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-factorsWEIGHT
"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?