HRT vs Antidepressants? during menopause

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Hi there

I went to my GP a couple of months ago to ask about HRT,, mainly because of lack of energy and moods.

I do not suffer from hot flashes or night sweats. But felt these moods where unbearable, and also can't handle stress as much as I used to. My GP gave me a prescription for tablets Elleste Duet, no estrogel {read on this forum} has been mentioned. After taking these tablets for 3 weeks, I felt very tired and barely could get myself out of the house and stopped taking them. I thought I let it be for a while. I recently returned to my GP, and she said if I am not having the flushes. I might be better off with sertraline this belongs to a group of anti depressant drugs. I only had a few minutes with my GP the patient before me took some time And felt like this was a quick fix. I do not feel I am depressed. Ones home I felt the GP could have discussed other HRT options, is it correct to assume HRT wont help for mood swings caused by menopause.?

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  • Posted

    Mood swings and fatigue are often experienced in perimenopause or menopause! I had moderate to severe hot flashes and night sweats but for me, the mood changes, irritability, depressive mood and spacey-feeling was very debilitating. Not only that, uro-genital changes caused severe pain with intercourse and I had frequent UTIs. It nearly ended my >30 year marriage b/c my husband was not happy with no sex (and I couldn't have cared less about having sex anyways!) At that time, my doctor recommended to me to start antidepressants....uh, NO thanks! SoI fought my way through the menopausal process but went on bio-identical hormones (plant based) about 14 months ago. I have made VAST improvements in all areas. I'm not familiar with Elleste Duet (I'm in the U.S.) but it sounds like synthetic hormones? Personally, I would never take synthetic hormones unless I had no other choice. Some thoughts/suggestions from a fellow sufferer who has done much research (as well as a retired healthcare professional, although this is not medical advice, just my own experience):

    *ask if these hormones are synthetic (if so, then one can only assume that the doc is not comfortable prescribing or managing patients on BIO-IDENTICAL hormones. If this is the case, find a practitioner who is very experienced and well versed in prescribing/managing patients on bio-identical hormones. These practitioners are out there!). Although bio-identicals are not 100% safe or indicated for everyone, they are WAY more easily tolerated--my experience with them has been life changing):

    *the synthetic progesterone (norethisterone) in what you are/have been taking may likely be what is causing your fatigue although there can be other reasons for the fatigue

    *bio-identical hormones have a variety of routes (transdermal like creams, patches, gels or oral, pellets,or a combination of these) Some women do well with one particular route over another.

    *make sure a full thyroid panel has been done and you are not dealing with a a thyroid disorder which may be contributing to your symptoms

    *make sure your Vit D level has been checked too...low D not only affects bone health but can contribute to low mood

    *get your TESTOSTERONE levels checked! During perimenopause and post menopause, testosterone levels drop (in my case, it was nearly non-existent)--this can lead to low moods, low/no libido, irritability, muscle/bone loss)

    *practitioners have little time to discuss anything anymore. It's impossible to get ALL the info you need in a couple of minutes. Do your own research about bio-identical hormones--this will help you formulate the right questions to ask when looking for a prescribing practitioner

    *NEVER assume that HRT won't help! In fact, with proper hormone replacement therapy (bio-identical), one of the benefits is a restored and more positive mood!

    Hope this helps!

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    • Posted

      Hey nothing wrong with my Iron levels, but no other {testostorone} levels have been checked it is not even suggested here with my GP in the UK. Also I doubt if Biodentical hormones I have heard and read about it are up for discussion or in the NHS package.

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    • Posted

      My GP wont discuss bio-identicals at all... only synthetic prescribed HRT on prescription except utrogestran which i had awful tiredness and nausea with.

      I finally ripped my latest regime of patches off last week... think I'm going to look into alternatives. ๐Ÿ˜•

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    • Posted

      Oestrodiol is bio-identical and requires a prescription. There may be a difference of identification about this. I suggest you ask for oestrodiol hrt (transdermal is best - i.e. patches, or daily gel (annoying), or pellet implants). Your dr should recognise. Pellet implants, although most convenient, could perhaps wait until you see how you go with other options. However, I was put straight onto pellets at same time my uterus was removed. They were magic.

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    • Posted

      oh only tried eleste duet hrt tablets for weeks and felt like you describe ..so bio dentical not even up for discussion I figured. what I have read about is Wellsprings Twenty to One hormone cream reviews say good results but how can you tell if these reviews are genuine?. and something like a magnet you have to wear in your undies that apparently does the trick but read It might fall in toilet if you don't pay attention. So the surch continues, I rather find a specialist that deals with this hormonal cases only and has time if someone like that excists in the UK.

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    • Posted

      I've tried 3 regimes with patches over the past 18 months and felt dreadful... they think it's the progesterone causing the issue but won't prescribe anything bio identical for me as there is nothing (other than utrogestan which made me very ill) available on the NHS... so I'm stuck. I'm going to see my doc again on Monday to discuss but I don't think I will get anywhere as there is nothing else available on prescription and they won't consider alternatives as there is a lack of clinical trials/safety. I have to take progesterone as I have a uterus, at the mo I feel like ripping it out myself!!!! ๐Ÿ˜•

      AJ. x

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    • Posted

      Yes, at the time I did not feel happy about having a hysterectomy and oopherectomy, I was only 38, but since reading about all the problems other women have with progesterone, I now feel lucky. However, my current dr insisted I take provera for 'balance' and I thought I would try it. It was the worse thing ever, she even upped the dose because of the way I was feeling. After reading heaps, I found that progesterone reduces or makes ineffective oestrogen. I told the dr I was not ever going to take it again. After that messing around, I don't feel that my oestrogen hrt works as good as it used to.

      I am appalled by the amount of progesterone that some women are told to take. A research professor of gyneacology in Leicester writes that only sufficient progesterone should be taken to prevent breakthrough bleeding.

      There is a bio-identical progesterone called Prometrium. In Australia they finally allowed it on our PBS scheme. I have not tried it because I don't want anything to do with progesterone ever again. Sometimes when we talk bio-identical some drs think it is about herbs and other natural elements which don't have any real medical studies on them. True bio-identical are chemically compounded to reproduce a component of a plant/plants that have a hormonal effect. They are still a medical (and perhaps synthetically devised) hormone.

      Do some research on Prometrium and take a copy to your dr. I know your issue is that it may not be covered by your NHS scheme but if Australia has examined it and allowed it, surely it is not far away in the UK. I do have to pay big time for my oestrodiol pellets but it is worth it for the well being it gives me. The patches and gel is on our PBS scheme.

      Good luck!

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  • Posted

    Also ask for an Iron Studies test which could reveal a different problem. When menstruation ceases, FERRITIN iron can increase and cause the same problems.

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  • Posted

    hi there i had these tables and wanted to hang myself from the nearest tree please dont take them they are awful your mood mood is affected by your hormones insist on HRT you might need to try a few before you find the right one for you good luck

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  • Posted

    ... I have been to my doctor so many times here in the UK but feel as if I know more than them! I have tried different synthetic HRT for a number of years and you are quite right, it did not help me one bit. I feel rock bottom at the mo...

    I have asked about bio-identicals but was only offered utrogetran as that's all that's on formulary on the NHS. I tried that together with oestrogen patches and felt like death! I have mentioned testosterone too and got a look like I was mad wanting to look into this. They won't check bloods again as they say they change daily in anybody so they go off symptoms... well I have felt horrendous for years now! I have just turned 47 last week.

    I really don't know who to turn to here anymore and have asked questions about buying bio-identicals online but not had much luck with replies.

    I'm so fed up I just don't know what to do anymore, I feel exhaustion to the point of feeling sick can't think straight, forgetful, brain fog, my mood isn't great and my anxiety is getting pretty bad now but i have no hot flushes. I have two children who are noticing their mother is different and it's getting harder and harder to try and rise above it.

    I have just this week stopped my HRT patches as my left breast feels lumpy and strange so now I'm freaking out about that!

    I plan to see my doc next week but I know the response I'll get - this is life, it'll pass... ๐Ÿ˜ฆ

    I just don't know what to think anymore...

    Sorry for the rant.

    x

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    • Posted

      Oh no need to Apologise JacynM All comments or stories welcome we all like to speak out about how we feel I just want reactions so I might feel I make the right decision about what to do or not and go with my gut feeling.

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    • Posted

      My hormone levels havent been checked either JacynM and HRT tablets were first prescribed, no further options than now anti depressanst but I am reluctant to take them, after only the 2nd visit in a year to GP. Like I said it felt like a quick fix because she was so busy. But it is your life their talking about. I think it all has to do with budget and limited options because of it. Maybe we should find a specialist that deals with this only.

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    • Posted

      I think you are right, I just read an article around women who need alternatives because progesterone isn't suiting them etc and the need to also look into testosterone as that is a major factor for some women but we have so little help/understanding that none of this is happening for people like us as there is distinct lack of knowledge/assurance around anything else than what is prescribed on the NHS and, as you say, it'll cost money as they'll have to send us for specialist advice/treatment which could get expensive.

      When i see my GP next week I will ask about blood tests for testosterone as well as oestrogen/progesterone as I REALLY need to know if the imbalance is causing me to feel so bad!! Last time i had them, over 3 years ago, they said my progesterone/oestrogen were really low but not sure of the level as i didn't ask... they've refused to do them again but on Monday I'm going to get shouty I think just to try and get some answers!!

      Sorry! I'm getting good at this rant malarkey!!

      AJ. (aka desperate hormonal wreck!) x

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    • Posted

      Also ask for SHBG test. Sex hormone binding globulins. If high, it is blocking hormones from getting to the tissues that need it (even though there is sufficient circulating in our blood), or if low, then perhaps too much hormones are getting to tissues.

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