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[Chi chi]

Hi everyone,
I'm new here and also new to the world of Bio identical hormone therapy.
Ever since having my first daughter 20yrs ago my mood became low, confidence went as did libido, its like I became a shell of my former self. Dr said I had post natal depression so prescribed AD's, CBT all that lovely stuff! None of it really worked and I just "got on with things"
Had my 2nd daughter 6yrs later and didn't really suffer any PND.
Periods have always been as regular as clockwork, never heavy or problematic and I actually used to think I was lucky compared to some women. I have always been on the combined pill since I hit approx 34ish I was the told I couldn't remain on it because of smoking and was offered the mirena or mini pill.
I decided to go for the mirena as I knew people that were on it and thought it was ok, we'll I suffered for most of the year that I was on it, seems I constantly bled and couldn't wait to get it removed! I then went onto the mini pill and periods stopped altogether, I thought this was great!
After being on this for approx a year I became very irritable, snappy and moody and just felt I couldn't cope, with anything! Libido has never improved since having children which of course has caused its own problems with hubby! I put the change in me down to having a teenage daughter that was, lets just say causing problems and a lot of upset! For the whole family ( got in with a boy that we didn't approve of that lived a train journey away )!!
Nearly 3 yrs ago I had a breakdown and couldn't really function at all, it was the most scariest thing ive ever experienced! i truly thought i was going mad and id be taken away into some kind if hospital! my life has never been the same since! I now have awful anxiety that it will happen again and just can't seem to shake off what happened to me. I was again given more AD's! My Dr said that I've had most if not all AD's now and didn't really offer any other help. I decided to pay for private counselling, therapy, hypnotherapy, EMDR and even acupuncture! None of it really helped!
I kept asking my Dr to test for other things that could be causing me to feel that way but he was always reluctant and told me "it's all in my head"!! I knew it wasn't!!
I looked into other possibilities and had a private saliva test for cortisol, DHEA which showed my cortisol was 40.4 the range was 21-41, my DHEA was 0.03 and the range for that was 0.4-1.47 this rang alarm bells for me so off I went to Dr again to show him, he told me he was out of his depth and referred me to an endo, the appt took ages to come through and was months away!
Me and hubby decided to go private and went to see a hormone specialist in London ( not sure if I can say who )?? Anyway after speaking with him he said it sounds like I'm progesterone intolerant!! I had taken myself off the mini pill 6 weeks prior to this and had felt somewhat better, not much though. I started my period on the morning of the appt! I had blood tests and a bone density scan which showed I am osteopenic in one of my hips. My hormone tests revealed my Oestradiol was 125 pmol/L, testosterone was 0.4 nmol/L ( range 0- 1.8 ) and my Vit D was 41 nmol/L (range 50-200) this has always been low as well as my folate neither of which my Dr was concerned about??
I was prescribed Oestrogel 3 pumps a day, testim ( a tube to last a week ) Utrogestan 100mg to be taken for 7 days at the start of each month and Vit D and was told that I would start to see an improvement soon! It took approx 2 months but I was feeling so much better!! Better mood, optimistic outlook, libido came back in leaps and bounds and just felt good! Friends and family had also noticed I was different and happier. By now I had increased my Oestrogel to 4 pumps a day.
It was now time to take the Utrogestan, 2 days into it I became tired, miserable, snappy and anxious, my mood started to go down and my libido was starting to disappear again ( this was 1 sep this year) I continued with the seven days but things haven't really improved and feel like I'm back to square one. We went for my follow up appt in London on 11 sep, I told him how I had felt and things had improved dramatically until taking the Utrogestan! He said that's because I'm progesterone intolerant but I must take it unless i want to go back on the mirena or consider a hystorectamy and remove the need for progesterone, he said utrogestan is very mild and to carry on with treatment. More blood tests revealed my levels had improved, my oestradiol was now 1001, testosterone is 8.3 and vit D is 41.
I am now to reduce my testosterone to make a tube last 2 weeks and he has increased my Utrogestan to take for 10 days but said if I get really bad that I can go back down to 7.
My libido hasn't returned and I still feel quite down, anxious and snappy and feel like im back where i started! I'm wondering if this is because of my testosterone level being high (I think)?? Or if its because of the Utrogestan?? I'm dreading having to take it at the beginning of October and just feel sad that I felt so good until taking it and want to be back where I was.  I would consider having my "bits" removed but how can I be sure its the progesterone causing all this?? Could it just be that my testosterone is too high?? I've also noticed that my tummy is bigger than normal even though I've only put on 1 pound since starting treatment and that I need to use lots of deodorant!! 

I've waffled for far too long here lol but thank you for taking the time to read it and I hope someone can offer some help or advice or even just put my mind at rest?

Thanks
Estelle 

[Chi chi]

Sorry another question  how do I know where I am in my cycle now?? I haven't really had a period except a tiny amount only when i wiped last Saturday (13th sep ) since then nothing but tiny bits of what looks like brown broken clots again only when wiped ( sorry too much info I know )  but I haven't had to use or wear anything. My stomach looks huge and bloated and this morning I have a slight pain on one side ( maybe an ovary)??
This is all so confusing?? 

[Dancinggirl]

Hi and welcome to MM estelle
You are in the right place to get support. You have explained your hormone story really well and that helps us all to help you.
Hopefully a lady posts under the name 'Hurdity' will be along soon as she is the expert on here about Utrogestan and she will hopefully answer your questions.
It sounds to me as though you are getting some very good help and advice - Utrogestan is the kindest form of progesterone but, like all progesterones, can bring some side effects.
Do read up all the info under the headings to the left of this screen as this site was set up by Dr Currie who is a gynae so the facts are clear and easy to understand.
I would also suggest you look at Prof. Studds website as he explains about the use of hormones in the treatment of all kinds of things - including PND, PMT and meno symptoms.

To try and answer your question about your bleeding - You are using a high amount of Oestrogel (3-4 pumps per day is quite a lot) and I suspect the 7 days of Utrogestan 100mg may not have been enough to make your uterus shed properly.  If you used one to two pumps per day then 7 days of Utrogestan may be enough. Hopefully Hurdity will offer more clarity about this. When using utrogestan sequentially, as you are, I believe the dose is usually 200mg for 10-12 days per month.  This would explain why your doctor has increased the number of days you take the Utrogestan.  I would question whether you are using too much Oestrogel - sometimes less is more. I used oestrogel for years and never used more than one and a half pumps per day - we are all different but I would have thought starting on a slightly lower dose would have been sensible. 
You don't say how old you are now? Have you given up smoking?
I hope that helps a bit.  I hope Hurdity picks up this thread soon.
Keep positing  DG x

[Chi chi]

Hi Dancinggirl and thank you for replying    I've just turned 40 and its actually Prof Studd who is treating me    unfortunately I haven't managed to pack up the smoking.
He didn't say to reduce the estrogen so I presume he's happy with that??


It's just all so confusing and I have lots of questions going round an round in my head like


Is it the Utrogestan or too much testim??
Am I peri??
What happens to our cycles, do we still have them while on hormones??
How to know where I am in my cycle??
What do my hormone levels mean?? Are they too low/too high??


Oh to be a woman!! 

I forgot to mention I also have bladder problems, always on the toilet and having to get up 2/3 times a night 

[Dancinggirl]

Hi Estelle
Prof. Studd has a done a lot of research on the effect of hormones and if you haven't read his website I strongly recommend you do as it may answer some of your questions. He has obviously deemed you well into peri menopause but your own hormones may well be kicking in now and again which causes fluctuations.  I wouldn't worry about trying to understand your blood test results. There is a good chance your periods may well have stopped altogether though through the peri stage the periods can stop and start for years - so I wouldn't worry about where you are in a cycle because the HRT will probably be controlling things.
You are having a premature menopause - I was peri menopausal from my mid 30s - so I can understand this is all rather baffling and a bit frightening.  You do need the HRT to prevent oestrogen deficiency till at least 50 - HRT will protect your heart and bones.
Though Prof. Studd is undoubtably a brilliant man and is leading the way in the use of HRT treatment, I have heard through this site that he is not that good at listening to his patients but just tends to hand out the regime he deems correct and expects you to get on with it. Does he have an assistant or nurse you can call for advice and support?
You may have been oestrogen deficient for some time and therefore your body will take time to adjust and welcome the hormones and slowly bring you back to some from of normality. When our hormones are out of balance you mustn't underestimate the effect it has on our health and mental wellbeing.
Bladder problems are another menopausal symptom and hopefully the HRT will help this as well.
I'm sure Studd will keep an eye on your uterus to check it is not getting too thick but I would definitely mention the bloating when you next see him.  PErhaps write down your worries and questions and also keep a diary so you can present these to him next time.
I think you should just follow his regime precisely and see if things settle down.

I do think it is important you give up smoking - I think you would be astonished how much better you will feel if you do. I believe smoking can reduce the effectiveness of HRT.   To help your bladder I would stick to water for a few days - make sure you drink enough - about 1.5 litres per day - and avoid caffeine and alcohol until things settle.
Keep us posted about your progress.   DG xxxx

[Chi chi]

Hi again,
Sorry if this is a daft question?? But what makes you say i am in fact in early menopause?? How do we know if we are or not? I think I'm still having periods?? I bled after coming off the mini pill ( 6 weeks after ) but was very light? Could that have been just a withdrawl bleed?? And now the HRT will stop the periods as I understand it so how will I know if I'm still having them or not??

I know what you mean about Studd, he does appear quite stern and I wouldn't like to cross him lol but I do trust his advice. I do feel things haven't really been explained to me and this is why I have so many questions I suppose??

You mentioned you heard through his site? How do you mean? I've read and re read his site but it all seems to go right over my head  I don't know where I am in all of it or how far along I am?

I've read that some women take Utrogestan vaginally to minimise side effects so I'm going to ask Studd if I can try it that way. I didn't realise bladder problems are or can be linked to the menopause, I've had problems for years and have been diagnosed as having irritable bladder syndrome, strangely though it seems to have gotten worse since starting the hormones?? Especially the urge and not being able to hold it 

Thanks again 

[Dancinggirl]

Hi Estelle
Prof Studd has diagnosed you as menopausal, probably from a combination of your recent medical history and the results of the blood tests.  Your oestrogen level was very low which at 40 would indicate premature(or early) menopause.  I can understand that you want to know as much as possible but once you become menopausal there is no going back and whether you are still in the peri menopausal stage or not doesn't matter.  The slight bleed after coming off the mini pill may have been just a brief spike in your own hormones or a bit of withdrawal bleed. What Studd is trying to do is stabilise your hormones so you feel physically and mentally better. He is also trying to protect your heart and bones from long term damage.
Yes, some women use Utrogestan vaginally but they tend to report that it aggravates the bladder so if you are having bladder problems already this may not work well for you.
You could ask your GP to be referred to a clinic that specialises in bladder problems as they can give some good advice and support to help with this. Do you do your pelvic floor exercises regularly?
Some women do need ADs alongside HRT to help with anxiety etc. but it is very early days with your HRT treatment and you need to be patient.
The progesterone part of HRT is often the 'fly in the ointment' for many of us - again, you need to give this time as you may find this stage gets easier as your body adjusts.
Are you sleeping better on the HRT? 
DG x

[Chi chi]

I know it sounds stupid but I'm almost glad, at least there's an explanation to everything now! It's not that I'm upset or can't come to terms with it, I'm just glad there's a reason I'm feeling like I do!

My sleeping has become worse over the last few weeks, takes ages for me to drift off then having to get up 2/3 times a night is a real pain in the ****! I'm used to having to get up but normally I'm out like a light when my head touches that pillow.

Something else I've noticed is that I haven't felt as cold as I usually do, I know the weathers been warm but I've been wearing shorts as my pj bottoms don't think I've ever done this for this long??

Thanks again, I can see I'm going to be spending lots of time on here! 

[Dancinggirl]

Having experienced an early menopause as you are experiencing, I know what you mean.  It is a relief to know that there is this underlying problem that is causing all the emotional and physical symptoms and that there is something that can be done to help it. What I will say to you is, don't expect the HRT to solve everything because it does brings some compromises.  The comprise for you (and it was for me) is the thorny issue around progesterone. I always had issues with progesterone so I felt this was something I just had to cope with.  I think if you can mentally prepare yourself for how you feel when you use it  and come to terms with that stage in the cycle then things will be easier.  Have you tried Mindful Meditation? I use this to help me cope with my meno symptoms now I'm off HRT - I was very sceptical about this but my GP recommended 'Mindfulness' - and I have to say it has helped.
http://www.amazon.co.uk/Mindfulness-practical-guide-finding-frantic/dp/074995308X/ref=sr_1_1's=books&ie=UTF8&qid=1411207628&sr=1-1&keywords=mindfulness.
You may eventually be able to go on a regime where you use progesterone every 6-8 weeks (so wider gap in the cycle)  - you may have to wait a few years before doing this - although I think you would have to reduce the level of oestrogen you use so the build up of the lining of your uterus isn't too much.
Keep going - you are doing the right things. Go and see your GP about the bladder issue - I have nocturia (i get up 2-4 times a night to pee) but there are clinics that help with this.
Please, please, try to stop smoking as you may find your meno symptoms are less and if you don't smoke you will be allowed to continue with HRT for longer. I know giving up smoking is very tough but, again, you can get help from the NHS on this.
Good luck  Dg xxxx

[Chi chi]

Hiya, thanks for the link, I'm going to get the kindle version and have a read 

I would love to give up the smoking, managed to do it for 3 months with the use of an ecig, then the breakdown happened and I caved in and started again! I thought at the time it was because I'd given up smoking as it just happened out the blue, no warning except I'd been feeling really agitated, no patience and just running on empty plus all the crap with my eldest  I wonder know if it was a build up of progesterone in my system?? Hopefully when I get settled on my treatment I'll feel in a better mindset to try again? I want to get off the AD's too but again don't want to add fuel to the fire just yet!

Thanks again, you've been a real help 

Ps do you know how to stay logged on? I've signed in and put log on "forever" but I still need to keep logging in??

[Dancinggirl]

I seem to stay logged in - don't know how I did it though!!!!
As long as you can still get logged in - that's the main thing.
Perhaps do another thread to get advice about that?
I agree, giving up smoking needs to be at a time you can deal with it. As for ADs - i think many women need ADs alongside HRT and the combination keeps them in balance so I wouldn't be in a hurry to stops ADs yet.
Good luck   DG x

[Chi chi]

Think I've sorted it now 

Sorry another question  I started a bleed last night/this morning? What's that all about?? It's been 3 weeks since I started Utrogestan and 2 since I stopped (started on 1st sep for 7 days so took the last one on 7th) I was told to expect a bleed around the 10th, I bled very lightly for 1 night on 13th and nothing since except a tiny tiny bit of spotting only when wiping for a few days, then this last night and today???
I have felt particularly anxious, dizzy/foggy headed and quite low in mood for the last week or so could this be why??

Sorry for all the questions  I'm just trying to understand and make some sense of it all 

Thanks again you've been a great help  X
P.s. I'm keeping a diary of everything that happens and how I feel so I can look back and compare each month 

[Dancinggirl]

Estelle
I'm not an expert but this could be your own hormones kicking a bit (through peri meno this happens) but I would contact Studd's secretary to ask him for advice.  You are paying privately and one of the advantages should be about getting more support and advice. You are using quite a high amount of oestrogen and a very small amount of progesterone but Studd is truly one of the top specialists in this field so I think you need to 'go with the flow'. I really wouldn't worry too much at this stage but I assume you are going back to see him soon?  It's good you are keeping a diary so you can give a clear account of your experiences on this regime. DG x 

[Chi chi]

Thanks, again!! 
Yes my next appt isn't for another 6 months, I understand what your saying about paying privately but I feel silly keep ringing them, if it was anyone else I'd be telling them "your paying for this service, don't be scared to ask questions "!!
I've emailed him before but he takes a while to respond 
Me and hubby are going to draft an email to him outlining all my questions and concerns about the treatment and possible hysterectomy?? I realise its a drastic decision so need to be sure if I decide to its for all the right reasons!

Hubby actually suggested telling Studd that I want to try a month or so without the prog to see if my mood etc improves, that way we'll know if it is the prog causing the drop in mood/libido etc??

Anyway thanks again  X

[Dancinggirl]

Unfortunately I doubt you would be allowed to go that long without progesterone on such a high dose of oestrogen as the uterus lining would build up too much which is not good.
I do think it is a good idea to draft a clear email to Studd including a summary of your side effects and your questions. Your last blood test did show quite a high level of oestrogen  (was it over 1000? ) and I would question whether you should now slightly reduce the dose of Oestrogel now your body has built the level up? I personally found that if I took too much oestrogen it made me quite dizzy and agitated when I was peri meno.  WE are all different so I can only speak from personal experience.
You could start another thread to ask other ladies about the option of having hysterectomy - many on here have had hysterectomies so will be able to advice better than I can - I have to say if it had been offered one in my late 40s then I would probably have jumped at it but I wouldn't have got it on the NHS as there weren't any real medical reasons.
Keep us posted.   Dg