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[joanie]

Hi I am new to this site and was hoping I could get some advice.  A year and a half ago I started having terrible fatigue, and emotionally no longer had interest in pretty much anything.  I went and saw my OB and he did bloodwork and said I was in full blown menopause.   He suggested I use an all natural HRT and did hormone bloodwork on me and sent the tests to the Compounding pharmacy.  They made a cream of estrogen, progesterone, DHEA, and testosterone to give me what I was missing.  In the past year and a half I have had many adjustments on the dosage amounts.  I first used a cream, then I went to a sublingual tablet, and I am now currently on a vaginal cream.  I still have night sweats.  The fatigue is much better.  My emotional state is a Nightmare.  I still have no interest in anything.  I am either anxious or weepy.  I feel bad constantly asking the compounding pharmacy to make adjustments.  I am starting to give up on the idea that my emotional state will ever get better.  I don't know where to turn.  I am so anxious or depressed that I don't want to be around people.   I don't know if it would be worth seeing a new Dr. in the St Louis area, or if that will even make a difference. I am just very discouraged.  If anyone has any advice, I would greatly appreciate it. 
Joanie 

[BrightLight]

Hello Joanie - I am in the UK and can't offer you any advice as I have no experience of HRT.  I wanted to say hello and hopefully someone with more experience can offer a comment on your situation.

I presume you have gone back to your Dr and told them that you are struggling?  Have they explained why your emotional symptoms haven't balanced out? 

[Hurdity]

Hello joanie 

Sorry to hear you are feeling like this.

My first piece of advice is ditch the compounding pharmacy !!

Sad to say from what I hear this is not the best way to take HRT in US/Canada., and a compounding pharmacy is not the only way to get bio-identical hormones.

Do have a look at this Youtube video by Dr Elisabeth Vliet a practitioner in US whoi explains about bio-identical hormones and the marketing hype:
https://www.youtube.com/watch?v=9XfpAATJkC8

Hereis some information produced by FDA in US about "bio-identical" hormones
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049311.htm

You can get bio-identical hormones through your regular practitioner and do not need to go to a compounding pharmacy. I think in US/Canada the progesterone is called Prometrium (here in UK it is Utrogestan) and will come probably as a capsule to be takne orally or vaginally - but you'll need to check this. Any oestrogen only preparation that comes as a tablet, patch or gel, that contains estradiol is bio-identical. You should be able to find a list of products available in Canada that you can choose from. Your regular practitioner will know the products - or if you find a list and put up the link we can help you choose one to suggest.

That's the first thing.

The other issue is what your OB (??what's this) means by your being in "full-blown menopause" ?? You go through menopause once you've had your last natural period and this is dated  after 12 months without one. The time leading up to this when your periods are irregular and symptoms appear - the peri-menopause - is when your hormones are fluctuating so mood swings are common even on HRT. Nevertheless you should feel better some of the time during peri-menopause when on HRT, which should lessen the impact of the mood swings.

Here is an article by Dr Currie the founder (and gynaecologist) of this site which tells you about the peri-menopause and what's going on in your body:

http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

Perhaps you could tell us how old you are and what your periods were doing before you started the HRT and what they're doing now?

The only thing I don't know about US/Canada is whether testosterone is prescribed by the regular doctor, but the first thing is to get the right amount of oestrogen and progesterone - and it sounds to me from what you say that your oestrogen dose is insufficient. If you are having these two hormones you shouldn't need DHEA which is a precursor of oestrogen and testosterone, but you may benefit from testosterone if this is low ( we can't get it prescribed in this country except some private gynaes or sometimes if women have had full hysterectomy and ovary removal).

Hope this helps 

Hurdity x