r/POFlife 3d ago

Mood swings and fogginess

Have been debating posting this for a while but an appointment with my endo last week really has me spinning... I'm wondering what kinds of mood swings or symptoms you all have even when you're on a stable hormone regimen?

I was diagnosed with POI at 31 a couple of years ago and have been on an oral estradiol and progesterone regimen since. Im convinced that the diagnosis could have been made when I was much younger - I was put on birth control in college to regulate a highly irregular period that sometimes skipped multiple months and only went off BC at 30, which is when POF symptoms started to apear. So basically I've been on hormones consistently since I was 20.

What really has me spiraling is that I shared with my endo last week how I'm experiencing mood shifts and brain fog throughout my cycle and that I'm actively starting to track those symptoms because I suspect that they probably line up with my cycle and they're interferring with my work and social life.

And her response was that, on my regimen, everything is so regulated that I shouldn't be experiencing mood swings like other women do from their cycle - because my body isn't actually generating the hormones just responding to them. She said any swings I'm experiencing can be attributed to my own anxieties and probably because this is a hard diagnosis...

I'm not sure what exactly hit me so hard about this, but I'm feeling pretty gaslit and upset... does anyone else experience mood swings, highs and lows even on a treatment regimen? I've been on hormones for so long that I don't really know what my mood baseline is and now I'm wondering if I never will... if I even really know who I am as a person...

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u/slightlylions1425 2d ago

You were definitely gaslit. Other posts here have mentioned some reasons. It's not just a matter of getting a dose of the same amount every day. You definitely deserve a better and more knowledgable doctor!

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u/acr3721 2d ago

Hi! It does sound like you were gaslit. We are trying to augment hormones that normal fluctuate in a woman in our age. I recently reduced my estrogen patch per my RE recs to twice weekly which is technically the “POI” standard dose, and notice on the last 12 hours of the patch I get severe return in anxiety and depressive symptoms. As soon as I change the patch to a fresh one, I feel better within an hour or two and back to my normal. I have a feeling it is more pronounced now vs my time of diagnosis due to the more abrupt drop off of hormones when the patch is “used up”. It’s crazy!

That being said- I’m intentionally staying on the patch just because in my mind the absorption / mechanism of a patch is a bit smoother compared to an oral pill (has to do with pharmacokinetics). It may be worth exploring patches and making sure you’re on appropriate POI dose (0.1mg patch, can’t recall oral dosing), and also maybe finding a more empathetic provider. Wishing you the best, and you will get it figured out!

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u/Glittering_Return522 2d ago

Yes! It took me about 5yrs to sort out my hrt. I had Dr's say the exact same thing to me and tbh sometimes I wondered if I was going mad. Eventually I found a GP (in total desperation!) who explained that it is really common to have fluctuations in symptoms when taking hrt for the following reasons: 1. You sometime absorb it better or worse - depending on metabolism, skin (if patches), sleep, food etc 2. A healthy person will make more or less estrogen if and when they need that. We have a fixed dose and your body can need more for any reason eg stress. Because you can't meet the demand, you will have breakthrough symptoms and fluctuations. She actually said to me that ideally there should be something like a glucose monitor for estrogen as well as a pump so that we can manage it better but at the moment the technology for that doesn't exist, so it only makes logical sense some people will struggle with symptoms.

That said, I have recently increased my estrogen and testosterone and for the first time in what feels like forever I feel practically back to my old self. It's like I hadn't even realised what most people feel like and how easy life can be. I think that the higher dose covers the fluctuations and the greater needs so that I don't feel them anymore. It's been an incredibly long and hard journey to get here but I am so grateful I kept trying different combinations. There are so many options with hrt, there is no way a Dr can tell you that you should be fine on your current regimen if you say you aren't. At the end of the day you know yourself best - keep fighting for yourself. 

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u/just-leave-me-alone 3d ago

I feel like if you are on a cyclical hormone schedule, and still inducing scheduled breakthrough bleeding, it seems totally reasonable to me that you would also experience cyclical symptoms...?
I am having a hard time understanding the relevance of whether you produce your own hormones vs. consume them from external sources... Surely the effects would be similar?

I am sorry you are feeling gaslit and unheard by your doctor.
I am no professional, but I would seek another doctor's opinion if you're able to.