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What Causes Mood Swings During Hormonal Replacement Therapy?

Posted on Mon, 5 Dec 2016

Question: Hi, I am in menopause and stated Biote pellet hormanal replacement 11 days ago. I am having estradiol12.5 mg, testosterone 125.0mg, progestrone 100mg. Blood work was fine except vitamin D was 12.2, now taking suplements. Before the hormonal replacement my estrogen was <5, testosterone 5. I do have panic disorder and that is the main reason i did the therapy. But now my anxiety is worse, I wake up shaking some days and feeling bad. I take xanax 0.5mg for the shakes. But the last two day i feel kinda week , plus anxiety and having nousea now since i took the progesterone . I can't remove the pellet either, so stuck with it. My doctor said he never had anyone with side effects, so he wasn't of help. I am sensitive to medicine, dont drink or smoke and don't have coffee or anything like that. What exactly is making me feel this way and what should i do? Thanks.

Answered by Dr. Albana Sejdini (3 hours later)

Brief Answer:
Symptoms precipitated by hormonal replacement therapy as following..

Detailed Answer:
Hi my dear,

I have gone through your medical history carefully and understood your concerns.

Let me recapitalize your case:
- 48 years old female in menopause
- stated Biote pellet hormonal replacement 11 days ago
- estradiol 12.5; testosterone 125.0; progesterone 100 mg
- blood work = fine; vit D=12.2
- no supplements
- personal history of panic disorder
- Xanax for the shakes

Now, taking hormonal replacement therapy will cause mood changes and might precipitate anxiety problems especially when it comes to testosterone levels.

Furthermore, progesterone can cause nausea, and fatigue or general unfeeling well.

Apart anxiety, oscillations in blood sugar levels (bsl) and blood pressure(bp) should be also consider and ruled out by monitoring bp and bsl.

Next, when having panic disorder, the upper limits of pain are reduced; explaining why you have started to have pain due to pellet (which is not normally associated with pain).

Here, I'd advise to consult further with psychiatrist in order to increase dosage of Xanax or change therapy. Furthermore, psychotherapy is also recommended to help you adopt with this new and harmless situation.

Hope this helps. Let me know if you have further queries.
Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Albana Sejdini (5 hours later)

Thanks for the reply. I am not understanding the meaning of this:" Next, when having panic disorder, the upper limits of pain are reduced; explaining why you have started to have pain due to pellet (which is not normally associated with pain)."
What kind of pain? I do not have any pain.
Also are those symptoms will go away or i will have then the whole time while i have the pellet? Thanks.

Answered by Dr. Albana Sejdini (17 hours later)

Brief Answer:
Detailed below...

Detailed Answer:
Hi back my dear,

Thank you for following up.

Now, to clarify my statements, when having panic disorder, everything you experience is always associated with anxiety or panic. When talking about upper limits of pain, I wanted to talk about all the (desirable or undesirable) events you might go through. They are always associated with a dose of anxiety from your part even unconsciously.

Usually, these symptoms will be fading by time. If they will become unbearable, then, should discuss with OG specialist about this pellet side effect and to remove it.
Sometimes, when side effects overcome the benefits, we are constrained to remove the pellet.

All the best!
Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Albana Sejdini (6 days later)

Thanks so much.

Answered by Dr. Albana Sejdini (2 days later)

Brief Answer:
Hi

Detailed Answer:
You are most welcome

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar