more than an hour it is he'll for about 2 weeks. I don't think there is anything I have tried I have felt good on but plodding along with the spray and 50mcg estradot. I can't tolerate any slight change inestrogen either as really sensitive to any change. I was terrified of shutting system down and now terrified they might withdraw it! Think I am a nightmare patient lol 😊
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Do you prefer the nasal spray to the Zoladex injections, Donna? Do you find your mood is fairly okay now, and pretty stable?
I'm desperate to find some stability. Feel so flat and low today.
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Hi Gypsy Lee
Hang in there and know you are not alone! You are right, our profiles sound really similar. Like you, I hate the unpredictability. As I mentioned before, I'm going to start a conversation about tibolone with my endo when she gets back from holiday. Maybe you could throw that into the mix and ask Prof Studd's advice on that versus Zoladex? The other thing of course is to consider whether our delivery routes of estrogen are optimal for us. As you know, they all have their pros and cons - and over on the Surgmeno website (where there is also lots of useful info) they quite often talk about different women feeling better on a daily dose (oral, gel, transbuccal) versus "trickle-dose" (Patch). I gather while the gel can be great for some women, for others it doesn't deliver quite so well. Maybe you could ask Prof Studd's advice on that - ie for women for whom the anxiety/depression aspects of perimeno are the most troublesome, do they sometimes do better on a different delivery route? From what I can see though on this site, he is quite a fan of gel. So maybe it's best to just ask him about tibolone versus Zoladex.
I really hope things shift for you soon. How far into peri are you? I'm 2 years in (as far as I know!)
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Hi Frankie
I did try patches last year, but was still very up and down on them.
Funnily enough, Prof Studd has just emailed me to say he made an error, and that if I had Zoladex, I should take Livial every day (he had said to just take it for 7 days per month).
I am just ridiculously sensitive to any fluctuations, so I don't think Livial on its own would help?
My peri started exactly 3 years ago. My PMS had steadily been getting worse, and lasting longer and longer for a year or so, before that. Then in December 2013 my PMS failed to lift when my period finished, and then I started getting insomnia + extreme anxiety. Then my periods suddenly got much, much lighter and only lasting 2-3 days.
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Our symptoms are very similar I started peri in 2011 and still massive fluctuations and I still feel I get break through symptoms as there is no other explanation. Don't know if there is much difference between zoladex or nasal spray. I've tried gel and patches and still not cracked it. I try to grit through the bad days also easier said than done. Try not to mention anymore when feeling shit as everyone's sympathy a bit tired. Sometimes a 10 minute read on this site reminds you that you are not going mad 😊
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GRL - Actually I think you should give Studd's suggestion a try. Livial(Tibolone) can and often does give you all the benefits of a conventional HRT without many of the fluctuations and side effects that progesterones bring. When I tried Tibolone I felt really good - particularly mentally (I slept so well) - if it hadn't aggravated my acne so badly (I'm very prone to acne) I would have continued with it. Tibolone works in a different way to other HRTs and gives a very consistent dose of all the hormones including testosterone - great for the libido, energy and a general ‘feel good' .
DG x