Hi FiGo - I take what the others have said about ADs but also note what you say about not wanting to take them and also your symptoms and it really does sound like you need to sort out your HRT and its effect first if you can - and if you can cope of course.
As I said in my previous post continuous progestogens can cause tiredness and low mood, headaches, depression - all sorts of unpleasant symptoms, but I gather you need to have a stronger one due to the fibroids. Low oestrogen can also cause continued low mood, and as I mentioned, low testosterone can affect energy, mood and libido too.
Here is what it says on this website about fibroids and menopause/HRT:
Fibroids
Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT. Could you consider having a Mirena coil fitted? You would then be able to have a higher dose of oestrogen without hopefully affecting the fibroids? Have other options been suggested apart from ADs which don't actually deal with the cause ie having the fibroids is hindering you taking the most appropriate HRT you need in order to deal with your menopausal symptoms and to function properly?
I agree you need to check you are getting adequate nutrients and minerals in your diet and ideally get the doc to give you general blood tests rather than fobbing you off with meds first!
Re your Q about norethisterone - 350 mg may not be high enough to give uterine protection when adding oestrogen as part of hRT. If you look at the doseages for post-menopause here:
https://www.menopausematters.co.uk/postmeno.php the dose for medium dose oestrogen is somewhere between 0.5 and 1 mg - and this is for women without fibroids. However if you have been prescribed it by a meno consultant it's worth a try but personally I would have thought that it may not be enough to protect your womb/fibroids from over-thickening from 75 mcg oestrogen.
There is also the option of taking the utrogestan vaginally but if you are in a relationship you may not want to do this continuously and taking a higher dose (200 mg) orally and continuoulsy is likely to be far too sedating/depressing.
It is so important to be able to feel good about yourself but you need the full support of the medical profession and the right treatment.
Let us know what you decide - whatever it is - and yes maybe contact Dr Currie (costs £25 - see home page) and ask her recommendation. There is also Women's Health Concern who have a telephone/e-mail consultation service.
Really hope you manage to find a solution so that you can turn a corner soon - I started HRT 11 years ago at just under 54 and never looked back - I never suffer low mood and do feel positive about myself (ageing aside!) and I would wish the same for every woman out there!
Hurdity x
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