Estrogen Replacement Therapy and Anti Depressants

I am 27yrs old and had a total hysterectomy at 26 due to advanced stage Ovarian Cancer. I have been on Premarin first 1.25mg and now .90mg. I have been having several problems with mood swings, irritability, and weight gain. My question is, how do I know if these are side effects from Premarin or if I am going through a depression? I am in councelling, but I just started and it's not clear at this point. I am interested in taking Wellbutrin but am afraid of over-medicating myself if these are just side effects from the estrogen. Also wondering, if I lowered my dosage of Premarin to .625mg, would that help with my weight gain? Are there Dr's that specialize in hormones? Sorry for all the questions - my quality of life is so miserable right now, I think I was actually happier when I was going through chemo!

[Machelle Seibel, MD]

A. It is understandable that you are having a difficult time.  27 years old is very young to face such a serious problem and also very young to have your ovaries removed.  Often women who have their ovaries removed at such a young age need higher dosages of estrogen for a while.  If you felt better on 1.25 mg daily than you do now, then it is likely that going to the 0.9 mg dosage is too little for this time frame. It might be necessary to stay on the 1.25 dosage for several more months or even another year or so.  Although there is always some risk of taking estrogen, the difference in risk between 1.25 and 0.9 mg may not be as great as the difference in how you are feeling. Eventually you will be able to lower the dosage with comparable benefits.  Even if the higher estrogen dosage makes you feel better, it is certainly not unusual for someone going through all that you have gone through to have some feeling of depression.  Talking with someone in therapy can help and adding an antidepressant might also be helpful. You might also want to speak with a nutritionist to help create the best diet for yourself and also try to make time to exercise 20 to 60 minutes daily.  Exercising can be a way to help control weight and it improves the way people feel. Realize this is a difficult time and keep working on ways to make yourself feel better.
Machelle M. Seibel, MD

[thecips]

I am much older than you I am 54 and post menopuase. I will tell you this. My changes were horrible.I felt like i had an interal fire within me.I couldn't sleep had panic attacks.mood swings. and depression. I have been on just about all anti depressants.The one that worked the best for me with no weight gain had been Zoloft and I am on the max dose.I also have been on therapy on and off for 4 years. If you find the right one it does help a whole lot.You get to speak your mind without being judged and with someone with no emontional attachment.I never took HRT and will not.But your so young and have a long way to go that in your case I would think just from a bone denisty issue you would be wise to take them at least on and off.My sister had a hyster 3 years ago and has tried not to take them and when she is off them is a wreck and very short tempered and depressed.You are so young to had to deal with this for the rest of your. My heart goes out to you.My flashes are so bad that i go out on my deck in the winter in my nightgown to cool off with being 25 degree's outside. I haven't worn more than a cape all winter in the last 4 years. Keep trying to find a doctor who really understands what your going through. I find women doctors are best when it comes to this.I couldn't cope without my Zoloft. I have tried and it isn't a pretty sight.
Good luck & God Bless
Linda

[Free Bird82]

I am so sorry for you!!  I'm not sure if you're reading this now, but please know that someone is praying for your return to health.  I hope you find the right doctor for you & the right medication.  Good Luck!!!