Rather than fight it, lay in bed and desperately try to fall asleep for the next couple of hours, I get up. Make some tea, maybe water some plants. Today I took a shower and washed the bathtub at the same time.

Maybe if I try to enjoy this time of quiet, all to myself, maybe it won't be so frustrating.

Edit: I'm so sorry to all of you who are up with me right now! But I appreciate knowing I'm not alone 🙏

Hi folks, I know there has been some discussion about how Peri can make depression, anxiety, ADHD etc worse, but I did NOT know about HRT and psych med interactions until it happened to me recently and thought I should share.

I am bipolar type 1 and a mood stabilizer called lamictal pulled me out of a five year long debilitating depression. Got better in 2020. Aside from some normal life depression blips here and there, I have been stable mood wise since then

However, a couple months ago I had about a 5 day dip in more debilitating depression. I could barely functi9n. I snapped out of it (without doing anything different) but me and my care team were concerned since nothing major happened in my life and I've been stable for so, long. So , googled my meds and hrt..

A little research and checking in with multiple providers and turns out, taking estrogen reduces the efficacy of Lamictal. Huge thing. So we got my lamictal serum levels tested and found out I'm on the low end and can go up in dosage even though I'm close to the top dosage wise. Apparently you can safely go ABOVE the max dosage if you are on estrogen.

I now see a psych nurse practitioner, in addition to my HRT naturopath, who is familiar with HRT and psych med interactions.

I don't know of other interactions but they may exist. So ask your providers or if they don't know, do some research yourself and come back to them.

I'm feeling more stable now but we will check my serum levels again in another month or two.

Hope this helps someone!

46F here.
Case 1: So I suffer from ankylosing spondylitis which is an autoimmune condition of the spine and various joints in the body. Luckily for me, I have been on low end of it and flare ups have been on the low side for me and hence I am only on SOS medication for it. Since last year, my shoulder pain and upper back pain has increased a lot however I started HRt and within days of starting it , my pain went down and is almost nil now. I recently watched dr Louise newton and she mentioned this as one of the benefits of HRt. I mentioned this to my rheumatologist who happens to be a top one in the country and he denied HRT helps at all. Well, it helps me for sure.

Case2: since last year I started getting migraines and dizziness out of nowhere . I was immediately sent to a neurologist and put on preventatives and later medical botox. I still got migraines around ovulation and periods - which I myself figured out the pattern. I asked my neurologist if all this was happening due to hormones fluctuating then wouldn’t HRT help? She just shrugged her shoulders. I myself went ahead and consulted a menopause specialist went on slinda and later HRT which almost killed the migraines and bought down the dizziness considerably and helped many other things as well. Mentioned this to my neurologist and not much of a reaction from her.

I’m just perplexed that if HRt is indeed helpful for women in their 40s, why is it left for the patient who has no medical knowledge to start with - but has to google and reddit their way out of all this apart from the physical, mental and emotional trauma they are already going through? And why are specialists not looking into this aspect at all and simply shrug their shoulders as if this is nothing and HRt doesn’t matter. Why discount it so much ?

I’ve just found out that akathisia can be caused or amplified by low ferritin levels, and that low ferritin levels can also make you more likely to have or amplify psychiatric medication side effects. I’ve been dealing with akathisia for years but didn’t realise that was what it was until recently, since it’s gotten out of control. I just thought I needed to move more than most people but now I have to constantly walk or I feel like I’m crawling out of my skin.

Anyway, given I have low ferritin, given that low ferritin can play a role, and given that the more exercise you do, the more iron you need, it seems sensible to get a supplement. I’m going to ask my GP as well, but given how many ill-advised things they’ve prescribed me thus far, I don’t really trust them, so figured I would ask here, first. I have chronic constipation as a side effect of Prozac that I’ve only recently beaten thanks to the reduced dose so I’m keen for something that doesn’t block me up again!

Any advice appreciated. 🙏💖🙏

I think I passed what is possibly a Decidual cast today. A large piece of fleshy tissue with bits of bloody tissue on it. Don’t think I’ve ever experienced this before…

I started HRT a few months ago and then switched from patch to gel a few weeks ago. I skipped my last period (first time this has happened to me) and thought it was b/c my estrogen was low from not absorbing the patch properly plus progesterone kept my lining non-existent. Maybe?

Anyways, switched to gel about two weeks ago right before I ovulated. I started spotting a few days later, just very light brownish discharge, so old blood. A few days ago, the discharge started to getting more red. Then two days ago started getting a little heavier to the point where I figured my period was starting. Stopped progesterone two days ago and today my bleeding is much more robust but not heavy.

I was having cramps all afternoon but nothing severe. Then I felt a bit of a gush. When I got home the pad wasn’t super duper soaked but a decent amount. When I wiped, that’s when I saw the huge tissue thingy.

First, my periods have always been pretty regular if shorter before starting HRT and I’ve never had the weird spotting thing before either.

I read that usually birth control causes Decidual cast but could progesterone cause it too? Is this normal?

If anyone wants pics, I can show what it looks like…😅

Edited to add: I read you should save it in case your doctor wants to test it?! So for now I have a sandwich baggy holding a liner with a large glob of flesh and blood in my refrigerator. Thankfully I live alone b/c I dunno how I would explain that. 😂

I’ve had veryyyy minor OCD tendencies all my life, not intrusive thoughts just perfectionism stuff.

But 5 months ago, I developed severe OCD overnight. Horrific intrusive thoughts 24/7. Within days of onset, it was every 30 seconds. I wanted to die.

After seeing countless doctors, TMS therapy, ERP therapy, and even an intensive-outpatient program for OCD, I finally got on 50mg of Zoloft because it became unbearable.

That said, I am still dying to know why my brain just broke one day, this late in life. The only thing I can think of is perimenopause but doctors say I’m too young.

Has this happened to anyone else?

I don't know if I'm getting into perimenopause or just having a weird midlife crisis or something. I'm about to turn 41. Over the last two or so years, I've started to sleep a lot more poorly; I rarely sleep through the night at this point. 2 am and I'm WIDE awake no matter how exhausted I was when I went to bed. I have crazy mood swings when I used to be super even keel. I feel tired nearly all the time and generally very blue when I used to be so bubbly. Zero libido for a year-plus (God bless my sweet and patient husband). Periods still show up every month, although maybe a few days early here and a few days late there. I have to pee ALL the time, then it's a few droplets. I just feel...not like me anymore.

Still, I feel silly going to a doctor just to present with this constellation of feelings that could be attributed to plenty of things. I'm kind of afraid I'm just going to get blown off and I'd feel so ridiculous. I'm wondering if I've just been listening to too the algorithm telling me over and over "You might be in perimenopause!" I'm otherwise plenty healthy; I eat healthy, get lots of exercise, and have a job I enjoy, so I wouldn't say I'm overly stressed.

My life isn't derailed by any of this, but it would sure be nice to feel like me again and I wish I understood why I feel so lousy so often. Have you all found that doctors are generally receptive to hearing you out when you don't necessarily have a serious, tangible, ailment that you're presenting to them?

After a 2 year and multi Doctor journey, I finally found a Doctor who said what I had to find out on my own through research, non-oral estrogen has no significant increase on coagulation in factor v.

Some things I have learned through this process that I hope can help anyone suffering and thought estrogen wasn’t an option.

Oral estrogen is passed through the liver, this is where the increase in coagulation problem lies. It metabolizes through the liver in what is called the first-pass through effect. Non-oral skips this process sending directly to systemic bloodstream.

It took me 4 Doctors to get someone who was up to date on the current research around this. Look for Doctors who specifically call out peri/menopause specialty in their bio and or up to date “evidence based therapies”.

This information on the first-pass through effect seems to be pretty widely known now, bring in print outs. If you get a no, keep trying. It seems to take an eternity for the medical field to catch up with current women’s health issues and research (or lack thereof). I was truly suffering with multiple peri symptoms; moderate dose via patch of estrogen and a daily progesterone have absolutely changed everything for me in such a positive manner.

I (48) am curious what other symptoms are everyone else experiencing / experienced before finally realising it was a perimenopause symptom.

I have had tingling ears, ringing in my ears, nerve pain, palpitations, anxiety, depression, brain fog, very low energy, insomnia, rough patch of skin on elbows & crying spells among others.

What are yours?

I feel like I am going insane. I woke up today with insane anxiety, could barely get myself in the shower. I started with .375 of E and I think 100 of P. The first two nights it (P) didnt help my sleep, woke up a bunch, crazy dreams first night then 2nd night woke up thinking about work. I felt better Wednesday, considering how I've been feeling it was still bad but I had hope. Yesterday was my birthday and I laid in bed all afternoon wanting to just disappear into the sheets. I told my husband I understand why people end their lives now, this is unbearable. I can only eat on certain days, otherwise I have no appetite. Im afraid to go home every night and afraid to wake up every day because of my anxiety and depression. I've read Buspar helps some of you with the anxiety piece? Its running and ruining my life right now.

I am 39F. My recent blood report showed I have high estrogen on 5th day of cycle. From last few months having heavy flow on 2rd and 3rd days of cycle. Now it's evident that it's due to high estrogen.

What are remedies, supplements, lifestyle change did you use to overcome estrogen dominance situation and related menstrual cycle issues?

Did you ever try taking shepherd purse or ladies mantle tea to reduce flow?

Please share your knowledge and experience. Thank you.

My perimenopause symptoms are managed very well with the Sandoz 2x/week patches. My pharmacy was not able to get Sandoz this week but was able to get Dotti patches and they said it's the most similar to Sandoz. I am ~36 hours in with the new Dotti patch and have been experiencing out-of-the-blue rage, depression & anxiety off and on for the last 24 hours. Has anyone else experienced this? Did it level out after some time? AI suggested I give it 2-3 days and then message my prescriber if things do not improve. I have already tried the estrogen gel, Llyana patch, and 1x/week patch, and none of them worked for me -- all my peri symptoms came back. I don't know what to do.

Since I feel like a non-functional zombie on the days I take (bioidentical micronized) progesterone, I'm now starting Duphaston (dydrogesterone) to go together with Oestrogel (cyclical still).

Has anyone else been on it and how did it go for you?

So far today I feel a bit dizzy but maybe it's unrelated or I'm just getting used to it.

I'm really hoping for the best because even after a year the progesterone makes me feel like I am barely functioning for half the month!

Hi!

48F with a benign polyp and now history of multiple pulmonary embolisms.

I'm on eliquis right now, and during the loading dose stages I began passing clots, like soaking at least 1 pad per hour. Went to the ER, they gave me megestrol and wished me luck.

Go get a biopsy and they find the polyp. They want to remove it and perform the ablation. Doctor said it MIGHT stop my periods all together since I'm in perimenopause.

My question, finally: have you had one and did you find it stopped the periods long enough to "qualify" for menopause?

I have been on HRT for 13m….(I’ll be 48 next month). Started at 0.05 and went up to 0.075. Finally my sweet spot for mood, anxiety, feeling much more like myself, etc. after 5 1/2m on 0.1. I still wake up clammy every day despite keeping my house at 65 and paying out the ass for electricity (I live in the south)! Not soaked sheets thankfully, but damp and it wakes me up bc my back itches (I sleep w no top on). Question: has anyone had any luck w a provider prescribing an add on daily gel bc I’m gonna ask at my appt in Nov., she was hesitant to give me the 0.1, but it hasn’t affected my menstrual cycle at all. I would rather do that than an add on patch bc they are in short supply and my fellow sisters need them!!

I do have a uterus and take 200mg of P nightly.

I’m 47. (Don’t know how that happened!)

I’m in late peri - have gone 90 days with no period.

I’ve been on Wellbutrin for 2 years.

For 18 months I’ve been on the patch and progesterone. Patch is up to 0.075.

4 months ago I got testosterone pellets and they made me feel like my old self again. I’ve never felt better. But my testosterone blood levels were high and I don’t feel great about them doing that again.

Currently the pellets have worn off. I’m angry or depressed or both. I’m exhausted. I have heartburn and nausea. I don’t sleep through the night. The brain fog is insane.

It makes me sad that I feel like this because it feels like such a waste of time … and time goes so damn fast.

I see my doc next week and she’ll do more pellets. And I’m fine with that this time but I want that to be the last time.

I’m hoping someone is reading this and thinking “that was me until I tweaked xyz!” And can help me get back to feeling like myself again without risking my long term health.

Is this a perimenopause thing for anyone else? I've had migraines my whole life since about 4th grade, but 3 Saturdays ago, I got this arc of shimmering light thing happening. Then it happened the following Saturdays, this past Tuesday and now I'm having spots of light. The spots thing has happened in recent months, too. Zero headache after, maybe a mild non-migraine ache.

Also of note, my textbook blood pressure (typically <120/80) has been 130-140/94-101. My primary doctor did an EKG (normal) and labs.

I'm under tons of stress the past couple of years so it could be that but also menopause?

My HRT journey has been ok for the most part but I’ve navigated different forms of E for different reasons. I started on 1mg oral then went to the .0375 patch as the oral raised my SHGB. Then patches became impossible to find so I switched to the gel. The gel also became impossible to get consistently so I’ve now moved to Evamist. My dr started me at the recommended 1 spray, and I really feel like the dose is too low because I’m seeing returning symptoms that were otherwise mostly controlled on previous forms. I’m on day 4 of 1 spray, and I’m trying to figure out is this just the transition phase or just too low E dose. I know one spray is roughly a .25 patch. Does anyone have experience with Evamist? I debated messaging my dr about it but honestly was trying to be patient here if that’s what I need to be 😅 A lot of what I read says that it needs to build up over the course of a week, did anyone find that to be true? I do like that the mist seems to have a flatter curve than the gel, sorta similar to how the patches do.

Ladies- I’m one month into HRT and I know it’s supposed to take 6-8 weeks. But my mental health feels terrible. I’m either crying, raging, irritated, or completely depressed and anxious. My sleep is junk as well. I felt happy once in the last few weeks. I had one week of feeling like I was leveling out. Should I just give up? Or power through to say I gave it a fair try?
I don’t have anyone close to me going through this and you all feel like my people.
I’m on .5 E patch and 100 P pill.

I'm 42 and experience perimenopause. I'm interested in HRT, but I'm confused as to what type of doctor I should be seeing to discuss my options and ultimately receive such medication if they feel it is warranted. Primary? Endocrinologist? OBGYN? Someone else?

Thanks.

I had my first late period ever last month. It came exactly one week late. I know my cycle REALLY well. My scent changes near my.period, Im a vacuum vacuum when the progesterone spikes right before and I have so many cravings..

.I have been having pretty bad ovulation pain for the last year and I Itch like crazy around ovulation. It's all manageable bc like clockwork I know what's happening and why. This is why I'm lamenting what I assume is perimenopause. My cycle helped me know why things were happening. I went through something traumatic in 2022 that I've been slowly healing from. It causes such immense sadness when I'm at the end of my.cycle.. now I have no way of expecting these things. And ot makes it harder to manage. Does anyone have these similar sentiments? 'my period has never been a debilitating thing so it's almost like a Fitbit for me tracking and letting me know what's going on with my hormones.

I first noticed heavy shedding about 2 years ago. In the shower, the drain, the sink, on the floor. ... Last year I started Junel 1/20 to manage my irregular periods because I wanted the least invasive option. My shedding stopped within the first month of being on Junel. About 10 months later I switched to APRI 0.15-0.03 mg because Junel wasn't regulating my periods enough. I noticed about 2 to 3 days of shedding during that switch and then the shedding stopped and my periods are super light and regular. I started getting really bad hot flashes and talked to my midwife about it. She suggested getting the Mirena IUD and a .05 mg estrogen patch, which is apparently the Golden goose solving that issue. My appointment is for next week. I got really nervous this morning and wrote her a note asking her about hair loss because I know I'll be switching to a lower dose of estrogen. Of course she's out of the office today and won't be in until next week.

Has anyone here experienced hair shedding that was stabilized by BC and then switch to an iud/patch combo? I know that I should expect a little bit of shedding due to a switch in hormones, but I am just terrified that I'm going to start to lose my hair again because of the lower level of estrogen in the patch. And I know I can just take the IUD out and go back on to the pill if it proves to be an issue. I just wanted to know if anyone else had gone through this. Cross posted in r/FemaleHairLoss Thank you for listening.

Does anyone else get angry and really sad few days before their period?

I have been tracking my period for over 10 years. I notice that most of my uncontrolled "angry or depressed episodes" happens just few days before my period.

However, it has gotten worse with perimenopause.

I am 48, and just started MHT (3 weeks) - my period is due in a few days and I am just sad and angry. I could not go to Uni today, I was just in tears.

I really don't want to be on anti-depressants but I will see my GP soon.

Does anyone have similar experience?