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[Hurdity]

Hi there Clovie - send me a message with your history in brief as a summary eg dates, treatments, who you've seen what they prescribed, which authority, specialists, what they said (re refusal or agreement to prescribe) etc and I'll see what I can do.

Hurdity x

[Julia Dizzy]

Hi SammieJane, Hurdity,
I'm 10 years post menopause now and only started on HRT last October due to never ending hot flushes/VA. I have been using Vagifem for about 3 years now and have just increased that to every 3rd night, as still having problems with VA around episiotomy scar tissue inside. (Not sure that will ever improve??)
I have been told I am one of the unlucky ones who will probably always have hot flushes. Great!! My gynae consultant Dr at my local BMI The Beaumont hospital (luckily referred by my GP Clovie - hope you get sorted too) started me on 2 pumps Estrogel and 100 utrogestan daily initially as I didn't want a bleed and have been using that. On my 3 month follow up visit when I said the only thing it had helped was hot flushes he suggested I increase my estrogel up to 3 pumps  (2 pumps one day and 3 pumps another day) along with one pump daily of Tostran gel for global anxiety and mood. But my boobs got very sore with this regime so I cut back to 2 pumps and 1 pump Tostran every other day as previously recommended on here.

I went back to see my consultant earlier this month and told him no drastic improvement in overall well being apart from hot flushes gone. I said I had reduced my Estrogel back to 2 pumps and Tostran gel to every other day, as my boobs had got way more burny/painful and he said that amount of Tostran would do no good whatsoever and to continue using it daily. (Boobs had improved slightly by reducing gel and Tostran I felt?)

So I have gone back to 2 pumps Estrogel and 1 pump Tostran every day since last week and now boobs are going burny/painful again. Also my skin where I've been putting the Tostran gel is all flaking off so I'm thinking to just pack it in. He never suggested testing my hormone levels and said to make another appointment for June if I needed to see him, or to cancel if I was ok.

I think I will just stop the whole lot for a few months to see how I get on??? Is this wise??? Its hard to know what to do for the best. He has not suggested any other regime such as Fem7 conti patches as they are still not available.

I have just had an extended period of really bad stress due to moving my 92 year old Mum with Alzheimers out of her home of 50 years into sheltered accommodation and sorting most of it all out myself. My head was bashed!! She has finally settled in and things are quietening down now, but I feel like have been run over by a steam roller! Am taking "Together Stress aid" which has Ashwagandha and Rhodiola in it along with B vits and magnesium also Vit D and echinacea to boost my immune system especially in these extremely worrying times with the Virus.
Hope all you ladies are keeping safe! xx

[Sammiejane]

hi julia dizzy

well i?m on 2 pumps gel 100mg utro and 2 x a week ovestin

been doing ok on this for last 5 weeks but then started getting bad watery discharge and burning in vagina and my mood a little in the low side so i?m wondering if i need an extra pump of gel it's almost as though the progesterone is down regulating the estrogen around vagina and mucosal tissues in mouth and mouth dryer and skin dryer so my GP said try 3 pumps and see if boobs go sore and tender then it's to much estrogen and aniexty and nausea may come to . i don't need progesterone but using it to stabilize the estrogen in regards to mood and help with sleep but if it dosent work then i shall just stop progesterone hopefully now my estrogen levels are good i will be able to add tesosterone due to recent events i've also been doing a lot of crying and feel like progesterone is wearing pelvic floor and urethra and may possibly be given me stress incontinenece so i?ll try more estrogen and see fingers crossed  x

[Ladybt28]

Hi JulieDizzy,
So I am on Utrogestan, oestrgel and tostran and have been on this regime 25 months.

Firstly, I will start with what I know and have learned about tostran.  There is no testosterone designed for women only so we are using a product designed for men.  The dosage of 1 pump a day is the standard dose when it is prescribed to a man for whatever they need testosterone for.  My label on my tostran said 1 pump a day but I have never ever used that much.  I started with half a pump every other day and then went to 1 pump twice a week and now I am down to 1 pump a week.  1 whole pump a day every day sounds like rather a lot to me JulieDizzy, and also the fact your skin is dry and flaking would indicate its too much.  Don't stop just drop the amount you use to 2 pumps a week and see how you go.

Secondly, I was prescribed 2 pumps of gel a day to start but it didnt control anything so I was told to up to 4 pumps.  When I did I got sore boobs and it didnt work immediately.  I got a couple of other side effect I hadnt had before but after 3 weeks these all went and the gel started to control the symptoms.  I was on 4 pumps for 20 months and then my body said that's too high and threw some side effects like itchiness and sore boobs again and so I am down to 2 and everything is fine.

I had been so bad before I got onto this regime that it took more than 3 months to see any effects of it controlling the symptoms.  I took at least 5 months before I felt anything was happening and 7 before I would say I started to feel "better".  I took nearly a whole year before I felt what I would describe as "well".
All the doctors say a minimum of 3 months on a regime but that doesnt mean it works in that time for everyone.  It would have been easy for me to get to 3 months and given up but long story short I didnt have any other options to choose because I had a few different hrts which didnt work at all in any shape or form, so I persevered and I'm glad I did but its up to you JD.  There are couple of other posters on here who have had similar experiences to me whereby they persevered over 3 months and nearer to 5 months before things got better, so it is a very individual thing.  Its hard to work out what's going  when you are starting out and I would say by and large GP's are no help at all.

You need to trust you're own judgement JulieDizzy, the whole thing is trial and error and really hrt is a slow burn and not a quick fix unfortunately. xxx  Dont know if any of this helps 

[Hurdity]

Great advice from Ladybt!

Just need to correct the testosterone info though! I think you are referring to the testogel pump pack which is two pumps per day for men. Tostran is 6 pumps per day for men as each pump delivers a tiny amount. All the info on doses etc iare in this thread as well as links to BMS info of T for women and Chelsea and Westminster leaflet:
https://www.menopausematters.co.uk/forum/index.php/topic,39588.msg666825.html#msg666825

Julia Dizzy - The recommended amount of Tostran is 2 or 3 pumps per week (or less if this suits!).

One pump per day is still too much though - over the (off-licence) recommendations and the doc should not be prescribing higher than these and especially at least if your blood T levels are not being checked which BMS suggest is wise to do. You should insist on blood tests for T and SHBG and refer your consultant to the (off-licence) guidelines, in my humble opinion. Whereas with oestrogen blood tests are not necessary as the advice is to go by symptoms, this is not so for testosterone which is, as Ladybt says, not available as licensed for women and is not our dominant hormone compared with oestrogen. If you can't get an appointment I would reduce Tostran to every other day MAX and tweak your gel dose as Ladybt suggests.

Also like I said before, taking progesterone daily doesn;t do wonders for mood for many women - who cotninue to take it cyclically and endure a bleed however unwelcome that is - since prog is all the time but cyclically only intermittently so you get a prog holiday!

Hurdity x

[Dotty]

Hi the up to date guidance for Tostran is 1 pump every other day, although that still may be too much . I use it 3 or 4 times a week x

[Sammiejane]

hi ladies

so i don't know what is going on i've been on 2 pumps gel and utrogestan daily but have been getting worse va

i upped time 3 pumps gel but following day felt awful to much estrogen so the next night stuck to 2 and used my ovestin as planned then thought following night i?ll use 2.5 which was last night but felt no difference today i thought the adding of utro with gel had also controlled my hair from shedding but today have lost a lot more hair whether this is due to upping and decreasing dose although this was only done over couple days i find the progesterone helping just have dry mouth and discharge watery like va worse so not sure what to do i reply thought i had break through as have been on this 6 weeks but as i don't need progesterone should i take this every other night or would this likely induce further shedding of hair also can't take gel on its own because i know this does cause shedding for me. x

[Julia Dizzy]

Thank you all for your kind words ladies and very helpful comments.... I decided to stop everything at the beginning of this week rightly or wrongly.... I will see how it goes and how I am feeling and I can always start again later on, or will that not work?? Will it undo the possible good I have done by taking it all for 5 months?? If the hot flushes come back then I will have to try again, because they are my worst symptom and don't want to have to put up with them. I don't get why the consultant said to use one pump Tostran every day then if it is too much?? Oh the confusion ??!! xx

[Ladybt28]

You may well undo you're hard work over the last 5 months when just bit of tweaking would bring things into line but obviously we are all different.  You can only try, but stopping and starting in my experience is not a good thing.

Lots of consultants don't know what they are talking about regarding testosterone and some arn't much more help with hrt either but 1 pump every day is absolutely too much and most of the ladies on here are agreed. x

[tbett]

I have asked a question on this thread before. I am 45 years old, had irreg periods for ten years, about every 3-11 months, then started with hot flushes, VA and anxiety about a year ago. A DEXA scan showed osteoporosis so I was started on Utrogestan 200mg day 14-25 and 2 pumps estrogel. I have noticed the progesterone makes me feel quite low in mood and then anxious, also exhausted. I read on here about taking it vaginally so spoke to the HRT nurse at our local clinic. As that is off licence she wasnt happy to do that so suggested increasing the oestrogen to three pumps. Over the last nine months I have had no period despite being on a cyclical regime. I saw a consultant endocrinologist about the osteoporosis who was happy with me to experiment with the progesterone, though admitted she didnt know much about it. She did say that some progesterones are more androgenic than  others (I also have very low libido constantly and small joint aches during the oestrogen only phase of my cycle). I have had oestrogen levels checked twice (they are about 5000!!). When not taking progesterone i tend to wake between 4 and 5.
I changed to taking the progesterone vaginally for the last cycle and have just had a painful heavy bleed day 2-7. I dont mind having a bleed, and my mood was slightly better with the vaginal progesterone.
My question is should I reduce the dose of the utro vaginally? My testosterone levels are fine. I know it is all just finetuning and I am willing to do that, just need some ideas. My GP has admitted I know more than her (info from this forum!), and I think the HRT nurse wasnt really sure what was going on. she may refer me to the local HRT consultant Mr Hillard, or I could see him privately. I also thought i might drop the oestrogen back to 2.5 or 2 pumps, though the endocrinologist said the estrogel can have variable absorption.
Any ideas appreciated!

[KBallinger]

Hi TBett

Not sure it helps ,but the only thing I can comment on is your levels of 5000.

When I changed my estrodot patches as I couldn't get them I felt awful. I assumed I was not absorbing and my levels were low. I had a blood test and I was at 4000. My gynaecologist explained at that level it was as if I had 0 oestrogen as the receptors switch off when levels go too high.

No explanation why my levels went so high after relatively stable levels of 800 for a while, other than I was holding onto and storing the oestrogen maybe due to different fillers. X

[tbett]

Thanks that is really helpful. I will fiddle with it. Anyone ideas about progesterone pv dose?

[SueK]

Hi everyone, I've just joined and would love any advice available !

I was on Femoston Continual for a few months but was having regular short cycle periods (normal for me) which were very crampy and painful often beginning with a migraine couple of days beforehand. Previously to this I had been off HRT for 4 months but couldn't cope with the hot flushes and mood swings.  The doctor said I would have one or two periods but that would be all.  Since coming off of Femoston cont I've read that I should have been 12months clear of a period and well into menopause before being put on them and I was only 4 months clear.  So I wonder if my body wasn't ready for this type of HRT.

Anyway I went back to the doctors 2 weeks ago to change HRT because of the periods and I'm due to start a new job.  She put me on utrogestan/estrogel but then said she wanted to refer me to the 'Cancer Exclusion Clinic' to have ultrasound scan and see a Gynaecologist because I had been having periods and I was 56.  I wasn't expecting to hear this and did swallow a bit  hard !!  That word hadn't been in my head at all !!  So I have an appointment booked.

I've decided to come off the HRT altogether as I've no idea where my body is at naturally.  I was only on it for 6 days (mistakenly putting 1 pump of gel on each arm !! )  and the came off.  Three days later I am having another period, I've taken it that its because I've messed about with my hormones but .... I'm worried sick 

Does anyone have any experience of coming off this HRT? 

[Julia Dizzy]

Hi, can any one tell me what the symptoms of Utrogestan intolerance are? Also where is the best place to apply for absorption of Estrogel? Thanks xx

[Hurdity]

Those who get side effects from utrogestan report fatigue, headaches, low mood, foggy head or depression mainly. Some report bloating, breast pain and other symptoms. They can be worse if taken orally although I get head fog, even more fatigue than usual, and sometimes migraines even when used vaginally although I take it cyclically.

I would have a look through this thread to find out where members apply the gel - but it is very much an individual thing probably and whatever is convenient and also depending which time of day you apply it too maybe? I only used Sandrena briefly and applied to inner thighs. It didn't suit me though as I porefer patches. Hopefully someone else might be able to help

Hurdity x