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[Annies]

Hi all,
I last visited this site well over 18 mths ago when on the cusp of starting hrt - which I tried v briefly  (days.. ) and bottled out of.
Here I am again staring it in the face after prolonged bouts of poor sleep, night time sweats (on & off) and low energy. I'm pretty sure the poor sleep isn't anxiety driven as I'm on citalopram long term and it always used to improve my sleep loads. I now regularly wake 8+ times a night and often feel drained by the morning. (perhaps stupidly use a sleep monitor which gives me the depressing stats!)
So my main concerns are twofold I guess and I'm hoping some of you can share thoughts on this.
1. Is persistently wakeful sleep a good reason to try hrt?
2. Should I insist on getting my oestradial checked before starting any hrt in case I'm oestrogen dominant & make matters worse ? I've just been to a menopause clinic after my fsh came bsck at 37 (postmeno apparently??🤔). Been given Evorel 25 patches to wear continuously, Tostran gel (blood t showed nearly zero)and Utrogestan 100mg for 10 days per cycle. My oestrogen/progesterone levels were never checked. Wore patches for 3 days and felt yucky - anxious in bed & light headed during the day. Clinic says try halving them.
Not tried Utrogestan part yet....

Sorry for long blurb but ANY advice really appreciated as I easily get freaked by meds that make me feel less able to cope than I already do at times! I'm 45 btw - in case that's relevant!
Thanks for reading...

[Hurdity]

Hi Annies

You have posted the same thing in two different sections so perhaps ask for the other to be deleted - or hopefully it will drop off the radar!

Firstly - you mention you have been on Citalopram long term - so I presume this is for problems you have experienced that are nothing to do with hormones or the menopause and you have unfortunately had these issues for some years?

In terms of menopausal symptoms - HRT is recommended by the medical profession as the first line of treatment and depending on how often your periods were before starting HRT it is important for your future health (cardio-vascular and bone) to take it at medium dose at least until the average age of menopause of 51/52. Ideally if your periods are few and far between  and you are near to menopause, you should be on a 50 mcg patch as this dose is licensed for protection against osteoporosis. (By the way FSH levels vary enormously throughout peri-menopause and can go into the post-menopausal range during peri-menopause).

It is not necessary to test either oestrogen or progesterone levels for healthy women who still have their uterus - and the guidelines are to diagnose menopause on the basis of cycle changes and symptoms alone over the age of 45. Progesterone is only produced in large quantities after ovulation - but you are taking progesterone anyway so no need to worry about oestrogen dominance, as either your own or the added progesterone will act to prevent the oestrogen lining from building up and getting too thick.

Personally I would not be taking the Tostran while halving the oestrogen dose - you need to get your oestrogen levels up and Tostran is actually much stronger than the other testosterone products so less easy to control the dose. Could it be the T that made you feel like that? However if your specialist ( menopasue?) clinic advised this then they must know what they are doing.

Anyway I do hope the  side effects wear off and hopefully you will feel the benefit of the added oestrogen very soon.

Hurdity x

[Annies]

Thanks so much for your response Hurdity- I'm sorry I didn't acknowledge it sooner, as only checked the site again today. 😶
The guidelines you mentioned re diagnosis being predominantly symptom based (over age 45) would explain why there was no talk of blood testing my oestrogen level I guess. (I imagine the fsh level is only loosely indicative too then as mine seems to have been yo- yo ing for about 5 years!)
As for cycle changes as a meno indication, mine is still happening about once a month but varies 21-28 days. Not actually missed one yet so just wondering if hrt is still a little early for me 🤔? Also no day time hot flashes.. disturbed & sweaty sleep my only real symptom.
I was curious about your thoughts on the Tostran Hurdity- is that because without enough oestrogen I'd be more likely to get masculinizing side effects (none of which sound a bundle of fun!!)?! If so I may check with the clinic about that one.
Thanks for reading again, you ladies are all so incredibly knowledgeable.

Xx