After maxing out on the drugs I take (venlafaxine, nortriptyline and Clonidine) Iāve been recommended to start HRT. However Iām feeling overwhelmed with which hormones to take, in which quantities and which method.
In most instances in seems to have made MAV worse but wanted to know if anyone had found that it had helped?
Hi - HRT is so individual. I tried if for a year and it made me worse. My friend is trying it and it has reduced her migraine symptoms. Weāre both on amiltripline as well. If you want to try make sure you have patches - thatās what they recommend to migraine people but GPs donāt always know that. Incidentally Iām also trying clonidine but have had to cut back as the increase made me worse. So hoping I can find the magic mix of ami and 25microgams Clonidne twice a day.
Thanks for responding, thatās really helpful to know. Was this patches and progesterone?
Dr S has just said that with his patients on HRT, 1/3 improve, 1/3 get worse and 1/3 stay the same!
Good luck with the āmagic mixā, let me know how you get on.
Hi - I had patches that were one type for 2 weeks then a different type for 2 weeks. They both came in the same box. My menopause fog is obviously blanking out the details! 
Ahh the delightful menopause fog!
I started HRT just over 2 months ago and for the most part have felt more balanced. Iām taking oestrogel every day and utrogestan tablets (2 weeks on, 2 weeks off). My specialist (I had to pay to get HRT as my GP kept saying I was too young!) started me on a very low dose of the gel and Iām now starting to increase my dose slowly. Iām getting headaches from the progesterone but thatās the only real negative at the moment. I think too early to tell if it will have a positive impact on my vestibular issues, but itās so far not having a negative effect which is great!
Should also mention that my vestibular consultant is very positive about me starting HRT. He feels that if we can remove, or minimise, hormones as a trigger, that can only be a good thing. Appreciate it doesnāt work for everyone however x
Thatās so interesting, thanks for letting me know. And that is good that youāve not experienced any negative effects. Iām really hoping it will be the same for me as I went through IVF earlier this year and didnāt seem to have any additional issues whilst using the estrogen patches.
Sorry to hear your GP wouldnāt prescribe HRT, that is really frustrating.
Can I ask where you are based and which specialist you are working with for the HRT? My GP and neuro are both keen that I find someone who understands vestibular migraine, or at the least migraine. Iāve been around the houses trying to track someone suitable down and the last name recommended to me - Mr Nick Panay, here in London - doesnāt have an appointment until Feb 23! Iām hoping to get started asap as Iām deteriorating by the day and not sure how much longer I can look at screens 
Iām in Hertfordshire, I see a specialist called Dr Imogen Shaw in Cambridge. Sheās excellent, would definitely recommend. She was part of the team who wrote the most recent NICE guidelines for menopause apparently - she comes very highly and widely recommended. My Neurologist referred me directly to her and I know itās quicker to get an appointment with her that way as opposed to self-referral. Iāve seen her twice now and both times I chose a virtual appointment as I could get an earlier appointment that way, plus it was cheaper! She is definitely experienced with migraine and has been very positive about HRT having a positive effect on my vestibular symptoms. Iām feeling hopeful! You could drop her an email and see if you think she could help you perhaps? The admin team are excellent and get back to you really quickly. Sorry to hear youāre struggling, it really is rubbish xx
Thank you SO, SO much. I was lucky enough to be able to see Imogen today! 
She has started me on the same HRT hormones as you. My periods are very irregular so not sure when the start point will actually be mind!
I am still finding it tricky when there is so much conflicting information on HRT. For example, Dr Shaw said today that bioidentical hormones are the only ones worth considering yet others and the NHS say they are NOT recommended:
https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/alternatives/
And a functional doctor I saw was very keen for me to do the DUTCH hormone test which Dr Shaw has said is pointless doing.
Itās good to hear your vestibular consultant is so positive about HRT. My neurologist says 1/3 get better, 1/3 stay the same and 1/3 get worse (which I think is the same as postpartum), but I know Dr Beh states in his Vestibular Migraine book that launched last year, āstudies have produced mixed results with most suggesting HRT worsens migraineā¦andā¦ a worsening of headaches in the peri-menopausal period predicts worsening of migraine headache with HRTā¦HRT for the sole goal of migraine control is not beneficialā
Hopefully, we will be those case studies that prove that it really can be effective!
Thanks again for replying, I really do appreciate it.
Natalie
xx
So so happy for you! Sheās excellent isnāt she. I was listening to a podcast about perimenopause and bioidentical hormones on Monday actually - it was Dr Louise Newson speaking with Davina McCall - she was giving her reasons for the treatment being the best and her frustrations around the NHS refusal to prescribe (I gather cost has a lot to do with it). Podcast was the Dr Louise Newson podcast, episode 098 with Davina McCall, Making a Menopause Documentary. Iāve listened to a few episodes recently, she talks to a wide range of people, worth a listen if you get chance. I have also done the DUTCH test via my Nutritional Therapist and whilst it gave me definite answers and reassurance that my hormones were all over the place and it wasnāt just in my head, the results didnāt really help me medically. Itās helped with nutrition, supplements etc but nothing further. My GP did blood tests after I spoke to her about it but they were all clear, apart from showing I had hashimotos, but didnāt get me any further re HRT etc. Wishing you all the luck, let me know how you get on!
I will check out that podcast (handy when TV/screens are once again becoming problematic 
), thanks.
And yes, I will update as to how I get on. Please do the same.
Good luck, sending out good vibes!
x
Also, my vestibular rehab physio sent me an episode of the Heads Up podcast before I saw Imogen Shaw - look for the Perimenopause and Menopause Migraine episode. It was really helpful. My medical team in Cambridge are pretty amazing I have to say (I also see my Neurologist and vestibular consultant there) and are very supportive which I know isnāt always the case. My brain fog is terrible today but have had my dosage tweaked after my HRT review so it might take a while to settle.
I love a podcast!!
Well, I started HRT 3 weeks ago and I realise this is still VERY early days to be mentioning but I found the first two weeks on the low dose of oestrogen gel (ā1 pumpā) fine, in fact, maybe even had some slightly better patches. I then added in the progesterone a week ago and have experienced a huge drop in my condition over the last few days. In fact today I have been in tears most of the day, feeling very anxious and migraine symptoms (dropping sensations, vision feeling off, phonophobia and photophobia, tinnitusā¦) are much worse and am unable to leave the house. I know itās probably impossible to know but my hunch is that itās the progesterone that is causing the issuesā¦however, I know I canāt take oestrogel without progesterone.
Hi Natty, Iām now on my 4th cycle of my HRT and this is the first one that I have felt pretty normal throughout. My third cycle was particularly difficult VM wise. She told me 4-6 months to see real progress. I would drop Imogen an email with your concerns - sheās very speedy to come back.
Hi Natty & all,
Iām new to this site, in the UK, just about to start hrt estradiol gel & progesterone capsules. Will post in a week or two how im getting on.
Im 54, no periods for 2 years, get occasional migraine with aura/flashing coloured lights and get cyclic episodeās of dizziness/ drunken feelings without sickness that can last for several weeks at a time. This has induced panic attacks and high anxiety, as doctors not sure what causes it. Bloods and mri normal.
Looking forward to reading more and contributing to this forum 
Hello there and welcome to the site.
Thanks for posting, I truly hope the more we collectively share the more we should learn about this awful condition.
Iām sorry to hear youāre suffering. I think itās extremely hard, if not impossible, to have extreme dizziness without some anxiety. Fingers crossed the hrt brings you some relief. There are of course many other forms of treatment which may also benefit you.
Iām now in cycle 5 of HRT and have recently upped the oestrogel from 1.5 pumps to 2 pumps following the recommendation from Imogen, the lady @CB2006 kindly mentioned. And from here I have to wait another couple of months and if no improvement up it to 3 and then if still no relief to up it to 4 pumps. Then if no progress I plan to swap to oestrogen patches and then finally consider the mirena coil, so in theory Iām looking at another year of trialling hrt before deciding to give up or not.
Then Iāll perhaps look more into CRGP.
Iām still having hot flushes so in theory do need more oestrogen and just preying I turn a corner soon. Not expecting a miracle but to get 50-60% would be amazing.
Can I ask what dose of HRT you are on and your plan for how to progress?