Contraception pill versus HRT

Posted , 17 users are following.

So I have been having peri symptoms for about 2 years. Foggy head, fatique, painful bones, headaches, mood swings, sporadic periods, hot flushes to name but a few. I finally plucked up courage and went to the doctors last week. She did a full blood works, thyroid, liver, kidney, anemia, except hormone level. She did not do this. All came back clear apart from a slight raised throid count. She said she would test for this again in a couple of months however I said to her I could no continue with how i am feeling and please could she let me try HRT. I was very surprised with the reply as I had not even given this a thought before but I am on the pill so apparently the estrogen i am getting through the contraception pill is far far higher the low dose given in HRT and therefore she said i was better staying on what i was on. So for me that was devastation. That was it. This is my life now feeling totally horrid for the next 5 - 10 years. She then got me to complete this form... asking how many days a week i felt tearful, useless, blah blah to which i scored a high 23... showing,.... im depressed! I was so angry. I honestly felt like she believed me but all she wanted to do was prescribe me anti depressants. Of course I am depressed feeling like i do but i have suffered depression before years ago and I am convinced it is not depression. So i have come away with a box of Anti depressants i really do not want to take and probably will not take. I had them previously and one of the side effects was excessive tiredness.. so i only stayed on them one month... Just looked at the box of these one and in big bold letters it says Can cause sleepness! I struggle to get through the day as it is and end up having snooze in my car at lunch time. I just feel totally deflated today. Like no one believes me and that i have to be like i am now until full blown menpause. I had no idea that being on the pill was stronger than taking HRT or am i just being blagged off? Am hoping some of you lovely ladies have some advice on how to raise my energy levels and how to get rid of my foggy head. i cannot function at work and am making so many mistakes. I have been taking vitamin supplements for over 6 months, calcium, magnessium, Vit b comples, Vit B6, Vit D3, Vit c and zinc plus macafem herbal rememdy. Im 42 years of age and feel like i have age in the last year. I never looked my age but not i look so much older. I should say they my mum has Rheumatoid arthritus and osteoporis both caused by not being on HRT at the menopause and I am so worried i will get this as it is hereditory. This past few months my elbows hurt when i rest on desk, my fingers are sore and burning and yet she said there was no signs of inflamation in my bloods so i am glad that is one good thing as means i do not have RA but what are these pains? Sorry for the long post. x

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  • Posted

    Hi Hun, I have read your thread with interest as very similar to me. As soon as I hit 41 the insomnia started, major anxiety and hopelessness. Dr prescribed antidepressants and sleeping tablets, I had also tried cbt and every type of vitamin supplement and mineral. At times I felt suicidal, could not get out of bed, and how I stumbled through work, God only knows. I'm about to turn 48 now and last year my doctor suggested hrt, which I would never would have considered (poison) I asked for my fsh levels to be checked and sure enough, peri meno! Because of my severe anxiety and insomnia my blood pressure was sky high, after years of being very low. However, I asked for 24hr bp monitoring, and it was border line. The dr weighed up the. Pros and cons and finally prescribed hrt (I asked for biodentical as opposed to the type that is derived from pregnant mares urine) I also take progesterone from day 15-26 as overys intact. The best decision ever. Still early days, but people have noticed a positive change in me. Go back to your dr and insist he/she listen. Take care of yourself 
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    • Posted

      Jackie

      Are you still having monthly periods? And which HRT are you on?

      I'm in similar situation. 47, all the peri symptoms. Can't get the doc to do tests though.

      Report Reply
    • Posted

      Hi, I have not had a bleed yet, am taking estelle solo 40 and 100mg progesterone. Dr's in general seem not to test unless you insist on it, I guess when we get to our mid 40's its inevitable that we are going to hit peri, some people suffer more than others, however, finding a sympathetic dr helps a lot. If you don't have one, always ask to be referred to gynaecologist 
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    • Posted

      Thanks for sharing your situation with me. That has helped make my mind up that I'm coming off the pill and onto HRT. I've not touched the anti depressants and plan not to despite hitting an all time low this weekend. I just had the most severe fatigue. The worst I have had so far.. The last thing I want is AD that say on the box can cause sleepiness! I am back at doc in 3 weeks.. Seeing a different doctor. Hopefully this one will be more sympathetic else I think I will loose the plot! I hate this person I have become and I'm pretty sure my family do to! X
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    • Posted

      Hi kezzabird30. I know this is a very old post, so you may not even read this.

      I was on oral contraceptives until I turned 53 and then my doctor made me switch to HRT because they are lower in estrogen levels. I also have CFS/Fibromyalgia, so when she switched me to HRT, my symptoms flared up. I actually felt so much better on the oral contraceptives and asked her to switch me back. She said she would only if I understood the risks involved, but only for a short time. 

      Have you gotten a full battery of test run to make sure there is nothing else going on with your health? Your symptoms sound a lot like mine. Anyway, if you read this, I hope you are feeling better :-) KPD

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    • Posted

      Cattrack,

      I read your response with interest, as I too am finding the low-dose pill to be too low to cover my menopause symptoms.  I'm going through on the early side - started peri at 39 and now am pretty much done at 45.  

      Did you find a solution?  Did you switch to HRT?  I'm looking at switching to bioidentical but I'm worried the dose will also be too low.  I've been on the pill at 20-25 mcg of estrogen and this seems too low.  I have very severe menopause symptoms.

      Hope you read this and we can connect.

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    • Posted

      Hi Ameliajane71,

      My menopause started at 51 and hormone levels have plummeted now that I am 53 so a low dose pill is no longer a solution. I did find a solution. Initially I took 2 contraceptive pills per day, 1 in the morning and 1 in the evening and that gave me 40mcg of estrogen and 200mcg of progesterone and that worked well for about 1 month until I found a doctor who provides HRT treatment. I wasn't too worried about taking 2 pills in the meantime because I am pretty healthy, don't smoke, not overweight etc. The reason I had to take 2 pills is because no doctor I went to would even prescribe me with microgynon 50 ED which would have given me 50mcg of estrogen and 125 mcg of progesterone in just the one pill. 

      But I finally found an HRT doctor 3 hours drive away who prescribed me combined HRT and it is worth going the distance. Another doctor at her clinic did prescribe bioidentical HRT, but I decided against that because the latest conventional HRT is exactly what bioidentical claims to be, produced from chemical extracted from plants and those chemicals are structured in the lab to be identical to human hormones. The conventional HRT is commercially produced and thereby subject to strict monitoring and checks by the regulator, and it's effectiveness backed up by research which is also monitored by the regulator. The brand calling themselves 'bioidentical' are apparently not regulated or monitored and there is supposedly no studies on it to prove it's effectiveness. I found out about that in an official statement published on the internet by the US drug administration. Also I don't see how they could structure hormones from plant chemicals in a compounding pharmacy anyway like the bioidentical people claim, so I decided to stay away from that.  

      What I am on now is Sandrena 0.1% gel which is 1.0 mg of oestradiol applied transdermally. AndroFeme 1 which is Testosterone BP and I have 5 mg of that in the form of a cream applied transdermally. Prometrium 100mg which is micronized progesterone and I take 1 capsule a day.

      The doctor said that this is lower risk of thrombosis than taking the contraceptive pill. The doses of estrogen and progesterone in what I am on now are mg, not mcg like the pill because they are in a different form than what is in the contraceptive pill but the doctor mentioned that what I am on is about equivalent of 50 mcg of estrogen and about up to 200mcg of progesterone taken in the contraceptive pill but I don't think there is any pill of this exact dose and I am also taking the testosterone which has also made a real difference in my fatigue and strength levels after only 3 days and I am finding exercise easier to do whereas before the the testosterone it was just getting too hard and I was just getting weaker and muscles shrinking even though I am doing exercise using some weights. With the testosterone I have even been able to  stay on the exercise bike without having to have a break after 3 mins. 

      I have to admit that doubling up on the progesterone by taking 2 contraceptive pills before I got on HRT certainly improved my energy level right away anyway,  maybe because it keeps your circulation up.  I think that the progesterone is just as important as the estrogen, but I think it's best to be on the proper HRT if possible. I do not have any menopausal symptoms now but I am not only concerned about symptoms but also long term heath and well being, and preventing bone loss.   The doctor also mentioned that testosterone is also important for bone health. The problem for some people is that if they want to take the testosterone I read on the net that the AndroFeme 1 is only available in Australia, which is where I am, but hopefully there would be some kind of testosterone available in other places because it is now becoming more popular to prescribe with HRT. I found this HRT doctor by googling 'hormone replacement therapy clinic'.  It's basically a matter of finding a doctor, most likely female, who has an interest and  focus on HRT so they know all the latest on it and what to prescribe.  I am glad that I didn't have to get referred to a gynecologist because that would have been more expensive.

      Hope this has been of some help and not to long winded. I'm interested in hearing how you go and what you decide to do.

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  • Posted

    Even though this blog is a yr old, I wanted to say that I am having the same problem finding a doctor who will respect my decision to go on HRT. The reason a lot of drs won't help is because they have no competency with it and don't care enough about women's health to get competent by using resources that they have to educate themselves.  Before I moved I had a dr who was helpful and in my early stage menopause he was happy to prescribe HRT, but that was too strong in early stage menopause and I had non-stop bleeding, so I tried the pill instead and it worked beautifully as the pill takes over what is going on and regulates your hormones whereas HRT just adds to what is there and that may not work to regulate well. But if a dr tested hormone levels it would be better to see what is low so know what doses of what hormones you need. Too bad no one will do this for me either. 2 years on from taking the pill I was getting symptoms same as yours although more fatigued not depressed but tired and losing motivation, pains, etc, and also skin severely itching, breaking open and bleeding and burning. With the only dr who would have helped me now living 10 hrs drive away, and no other dr willing to help, I started taking a double dose of my contraceptive pill, taking 2 instead of 1 - PROBLEM SOLVED. 

    My skin bleeding and itching started going away within 24 hrs and all cleared up now, 2 weeks later my energy and outlook is coming back, and I am feeling fitter from my exercise whereas before I was getting nothing out of exercise and losing fitness regardless of exercising. I have to point out that the pill I was on was only 20 mcg of estrogen, and 100mcg of progesterone, and the estrogen was probably too low for me at this point. I'm a bit concerned at now taking 200mcg of progesterone and wonder if that is too high, and I think it is really bad that I have to treat myself. However this is only temporary until I find an HRT competent dr and tells me something about what I need to do. I am reading a lot that the progesterone gets the blood flowing better and burns fat and i am definitely feeling that. Before doubling my pill dose I was getting these funny palpitating faint heartbeats that made me feel like I was in defib all the time, and one of the first things I noticed after doubling the pill dose was a strong regular heart beat. This difference was so noticeable that I wondered if I was OK, but after reading a lot I am at the conclusion that this is a good thing and I certainly feel better.  Really it's just that I have my normal heartbeat back that I would have had several years ago

    There are some clinics that are a long distance away from me that claim to have doctors who help with HRT and I am planning to drive the 3 hours if they will see me or fly to where my old dr is to get proper treatment because I don't want to have to keep treating myself with a double dose of this pill in the long term unless a competent dr who knows something about HRT says it's ok.

    Also, some of your problem could be testosterone loss because loss of this hormone is also associated with your problems. Loss of testosterone causes a woman to deflate mentally and physically. Women need testosterone to be healthy as men also do, but just at a much lower amount for women. I am hoping to also get on a small dose of this. I already asked a doctor to prescribe this for me but he refused to help even though there is a testosterone treatment for women called AndroFeme1, but I got the impression that his problem was that he just didn't know anything about it and didn't want to know and was only interested in dealing with other common problems like cold and flu, same as another 2 drs that I asked for help with HRT. One was a female dr who cringed and screwed up her face as she said "I'm not comfortable" when I asked if she could just prescribe me with a pill with a better balance of hormones that the one I was on. She couldn't admit or explain why she wasn't "comfortable" with helping me with HRT but the fact she couldn't say why just says that she just has no idea. I have healthy blood results  so the problem is definitely with them, and it's not just with male drs.  It totally sucks that this has resulted in me having to take a double dose of what I was on. You'd think that at least one of these doctors could have referred me to someone but not even one of them had the competency to even do that. It would be interesting to know how you're problems are now, and whether you got any help of the kind that you wanted. 

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    • Posted

      ?2  jackied68   kezzabird30

      2 years ago

      Hi Hun, I have read your thread with interest as very similar to me. As soon as I hit 41 the insomnia started, major anxiety and hopelessness. Dr prescribed antidepressants and sleeping tablets, I had also tried cbt and every type of vitamin supplement and mineral. At times I felt suicidal, could not get out of bed, and how I stumbled through work, God only knows. I'm about to turn 48 now and last year my doctor suggested hrt, which I would never would have considered (poison) I asked for my fsh levels to be checked and sure enough, peri meno! Because of my severe anxiety and insomnia my blood pressure was sky high, after years of being very low. However, I asked for 24hr bp monitoring, and it was border line. The dr weighed up the. Pros and cons and finally prescribed hrt (I asked for biodentical as opposed to the type that is derived from pregnant mares urine) I also take progesterone from day 15-26 as overys intact. The best decision ever. Still early days, but people have noticed a positive change in me. Go back to your dr and insist he/she listen. Take care of yourself 

       Report this

      ? 0

       Reply to jackied68

      ?5  CCinCal   jackied68

      2 years ago

      Jackie

      Are you still having monthly periods? And which HRT are you on?

      I'm in similar situation. 47, all the peri symptoms. Can't get the doc to do tests though.

       Report this

      ? 0

       Reply to CCinCal

      ?2  jackied68   CCinCal

      2 years ago

      Hi, I have not had a bleed yet, am taking estelle solo 40 and 100mg progesterone. Dr's in general seem not to test unless you insist on it, I guess when we get to our mid 40's its inevitable that we are going to hit peri, some people suffer more than others, however, finding a sympathetic dr helps a lot. If you don't have one, always ask to be referred to gynaecologist 

       Report this

      ? 0

       Reply to jackied68

      ?3  kezzabird30   jackied68

      2 years ago

      Thanks for sharing your situation with me. That has helped make my mind up that I'm coming off the pill and onto HRT. I've not touched the anti depressants and plan not to despite hitting an all time low this weekend. I just had the most severe fatigue. The worst I have had so far.. The last thing I want is AD that say on the box can cause sleepiness! I am back at doc in 3 weeks.. Seeing a different doctor. Hopefully this one will be more sympathetic else I think I will loose the plot! I hate this person I have become and I'm pretty sure my family do to! X

       Report this

      ? 0

       Reply to kezzabird30

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      ?3  KPD   kezzabird30

      2 months ago

      Hi kezzabird30. I know this is a very old post, so you may not even read this.

      I was on oral contraceptives until I turned 53 and then my doctor made me switch to HRT because they are lower in estrogen levels. I also have CFS/Fibromyalgia, so when she switched me to HRT, my symptoms flared up. I actually felt so much better on the oral contraceptives and asked her to switch me back. She said she would only if I understood the risks involved, but only for a short time. 

      Have you gotten a full battery of test run to make sure there is nothing else going on with your health? Your symptoms sound a lot like mine. Anyway, if you read this, I hope you are feeling better :-) KPD

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       Reply to KPD

      ?2  ameliajane71  kezzabird30

      about a minute ago

      Cattrack,

      I read your response with interest, as I too am finding the low-dose pill to be too low to cover my menopause symptoms.  I'm going through on the early side - started peri at 39 and now am pretty much done at 45.  

      Did you find a solution?  Did you switch to HRT?  I'm looking at switching to bioidentical but I'm worried the dose will also be too low.  I've been on the pill at 20-25 mcg of estrogen and this seems too low.  I have very severe menopause symptoms.

      Hope you read this and we can connect.

      Report Reply
  • Posted

    Just reading this and having a terrible time with the fatigue . Awful awful !!!!

    Anyway went to a hormone dr and got BHRT but i believe the estrogen is making me dizzy.

    Thinking of going on a low dose pill as I cannot stand this anymore ..... don’t have a life ... can’t drive anywhere as feel so ill. Wondered if it eased anybody’s symptoms I’ll take anything right now !!!! 

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    • Posted

      Hi Lori,

      This all depends on what 'kind' of BHRT you are on, the unconventional  un-regulated 'compounded' BHRT, or the conventional regulated research-validated BHRT now produced by pharmaceutical companies. I would be interested to know the exact name and brand of HRT you are taking.

      "The main issue with ‘bioidentical’ or compounded hormone therapy products  is that they are unregulated and there is no  research evidence that the recommended doses of the hormone preparations are safe or effective.  Conventional HRT products have undergone rigorous testing often for years before being available by prescription by medical practitioners"  .https://jeanhailes.org.au/news/why-women-use-bioidentical-hormone-replacement-therapy-bhrt

      This refers to the BHRT products that are not made within the conventional pharmaceutical system and are not research validated or regulated.  I am not affiliated with that website. I have seen this same information where the  FDA has made the same statement which states their position. Conventional HRT is now also biodentical, so there is no need to take any risks with BHRT products that are not regulated with no officially accredited validation of their ingredients, quantities or effectiveness. 

      I take Promentrium (progesterone) and Sandrena (estrogen), both bioidentical from plant sources structured in the appropriate laboratory conditions into the identical human hormone. And they do work. If you are still suffering from critical fatigue then you are either taking something ineffective or there is something else wrong with you, such as thyroid disfunction, which I have heard can take a while to turn up in blood tests, or some deficiency or illness. 

      A low dose contraceptive pill still left me fatigued. I had to take 200mcg of progesterone in contraceptive pill form for my fatigue to be instantly relieved (it's the lack of progesterone that causes extreme fatigue because it affects your circulation and metabolism) and at least 50mcg of estrogen in pill form  to clear up the itching and bleeding on  my skin. But the contraceptive pill is higher risk for thrombosis than the new conventional bioidentical HRT, which is also  lower risk than the older HRT, so that is why I switched to the proper HRT.

      However, the Promentrium can make me a bit dizzy and drouzy when I take it, more so if I take it around the same time as eating (don't know why) so I take it just before I go to sleep, and that's fine because I sleep better for it anyway.  Maybe that is you problem with your dizziness if you are taking promentrium, or maybe you need the higher dose if your hormone levels are too low, and that is why you are still fatigued.

      I have found that  the right progesterone for me (taken just before going to sleep) solved my horrible fatigue problem. I could barely drag myself around the house before taking it, so maybe you just need the right kind and the right dose. I think you should also get a blood test to check your iron, B12, D, thyroid, blood count etc. This is pretty essential in your situation. Let me know how it turns out for you.

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    • Posted

      I have estrogen and progesterone bioidentical and yes after a week on it got very very dizzy . Not sure if it’s the progesterone or the estradiol making me dizzy ? 

      The fatigue is unbearable though ! Been going to sleep by 10 up at 8am but still look like I’ve not slept in a week . I didn’t know it’s lack of progesterone that  makes you fatigued ?

      Can’t seem to nap either as I feel kind of wired but tired if that makes sense . 

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    • Posted

      I just went over my blood work with dr yesterday . I’m a bit low on B12 but apart from that I’m super healthy thyroid good etc . So it’s all hormones !!! Depressing ! 
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    • Posted

      I take the estrogen and progesterone separately, the estrogen trans dermal gel applied in the afternoon, and the progesterone capsule at night, so that's how I can tell it's the progesterone sometimes makes me dizzy. I googled to try and find out why and read somewhere that if you take the capsule form it goes through the liver and the liver converts some part of it into some kind of sedative. This corresponds with what was happening to me, but sometimes it doesn't happen. This could be avoided if there was a trans dermal gel or patch for the progesterone to avoid it going through the liver.

      This is an article about the vascular effects of progesterone. Basically it prevents the blood vessels from constricting so that your blood will circulate better and reach better into the smaller vessels:

      Vascular Effects of Progesterone | Hypertensionhyper.ahajournals.org/content/37/1/142by M Barbagallo - ?2001 - ?Cited by 105 - ?Related articles

      There are a number of valid scientific articles about this. I can not remember where I also read that progesterone also assists in regulating the electrical impulses pumping the heart, and these things really affect your energy levels. 

      I literally noticed the effect on my heartbeat suddenly stronger when I increased my dose of progesterone and that's when my fatigue also suddenly left. It was a pretty instant thing - like one hour after taking the extra progesterone my heart was suddenly pumping, and the next day I had my energy back. 

      Like I said in a previous comment I had been wondering for the previous year why my heartbeat had seemed to become weak and irregular and this had corresponded with growing fatigue even though I was already on HRT but it was just a really low dose that I started with at the start of menopause and was no longer enough as my hormone levels were plunging and I had to substantially increase the dose - by about double. That solution might not be for everyone if they are in a risk category.  Like you, it didn't matter how much I slept. I could hardly get out of bed. That is why I was thinking that if you are on the conventional HRT which undergoes the checks to make sure that the hormones and quantities that are supposed to be in it are actually in it, then it might be the same problem I had that the dose might be the problem.

      It's hard to find a doctor who can deal with this. The doctor needs to be HRT friendly - some are not and will leave a woman languishing. I had 3 doctors refuse to help me because they really didn't know much about HRT, but  I finally found one who knew what she was doing. 

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    • Posted

      I would consider taking a B12 supplement because being low can affect your immune function, nerve fibers, and anxiety levels. It depends how low. Mine got down to 170 pg/ml and by that time I was already developing shingles, and I was otherwise healthy except for the low B12. It helps to get a copy of your results from your doctor. Apparently the acceptable normal level is a minimum of 400 pg/ml.

      If you are consuming plenty of B12 and your HRT is already high enough, yet you are still suffering fatigue and low B12, it might need to be further investigated why this is. There is also vitamin D3. Low levels of that  can apparently knock you down too. 

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