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[Miss-Shelf]

Hello amazing MM people,

I'm hoping you can help.   I've tried searching this thread but I'm having a massive anxiety/brain fog meltdown at the moment and losing the will to...you know!

I switched to estrogel/utrogestan a few months ago due to the patch drought ( previously on evorel sequi for 3 yrs) 

None of my GP 's are knowledgeable  about it and they are not helpful about dosage and have prescribed different doses randomly asking me what I do and how much I want - I dont know the answer!

I find it difficult to remember to take both the gel and the tablets so I'm not doing well on it yet

Getting some hot flushes, loads of itching and right now have the sad-anxious-rage which I find so very hard to deal with.   My period is week late so PMT is extended.  I have a lot of additional life stress at the mo so it's all in a big ball of agggghhhh

In lack of GPS guidance I took myself onto 4 pumps gel a day ...one month I took 200 utrogestan and got lots of PMT so cut it to 100 utro...could that be why no bleed this month?   Is 4 pumps giving too much oestrogen ?

Thanks for reading

[Pauline b]

I have just changed from ultrogestan orally to vaginally as my breasts were really tender. I have been going this for a week but feel like i am now getting too much progesterone. Terrible nightmares awful sleep headaches. I have been using 100 vaginally every night but some guidance on the site suggests alternate nights . I'm confused can any one clarify for me the continuous vaginal dose?

[Ladybt28]

I'm with Stellajane, Miss-shelf - 4 pump is considered a higher dose so you would need 200mg x 12 days in order to shed the womb lining.  Its very trial and error regarding pumps as to what balances the symptoms for you.  How long have you been on the gel since the change over?  The starting dose is usually 2 pumps and then you should build up if the symptoms don't come under control by half a pump each time but what I found with gel is that it takes quite a while to adjust.  So when started I upped half a pump and waited a week and then went again.  Its quite a tortuous process but worth it when it hits the right spot.
It is possible 4 is too much for you drop, half a pump and see how you go.

I also take my utogestan vaginally so it minimises side effects on the stomach and the liver but I take it on the same cycle as Miss-self 200mg x 12 days.  I believe Pauline b that you can take it every other night 100mg if your on a low dose oestrogen but the actual normal written up dose for utrogestan by Besins is 100mg every night on continuous.  I have leaftlet from Besins and I think it is on their website which has a little chart on it for both continuous and cycle doses.

[Dotty]

Hi Miss-Shelf if you were on Evorel Sequi then the equivalent dose of gel is 2 pumps x

[Bryony]

Hi
I have been wondering whether to pay for blood  tests privately as have been on  hrt (now on 4th brand) for around a year, with some improvements in symptoms but still really struggling with the sleep (i now think 6 hours, never continuously, is a ?result?) and anxiety - i have a stressful and demanding job and about to start a new role so really need to be able to function normally! Recently night sweats returned so i asked my GP if she thought my dosage should be increased , so immediately she doubled  it (kliofern 2mg/1mg). My appointments are always rushed, and i just feel like shes trying to get me out the room (which to be fair she probably needs to as always seems to have too many to see, running late etc - symptom of the nhs). I haven't directly asked for a blood test, but was refused one when i was peri menopausal.  I also have zero sex drive, so low it doesn't bother me, but not great for my poor long  suffering husband. I asked about testosterone level possibly being low but GP categorically  told me that testosterone not available on nhs (wonder why its written about on nhs website?).  Any views on whether my gp would agree to a blood test and/or whether a private consultation would be worth it - local consultants charge around ?400 including blood test cost?

[Sammiejane]

hi

with regard to breast tenderness and pain

i've been on gel only and had horrific pain swelling enlargement in breast that i couldn't touch them or wear a bra

i?m now in combined with utrogestan and pain isn't half as bad as it was

i've been advised by GP if the pain is at the top of breast and around nipple this is estrogen related it it's under boob this is progesterone .

and this is true as when i was just on gel my pain was localized to nipple area x

[Baby]

Can I have some advice please. I am in my first month of this HRT. Done two weeks of two pumps and one week of three pumps along with one week so far 200mg ultra. Dont feel any better. Did three months before of conti which gave me terrible mood swings. Should I increase to four pumps. Any advice appreciated. X

[lillith112]

I wonder if anyone can help me, I still have a cycle and I have started on Estraderm 50 patches and utro, my Dr said to use patches continual and utro 100mg 1-26 which I found odd so I'm doing utro days 15-26. My period has come early on day 24 so I'm still taking utro. My question is do I need to be taking 200mg utro to lengthen my cycle as I thought the bleed doesn't come until you stop the utro ?. 

[Ladybt28]

Hi Baby, It's really early days for you.  What I would say is that gel is a "slow burn".  Takes a while to settle especially after a change from one type of hrt to another.  Stick with the 3 pumps for at least a whole month.  It is usually a good idea not to mess with the number of pumps for at least a month at a time.  To start low and work up.  It gives you a better idea of what is actually happening to you body.  It took me 5 months to see an improvement and get the number of pumps right.  Although doctors and consultants say a minimum of 3 months on any hrt regime before you might see proper improvement I would say that gel is one of the ones that can take the full 3 months to get a result.  It's like it all happens at the end of the 3 months.  I know everyone is different but from doing a lot of reading on the forum, that is the opinion I have built up about the gel.

You might end up on 4 pumps at the end of 3 months but my opinion is that if you jump straight up to 4 then it might be too much for the body to adjust to all at once and you end up with side effects.  I found slow and steady wins the race! xx

[lillith112]

Thanks for your reply Stellajane. I'm slightly confused, do I count day 1 of my cycle the day I stopped the utero and start it again day 15, or do I count cycle day 1 as day 24 when my period started ?  . I'm unsure when to start the utero again. 

[tbett]

I have done quite a bit of reading of this brilliant forum. I am 45, diagnosed with osteoporosis, had irreg periods for 9 years, often every 6-9 months, started on HRT 9 months ago as i was starting to have menopausal symptoms of hot sweats, anxiety, low libido, poor energy and brain fog and poor sleep. Blood tests were normal. I am on 2.5 pumps of oestrogel and 200mg utro day 15-26 orally. Generally my symptoms have improved. My oestrogen level when checked last was about 500, my testosterone level was on the upper end of normal. I have had one bleed in 9 months despite being on the cyclical regime. My libido is still non existent, and i have had really achy joints over the last few months (this can sometimes keep me awake). My energy levels arent great. I did still get periods of anxiety but its loads better.
My question is about testosterone. I have read a fair amount about it and some members have been so helpful and knowledgeable (hurdity especially!). I think people who prescribe it tend to go on symptoms only? My SHBG was quite high but FAI looked to be in the normal range. I know that everyone reacts differently to different hormone levels. Would my increase in oestrogen levels affect the testosterone? Is it worth trying higher oestrogen? Any thought on why I am not having a bleed? (I get period pain though its manageable).
Any ideas appreciated, I do have a really nice nurse at the menopause clinic and I saw an endocrinologist but they werent sure why I have early osteoporosis (no risk factors as oestrogen levels were normal), I know that low T can cause osteoporosis. Hormones are a minefield!

[Sammiejane]

hi ladies

i?m using progesterone as a mood stabilizer and 2 pumps gel it has been 3 weeks however i?m know not sleeping as great and come 4pm on wards i?m getting really bad headaches and vagina is dryer and i?m constipated x

do i need to increase the estrogen to 3 pumps or is progesterone not suiting me i use utrogestan x

[Hurdity]

It maybe the progesterone sammiejane - I know you wanted to try it but taking it continuously as you are doing can lead to some of the side effects you mention.

tbett - I answered on your other thread.

Hurdity x

[Sammiejane]

hi hurdity

thank you for replying

as it's early days do u think i should give it a little longer

i am less bloated though and my mood is so much better x

if i stop the progesterone then it means changing the gel to a patch as the gel doesn't suit me on its own. x

[Sammiejane]

hi hurdity

sorry forgot to say do u think it's worth trying 3 pumps can't do half a pump as never get the correct amount out x 3 pumps a lot of gel though so would rather a patch x.