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[Rachelle]

Hello! I'm 39 . After having ovaries removed in July due to BRC1 faulty cancer genes am in surgical menopause. The GPs  (UK) don't seem overly sure what to do with me, which has left me feeling anxious and depressed at times. Currently on Evorel Conti .50, but still having night sweats some insomnia and anxiety levels increasing. So I thought I needed a higher dose.
Finally got an appt with doctor who told me to keep same HRT but add in 20mg Prozac for 6 months. Then finally got appt with consultant who thought the Prozac was not necessary, I needed more HRT, so to double up patches.
Any thoughts or advice or experiences with any of this!? As 2 medical professionals seem to think different advice, I am still as confused as ever!!!

[Dancinggirl]

Hi and welcome to MM
You are young and need the oestrogen.  I agree with you and the second specialist - Prozac is not the way to go. Doubling up the patches is not the best way forward as this would be such a big jump in dose - there are far better options available that would allow you to adjust dosage to your needs. The Evorel patches have a synthetic progesterone given all the time that could be effecting your mood so it might be a good idea to try a sequential HRT (this would mean a monthly bleed).
Trying a different HRT combination would be a good idea.  Possibly have a Mirena fitted and then use oestrogen as patch or Oestrogel? - this would allow more flexibility of dosage and therefore better control of symptoms. You could simply try HRT pills as well - Femoston has a kinder progesterone and comes as sequi or conti so you could try the sequi first to see how you feel.
Do look under TREATMENTS above to see your options as I feel you may need to experiment with different types to find what suits.
You have lots options - we are here to help, so get clued up and go back to the doctor and ask for something different to try.
I had POF and at your age I was on 2 pumps of Oesrtogel each day with Provera for 10 days each month - this worked really well.
DG x

[Rachelle]

Thank you my instincts have told me all along that I simply needed more estrogen, I have told 3 doctors but they all said 'Evorel conti ' or Elleste conti was the highest dose so I couldn't go any higher, and they do not provide me with any alternatives...other than Prozac!? After some research I asked the last doctor if I could go on a higher estrogen only patch ( as I know they come in .75 and .100 which is higher than what I am on now of .50) and take a separate progesterone but they do not listen and do not seem to know about anything or give me the education / best treatment. It's taken me 4 months to get an appt with the doctor that supposedly knew the most about hrt at this practice, and she gave me Prozac everything I say / ask for hits a brick wall. I'll be waiting months for another appt. it's so confusing I've even been regretting the surgery as I expected to be in safer hands. I'll read up on the treatment pages thank you.

[CLKD]

Of course, a good Surgeon would have charted with you prior to surgery what might be necessary after intervention!  But because men don't suffer with symptoms, it isn't on their radar    Did you see the Consultant who did your Surgery?  Maybe make the suggestion that it is discussed before the lady goes to Theatre?

Browse round.  Make notes.  Keep a mood/food/symptom diary too.  Prozac wouldn't have been my first choice of AD anyway although some ADs are known to ease anxiety symptoms. [Prozac made me  ]

Eating regularly can ease anxiety surges.  Let us know how you get on!

[Hurdity]

Hi Rachelle

 

Sorry to hear this - I agree with Dancinggirl. You should not be prescribed an AD especially not at your young age. If you have no ovaries then you definitely need a higher dose of oestrogen and there is no way I would double up Evorel conti - I wouldn't even want to take it on that dose because it would mean taking the synthetic progestogen norethisterone all the time - which itself can cause problems in some women.

If your specialist GP is no good then insist on a referral to a menopause clinic or go and insist on the type of HRT you have chosen ( look at Dancinggirl's suggestions). At your age time is of the essence so I would go to the first GP in the practice you can get an appointment with - having researched what you want, and written it down as well as the reasons you don't want to go on an AD, or double the patches!

Een I am on a slightly higher dose than that ( although doc doesn't know!) at age 63 I am on 62.5 mcg. I started on 50 mcg on late peri but I was around 54 not 39 - your oestrogen levels on average would be much higher than this. In your position I would actually ask for a blood test....
If we can help again do ask and good luck

Hurdity x