HRT questions

[white_hart]

People who take/have taken HRT for menopause symptoms, can I ask how you've found it? My GP suggested that menopause might be exacerbating my existing mental health problems and contributing to the current kablooeyness, and asked me to think about whether I'd like to try HRT. My first reaction was no, because I've never wanted to go on HRT - I had a horrible time on hormonal contraception and worry it would actually just make my mental health worse, and also I was so delighted to be over the whole thing that I hate the idea of having to take medication for something I welcomed so much. (Plus some complicated gender feels about HRT making me more woman and less genderless goblin, which I should probably just try to get over because I can't change my endocrine system by willpower alone.)

But...what if the tiredness and brain fog aren't just because I've been under continual extreme stress at work for three years, and have had various non-work stresses as well? What if it is to do with menopause and HRT would help? (I was ranting the other week about medicalisation of normal life stages and capitalism not letting people just have less energy at some life stages than others, but however true that is it doesn't change the fact that capitalism is the ocean I'm swimming in.)

Anyway. What is your experience of HRT? In particular, has anyone had good experiences with HRT after bad experiences with hormonal contraception?

Comments

[cmcmck]

I've been taking it at high dosage all my life since 18 for obvious reasons and have never found any problems with it.

I'm aware that it works better for some people than for others though.

The best advice I can give is suck it and see.

[chiasmata]

So, I don’t get on with hormonal contraception At All, in that it repeatedly completely fucked up my mental health in my early twenties, and I won’t go near it even though it’s often recommended to me for endometriosis pain. However, when I went on blockers with tibolone as add-back, I was absolutely fine - no decline in my mental health at all.

[chiasmata]

To clarify: the blockers put me into a menopause-like state, and tibolone is HRT.

[white_hart]

Thank you - it is really useful to know that people who had problems with hormonal contraception haven't had the same problems with HRT.

[lilliburlero]

No personal experience of the oestrogen-based sort to share, but wondered if low-dose testosterone might be something to explore? From what I can work out from the internet, it might be a bit of a long shot, as it only seems to be indicated if oestrogen HRT hasn't worked in certain ways - and one of those ways seems to be "lack of sexual desire", which isn't entirely helpful if you're happily asexual. On the other hand, when you said "genderless goblin", low-dose T is immediately what I thought of.

My own experience of T in higher doses is of mood stabilisation almost to a fault: mostly it's brilliant but there have been one or two occasions when I have felt It would be extremely nice to be able to have a little cry now and I just couldn't. Very weird for someone who was always told in childhood they cried too much and too easily and learned all the tear-suppression strategies.

[hilarita]

Yeah, I was going to mention low-dose T as well - it's an HRT that can be prescribed to (apparently) cis women, and it might work better for you.

[hilarita]

I say this mostly because I am contemplating it myself, when the time comes.

[cmcmck]

Being a trans woman I find the thought horrifying for obvious reasons, but I know it does work for some apparently cis people.

[white_hart]

Thank you - it certainly sounds like something I might look into. (And I'm fairly sure oestrogen HRT wouldn't increase sexual desire :-D)

[aunty_marion]

I am one of the people who found the Pill an absolute godsend from a mental health point of view - until I went on it in my mid-20s I hadn't realised I was getting up to THREE WEEKS of PMT a month!!! Honestly, like coming out from under a cloud. So I stayed on the Pill, though I didn't actually need contraception most of the time, till I was in my late 40s. Then I started getting 'breakthrough depression', went and wept at my GP who passed me almost immediately to the GP in the practice who was the menopause expert, who said 'yes, almost certainly menopause' & put me on HRT patches, which I was taking till about 4 years ago, when they went into short supply (I assume Brexit). Then I had tablets and gel for about a year, which was OK-ish (except for not having sufficient places to apply the gel nor flexible-enough shoulders), but when lockdown started I considered the likelihood of DVTs etc due to inactivity AND being on HRT, and took myself off the HRT, that being something that was easier to control! I've managed OK without it since then, but it was as much of a godsend while I was on the patches as the Pill had been.

From a mental health point of view, I loved being on the Pill, and then on HRT - both much better *for me* than any ordinary 'antidepressant'. However, as I'm aware, hormones affect different people differently; it is entirely personal!

[white_hart]

Thank you!

[muninnhuginn]

Haven't tried it. First off because I didn't get on with hormonal contraception at all. Second because (pre-Covid) with the menopause I got brain power, energy, lack of mood swings, plus hot flushes (which I can live with). So I'm the examplar of what happens if you don't do it.

[white_hart]

Yes, pre-COVID I was fine - I had hot flushes but otherwise was doing just fine (though the night-time hot flushes do affect my sleep a bit, but it wasn't too bad).

[rachelmanija]

I had horrible experiences with hormonal contraception, once while using it for birth control and again because doctors were willing to prescribe it for menopause while refusing to prescribe actual HRT.

I finally found a doctor who was willing to prescribe an HRT patch. All my menopause symptoms instantly vanished, with no side effects. The amount of hormones in HRT is waaaaay smaller than the amount in birth control, and getting meds via a patch is very different from getting them via a pill. I recommend the patch if you do try HRT.

[white_hart]

Thank you - that is really useful to hear.

[anna_wing]

I honestly think that it would be impossible to tell unless you experiment, because there are so many different kinds of HRT, and both menopause itself and pre-menopause are so variable across individuals. I had hormonal contraception most of my adult life for endometriosis, and slid painlessly into menopause bar the occasional hot flash for a couple of years, but friends have had widely differing experiences both with and without HRT.

[antisoppist]

Hormonal contraception dampened everything down, including libido, in my late 20s. I wish at the time I'd complained but I assumed this was how it worked. Mini-pill while breastfeeding made me very depressed, which at the time was said to be post-natal and normal, except that when I stopped taking the mini-pill it was like the sun coming out. Mirena coil, which I tried next made me feel amazing and energetic and have a sex drive again except they said this one wouldn't need replacing because I would be through the menopause by the time it ran out and that would have been three years ago and I'm now wondering if I could go and ask for a new one anyway and if that would remove the fog and exhaustion.

In other words different hormonal products have very different effects on the same person and probably even more so on different people. I wish they could do some sort of analysis of what your brain and endocrine system are like to start with and prescribe based on that rather than it all being very hit or miss.

[white_hart]

Thank you - yes, some kind of personalised analysis would definitely be helpful!

[callmemadam]

As people have said, everyone is different. I can't help you because I was lucky enough to have a very easy menopause. In fact, it was a blessing because I've never had a migraine since.

I meant to say that friends who did take HRT thought it worth it to relieve the really horrible symptoms they had.

[mrs_redboots]

I, too, had an easy menopause and got through it on evening primrose oil and dong quai alone. The menopause nurse at our health centre was on board with this, and said if it didn't work to come back, but all was well. But we are all different, and react differently to different things. All you can do is give it a whirl, and remember, there are different sorts of HRT, not just one-size-fits-all. Worth reminding whoever is prescribing for you of your early history of not getting on with hormonal contraception (nor did I, although I was sort-of all right on the mini-pill).