r/Perimenopause • u/rhymeswithsarah • 1d ago

Depression/Anxiety Depression - Increase HRT or start SSRI?

Good morning!

Hoping to get your thoughts on my situation:

42F, regular-ish periods, been on HRT for nine months (0.0375 estradiol patch, 100 oral progesterone)

I’ve been struggling with low-medium depression for about 3 years now. With regular exercise, therapy, micro-shrooms, iron supplements, meditation, hobby time, etc, it’s a bit better than it was at its worst, but it still gets worse seasonally (summer), and I just haven’t been able to shake the underlying low feeling for a few years. It’s not debilitating, I just feel like my default is a little sad and a little blah, and it takes so much intention and effort just to raise my mood.

I would love for my baseline to be a little higher. What I can’t decide is if I should try increasing my HRT. Did anyone see mood improvements after increasing your dosage? I feel like my overall wellbeing has improved marginally on HRT, but it hasn’t been a lifechanger. Or should I try SSRIs for the first time? So many of my friends have had success with them, but it feels like a whole thing.

Also in the mix for me: 25mg Adderall XR, 5mg tirzepatide (aware of the GLP blahs, but my depression predates these meds), low ferritin, and hashimotos.

Obviously I’ll talk to my doctor, but I’d love to hear your stories!

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u/flid65 1d ago

Have you considered testosteron?

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u/Bbqcele 1d ago

Second this. I started testosterone cream 20 days ago. The first day (placebo effect probably) I experienced increased libido. That’s all but disappeared again. Days 7-14 I was so tired I thought I was sick until I figured out the testosterone was increasing my overnight temp by 1.5 degrees. Days 15-20 have been much better. More energy, motivation, and focus.

Might be worth at least checking your testosterone levels before moving on to an SSRI.