HRT Treatment – Types of HRT

So I’ve been on HRT for approx. a year now (I can’t believe it’s only been a year LOL). I’ve been having a few concerns about things that may or may not be connected to the types of HRT I’m taking. Before I go into the issues and concerns I’ve been having, I thought it would be useful to explain a little more about HRT Treatment.

What is HRT ?

HRT (Hormone Replacement Therapy) replaces the hormones that a women’s body stops producing during Perimenopause and Menopause.

The 2 hormones used in HRT are:

• Oestrogen
• Progestogen

HRT is offered as either Oestrogen-only HRT or combined HRT (OEtrogen & Progestogen).

To learn more about the types of HRT, then read my previous article where I go in-depth into each type currently offered.

Body Identical HRT

Body identical or bioidentical hormones include estrogen you take through the skin in a patch, gel or spray, and micronised progesterone, known as Utrogestan® in the UK. It is the safest and most regulated type of HRT treatment.

Body Identical Hormones – Click here to learn more

Compounded Bioidentical Hormones – Click to learn more

My HRT Journey

Initially, like most women, I was put on the Evorel Conti (combined Estrogen & Poestrogen) patch. After 3 months it became apparent that it wasn’t quite having the effect we wanted. It did immediately help with night sweats and hot flushes, but not much else. God, I wanted to be one of those women who say HRT changed their lives overnight! I will add that alongside the HRT I was also on Lisinopril (10mg) for my high blood pressure and Mirtazapine (30mg) for my depression and sleep issues – which we now know is probably much more likely to be the ADHD.

Anyway, it was decided that it would be worth upping the level of Estrogen to see if that helped. So this meant moving to a combination of Progesterone tablets and Estrogen patches at a higher dose. This did seem to make a difference initially and at the same time I’d also found the NUMind wellness supplements which I cannot tell you how much have helped my sleep. But over the next 6 months or so I began to have some concerns.

Is This Right ?

Weight gain

When I started HRT I noticed that I was slowly gaining weight. Initially, I put this down to being perimenopausal as I knew to expect possible weight gain, especially around my middle. However, when I started the patches/tablet combo I noticed a substantial amount of weight gain. I also noticed that my bloating was getting substantially worse. In just over a year I gained 3 stones and looked 9 months pregnant for the majority of the month.

When I mentioned the weight gain in my first review I was met with almost disdain, as if I was being vain. However, when I mentioned this time the GP was so lovely and was as concerned as I was, especially as so much is around my middle. In her words ‘Let’s make sure it’s not something we are giving you that is causing this before we look at other factors’. It was so refreshing and validating!

We discussed the Mertazipine, which can cause increased appetite, and decided to drop it down to 15mg. I’d been put on the 30mg at the OT’s suggestion, to aid sleep but it had not worked for me, so I was happy to drop down.

bloating

As said I’d also noticed the bloating was constant and quite uncomfortable. The GP explained that it could be water retention and bloating from the Utrogestan capsules I was taking. At the moment I take these orally, 2 tablets to be taken two weeks on, and two weeks off. However, once you’ve been on for over a year, you can change to one tablet every day. She also suggested that I switch to taking vaginally – cue my 11-year-old son’s mortified face as he was in the car when I took the call! She felt that taking it that way would localise the effect and hopefully cut out the water retention/bloating.

memory

Now, this is partly related to menopause but more to ADHD. I am absolutely rubbish at remembering things, especially if there is no real set routine. So applying patches twice a week was a kind of recipe for disaster. I asked if there was anything I could take daily along with all my other medication. She suggested that I move to try the gel, 3 pumps a day. So now going from the medication I took daily, twice weekly and two weeks on two weeks off, I was now taking everything daily. Perfect!

high bp

I was also a little concerned about my high BP as it had risen again, so we also decided to raise the Lisinopril to 20mg from 10mg to see if that helped. I need to have a check-up and bloods in two weeks for this to ensure my BP has come down and that my kidneys are okay at the higher dose.

Moving Forward

So I’m excited to start the new regime and see what happens. I also hope this gives you a little insight into the types of HRT and HRT treatment. I think for most women it isn’t that simple overnight fix, and we needed to be able to have the knowledge to understand not only that but also to question when we don’t feel something is right.

What’s your experience of HRT so far, I’d really love to hear your stories in the comments below.

Fay x

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Useful menopause sites and information:

https://www.balance-menopause.com/

Menopause – NHS (www.nhs.uk)

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