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[dazned]

Anyone ?? 

[Dancinggirl]

Hi dazned - As you are using this long cycle, starting Utrogestan earlier won't make any difference.  I'm experiemtnling, using Utrogestan on different cycle lengths to try and find the best regime for me.  I started with regime of 6 weeks of oestrogen only then 14 days of Utrogestan with oestrogen and so this month I'm using oestrogen only for 3 weeks and then do 12-14 days with Utrogestan.  I'm trying to get a lighter bleed.
SO, If you are wanting to take a break from HRT and need to have a bleed before you finish, you could start it anytime and then stop everything after you finish the Utrogestan phase. Hope that helps  DG x

[dazned]

Thanks DG .I am seriously considering stopping for awhile as my aches and joint pains are much worse than when on the old hrt even on at moment estrogen and I cant see the utrogeston helping in that department. Iam 6 weeks in on e only so thought i would do just 8 weeks then start utrogeston hopefully have a bleed then see how I go without . I will still have enough estrogen and utrogeston pessary for another 3 months if decide to start it again I've been on hrt now for 6 years so I thought I'd see what the state of play was without one can only hope I might not need it and if I do badly at least I will be reminded of why I needed it in first place. Thanks again x

[Dancinggirl]

dazned - I would gradually reduce the amount of oestrogen you use over the next 2-4 weeks before you stop completely so when you finish the Utrogestan you don't suddenly do a big drop.  DG x

[foreign body]

i am so glad i came across this thread. I am 51, reached the menopause a year ago and have been trying different approaches to address low energy, low libido, insomnia and hot flashes. A doctor who specialises in bio-identical hormones put me on DHEA, testosterone cream, utrogestan, estriol cream. I felt great for about two months, my libido was unbelievable, i was almost manic due to excessive mental and physical energy, but then my skin broke out with cystic acne, the worst i ever experienced, the hot flashes and insomnia returned and i became a nervous wreck. Also, the cost of blood tests, doctor's consultation and bio-identicals was something i couldn't afford any longer, so i quit and went to see  my gynecologist who prescribed Angeliq. It didn't work for me. I became depressed, the pills didn't make any difference to my symptoms, nor to my acne. So again, i quit after 3 months.
I bought some estrogel and after just one week on 2 pumps a day, i felt a lot better. I could finally sleep, no more hot flashes, my mood improved and so did my libido and skin.
When i added utrogestan i felt terrible again. No energy, depression, bad skin, foggy brain. I don't know if i am progesterone-intolerant, but this hormone certainly doesn't agree with me.
I wanted my life back, so i decided to use estrogel without taking utrogestan. I have been feeling great, even after reducing the dose to 1 pump a day. Now my question is, what are the risks involved in taking a low dose of estrogen without progesterone? i am very slim (ex-ballet dancer) work out regularly, and my body type (narrow hips, small breast) suggests i don't store much estrogen.
Thanks for your advice!

[dazned]

Hi if you still have your uterous you MUST have progesterone !
It protects the lining by opposing the estrogen if you dont have it you run the risk of endometriosis cancers! Your weight doesnt bear any relevance to taking progesterone or not. If you have had hysterectomy THEN it is ok to have estrogen only.

[Dancinggirl]

Hi and welcome foreign body
Where do you live? You say you bought some Oestrogel - did you get this with a prescription?
Dazned is right I'm afraid - being ultra slim doesn't mean the oestrogen won't build up in your uterus.
I'm afraid you can't use oestrogen without some progesterone or your womb lining will thicken and this will give rise to erratic and excessive bleeding and a higher possibility of womb cancer. Utrogestan is the most bio identical progesterone you can use but if you are very sensitive then even this can cause problems. You can try doing a longer cycle, so use oestrogen done for 4-6 weeks and then 12 days of utrogestan with the oestrogen so you have fewer bad phases, however at 51 you may not be deep enough into menopause to prevent problems with break through bleeding. It is important to keep the womb lining thin and a withdrawal bleed is essential to do this.
Did you take the Utrogestan continuously or on a sequential basis?
It is likely that the testosterone would have caused the acne - this is a common side effect - but Utrogestan shouldn't really give skin problems. If you are seeing your gynae privately then he/she may let you try using Utrogestan as a half dose of 100mg for 12-14 days on a long cycle(particularly as you are using such a low dose of oestrogen) but they may insist on a scan regularly to make sure your womb isn't thickening too much. You won't get this on the NHS though in you are UK based.
I hope that helps.  DG x
P.S. I'm an ex dancer - now 59 - joints not great!!!!

[Hurdity]

Hi foreign body

 

I agree with the others - you must take progesterone to protect your womb.

I am on a long cycle and this is endorsed by my (NHS) doc although I don't think it's in my notes. They definitely don't send you for scans but of course if you have bleeding problems you are then referred for a scan. However it could be too late at this point because changes may already occur before you get breakthrough bleeding from an over-thickened lining.

I presume from your user-name you're not from UK, as this is a UK site?

Hurdity x

[foreign body]

i live in Hong Kong, where you don't need a prescription. One can get virtually any drug without a prescription.
I took Utrogestan vaginally without suspending Estrogel, but the symptoms were pretty bad. I will schedule a uterus scan every six months, just to keep an eye on the lining. Just to be on the safe side i may resume taking utrogestan for 12 days every 6 weeks. I just dread taking progesterone because it makes me feel like a zombie.
In the past women were treated with estrogen alone in higher doses than what i am taking, that's why i thought i could avoid progesterone. It's true that the risk of developing endometrial cancer was higher on that protocol, but it's also true that by adding progesterone the risk of breast cancer would increase. New studies have shown that estrogen is safe for the breast when it's not combined with progesterone. So, we are at risk of developing two different types of cancer on these two protocols.

I just wonder why my body thrives on estrogen, while some women experience side effects such as weight gain, high blood pressure or headaches. Shouldn't we listen to our bodies? For instance, when i was fertile  i couldn't take the pill because it made me very weepy and killed my libido, while other women tolerated it very well.

I also read that smoking inhibits the absorption of estrogen, so that it's also a variable that should be considered, as i am a smoker. When i take progesterone, my estrogen levels probably drop to almost zero, hence the side effects. That's probably why Angeliq HRT didn't work at all.

I am also convinced that our Body Mass Index is a factor. Women with a higher BMI are more receptive to estrogen than those with a low BMI.
Unfortunately there are very few studies assessing the risk of estrogen-only therapy for the second type of women.

http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A-17.pdf

"In the Million Women Study(Beral et al., 2005), the risk was somewhat lower in women with a BMI of <  25  kg/m2
 than in women with a BMI of 25 kg/m2 or more. In two of the cohort studies (Lacey et al., 2005, 2007), the risk of endometrial cancer increased with duration of use, and decreased with time since last use. The risk remained elevated over that of non-users after 5 or more years since cessation of use in one study (Lacey et al., 2007), and 10 or more in the other (Lacey et al., 2005)."

http://www.cancer.org/cancer/endometrialcancer/detailedguide/endometrial-uterine-cancer-risk-factors
WEIGHT
"Most of a woman's estrogen is produced by her ovaries, but fat tissue can change some other hormones (called androgens) into estrogens. Having more fat tissue can increase a woman's estrogen levels, which increases her endometrial cancer risk. In comparison with women who maintain a healthy weight, endometrial cancer is twice as common in overweight women, and more than three times as common in obese women.

DIET AND EXERCISE
A high-fat diet can increase the risk of several cancers, including endometrial cancer. Because fatty foods are also high-calorie foods, a high-fat diet can lead to obesity, which is a well-known endometrial cancer risk factor. Many scientists think this is the main way in which a high-fat diet raises endometrial cancer risk. Some scientists think that fatty foods may also have a direct effect on estrogen metabolism, which increases endometrial cancer risk.
Physical activity lowers the risk of endometrial cancer. Several studies found that women who exercised more had a lower risk of endometrial cancer, while in one study women who spent more time sitting had a higher risk.

I have always been underweight, i still exercise a lot despite retiring from professional dancing, am a vegetarian. My unusual BMI after the menopause (i still weigh 100 lbs) might explain why progesterone (which opposes estrogen) exacerbates my menopausal symptoms. Could it be that i simply haven't got sufficient estrogen in my body when i take progesterone and that just a small dose of estrogen is enough to make me feel great?

[Dancinggirl]

Hi foreign body - You are correct about the cancer risks but my gynae did point out that using oestrogen alone is likely to result in problematic bleeding sooner or later so it's not just the womb cancer risk one should take into account when using oestrogen without opposing progesterone. I am certainly no expert but I am using one pump of oestrogen per day and 12 days of 100mg Utrogestan a month to induce and bleed and this results in a good bleed which must mean my lining has built up significantly. I doubt your body weight ratio will stop your womb lining from building up.
I strongly suggest you stop smoking as this will increase your risk of all the cancers and certainly reduces the positive effectiveness of oestrogen - it may explain your negative reaction to the Utrogestan as well as this may not be absorbing correctly either.  You do need to take the Utrogestan at bedtime on an empty stomach otherwise this can effect things and could also give more side effects - using it vaginally can work well though.
Why do some women get side effects on HRT and some not? We are all different and it's a trial and error thing finding the right balance.  Good luck  Dg x

[foreign body]

DG, you are right about the risks, it's just that my time on progesterone is hell and i didn't experienced any bleeding, just horrible PMS plus hot flashes. My periods were always very light and only lasted 3 or 4 days before the menopause. My uterine lining didn't get very thick when i tried IVF several years ago and was on a high dose of estrogen. I just wonder how many women developed endometrial cancer when estrogen-only HRT was prescribed in the '60s, '70s and '80s. Now the pendulum has shifted towards estrogen+progesterone but who knows how many women will suffer from breast cancer as a result of progesterone added to modern HRT.
I  know about the impact of smoking but i never managed to quit for more than 3 months. My mum is the same, she is still smoking a pack a day at age 76. She even smokes when she is in bed with flu. We are hopeless hardcore smokers!

[Dancinggirl]

foreign body - We all have to make our own decisions about what our bodies need. Here in the UK we have to go through a doctor for HRT and pay privately if we want to go 'off license'. I do wonder if you are actually absorbing enough oestrogen - have you had blood tests to look at your oestrogen levels recently?  If, because you smoke, you are not absorbing the oestrogen properly then when you add the progesterone this would have a negative effect because there isn't enough oestrogen to balance this.  As I said before, I am no expert so I would really urge you to seek professional advice if you want to continue with oestrogen only - at least have regular scans.  Good luck  DG x

[foreign body]

i am two days into my utrogestan phase and absolutely hate it. When i get up in the morning i feel like an 80 y/o. My muscles are very tight and achy, i try to stretch and realise that my flexibility is gone. I will put up with it for 10 more days but then i am off for a two months holiday and won't take utrogestan while i am away...i don't want to spoil my holiday. When i return to HK i will go for a scan and blood test. My last blood test showed very low levels of testosterone, estrogen and progesterone. That's why my gyno put me on Angeliq, which did nothing for me, except messing up my skin.
I am convinced that the medical establishment is still groping in the dark when it comes to the menopause.

[Dancinggirl]

foreign body - The menopause is still a bit of a mystery because we are all different and how our bodies react to the change in hormone levels will vary greatly.  How each of us react to HRt will also differ and tailoring is really the answer, however, this will still be and trial and error process.
Are you using 200mg or 100mg of Utrogestan with each dose? The side effects you are describing are very unusual - most women just find they feel a little sedated when on Utrogestan and I have to say I actually very good on it - we are all different, so our reactions will be different. I still think it is a lack of oestrogen that may be your problem. If your last blood test showed very low oestrogen with one pump of Oestrogel then I'd increase this to two pumps per day as you may need more because of very low body weight and smoking.  If you are finding one pump per day is enough to keep flushes etc at bay you may get away with doing Utrogstan for 10 days every two months of 100mg Utrogestan and have a light bleed and have scans annually to check that the lining is OK. Angleique is not a good HRT preparation - I tried it and it made me feel awful.  It has the synthetic progesterone which can often bring problems. You might do better with Femoston which has a kinder progesterone - in fact some women choose to have the conti version because they feel better when on the combined oestrogen with progesterone of Femoston!!!!
DG x

[Cassie]

Hi Dancing Girl how long have you been using the 100mg with 1 pump of gel, have you had a check to see how your uterus looks, the lining? I am thinking of reducing my dose down to 1 pump and seeing if can get by, the little extra half really makes a big diff I find, but I guess one can only try and see how one gets along....the great thing about the gel one can adjust accordingly.