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[Hurdity]

Hi there - Yes that may well help a lot! However there is still the progesterone withdrawal which causes a reversal of the physiological changes it effects on the body and this is part of pms (for some women) as well as reduced oestrogen in the normal menstrual cycle. Actually lately I have been minimising it - the withdrawal symptoms (thanks to the 100 mg dose and those confounded little balls!) but spreading the last 200 mg dose over two days to give 2 x 100 mg which makes the withdrawal less abrupt. One the prog has gone I'm fine even with the bleed. I can't say in your case whether this will bring on a slightly earlier bleed ( because you have lowered the prog dose)  but in my case it doesn't because I am on a much lower oestrogen dose than you and have never had a bleed before stopping the prog. Good luck with it all and try not to worry nor expect problems - just go with the flow ( literally) and enjoy Christmas and your birthday

In haste!

Hurdity x

[Spangles]

Hi ladies,
I've only just picked up on this thread.
I use Utrogestan 200 for 12 days, evorel 50 patch. I suffer from anxiety which is high at the moment.
Can any one say what is best hell or patch? I'm interested to know, I get many side effects but I don't know if they are from the oestrogen or the progesterone?
Thanks
Shellb

[Mary G]

Definitely gel for me.   I found patches didn't stick properly, I didn't get anything like enough oestrogen out of them and I didn't like having to wear the thing either.   I also like the flexibility of the gel.   

Why not give it a try.

[Spangles]

Thanks Mary G,
I am thinking about it, just a little concerned about side effects and symptoms changing as I am very sensitive that way. I do get get up of having to scrub off the left over adhesive from the patch and always get red marks where they have been. Can you use the gel as and when needed? What I mean is can you alter the dose accordingly?
Thanks
Shellb
xXx

[Mary G]

I hated those black marks and to be honest, the thought of having to wear a patch on my backside for the rest of my life filled me with horror!

The gel is very dose flexible and it kicks in very quickly when you adjust the dose.   Two pumps of gel is roughly the equivalent of a 50mcg patch.  I split the dose by doing one pump in the morning and one in the evening to keep the level constant.

[nobodysdriving]

Hi all

just wanted to introduce myself in this thread as I have just recently started Oestrogel and Utrogestan!

I am 48 years old, my last period was in September 2016 (so 1 year and 3 months ago), I am hypothyroid with a different type of hypothyroidism from mainstream....I am 'resistant to thyroid hormones at cellular level', so therefore I need very high doses of T3 (liothyronine) and NOT T4 (levo) to keep me healthy.

I have been since 2012 on 180mcg T3 daily, I take this at once when I wake in the morning.

I eat a 'zero carb diet' since 2015 (so over 2 years now, I was paleo before that), so I eat only meat/eggs/cheese.

this diet has been the best 'for me' and I have stable low blood sugars (ie between 3 and 5 mmol/L), have eliminated my carpal tunnel, eliminated food sensitivities, maintain low insulin levels/repaired insulin sensitivity, perfect cholesterol ratios, good vitamin D etc....

I have been on testosterone gel since a year ago, this has helped tremendously with libido, muscle mass, energy levels, I take 10mg daily (so 1/5 of sachet) and this has not given me any negative side effects plus keeps my free testosterone in the top of the normal range for a female.  My 'total' testosterone is high but this is not the one to look at as I have an extremely high SHBG due to my T3 dosage and as you may know a high SHBG inhibits the testosterone and it is the 'free' testosterone circulating which will give you its effects.

Anyway, my Oestrogen has been very low, my latest blood test just at the beginning of December was <18 pmol/L

The only symptom I had from the menopause was VA, I got very suddenly and quickly very dry down below, at first with extreme itching, I thought I had thrush...but was negative for this.

I was reluctant to go on HRT at the time as I had no other symptoms and tried to address the VA more 'naturally'. After some research I found out about 'home made' DHEA vaginal suppositories, so I have been doing these for year...I just melt some coconut oil, then in its melted state I fill in a 'baby bottle teat' with coconut oil, add the powder contents from a 10mg DHEA capsule, mix it with a toothpick into the melted coconut oil (2mls) in the silicone teat, then put it in freezer upright (into a small container) to freeze.  Once I need the suppository I just take it out of freezer, squeeze it out of the silicone teat and it is a small sized suppository which I insert high vaginally as I lie in bed.  This will melt and some will leak out but I lie down for 30 minutes then if I get up and if any more escapes (which normally does) I let it.

At first I was doing these suppositories every day for a week, then went onto 3 times a week and now been maintaining with very irregular 1 to 2 a week suppositories.  This plus using coconut oil as lubricant rather than KY or other things, has worked very well for me.  (oh yes, I tried Replens prior to the coconut oil/DHEA but this gave me the 'toilet tissue remnants syndrome' which was quite 'gross' so stopped it).

Anyway...sorry to keep you.... LOL

I go to see my endocrinologist once a year and I have been having regular DEXA scans in past.  My DEXA has always been in 'osteopenia' range, however my latest this November has gone into outright Osteoporosis, probably because of the menopause (and I am only 48).

So my endo suggested HRT (as I am not in favour for alendronate etc), I said to him 'I'll think about it'..came home and did some research and found out about the Oestrogel/Utrogestan HRT which is bioidentical.  This I don't mind trying I thought to myself....

So I went to my GP and asked him to prescribe it and he said 'sure, I never have prescribed it but if that's what you want no problem' and off I went with a prescription for Oestrogel and Utrogestan.

I started just a week ago on 2 pumps daily and 100 Utro orally every day (continuous as I don't fancy having periods again).

Years ago I was on depoprovera for contraception so as I had no side effects to that I am hoping I will have none on Utro...we will see.

I am due to up my Oestrogel slowly up to 4 pumps per day, there is small limited studies on Oestrogel dosage and treatment of Osteoporosis but what I found was that on the 4 pumps a day regime the improvement in bone density was a little better than on 2 pumps, although the 2 pumps gave a good result too and is a good dosage for osteoporosis treatment.

We agreed with GP that I would go up to 4 a day and that if I ever have any untoward symptoms we would look at reducing it.  The GP is not interested in doing any blood tests but I get them done privately (and I test my free testosterone and SHBG privately) so I will check my oestradiol, testosterone, SHBG and free testosterone at 1 month and 3 months post HRT initiation to see how I am going.  I am also interested to see if the addition of oestrogel will mean I need less testosterone gel but we will see.

so yes...here I am a new 'recruit'

PS I will try vagifem now (GP prescribed it) just because then I don't have to produce home made suppositories anymore LOL

[Sarai]

Hi nobodysdriving, you certainly know your body well and look like you research widely.
I do too for my autoimmune stuff and bone issues.
Well done an endo brave enough to allow hrt as first line treatment.
I have had to battle to get hrt as opposed to bisphosphonates, I have osteopaenia still, well did last year, at 55. But I have fractures.
I interested in the fact that you say oestrogen/utrogestan is bio identical. Do you have the exact names and doses so I can tell my GP as I'm wanting to change.

[nobodysdriving]

Hi nobodysdriving, you certainly know your body well and look like you research widely.
I do too for my autoimmune stuff and bone issues.
Well done an endo brave enough to allow hrt as first line treatment.
I have had to battle to get hrt as opposed to bisphosphonates, I have osteopaenia still, well did last year, at 55. But I have fractures.
I interested in the fact that you say oestrogen/utrogestan is bio identical. Do you have the exact names and doses so I can tell my GP as I'm wanting to change.

Hello Sarai,

thank you for your reply.

when you ask for the 'exact names' do you mean the actual drug names? if it is that you mean then they are indeed 'Oestrogel' and 'Utrogestan'

here are the links to PIL (patient information leaflets):
https://www.medicines.org.uk/emc/medicine/19895#FORM
https://www.medicines.org.uk/emc/product/353

they are not expensive to the NHS so I would imagine your GP will not mind prescribing it, he/she may say like my GP that they are not 'conversant' with it, but still....my GP was not afraid of prescribing it, he was very happy to oblige

the Utrogestan progesterone is 'micronised progesterone' as you will see from the leaflet.

and well done for winning the battle of HRT vs bisphosphonates

[Sarai]

Nobodysdriving thanks it was a hard battle and I don't expect it to end, every dr I see apart from GP who's given wants me on the meds.
Can you tell me if you know is it oestrogen or progesterone that causes anxiety and the big sore boobs?
I'm still with the Evorel conti 50 until I get to the GP but wasn't anxious until I went on the hrt and the boob thing is recent after 8 months on it. Frankly I'm going to struggle to cope the the pregnant boobs for years to come as with my back issues it's very difficult.
I'm just struggling to find information and I never really took any notice over the years f why my body did what it did.
I have to get this right as my hrt plan is long term to keep my bones at least at the level they are which is osteopaenia.
Thanks for reading.

[aspie65]

I haven't read all 88 pages of this thread so I apologise if this has been covered.  Today I stumbled across a really useful website which covers the issues of gel application.  It answered a lot of my questions and I hope it can help someone else.

http://surmeno.blogspot.co.uk/search/label/gel

[Hurdity]

Hi aspie65

Thanks for this link - very helpful! I'm sure lots of women who use gel and have questions about it will find this useful.

Hurdity x

[foreign body]

i have been on utrogestan/estrogel for 3 years, two pumps of estrogel, tried different doses of utrogestan because of side effects and settled for 10 days of 100mg (vaginally), which is enough to bring about some light bleeding and keep my womb lining within the safe limit.
All is relatively well, no vaginal dryness, no insomnia, no hot flushes,  just some constipation and low mood. BUT in the last 6 months i noticed that my hair is thinning, i lose a lot more hair than i ever did, and my skin is also thinning, getting very dry, losing elasticity, i can see new wrinkles around my eyes. My eyes are also extremely dry and need to use eye drops.
Of course, this is part of the natural process of aging, but i wonder if hair and skin could be improved by adding more estrogen.
Has anybody noticed positive changes by increasing estrogel?

[Mary G]

foreign body, it could be that your own oestrogen levels have dropped further or bottomed out and you need more oestrogen now.  The symptoms you mention do suggest low oestrogen. 

It would be worth having a blood test to see how much oestrogen you are absorbing.  I suspect your levels might be low if you are only getting a light bleed on 2 pumps of gel but I might be wrong of course. 

Getting the right dose of oestrogen is difficult and for a long time I found myself in a kind of halfway house where I was relieving most of the symptoms but not firing on all cylinders and not feeling as good as I should.  You might find that 1 more pump of gel makes a real difference.

[Hurdity]

Hi foreign body - the thing is it is not realistic for us to maintain the same levels of oestrogen we have during our fertile years so once post-menopausal, if we still have a uterus - then it's a question of balancing trying to have as high level of oestrogen as we can to feel good - but not too high so that we need to take more prog. Therein lies the dilemma we all face. Two years or so post-menopause our endogenous (internal) oestrogen levels should have stabilised so we rely on exogenous sources ( from HRT) - but I'm not sure this will be sufficient to prevent those changes you mention ie loss of hair, skin elasticity etc. There is also the problem of testosterone deficiency and tesosterone levels do play an important role in our hair - but I don't understand this fully (if anyone does?).   Ditto thyroid function - had an effect on hair and skin (but there would be other symptoms if thyroid function was declining - weight gain, feeling cold, fatigue). Testosterone levels also can affect mood. So it's not that simple really! I don't think testing oestrogen levels will necessarily help because of all these other factors. However by all means consider increasing the gel with the OK from your doc - but this may also mean a higher dose of prog - as the downside! Sorry if this sounds gloomy!

Hurdity  x

[Kkay]

Hello Nobodysdriving,

Thank you for such an informative post.

In addition to early menopause 12 years ago I am hypothyroid and have been struggling with getting my replacement levels somewhere where I feel good. You wrote that you are resistant to Thyroid hormone at the cellular level - if you don't mind, could you explain how you or your endocrinologist figured that out ? I am on Thyroxine 100mcg and think I should be feeling a lot better than I am . I am very interested in exploring T3 replacement rather than T4, so would be grateful for any advice you may have re all of this.

I'm also on 2.5 puffs of Estodose daily.

Thanks !

 

kkay