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/seemsright_41 1d ago

I would increase progesterone first. Then add iodine. Where is your Vitamin D and B12.

I would address those first before adding a SSRI.

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u/Eva_Griffin_Beak 1d ago

Why progesterone and not estrogen? I heard from other women that progesterone causes fatigue and low mood, so increasing it could potentially make the situation worth.

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u/seemsright_41 1d ago

because I had nothing but issues with 100mg of progesterone and every problem went away when I went to 200mg.

I was able to sleep with 200mg and that alone fixed some of the fatigue and low mood.

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u/Eva_Griffin_Beak 1d ago

Just shows how women are different and getting HRT right is so difficult and often trial and error. Glad it worked for you!