Female hormone replacement therapy / HRT - estrogen and progesterone

[Nikki]

ADMIN NOTE Also see

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I didn't really know where to put this.

 

I am tapering bio-identical hormones. Not bad. Off progesterone/testosterone.

 

Went to doctor today. My Blood Pressure has been high and I take Lisinopril.

 

He said Estrogen causes HBP which I had read about. I told him I had read that Celexa (all ssri's) can elevate blood pressure. He said he didn't think Celexa does that.

 

He told me to taper off estrogen over a course of months if I needed to.

And here doctor's tell patients to just stop taking ssri's.

 

I told him it would take me another few weeks. Then have blood pressure taken again.

 

I do need to make another drop in dose of the Celexa (and I do think they can cause HBP, particularly from a weight gain).

 

There is a large part of me that is glad that I am going to be getting off some medications.

 

I do need to lose weight and I have a hard time with that. I believe ssri's keep it on, and so does estrogen. I also know I am a sugar addict. Honest to God, I never craved sugar like I do after going on ssri's. I had it under control and it wasn't 24/7.

 

Today one of my customers told me that I get one helluva workout with my cleaning business.

So how come I am not like Twiggy????? I should be

 

I am excited to be coming off of four drugs: Celexa - Estrogen - Progesterone - Testosterone. Alot less visits to the Drugstore.

Edited November 3, 2019 by Altostrata
Added admin note

[Altostrata]

Yep, you have to taper estrogen, too. All the steroids.

[Nikki]

Okay, here it is

 

Was off Progesterone/testosterone for three weeks. Wired and constantly hot, sweaty.

 

Tapered Estrogen and forget-about-it Major hot flashes, perspiration, wired, not good at all. However there was no anxiety/melancholy.

 

Yes, I am back on progesterone/testosterone and estradiol in very small doses and there is a world of difference.

 

Soo...in order to get off Celexa as safely as possible, I will remain on hormones. Hormones and Celexa drops = feeling lousy.

 

I would rather be rid of Celexa more than hormones. I tried, not is not the time

 

Hugs I guess Suzanne Somers is right after all.

[Barbarannamated]

Nikki,

 

If I knew of something that would make "world of difference" at this point, I'd have no hesitation. There are many new opinions and interpretations of data coming out about HRT used in the big Womens Health Initiative trial. So confusing. The main point that has been brought to light is that the median age of women enrolled was 65. They had already been post menopausal for 10-15 years. To use that as a guideline for treatment of pre/peri-menopausal symptoms or other endocrine failure is ludicrous. [i'm using the definition that menopause begins when periods stop permanently ("pause of menses")]. One doctor said that "post-menopausal" would start with death.

 

BTW, when did you notice that you began to grind your teeth/bruxism? My doc changed my estrogen recently and I'm grinding my teeth and waking with headaches again. Not certain if it's related.

 

I'm glad you found something that helps you.

[Sparrow]

Would anyone care to share how much estrogen and/or progesterone you're taking? If your prescriber uses blood levels to help determine dosing, what levels are you shooting for?

 

My hormone doc wants my estradiol around 70 pg/mL and progesterone about 20 ng/ml. Last time they were tested, my est was 35 and progest was 15.

 

I'm taking 500 mg of compounded bioidentical progesterone (orally) and using a 0.1 mg PLUS a 0.025 mg Vivelle patch twice a week. I'm worried. Those are pretty hefty doses and yet the hormones are still low. Why?

 

Sparrow

[Barbarannamated]

Sparrow,

 

My doc changed me to Bi-est (20% estriol/80% estradiol) and shooting for pharmacologic (not physiologic/replacement) level to treat mood and energy. Currently at 0.75ml (or mg). It's a compounded cream. I liked the ease of Vivelle better. I was on 0.1 Vivelle. Doesn't sound like an increase..?

 

I have progesterone, too, but afraid to use after my severe reaction to Prometrium (immediate horrid depression, nightmares w 1 dose) that nobody can explain. It is supposed to be a "natural progesterone" (estradiol) and seems to be the choice of the docs I've talked to. There was mention on adrenal forum about using progesterone with caution in adrenal impairment but I don't recall the details. It seems akin to someone having a psychotic depressive reaction to one SSRI but told to try another. It was that extreme.

 

I suspect it will be difficult to reach a consistent level/balance as drugs are getting out of system. The SS/NRIs effect so many hormones, especially adrenals. The adrenals are in direct communication/axis with ovaries/testes (gonads) and thyroid (OAT axis). Then balanced among themselves, I believe.

 

I'm not sure about benzos.

 

This was a long way of saying "I don't know".

[s1335]

Hi s...

 

I tapered Lexapro (similar to Celexa (citalopram) and it was the anxiety/depression that caused me the most harm.

 

In the Celexa taper, I am finding it easier. I can't do the slow taper others refer to. I did that with Lexapro and it took 2 years out of my life.

 

I drop in a larger amount with Celexa and wait a few months before doing it again. This method (so far ) seems to be okay. I am not suggesting you do this. This could change again with my next drop. We really never know.

 

If you feel that you can't do the taper right now, then don't. You don't owe anyone an explanation. It does take a toll and takes away a decent quality of life for alot of us.

 

If you read Strawberry's Posts on her taper (here on this site or in her blog), you may be able to follow her pattern of tapering which gives alot of people the least amount of agony.

 

You can taper for a period of time and then halt. Take a long break and feel better.

 

If you felt good at 20mgs. and think that you need to get back to that, then do so. I did that with Lexapro after my first tapering attempt. It was bad, my daughter was little, I had just gotten divorced and I needed to keep my wits about me.

 

You have choices. A word of caution....don't keep playing around with Celexa. Sometimes reinstating after upping and lowering doses over and over can render it ineffective.

 

Best Regards

 

Thanks Nikki. If it can be rendered ineffective, then maybe I should stay at 20mg. I was on 40 mg before and was doing very well, but I am now worried about the fluctuating dosages that I've made.

 

Hopefully it is still effective...

[Nikki]

Wow so many responses and info....thank you

 

Barb...about Bruxism. Started after going on ssri's. Got worse with Lexapro, and just continued after that.

 

What has helped is meditation. Big difference. Need new tapes. Doing it again, have old CD's and haven't been doing it religiously.

 

Progesterone was described to me as the 'calming hormone' and I believe it.

 

Now that I am working and my business is building, I really don't have anxiety or the blues.

 

s: if you were doing well at 40 mgs. of Lexapro why not go back to 35mgs. and stay put.

Please don't worry about the fluctuations. You only recently did it. Just focus on stabilizing and you will

 

I take 1/4mg. Estradiol now (was on 1/2mg.) My progesterone is high and needs to be reduced. It is 100mgs. The testosterone is 1/2 mg. and I am okay with that. I want to take the least amount of all three drugs.

 

I will probably have the progesterone cut in half. 50mgs. or less.

 

Just realizing with playing around with trying to get off HRT that it does help me feel better. Alot better. So I would rather keep this and get off ssri's.

 

We ladies have so much more to contend with than men in regards to hormones, pregnancy, menopause, etc.

 

Hugs

[Fenrir]

At the end of August I made some hormonal tests and these are the results:
 
- TSH: 6.60 mUI/mL normal: (0.31-4.50)
- Basal Testosterone: 35,9 nmol/L normal in men: (8.2-34,6)
- Cortisol 281 ng/mL normal at 8AM: (50-260)
- Prolactine 34,5 ng/mL normal: (4.0-15,2)

   
 
I think paxil messed me up very well
 
At the I had already began my tapering from 20mg and I was at 14mg (still here after crashing reached the 10mg dosage as you can see in my sig.)
 
Some inputs? Should I have more test or wait?

[Zoe]

Hi Lex- I recently had my hormones checked also. I ended up going on an estrogen troche & a progesterone cream. The original level that I was put on really helped & then I went to see a nurse practitioner who doubled the amount without any testing just saying that I wasn't on enough. ( I should have been smarter than to fall for that) She also put me on DHEA. Within a week my anxiety was going up tremendously again. She didn't return my call, so I talked to the compounding pharmacist who recommended that I cut the estrogen back to the original level & keep the progesterone cream where it was. I also eliminated the DHEA. It has taken about 3 weeks, but I feel like I am starting to settle back into my normal anxiety levels. My point in all of this is to be very careful what hormones you take & who prescribes them. They have definitely helped, but you can end up agitating yourself also. Alto or someone else more knowledgeable will come along and help you soon I'm sure. Hang in there. Hugs & prayers being sent your way.

[oskcajga]

1.  I am among those who went to see an endocrinologist to test a wide array of blood hormones in an attempt to explain the debilitating withdrawal symptoms related to psychiatric medication usage.  In my case, levels came back within the "normal range" some seemed a bit low on that range, but they were all within normal. 

 

**However, there's a massive problem with the common blood testing methodology that people don't seem to understand:  hormones fluctuate quite dramatically throughout the day - and one blood test cannot always expose a legitimate overview of our endocrine functions.  Instead, we would require multiple blood tests over a number of days to accurately diagnose any condition.  But of course doctors do not always have the time for that, and often rely on ONE blood test to diagnose and prescribe patients with a regime of exogenous hormones.  Even if the person is fasting, there can still be considerable variations in hormone levels throughout the day.  Therefore, this is sometimes a fundamentally incorrect approach, and any doctor who has gone through a basic 1st year medical school program should know better.

 

Here's a couple of basic references in the subject of hormone variation over time.  If you go to your local library and find a medical physiology textbook, you can also discover the same thing:

 

Thyroid hormone:  http://www.naturalmedicinejournal.com/journal/2012-12/thyroid-stimulating-hormone-fluctuates-time-day

 

Cortisol:  http://imgur.com/BjkVH3R

 

Testosterone:  http://imgur.com/7ZIEfjV

 

Hormonal changes during the normal menstrual cycle in females:  http://imgur.com/mWMElIw

 

2..  Why exogenous hormones are problematic:

 

Hormones operate very heavily upon negative feedback.  So if an exogenous hormone is introduced into the blood stream, your endocrine glands will ramp down the production of that specific hormone.  Tropic hormones will be released in less quantity by the hypothalamus pituitary axis, leading to less production from the specific gland (e.g., less cortisol production from the adrenals, or less thyroid production by the thyroid gland).  When the exogenous hormone is then stopped, either because we run out of the meds, or the side effects become unbearable (e.g., cushing syndrome, heart complications, liver challenges), there is a delay in the natural production of the hormone, and therefore the patient goes through a "withdrawal" period, where there is now not enough natural hormone production in the body.  Usually the endocrine glands will be able to function again and bring blood hormone levels back to normal, but this can take a long time.

 

--------------------

 

3.  Taking exogenous hormones without an underlying endocrine gland disorder is analogous to taking a psych med - short term benefits long term adaptations and side effects.  Moreover, because hormones and neurotransmitters are all interconnected and feed back on one other in elaborate and poorly understood fashions, there's a possibility that any pre-existing neurological dysregulation could become exacerbated by any one or more hormone therapy treatments.  

 

4.  Osk's personal recommendation:  Be careful with exogenous hormones of any kind - they are another massively over prescribed medication that makes Big Pharma and doctors very wealthy.  Sometimes they are necessary - but terribly risky otherwise - ESPECIALLY if your endocrine glands still exist within your body in an otherwise healthy state. 

 

There are some exceptions to this role, for example Hashimotos  Disease individuals basically NEED exogenous thyroid hormones to function.  Other examples include conditions where the endocrine gland has been ablated for one reason or another and you can no longer produce hormones naturally (e.g., testicular or ovarian removal). 

 

5.  Please be careful before "trying" exogenous hormones - there's big risks, and numerous side effects. I have a family member who after a number of cycle of cortisone treatment suddenly developed cushing syndrome which lasted for over 10 years AFTER stopping.  So there are potential long term risks.

 

Moreover, I've read anecdotal reports of people who take exogenous hormones for SSRI and psych med problems (these were located on the now defunct website, Paxilprogress.org), and they got short term benefits for a while, and then no longer get these benefits - but are now stuck taking exogenous hormones.   From these perusings on that now defunct website, I also noticed that there were a number of anecdotal reports that SSRIs and antipsycotics threw normal blood hormone levels out of whack in a surprising number of individuals - but unfortunately hormone therapy did NOT always relieve these problems and sometimes lead to hormone therapy withdrawal or side effects (or no effect at all).

 

I hope this helped someone

 

Footnote:

This is my personal opinion only.  I am not a doctor or medical professional, and this post is not meant to be interpreted as medical advice.  Please contact your doctor for medical advice.

 

 

TLDR:  Endocrinologists do not always practice the best diagnostic testing (too many patients, too little time/compensation by insurance companies), and hormone therapy can be very risky (because hormones operate via negative feedback), please be very careful.

[Wildflower0214]

I appreciate your writing this. I have often suspected all of the above. I have seen so many people get placed on hormones during AD use or WD. This happens so frequently with thyroid diagnosis and then hormone replacement. It seems like the thyroid really gets knocked around during WD, and I just can't see how testing thyroid hormone levels during this process could be used to make a diagnosis.

 

I'm pretty sure I have a wonky thyroid at the moment, but I have stayed away from hormones for two reasons.

1) I couldn't tolerate any kind of med at this point in time anyways.

2) I have no idea if my thyroid will even out after a few years, it may. feel the need to give my body a chance to balance out before I consider taking anything.

 

I understand others may have a different viewpoint. That's ok, this a decision I have made for myself.

[NoMeaning25]

I was on birth control for many years. I cold turkeyed them in beginning of ad withdrawal but suffered severely. I went back on but it didnt help my symptoms. I had to taper off them. I developed severe fibroadenomas in my breasts. I think this is the reason im so severely effected. Im dealing with ad withdrawal, birth control withdrawal, adverse reaction, abuse and break up of a 4 year partner.

 

Im in a bad place right now

[Newbeginning]

So if someone has low thyroid they should not take hormones? 

[Lynnardgirl]

My doctor gave me some estrogen cream because he said I’m very very low and was wondering if anybody else

started using estrogen and is going through withdrawals! Did it amp up your symptoms? I really need estrogen because this might be the cause of my horrible anxiety along with the withdrawals! Any help would be appreciated Thanks everyone God bless you

[Altostrata]

@Lynnardgirl, see above discussion.

 

I would be very, very careful about adding estrogen cream -- try a very little bit at first to see what it does.

[Lynnardgirl]

On 11/3/2019 at 9:13 AM, Altostrata said:

@Lynnardgirl, see above discussion.

 

I would be very, very careful about adding estrogen cream -- try a very little bit at first to see what it does.

Altostrata 

I started on a very low dose and I can’t seem to get out of this wave! I stopped using the estrogen 

Do you think it will subside wow this is awful

[Altostrata]

Did the estrogen make it worse? Estrogen has a very long half-life, this will gradually go away.

[Lynnardgirl]

5 minutes ago, Altostrata said:

Did the estrogen make it worse? Estrogen has a very long half-life, this will gradually go away.

Yes it made me worse! 

[Lynnardgirl]

On 11/28/2015 at 12:12 PM, Wildflower0214 said:

I appreciate your writing this. I have often suspected all of the above. I have seen so many people get placed on hormones during AD use or WD. This happens so frequently with thyroid diagnosis and then hormone replacement. It seems like the thyroid really gets knocked around during WD, and I just can't see how testing thyroid hormone levels during this process could be used to make a diagnosis.

 

I'm pretty sure I have a wonky thyroid at the moment, but I have stayed away from hormones for two reasons.

1) I couldn't tolerate any kind of med at this point in time anyways.

2) I have no idea if my thyroid will even out after a few years, it may. feel the need to give my body a chance to balance out before I consider taking anything.

 

I understand others may have a different viewpoint. That's ok, this a decision I have made for myself.

Yes I have to agree with you! Tried estrogen cream and wow made me go into the worse wave!

no more for me! Yes let our body try and balance out before trying anything 

[getofflex]

I am a 58-year-old menopausal woman. My periods stopped two years ago. I have been tapering off Lexapro for 2 1/2 years. I have not Done a dose change in 2.5 months. The problem is I’m suffering from frequent and debilitating hot flashes that keep me up half the night. My nurse friend suggested going on Progesterone hormone replacement therapy. I called my doctor today and I’m supposed to talk to her tomorrow. Maybe she will suggest estrogen hormone replacement therapy. Now my question is if I go on hormone replacement therapy is this going to screw up my brain chemistry since I’ve already sensitized because of tapering off of SSRIs? I don’t want to go from the frying pan into the fire. Please advise

[Altostrata]

@getofflex, please see this and related topics in the Symptoms and Self-Care forum.

 

The staff can't advise you on general medical matters, sorry.

[Junglechicken]

Anyone experience worse WD following having the mirena coil fitted?

[Vonnegutjunky]

I just wanted to chime in here on this post to give what happened to me - not to discourage or scare anyone - 

 

I started peri as I began my screwed up taper and reinstatement - it was fine I never really had a lot of menopause symptoms - 

 

lasy year I started getting UTIs about once a month- at this point in my taper I had already gotten gallbladder surgery and passed a kidney stone without any adverse reactions to any of the meds I needed for those situations - I was also taking a ton of keflex for the utis with no issues- 

 

so my doc said my estrogen was low and that protects the bladder and I should start hrt - it would help with the frequent utis- so I didn’t think twice about that - she started me on the lowest dose of prempro - 

 

initally I didn’t have any side effects but about a month into taking it my breasts started getting very painful  and I started bleeding again (hadn’t had a period in almost 5 years) 

 

Going into 7 weeks is when it started getting bad - I felt slowly like I was back into cause adverse reaction- just a cns reignited - the same symptoms of panic, intrusive thoughts, skin on fire, screaming tinnitus, double vision, severe pots, and muscle twitching and cramping - 

 

I stopped the hrt at about 2 months in - that was back in may 2022 - I am still expericing the fall out from that (4 months ago ) I have windows but the waves are still almost as bad as they were so many years ago -

 

I should also mention, at the 7 week period, I also needed to take keflex again due to me getting another uti - so the hrt didn’t do a damn thing for that - 

 

so I am waiting for this fire to quell so I can try to live again- 

[Terrie]

Hi there

I am seeing a functional medicine nurse practitioner as my hormones are all super low from being on medication‘s and from withdrawal and who knows what else? Some levels don’t even read on the scale.

I read on “the withdraw project “that having Low hormones is a result of withdrawal and that taking hormone replacement therapy is risky and it can make symptoms worse.

The functional medicine specialist I am seeing disagreed and put me on DHEA, estrogen, progesterone and testosterone. It’s been six weeks and I don’t notice a difference. I don’t feel like I’m getting any better. I have chronic fatigue that started just before I started withdrawing from anti-depressants and it’s just gotten worse with withdrawal. I don’t know If it’s from the hormones or what the start of it was. I was told it could be from the Covid vaccine.

So my question is did anybody else get started on her hormone replacement therapy because of low hormones coming off of anti-depressants? And how did it help you or does it make things worse.? And does it take a while to notice a difference? Thank you

[Altostrata]

Hello, @Terrie See the earlier posts in this topic.

 

If you have any adverse effects from these powerful hormones, please talk to your prescriber. We do not provide peer support for this sort of thing.

[AnnaRetlaw]

HRT tapering

 

Hi there

I looked everywhere for posts on this topic but couldn’t find information on this.

By the time I found this site I was already on HRT. I read somewhere (on another site) that this is not recommended as to the HRT affecting the same neurotransmitters as SSRI’s . I don’t know what that means.

I am pretty sure I am getting more depressed being on HRT, although in withdrawal I am always  depressed regardless.

does anybody have any information on this? For example HRT causing increased withdrawal symptoms, etc.

Also does anyone know how to find (safe) info on tapering. I have been on them for 4 1/2 months now. My doc says I can go off CT. I don’t trust her

Thanks

Edited March 3, 2023 by manymoretodays
title added

[manymoretodays]

@AnnaRetlaw

This was the closest topic to your concern I could find.

And I do see Alto state in one of the first posts(do scroll back and browse this topic), that yes estrogen, and all steroid do require tapering.

 

You may be able to get away with something greater than the 10% we promote for the rest of the drugs here.

I don't think HRT works just like a SSRI, but indirectly everything influences everything AND if you feel sure the HRT is not helpful, might as well do a slower approach than your doctor recommends.  That's harm reduction.  It's good.

 

Possibly you'll get some other input here as well.

Good luck.

 

L, P, H, and G,

mmt

[zma1]

So what I’ve learned and experienced is that some women in peri/menopause that are not going through ssri withdrawals, have the same symptoms as those not in peri/menopause but are going through ssri withdrawals! Im doing both.  The ssri withdrawals are worse for me,  but I know withdrawal is exacerbated by perimenopause. 
 

i take 100mg progesterone nightly and it has really helped my general anxiety and insomnia. I definitely prefer hormone replacement  to antidepressants for anxiety but it doesn’t work the same for everyone. Im still producing estrogen so when I tried to add estrogen hrt my anxiety kicked in hard so for me right now the progesterone is all I need. Some women have a pretty intense intolerance to micronized progesterone which is unfortunate because it is a very safe form. 
 

Anyway, I think you should always taper anything you’ve been on for a time. SSRIs, bentos, hrt, Prilosec, caffeine— all of it— just some things are quicker tapers and others obvi much longer😊

[Mcat]

Hi all, 

 

I wonder if any women here have experience with HRT/Mirt/serotonin syndrome. I ask because I recently came off Mirt (see signature for the sorry tale), had a pretty hellish 6 weeks where I wasn't sleeping and upped by 50mg oestrogen patch to 100mg in the last week or so of that time, and then ended up going back on 7.5mg Mirt on the bad advice of psychiatrist 10 days ago and from the instant, I went back on it I had this unpleasant, unsettling shaking CNS sensation that was quite constant (worse the more stress/anxious I was) until finally, after 8-9 days back on the med, the hypnic jerks (which I now know is a side effect of the Mirt that interferes with sleep - it kicked in Oct 22 and was the reason I went off it in Jan this year) came back. I saw a mention on another thread that these jerks can be a sign of serotonin syndrome, and I didn't get the internal shaking feeling when I originally commenced Mirt while on the lower dose of oestrogen in April 22. Since I know oestrogen can affect serotonin production/functioning, I'm wondering if that might be why I've gotten the internal shakes this time - or is it more likely to be a result of a completely confused CNS after a too-fast WD?

[Onmyway]

@Mcat, pls do a search about whether a specific topic exists before you start a new topic. We like to keep our threads tidy so people can find what they are looking for easily. 

I have merged the topic you started here. 

You can also ask about specific questions about your case in your own intro thread. 

[Mcat]

Thanks @Onmyway- live and learn!

[zma1]

Hi @Mcat. I have not experienced what you describe from estrogen/hormones/ serotonin syndrome. But I do get internal shakey feelings usually around my period and it corresponds to hormones dropping or maybe surging. I have had those jerks, but it’s when I reduce my ssri and it doesn’t happen every time I do a reduction. It’s almost like a whole body zap. So my best guess is that what you are experiencing is a seriously sensitized nervous system. If you do reductions in ssri, I would not change any of the HRT for a while and Vice versa. Let your body adjust to one change at a time and then stabilize. However that stabilization is tricky when you’re in perimenopause isn’t it? It’s all wacky when you least expect it anyway. So any changes you can control should be sloooow and gradual ❤️

[zma1]

Oh I’m sorry @Mcat I just saw that you’re post menopausal, not peri. But I still suggest the same- one thing at a time and then hold. Those jerky feelings must be a drag. I totally get why you want to be off in a jiffy. 

[Mcat]

Thanks for responding. No question I need to stabilise (the pressing question is just how), and honestly, I don't think the hormones are my biggest problem right now (though who knows, as it's all a hot mess).