Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: somersetfi on January 13, 2022, 02:47:52 PM
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**Hi everyone - my original post is below but first, an update as I think it might help others*
I had my blood tests last Thursday and got the results last Friday.
My menopause consultant very kindly read the results for me.
Essentially I have the oestrogen levels of an 80 year old woman who's never had HRT.
Not great but at least I have an answer.
Essentially the patches aren't doing anything for me (which many of you suggested - thank you).
I guess I just don't absorb the oestrogen like other women (is that a 'thing'?)
I'm going back on the gel but a different brand and a stronger dose.
I'm also coming off the testosterone (for now) so my body can settle.
I'll be taking the progesterone by mouth, as usual.
Updating as you've all been so kind and I hope this might help someone.
I also hope the oestrogen boost makes a difference.
Thank you.
x
Hello
I’m new to the forum and would love some advice.
I’m 47, nearly 48.
A little background:
Since 2020 I’ve had all kinds of changes – from sudden changes in my normally clockwork period cycle to a total drop-off in how I orgasm (teamed with zero sex drive) – plus dry, brittle hair; terrible insomnia; and odd things such as dizziness and blocked ears.
I thought nothing of it until I started having terrible vaginal dryness and pain, coupled with recurrent UTIs.
I finally joined the dots, realised I was peri-menopausal and took advice.
From February 2021 I started taking Vegifem pessaries every other night.
Then from April 2021 I went onto ‘proper’ / systemic HRT – and started taking gel-based oestrogen (Oestrogel) – x2 pumps inner thighs. This was prescribed with progesterone (x2 100mg Utrogestan tablets orally for 14 nights every month).
It all seemed to be helping until around November 2021 (last year) when the vaginal pain returned with a vengeance.
I had a consultation with my (private) HRT specialist and it transpires I’d been given some of the newer batches of Oestrogel, widely considered to be less effective.
As an interim measure, I was advised to up my gel from x2 pumps top x3 and this seemed to work.
But I quickly opted to go onto patches (simply because I stopped trusting the Oestrogel company) - and since December have been on a 50mg Estradot patch, rotating twice weekly from one bum cheek to the other.
Also since December (once the bad symptoms stopped) I started on testosterone - 5mg Androfeme applied once daily to alternative outer thighs (simply because the lack of sex drive has continued – along with a general lack of motivation).
So, just to recap: since December I’ve changed from oestrogen gel to patches; am still on progesterone orally; and also added in testosterone.
Which brings me to where I need help.
Over the last month or so I’ve noticed a terrible, terrible depression. I mean, I feel really awful, I can barely get out of bed, and my mood is incredibly sad and low. I’m normally really proactive and spinning several projects and ideas at once. At the moment, I can barely get dressed. I feel so embarrassed saying all this. I’ve never previously had mental health issues.
I’ve been researching and it seems that progesterone has links to low mood, and that to counteract this, some women take Utrogestan vaginally.
I asked my HRT specialist if I should try this and she agreed to try.
But taking it vaginally was not only really messy the next morning but seemed to be creating thrush / more pain so I stopped after two nights. Maybe I should persist as two nights isn’t that long.
I’m just really confused and worried about what to do and what might be causing this low mood. I’m also confused as to why Utrogestan would suddenly be causing such a low mood when I’ve been taking it for around x9 months (the only recent changes have been in swapping gel for patch - and adding in testosterone. Neither of this can be to blame… can they?)
Obviously I’ll be seeking medical advice but appointments do take a while so in in the meantime I’d truly value any advice / thoughts / experiences.
I've booked a telephone GP appointment and am hoping to get some blood tests done.
Huge thanks.
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Utro is the least likely culprit given you've been on it for a while without problems. It could be either the patch or testosterone as you started both in Dec. It's really better to change one thing at a time so you see what effect it has. If it was me I would go back to gel and utro and wait for the depression to go then change one at a time. If you had no other symptoms except VA on the 2 pumps I don't think you need a higher dose of gel. VA is often not controlled by hrt so you need to look at the topical oestrogen. I don't know enough about it to comment but there are lots of posts on it, sometimes the dose prescribed is insufficient.
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As Sheila99 says it’s not a good idea to change more than one thing at once. Progesterone is the usual culprit for depression but I agree you’ve been on it for a while so in this instance doesn’t seem to be the problem.
You could as Sheila99 says go back to the gel or even try a different patch- evorel is good- and try that.
Re androfemme I haven’t tried that but do use testim gel and find I can only use it 3 x per week without suffering side effects, any more and I struggle. As you are using yours daily maybe try alternate days and see if that makes a difference.
A few tweaks and I’m sure you’ll get it sorted. Wishing you well x
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Depression is awful. I was unable to get out of bed ........ Could you stop the progesterone to see if the mood lifts? No one should suffer depression that badly, I never want to feel that ill again!
Keep up with the vaginal atrophy treatment. Nightly if necessary, it can be Trial and Error to sort, as well as a moisturiser on the outer areas. VA mimics urine infection-type symptoms really, really well! ABs will ease symptoms but won't solve the lack of oestrogen. As levels drop the body may become dry: inside and out!
U may as suggested be using too many products at once. Some find that keeping a mood/food/symptom diary useful. Let us know how you get on.
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Thank you to all of you for replies so far.
I really appreciate it.
Please do keep any more thoughts / experiences coming.
Thank you again.
xxx
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Somersetfi
I have also had this dark cloud heavy experience and it happened in December just before my period. It was absolutely awful. I wasn’t taking progesterone at the time. It also was way worse in the morning. I’m dreading it coming back. Absolutely terrified. I’m nearly 43 but have had peri symptoms since 38.
My guess is that I’m not on high enough estrogen…
Just wanted to reply so that you know that you aren’t alone.
A x
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Sounds like you may not absorb the patches as well as the gel. You could go back to the gel and see if things improve. It really is difficult trying to work it all out. I get progesterone side affects when my Estrogen is low and the balance is off.
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Have you managed to get out of bed today somersetfii :-\. Get into the sunshine if possible, it can brighten the mood.
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Hi Somersetfi,
Sorry to hear you’re struggling. Something very similar happened to me in December after I changed my estrogen delivery method. I’ve returned to the regime I was on before swapping and I’m back to feeling good.
I hope things improve quickly for you, sending hugs.
Victoria.x
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https://lizearlewellbeing.com/healthy-living/menopause/oestrodose-oestrogel-what-you-need-to-know/
I would try the gel again - and stop the testosterone until stable. Meanwhile do meditation , eat well and try not to worry . I hope you feel better soon.
PMXX
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https://lizearlewellbeing.com/healthy-living/menopause/oestrodose-oestrogel-what-you-need-to-know/
I would try the gel again - and stop the testosterone until stable. Meanwhile do meditation , eat well and try not to worry . I hope you feel better soon.
PMXX
:thankyou:
That's a great link, thanks for posting it.
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https://lizearlewellbeing.com/healthy-living/menopause/oestrodose-oestrogel-what-you-need-to-know/
I would try the gel again - and stop the testosterone until stable. Meanwhile do meditation , eat well and try not to worry . I hope you feel better soon.
PMXX
:thankyou:
That's a great link, thanks for posting it.
Hi sheila99, Happy New Year!
PMxx
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https://lizearlewellbeing.com/healthy-living/menopause/oestrodose-oestrogel-what-you-need-to-know/
I would try the gel again - and stop the testosterone until stable. Meanwhile do meditation , eat well and try not to worry . I hope you feel better soon.
PMXX
:thankyou:
That's a great link, thanks for posting it.
Hi sheila99, Happy New Year!
PMxx
Thanks. Happy New Year to you too.
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Looks like the original poster has gone away :-\
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Hi there. So sorry for the delayed response. Thank you so much everyone - I really really appreciate these posts. I'm feeling slightly better this weekend but am still quite concerned. I've arranged to have blood tests this week and am seriously considering going back onto the gel. It feels quite complicated to get all this dosing correct. Thank you so much again. xxx
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Hi! it's difficult to find a regime that suits, it's the trial and error that can be tiring. Did the depression lift?
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Hello, i'm 52 and have been using Oesgrogel 2 pumps nightly and 200mg Utrogestron day 15-27 of cycle.
I originally took HRT for joint pain and sleep problems.
In September i had a nervous breakdown, a mixture of things, some family problems but I had also stopped taking fluoxetine earlier in the year, I had cut it down over a long time to such a tiny dose I thought I didn't need it anymore.
Since September life has been all over the place. I am back on Fluoxetine but in December my gp upped my Oestrogel to 4 pumps . My last two bleeds have been terrible and this weekend I was passing huge clots.
I have lost my appetite again and have been wretching in the morning and yesterday i couldn't get out of bed.
GP thinks this could be progesterone intolerance and looking back through my cycles I have felt worse during the progesterone taking.
GP said only way to know would to be to stop HRT . She suggested tapering the oestrogel back down over next couple of months but the progesterone dose would be the same so I didn't see the point in that.
Any thoughts please?
I'm bit terrified of stopping HRT and getting some awful symptoms , but I will put up with my original joint pain and broken sleep over depression any day
Thanks
Sara x
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Don't stop. It may be that the hike is too much too soon.
Could you get a referral to a dedicated menopause clinic sarasbuddy? Progestrone upsets many !
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Thank you for your reply CLKD.
I will look for a menopause clinic but there's been no mention of one from my GP and I think the private route is the only option.
Out of interest, what could happen if I suddenly stopped?
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You'll probably feel absolutely dreadful!
There are NHS menopause clinics but sometimes paying a fee a couple of times for informed advice, is well worth it. MayB keep a mood/food/symptom diary for a while? Will give you a base-line.
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If you think you can cope I would ride it out a bit longer. You don't know how much your own hormones are causing havoc. I get fatigue on utro. On an annovulatory cycle it isn'tnnoticeable til day 8 yet there have been times I've barely been able function when I've produced a lot of my own progesteron.
It's a big jump to go from 2 to 4 pumps so I would cut down to 2.5-3 and see if that mekes things better. Why did she increase it? Did you have meno symptoms that were uncontrolled?
Wretching isn't a normal side effect of utro particularly when you've been on it so long without problems - perhaps you've caught a bug?
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Hi Sheila
The dose was increased as I was having bad anxiety and feeling jittery. It was an experiment really as we agreed that we don't know how much was life, medication (fluoxetine) or hormones causing the problems.
I think I will reduce the oestrogel dose and book a consultation with a menopause specialist with my birthday money.
Thank you for replying :)X
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Ask for an NHS referral first? Although paying might give you a quicker appt. as well as a longer chance to chat. In the mean time make a note of your symptoms etc., something to chat to the Dr about.
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Sarasbuddy sorry to hear of your troubles. If it’s progesterone intolerance lots of us take a reduced amount (off license) 7 days x vaginally. The late Professor Studd pioneered the regime for progesterone sensitive women (type it into the search box). You do have to have annual scans if you try this to make sure it’s working. I would also tell your doctor if you decide to trial it. I follow this regime and womb lining has always been fine. It’s the only progesterone I’ve managed to tolerate and in my opinion is the best of a bad bunch re current options available on the nhs. Also like others have suggested I would drop your gel back to an average dose.
Hope you feel better soon xx
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Hi Perinowpost
Thank you for your reply. I had just copied and pasted this from John Studd website and was going to ask for opinions but you got there already !
'The best method of taking bioidentical hormones would in my view be Oestrogel 2-3 measures daily with the possible addition of transdermal testosterone gel and then Utrogestan 100 mgs daily for the first 7 days of each calendar month. This would bring about a regular scanty bleed on about the 10th day of each calendar month. You will find more details of this treatment for menopausal symptoms, hormone responsive depression and osteoporosis in this web site but please remember that it is not a recent American discovery. That would be too much to bear!'
So next time my progesterone is due should I just do 7 days on the lower dose?
I will tell my GP I'm doing this also.
Many thanks for everyone's replies , so helpful X
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Good morning. I am a mental health trainer and also living with depression since a young age. But this felt different. I can’t explain how but I knew it wasn’t my usual dark cloud descending on me. I changed my progesterone dosage and now only take it every thirteen wks (which is about to change due to new guidance apparently ). However you are feeling today it does pass and it Definately csn get better 💚
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Hi Tallbetty,
Did changing your progesterone dose help? X
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Morning Tallbetty - 'new guidance' - can you tell us more?
:welcomemm:
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Sarasbuddy yes I would just do it, it’s your body. I adopted the regime after researching on this forum (I didn’t have to pay) and told my nhs meno specialist afterwards, she said she’d support me in whatever I wanted to trial x
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And the health warning...
If your lining builds up because you use too little progesterone you are at greater risk of cancer. You should go off licence only if you've run out of options and you really can't tolerate it. If you do it is so important you have regular scans. Obviously the higher your oestrogen dose the greater the risk
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Thanks Sheila
Absolutely understand the health warning, and will speak to my gp about what I decide to do.
So just to clarify, it's 7 days since I stopped progesterone , when would I start the 7 day regime at 100mg ??
Thanks so much for taking the time to reply XX
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Hello,
Thanks for the update. I’m glad you’ve got some answers. I feel like I didn’t absorb well with patches and had that same awful onset as a result. It definitely is a thing. I’ve had a horrible period recently and before that feeling very low.
Sending hugs x
Angela