Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Gilla999 on March 02, 2023, 04:20:05 PM
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As most of you know, I've been having a very rough time of it since the middle of December, with surging / fluctuating Estrogen levels kicking off some kind of autoimmune/mast cell response that has been hell on earth to try to get under control.
My Estrogen soared very high so I dropped from my 4 sprays of Lenzetto right down to nothing over the course of 6 weeks. My Estrogen was still 800 pmol even on no HRT. I stayed on nothing for a week until things became unbearable and then restarted on a 25mg Estradot patch and then up to 37.5mg which I've been on for about 10 days now. Touch wood, the autoimmune / allergy response seems to be easing off (I am also taking prednisolone which may well be helping) but I'm still left with two really horrible issues:
The first is overwhelming depression - I mean really, really bad, to the point I can't function or do anything except sit on the sofa and eat. No energy or enthusiasm, everything just feels maudlin and it gets worse as the day goes on. The second is this relentless fast heart rate (90s at rest, usually late 60s) from lunchtime onwards (absolutely fine in the morning). My blood pressure is also lower than normal at 86/55 ish repeatedly.
I did wonder if it could be that my Estrogen level is too low, but the confusing is that I'm not experiencing any of my classic low E symptoms such as night sweats and 3am insomnia. I'm also not anxious at all - its just this overwhelming depression, it feels like I'm sitting under a rock. I did start a very low 10mg dose of Amitryptiline 4 weeks ago for sleep, but I would have thought the start up side effects from that would have eased by now and that it's unlikely to be causing depressive feelings.
Has anyone else experienced very bad depression as a symptom of low Estrogen? I'm aware of course of anxiety, but can't recall seeing depression mentioned much. It's absolutely not normal for me (anxiety yes, depression never!) so I do feel that something chemical is causing it and trying to work out what it could be.
Thanks for any experiences shared xxx
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Sorry to hear how bad you are feeling Gilla. I guess depression can be a symptom of low oestrogen, but I think you have to maybe factor in life events also, as I think these can contribute?
When I am feeling rubbish, the only thing for me, is to get to work. My mood soon lifts during the course of the day ( I have a VERY busy job, so no time to dwell!) Are you working? Do voluntary work etc?
Can you get out for a walk? Daylight soon lifts the mood!
Hope you feel better soon and you are well supported. Xx
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I'm not on HRT but everytime I've tried estrogen, 3 times, it makes me feel boarder line suicidal for some reason. No clue as to what my estrogen levels are naturally.
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Depression can definitely be a symptom of low oestrogen. However, it can also occur when hormones are out of balance too. Your O reading sounds like it’s too high if anything (I’m no expert on this though). Do you take any form of progesterone?
Also, could it be you’re not getting on with estradiol? I couldn’t tolerate them but much prefer evorel x
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Thanks ladies, I really appreciate your feedback.
Yes Perinowpost, my E definitely was too high - that reading was last month and I'm due another blood test on Monday (day 21) so I'll see what it is then. I'm not suffering from my high Estrogen symptoms now though which are super stimulated feelings, horrid anxiety etc - so I don't think it's too high right now.
Yes I'm taking Utrogestan vaginally sequentially and also topping up with a BHRT Progesterone cream (25mg a night).
Interesting on Estradot - I actually have both Evorel and FemSeven here in storage (long story, to do with shortages!) so I could try swapping to a different brand. Can I ask what you preferred about Evorel?
Nas I agree - there is SO much going on for me with my health that (a) makes it impossible to know what's what and (b) in itself has just been an awful lot psychlogically to deal with on your own (I live alone and don't have family/friends nearby). I have a very busy, high pressured job but since the anaphylaxis started in December I've been signed off on long term sick - definitely not quite well enough to go back just yet, but I am trying to do a few garden jobs during the day, just to do something!
Jaypo what you've described is definitely how it's feeling right now, and it's a new one for me. I'm really hoping that it passes soon :)
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Hi Gilla999
i just wanted to give you some support really.
im so sorry to hear about your depression its truly awful.
anytime you want to talk feel free to message me.
take care xxx
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Depression may be hormonally linked. It is an illness on its own and should be treated as such with appropriate medication. In the 1980s I went through 5 different ADs B4 finding one that didn't make me feel sick :-X. After that, once I stabilised, I began to feel better.
My pre-menstrual depression was totally different to the daily illness. It was in the 24 hours B4 a bleed began even if a period wasn't due.
6-9 months of appropriate treatment might help at this stage?
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So sorry you’ve had such a rough time. Debilitating depression was my main perimenopause symptom. I really thought life was not worth living although I knew objectively my life was ok - just couldn’t shake the constant feeling of despair. Started 25mcg Estradot and began to feel slowly better within a few weeks. Now 3 months in and on 37.5mcg feeling almost my old self - still occasional dips and swings but at least I can function. For me, my hormones absolutely causes low mood. Hope you find a solution, it’s so hard to feel that way.
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Hi Gilla999, sorry you're having such a difficult time with depression. I was definitely affected by severe depression related to the menopause. Unfortunately having a history of depression (and all the problems of covid on the services) meant it was assumed to be my mental health. After being prescribed more medication and still not improving I eventually started HRT with the invaluable support from Steph at Menopause support. I took Lenzetto, 2 sprays, having started with one, and progestogen. It was only then that I started to feel my depression improved. The depression continued to improve and I was then able to start doing relaxation and exercise which I find really helpful....when I'm not too low to bother lol 🙂
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Gilla999
A couple of things. I couldn’t tolerate estradot as my body doesn’t like what they’re made from, so I didn’t get the benefits (soy, silver birch family I believe). My body loves evorel (Mexican yam).
Also, re supplementing extra prog you may be taking too much and hence the depression. I can’t even tolerate daily utrogestan so extra would definitely tip me into the big D. Something to think about. Either way looks like your balance is out x
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Thanks ladies - it's really helpful to know that this is a "known" potential side effect of low Estrogen, as it wasn't something I'd seen talked about much before. Cosmo, I can really relate to not being taken seriously because of existing issues - I had exactly the same thing about insomnia, it took me a year to be taken seriously that this wasn't my "normal" insomnia and was in fact hormone related. As soon as I started Lenzetto, the insomnia disappeared for me. So glad to hear you're doing a little better now :)
Perinowpost - interesting on the formulation, I'd read a little about this on the forum. I have a Day 21 blood test on Monday so it will show what my Estrogen level is doing and if I'm absording the patches at all. I'm certain that if I increased to a 50mg patch things would improve, but I absolutely cannot do that without triggering all of my severe allergy symptoms. It's like my body has become allergic to Estrogen (whether its own or external). Generally I've always done ok with Progesterone - maybe because I'm still ovulating so it's being produced naturally too - unless I take it orally which is a total no go! But I'll definitely have a think about it.
CLKD I'm glad you eventually found an AD that helped you. To confuse matters I am already on Sertraline 50mg and TWO other ADs at very low doses for sleep (as I'm switching from one to the other - Mirtazapine to Amitryptiline.) My psychiartrist is aware and has told me there is likely to be little risk because of the low doses involved (7.5mg and 10mg respectively) but overall I feel like I'm on enough meds that I should NOT be feeling such overwhelming depression like this, especially when depression is not a "thing" in my past at all.
Thanks again for all the helpful replies and comments - really reassuring and helpful xx
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Let us know how you get on? :hug:
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Gilla999 - I am so very sorry to hear how you are suffering I really feel for you. Just to say when I had very low oestrogen levels a few months back (53 pmol on blood test) I felt absolutely awful. Aches and pains, headaches, fast heartbeat, insomnia and felt really low and angry and down all the time plus horrendous relentless anxiety and panic. Having swopped onto Estradot patches from Oestrogel which I was clearly not absorbing at all and having worked my way slowly up dosage wise aiming to get to a 75 patch (I am now on 68 and hope to go up to 75 in a couple of weeks) I am steadily improving. My last blood test was 144 and I have been advised to get up to nearer 240 so have another blood test and consult in May when hopefully my levels will have gone up again. All I can say is that yes the higher dose has made me feel a lot better but fully realise that you had too high a level for a while so are in a different boat. I do think Covid really seems to mess with hormones too. I hope so much you start to feel better soon but yes just to say I felt really awful when my oestrogen levels were low.
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Thanks CLKD, sending a big hug back to you too.
Thanks for sharing that Pippa, it's really helpful to know. I didn't realise you had also suffered from depression-like feelings as well as the anxiety. I've caved today and swapped my 37.5mg patch for a 50mg. I'm absolutely dreading the ensuing severe allergic reaction I'm going to get this eve/tomorrow, but this depression is absolutely all-consuming and I can't function. All I can do is sit here and sob my heart out all day, and it's really very un-like me to be like this. What confuses things greatly is that I'm not suffering from any of my classic tell-tale low Estrogen signs such as night sweats and 3am insomnia - that's the only thing that makes me question the cause, but I just can't fathom what else it could possibly be other than the quite drastic change in my HRT over the last 4 weeks. I have a blood test on Monday so just really hoping that sheds some light. I know there is the belief among some that Estrogen levels aren't reliable from blood tests (especially in Peri) but I have found them to be so helpful and insightful in my journey - I just wish there was some easier/cheaper way to get the data.
As a side note Pippa, I find your Estrogen levels really interesting as I did quite a bit of research on the trials they have done for different kinds of HRT products and strengths and the average pmol obtained from them by post meno women in trials. A 50mg Estradot patch gave an average of 183 - 201 pmol, which is more than you seem to be getting even on 68mg. It's like you're a super non-absorber isn't it! I can't imagine how challening this must be and have been for you to manage xx
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:thankyou: When I was depressed I couldn't function, I would sit: staring at a wall: numb.
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Yes I've spent much of the last two weeks staring in silence out of the window feeling unable to do anything at all. It's not something I've ever experienced before and very overwhelming. So glad that you're not in the place anymore CLKD xx
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So am I. Medication helped a lot. It's awful as well as being difficult to explain. Be kind to yourself!
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Gilla999 - Hi Gilla, firstly I am so very sorry to hear just how much you are suffering. Depression (and anxiety) is really awful. I hear you I really do. I had post natal depression both times after my two children were born and it was utter hell. Waking in the morning and dreading the day ahead and how to cope and the tears and sadness that went along with it. It is truly horrible and I so hope you going up on the patch will help you and also not cause the side effects you have had previously. I am ridiculously sensitive to dose changes or anything and certainly with oestrogen levels. This is why I have been going up so very slowly. My reading of 143 was on just over a 50 patch so as I have since gone up to 62 and then 68 and soon 75 I am hoping very much that I will be absorbing better. You are right I am clearly not a great absorber which is why the Meno consultant advised me to go up to a 75 (which actually would equate pretty much to the 25 plus years I was on Oestrogel as I was on 3 pumps worth then). Anyway time will tell and I will remain on the 75 patch till the check up in May but she did say I may need to go up to the 100 but I am hoping not. More importantly I really really hope the 50 patch will help you to start to feel better. I was put on Evorel by my GP during the shortages but it made me really ill with the worst migraines I have ever had literally every day but Estradot seems to suit me much better and they stay stuck on too. My daughter in law on the other hand is on Evorel and it suits her so it really is such an individual thing. Sending love and empathy xx
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From what I have read and experienced myself, low oestrogen leads to low serotonin levels which lead to depression and in some people, migraines.
Low progesterone (which tanks well before oestrogen in perimenopause) is associated with anxiety, panic attacks, suddenly developing new phobias and insomnia.
The challenge is getting the HRT dose right in perimenopause and then getting the maintenance dose right for the many post menopause years which are usually far more stable. Quite often, other medication like ADs are needed too.
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:thankyou: that's informative as I often wondered which hormone dropped off first.
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Thanks Pippa for that info, it's very helpful! Can I ask how you are managing to get such specific patch doses? As that's something that I think would be good for me too (and was one huge benefit of Lenzetto).
I feel SO much better mentally since increasing to a 50mg patch.... the depression has lifted, but as expected it then triggered off all of my autoimmune/allergy issues last night. Bright red flushed skin and then my skin on my face started peeling (!). I couldn't get to sleep without valium as I knew would be the case, because when the flares happen I also get a surge of adrenaline (which is apparently par for the course with severe allergic type reactions).
I just find it so baffling and can't find anyone, anywhere on the internet talking about having an autoimmune condition related to their own Estrogen!
Mary G yes, I'm aware of the Estrogen/Serotonin link and think it perhaps answers why I am so sensitive to Estrogen drops - I also have to taper my antidepressants ridiculously slowly or I get horrendous withdrawal, and I always used to get terrible PMT which they also think is related to the serotonin drop.
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Hi Gilla - I use a tape measure and mark a 1/4 off the patch to get my 3/4 of a 25 patch as accurate as I can. I do intend to go onto a 75 patch which will make life a bit easier not having to cut up patches every time but I have found this method worked well and enabled me to increase my dose slowly. I was so sorry to hear that the 50 patch caused your other problems to come back. Do those symptoms calm down when you level out at all? xx