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[julie55]

I'm on two pumps and 100mg vaginal daily

[PMDD]

I have recently changed from Evorel Conti (not absorbing properly!), over to 2 pumps oestrogel and prog 100 vaginally (Also recently diagnosed endo hyperplasia 13/14mm)

With having PMDD I am very hormone change intolerant, and have my pituitary gland 'switched off' with Prostap Injections monthly.

Soo....initially first few doses of oestrogel & progesterone, I actually felt 'normal' the most normal I have felt in years....I was properly excited for the future....and i'm not saying it's turned horrendous, but there are definite changes in my personality over the last few days, and I am seeing my Gyn tomorrow. I can be calm and quiet, or screechy, or even sedated feeling at times too. Generally, though I am losing interest in things I normally enjoy.

What are your thoughts, I feel I am buggered because I have to have a progesterone! I get serious palps without the oestrogel.....or could the oestrogel not be high enough??

My brain just isn't working anymore 

[Zar]

Hi all

I'm new to HRT (since February this year), so this forum has been a godsend to me! As has the HRT for the dramatic improvement in my quality of life! I'm 52.

I started on Evorel Sequi (50) patches but due to shortages have now changed to Oestrogel (2 pumps) and utrogestan (200mg - 2 x 100 mg days 15 to 26). Just started this regime last week. The patches were great but shortly before changing to gel/tablet, I noticed I was getting the odd tiny flush now and then. Since moving to gel/tablet it's been the same. Nothing horrendous and I can live with it (before HRT I was having a severe flush every half an hour - proper sweating ones where I looked like I'd had a bucket of water thrown over my face! Clothes soaking! Had a huge impact on my career as I ended up reducing my working days to 2 days - but that's a whole other story for another forum!). But I wondered if a small flush now and then is a sign that I should up my dose? I also have fuzzy tinnitus. Last night as a trial I put a 3rd pump of gel on before bed - I got a fab sleep and woke up clear headed and rested. Feel great today.

I'm trying to get through to my doctor to ask but it's been engaged all morning. So I wondered if you have any thoughts on this. Can I go up to 3 pumps if I like or is it best to get clearance from the doctor? Also, if I up my oestrogel, do I need to change my utrogestan dose to match?

Thanks for all your support, help and advice.

Ps as a side note: HRT has had such a positive impact on my life, I have lost a stone as I now have the energy to exercise and don't fatigue as easily as I did before! All of my aches and pains have gone! No creaky knees and odd muscular pains! ☺️. Long may it last! x

[Zar]

Update! Got a call from the nurse who said it's ok to go up to 3 pumps. Infact I could go to 4. I may have to as I've had a couple of quite significant flushes today even after taking the 3rd pump 😖😖😖! I?ll see how I get on with 3 for a while first. 

Last question - I've only been on the utrogestan phase for a few days but I feel very bloated. My tummy is bloated. I take the tablets orally so I wondered if going through the vaginal route might help this?  Or is bloating just something that happens with progesterone regardless of the route? If I try the vaginal route do I still take 2 x 100 mg on my usual cycle: days 15 to 25? 

I must apologise for the fact that there are random question marks everywhere 😂! 🤷🏻‍♀️

Thanks for all your support and advice x

[sheila99]

If you take it vaginally it's the same dose and the same capsules. You need to take it just before you go to to bed though - gravity - just push them up as far as you can. Definitely worth trying it this way. I don't get bloating but haven't taken it orally.

[patti]

Hi Zar, I have always taken utrogestan vaginally 100mg last thing at night with 2 pumps of Estrogel as I have Coeliac disease - and the less things that have to pass through my intestines  - the better !
Sometimes I get bloating and always have Stomach cramp the day my bleed starts - sometimes quite bad , but when I had normal periods I always had terrible cramps ( wish I'd had the hysterectomy)
But the pros outweigh the cons - and I wouldn't go back to feeling as awful as I did before the Gel and the utro , stick with it , it took at least 9 months for my bleeding to settle into a pattern ,which is now manageable 

[3isenough]

Wow. Tonight I have estrogel on one thigh, voltarol on another testosterone on my forearms and liothyronine in my mouth... jeez getting older is like a trip to Pizza Hut ice cream factory WITH ALL THE TOPPINGS 

[Hurdity]

Ditto Zar - as sheila99. I've never taken it orally and never had bloating with Utrogestan

Hurdity x

[Zar]

Thanks everyone for your response. I?ll try vaginal tonight then. I feel happy with the Utrogestan other than that. I did always get bloating at that time of the month naturally so it may just be something I need to put up with.

Just another thing to mention - yesterday afternoon I went up to 3 pumps of Estrogel (I took an extra pump) as I'd had a few small flushes. But I didn't like it. The fuzzy tinnitus got stronger and I was conscious of feeling my heartbeat - it was thumping in my head. I wear a Fitbit which reports on your daily resting heartbeat and it's been pretty steady at 56 bpm for a while now (that's resting heartbeat) but when I went to bed last night it had jumped up to 59 as the day's average. While lying on bed relaxing I was conscious of it beating quite fast - up in the 70's even when lying supposedly relaxing - and I could feel and hear it thumping in my head 😖. I'm certain it's to do with the Estrogel so today I'm going back to 2 pumps but I think I?ll call the doctor and ask to go back on the patches as I feel that the estrogen must be released at a more steady rate throughout the day with the patches (not sure if I've just made that up?).

I guess this is all trial and error as you guys on this forum keep saying. I?ll get there eventually - I'm really just fine-tuning and tweaking now!

Thanks again for all your help and words of advice.  x

[sheila99]

Getting the right dose can be trial and error and I agree 3 pumps is too much. When I was trying to sort mine out I increased by half a pump at a time so could try increasing by a bit rather than a whole pump. I find that an advantage with gel but of course you could always cut a bit off a patch too. I started on patches but had to change because of an allergic reaction. I can't say I've noticed any peaks and troughs with gel.

[Zar]

Hey all!

Thanks again for all of your advice. My update is that a quick call to the doctor and pharmacist has resulted in my return to patches. I felt really odd on the gel and I was still getting hot flushes so perhaps wasn't absorbing it well enough. So I'm now on Evorel 50 + utrogestan 200 (2 x 100) on days 15 to 26. I feel I should be on Evorel 75 but they are not in stock so I've put on a 50 Patch plus half of another one to make it up to 75. So far so good today.

The only thing I've noticed is that the utrogestan (Orally) seems to have made my fuzzy tinnitus worse. When I'm busy I don't notice it, but when sitting quietly it's noisy and frustrating and I can hear my heartbeat. I know I should try the vaginal route but have chickened out so far, really because I've read on here that people often go down to 100 mg vaginally as the absorption is better so I'm hesitant to absorb 200 mg vaginally incase it makes me feel worse and also not sure if I should go down to 100 mg so soon. I think I?ll give this routine a chance to settle and then think about vaginally next month if the tinnitus doesn't go away.

Hope you are all well! I really appreciate your input and support! x

[pluto]

Hi Zar,

Because progesterone absorption is so much more efficient when it's taken vaginally, the 100mg dosage for taking Utrogestan vaginally is supposed to be equivalent to the 200mg oral dose. So if you do choose to take 1x100mg capsule vaginally don't worry about going 'down' in dose because you won't actually be reducing how much your body absorbs.

[sheila99]

Not according to the manufacturer who you would have expected to have done sufficient testing to know. The dose is exactly the same whichever way you take it. If you take less it should be done with the agreement of your doc and regular scans to make sure your lining isn't building up. You're at greater risk of cancer if your lining isn't thin so IMO not worth the risk unless you can't cope with the side effects. Many people do take less are are OK but you don't know if you're the one that isn't.

[pluto]

You're absolutely right, sheila99, about taking any dose under appropriate medical supervision.

Zar - Hurdity has just bumped a really useful thread that includes lots of info about different doses and routes of administration for Utrogestan, in case you're interested. Look for "Vaginal progesterone inc Utrogestan, and endometrial protection: some studies"

[Hurdity]

Thanks pluto

Thing is Zar - when taken orally there are large quantities of metabolic by products which are what some women find gives them side effects, whereas taken vaginally much of it goes straight to the uterus where it is needed (hence the lower dosage to give endometrial protection). The progesterone absorbed into the bloodstream through the vagina/cervix does not have to go through the liver so these metabolites are not produced in high quantities.

Although sheila99 is right that the manufacturers give the vaginal route at the same dose as an alternative to oral intake, the research (limited trials) on the thread pluto mentioned here https://www.menopausematters.co.uk/forum/index.php/topic,43633.30.html not carried out by the manufacturers, do show that on average half the dose taken vaginally can be sufficient when compared with oral intake. However as sheila99 says this should only be done under medical supervision so that your womb remains protected.

Ideally initially you would use the licensed dose for a few months and see how your womb reacted, before reducing if eg no bleed - but after consultation with your doctor.

Hurdity x