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[CACEY]

Thought I would give quick update re above regime. After having mirena removed (due to specialist thinking I needed more progesterone) I have been on this new regime for the past 4 weeks, not sure if I need more oestrogen, as have constant one sided headache, joint pain, hot flushes at night are the worst they have ever been... Whilst the anxiety has now disappeared, thank god, also I am noticing that I am getting lots of hot moments throughout the day. Also my mood is kinda flat. I have another appointment with specialist tomorrow, but would really appreciate any advice as not sure if I am able to top up with oestrogel, or if indeed it is lack of oestrogen. So tired of trying to find the right balance, it has been going on now for the past five years.. I would stop HRT all together, but am too scared of going back to that dark place I was before.. Cacey x

[Dancinggirl]

You might do well on Oestrogel with Utrogestan - I've recently started this on a sequential basis but I'm feeling really good when I use the two combined so I may start it continuously. DG x

[Sunnydays]

Hi Cacey, not sure if I'm being much help, but I tried Fem Seven conti and made my own decision to stop it after 6 weeks as the head ache became excruciating. I have been off hrt for about 4/5 weeks so I might have a bit of estrogen still left in my system but I feel in a very good place at the moment. I am going to try a conti ultra low dose and am holding off to see how I feel. This morning's news report highlighting the risks of clots and strokes is not helping my decision (why do they report it, when they clearly don't provide all the detail although do state that the increased risks are not high)
Lots of the ladies take the regime mentioned by dancing girl and have success.
Good luck

[Hurdity]

Hi there

The problem with any continuous combined HRT is that you have to have progestogens all the time and these can give rise to constant low grade side effects (or even greater ones!) in women who are sensitive, or intolerant.

CACEY - I find it strange to remove the Mirena to give extra progestogen because my understanding is that this gives a high dose of progestogen directly to the uterus (continuously) and because of this can even stop periods in women with a cycle. Howevere it is only licensed for use as HRT progestogen for 4 years so maybe works less well - depending on how long you've had it in.

Are you just on the Femoston conti and did you change from Estrogel ( I think you did from what I remember?). Depending on your dose of Estrogel your body will have to acclimatise to this new way of getting oestrogen, from a tablet and it could well be that you are absorbing less oestrogen than you did before. Your symptoms certianly do sound like the oestrogen dip, but you won't be allowed more oestrogen without progestogen I doubt due to needing to keep the uterus lining thin.

I would suggest your headache could either be due to the continuous progestogen or the oestrogen dip, or maybe even a bit of both, depending on when the symptoms became noticeable.

I wonder why a new Mirena wasn't suggested? Did you have heavy bleeding while still on it even after 9 months, even before it had "run out" of progestogen? I can't remember how old you are and where in meno ie whether you're post - if indeed you know!!

Hurdity x

[CACEY]

Hi Hurdity

I am currently on femseven Conti Patch. Prior to this I had the mirena Coil in for 18 months alongside Estradot 50 Patches. For the first twelve weeks of having the mirena inserted I felt fantastic, but over the next year my symptoms started increasing again, no two days were the same, my body constantly kept crashing from feeling normal for about a week to severe symptoms. I tried upping/ decreasing estradot patch, but this had no bearing on the symptoms.
Whilst I had the mirena I had hardly any bleeding only the occasional spotting. I went to see a specialist who felt that my body needed a higher level of progesterone than the  mirena, hence trialing  me on constant progesterone via the Femseven Conti Patch. Whilst I have had some improvements with mood etc, the night sweats are awful throughout the night, and when I manage to fall asleep  I wake up feeling terrible every morning, joint aches, foggy brain and this constant one sided headache. I have got a box of Testrim gel in the cupboard and wonder if this would help with the symptoms (although reluctant to try, in case I feel worse) I am hoping the specialist will be able to throw some light on this when I see him tomorrow.
I am 51 and have been having symptoms for six years, so I am hoping that I am nearly at the end of peri 

[Sunnydays]

Hi Cacey
I wondered how you were getting on with femseven? As mentioned before I stopped for all the reasons you're giving. After 6 weeks I have restarted but have cut the patch into a quarter and will build up as needed. SD

[CACEY]

Hi Sunnydays
Still struggling to find the right mix, constant headache still there, just been diagnosed with sinus infection, although day 5 of antibiotics and no change. Had results of bloods last week and oestrogen 200 Progesterone 1 and FSH 68. Specialist said levels were all good and that my symptoms were not down to the menopause.... I did try to cut patch in half, but night sweats back, streaming eyes, joint aches and headache is getting worse....So back to the drawing board again.... Cacey x Really hope it works for you on half a patch x

[Sunnydays]

Cacey, I thought I too had a sinus problem, 4 weeks or so into the femseven. I was steaming several times a day - helping a bit but making my skin sore. I have always suffered from catarrh - constant dripping at the back of my throat. I purchased a neti pot - it enables you to do a saline rinse. I have used this before years ago; I recall a GP telling me that when there's so much cataarh in the nose/throat area, it can start to impact on sinuses. They prescribed some sort of nasal spray to use for 6 months but i declined it.  me I must say the neti pot has helped me enormously x

[Hurdity]

Hi CACEY

Are you in UK? That does seem a strange piece of advice from a specialist?

The only indication that you would need extra progesterone while using the Mirena would be from excessive bleeding. As you say you only had the occasional spotting - so to me, your symptoms were either to do with the side effects from the progestogen in the Mirena itself (being absorbed and you body reacting to it), or from insufficient oestrogen.

It also depends where you are in menopause - sorry - I can't remember? If you are still peri-menopausal then even with a constant dose of 50 mcg oestrogen transdermally - your cycle will still break through from time to time if your ovaries are still working, until you are post-menopausal.

You are actually giving yourself more progestogen now systemically by using the Femseven - which is the same type (levonorgestrel).

If you are having night sweats then you do need to increase the oestrogen. Such a pity now to be on a combi patch because this makes it more difficult to increase oestrogen alone as it delivers a constant dose of both hormones. The beauty of the Mirena - if you tolerate the small amount of systemic absorption that occurs - is that you can increase the oestrogen dose until you reach the sweet spot. The fact that you didn't suggests you are still peri-menopausal.

200 pmol/l ( if that was the unit of measurement) is quite low - I think mine are a little over this, but it is still sufficient in my case to keep flushes and sweats at bay. Perhaps it comes a bit unstuck over the week so you are actually getting a bit less than the  50 mcg per day? Also levels are not an indication on their own as to whether a woman experiences symptoms - if you are still getting sweats then this isn't enough for you!

Hope that doesn't sound too rambling!

Hurdity x

[CACEY]

Hi Hurdity, thanks so much for your reply, very helpful, I was very suprised by what the specialist told me, although he also said my night sweats and headaches were nothing to do with the menopause........... He said I would be able to add oestrogel to the mix (patches) as I would be covered sufficiently re progesterone.
My headaches have been none stop and night sweats ramping up every night. I have now applied a dose of gel to see if it eases the head, fingers crossed for the morning.
Not sure if I am still in peri, as have only had occasional spotting over the last year, although since switching from mirena to patch I have had no spotting or any signs of a bleed. I am 51, very slim and struggle to put on weight, I don't think my oestrogen is high as my boobs have all but disappeared (( I am really confused as to what to do next..

[CACEY]

Hi Sunnydays, thanks for your reply, I have got a neti pot, only used it a couple of days, didn't seem to make any difference, maybe I should give it longer. How are you doing re cutting the patch? Due to night sweats I added oestrogel, one blob last night, made no difference, woke up this morning feeling really rough and headache still there. At a loss what to do next..

[Dancinggirl]

Cacey- Headache may be nothing to do with hormones - it could be bad tension across your neck and back due to being tired and/or sinus problems. I get nasty headaches and they don't seem to relate to my hormones. 
Can you get a good massage?  Perhaps do some steaming to if it's sinus. DG x

[peegeetip]

Hi DG,

I sent you a PM btw

I've noticed recently if I forget my HRT till later in the day my head is often thumping.

Could be other things as you say but early in Peri my headaches were terrible.

Since HRT far far fewer.

[Dancinggirl]

Since I went back on HRT I have been getting fewer headaches.  i think mine are mainly to do with sinus issues and my sinuses seem to be less sensitive on HRT - less dried out.  I do carry a lot of tension in my shoulders though and when I'm tired I can feel the shoulders tense and it's difficult to keep them relaxed.  Dg x

BTW peegee - thank you for PMs. xxx

[Sunnydays]

Hi Cacey,
I started on a quarter patch last Thursday. The only thing I've got from it at the moment is a headache that started three days ago - really annoying as by cutting it in quarters it means its an ultra low dose!  It could be down to sinuses though as I have pain behind my eyes, on my eyebrow line and in my cheeks. Blinking sinuses, I never used to have a problem. Back to steaming and u the netti pot to twice a day and see if that helps!

I have just this moment changed the patch and I'm finding it a real problem to do in that I can't take the backing cover off without touching the actual patch with my hand. It's also such a weird shape that the edges don't seem to have stuck this time. aaaagh! any ideas?? I expect I'll have to go up to half a patch but will wait a couple of weeks.
This hrt business is like being stuck between a rock and a hard stone! I wanna be 40 again!