HRT: Not all Plain Sailing

Last week I took a week off from any posting about Menopause because quite frankly I was shattered. Doesn’t this sound all too familiar eh? A couple of things that rear their heads as you get to this stage of life reared their heads, but I was also coming to the end of the first 12 days of the month in which I take progesterone alongside the continual dose of estrogen. And it knocked me for six.

And this is what I’d wanted the next post about HRT to be about (albeit written with a clear head). I’ve spent the last three weeks writing about the rationale behind my decision to start taking HRT during perimenopause and it can read like the best thing you’ll ever do. And don’t get me wrong, it has already been a game-changer. But that doesn’t mean it’s all plain sailing.

I’ve heard a number of storied of people who think that once they’re on HRT and they’ve got that relief from the symptoms that that’s it. Forget everything else you’ve learned about managing the madness of hormonal shifts, it’s gone. And you do get relief. But HRT doesn’t mean The Menopause has stopped. Your body is still naturally producing these hormones at varying levels and there will be stages where say your natural estrogen production will noticeably drop and all of a sudden everything is out of whack and the symptoms are back. Of course, it makes sense when you think about it. So then you need to review your dosage and adjust. Which is why it’s also important to continue with some of the complementary ways you might have already learned to manage some of the more unpleasant symptoms.

But you might also need to adjust what you’re taking or how you’re taking it. This might be right at the start of taking HRT, when maybe you think it isn’t really working for you, but what isn’t really working is the combination of what, how and how much you’re taking. And so you have to speak to your doctor (or if you can, and I’d really recommend it, a GP specialising in The Menopause) about tweaking it. And so we circle back to my relationship with progesterone. Progesterone will naturally make you tired if you’re taking it in pill form (which I am because this is a body-identical type that I’d prefer to use just now) and so you’re advised to take it at night. The thing is that it can leave some people (me) feeling pretty wrecked in the morning. It can also leave one in ten women feeling very depressed.  

The first couple of days I first tried it completely surprised me; I’d expected to feel drowsy when taking it which is why you’re advised to take it at night. But I never expected to feel so floored through the morning. So then I started looking into this a bit more, because I don’t really want to spend two weeks of each month like this! And that’s the reality of it. If something isn’t working, it doesn’t mean HRT is bad, it’s just that there may be a better combination, a different way to take it. Maybe I have to weigh up the pros and cons of taking a non-body identical type of progesterone which means I might miss out on some of the benefits it provides but it also means we don’t spend the first two weeks of every month’s morning yoga classes in a prolonged Savasana!

The point is that HRT is massively beneficial, but like anything else, it’s not bullet-proof. You have to be aware of what’s going on, flex your approach, be open-minded to alternative methods even if you were initially unwavering in what you thought your approach would be.

At the moment I’m looking more closely into an alternative way to take this pill form of progesterone so that my body doesn’t have to digest it. I’ve also heard it takes a wee while for the body to get used to it, so while I’m very keen to sort it out fast, I’m also going to practice what I preach and take it slow while swotting up on other options so I’m ready if I need to be!