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[GypsyRoseLee]

On my first cycle of Utrogestan there was a 4 day gap between ending the Utro and my withdrawl bleed starting. Plus my mood really crashed when my bleed started and I felt very low & anxious over the next few days until it finished.

After that first cycle of Utro I left a 6.5 week gap before taking Utro again because we were away on holiday and didn't want a withdrawl bleed. My consultant advised me to do this. My consultant also swapped me to a higher 50mg patch.

I started the Utro as soon as we got back off holiday. I felt very low and anxious at first, but then my mood dramatically picked up on day 9. Then my withdrawl bleed arrived early only on day 11(this Tuesday)! Well my bleed has now finished and I still feel really great 

My question is, even though I started my bleed early on day 11 of Utro (Tuesday) do I still count Tuesday as day one of my cycle? Just want to work out when I'll need to start next cycle of Utro this month?

Also, I was wondering why my mood hasn't dipped at all with my withdrawl bleed this time? Is it because I am wearing a higher dose patch? Or is it because I didn't get chance to suffer any withdrawl symptoms from the progesterone because my bleed arrived while still taking it?

[Briony]

Cant help re which day to count as day one (Hurdity's a good one for those sorts of questions, so hopefully she'll be along). What I can say is that in the early days of HRT, your body is taking time to adjust. You will have good days and bad days, good months and bad months. Trouble is, at this stage, so early on,  there is no 'big picture' as you've been taking it for such a short time. Try not to read too much into how you're feeling on a short term basis and wait to see what picture emerges when you've given your body time to adjust. People advised me that three months was the minimum before I'd get a true picture of what HRT could - or could not - do for me (some even said six, and I think I'm in that camp myself).

In my case, I could gradually see that the good days were out numbering the bad days, and that overall, I felt better than the pre HRT/pill days. That said, it's not a cure-all and I still do have bad hours/bad days/ and sometimes even bad months (who doesn't?).  I have also realised that the more estrogen I am taking, the better I feel ... but each time I've taken more, there are initial teething problems.


So good to hear that things are looking up x

[GypsyRoseLee]

Wise words Briony.

I'm hoping that having been on the higher dose for 6 weeks now it's slowly starting to have an effect. Makes me wonder how great I would feel if I was upped to 75mg 

But happy to pootle along for the time being and just see what happens over the next 2-3 months.

[Briony]

I remember that feeling - and even experimented by cutting a 50 patch and adding it to my 50 dose without mentioning it to the doctor. Trouble was, I'd give it about 5 hours, feel no better, then panic and convince myself it was far too much for me (!)

On Qlaira, you take the equivalent of 100mcg patch for most of the time, two days with the equivalent of a 50 patch and two days with the equivalent of 150mcg patch (plus two blanks). (I know you can't make direct pill/patch comparisons, but you see what I mean). With this in mind, I can see that even a 75 mcg would have been doing nothing for me. Looking back, I read far too much into how I felt by the hour/day ... though when it's all new, there's not much else you can do. Patience has never been a strong point of mine! x

[GypsyRoseLee]

I am the LEAST patient person ever, too. I want results as of yesterday 

I didn't realise the concentrations in the Pill were so high. But I can see how that could really be a benefit. If I find over the next couple of months that I am still getting the mood swings and several days at a time of feeling very depressed and anxious then I will almost certainly give the Pill a go.

[Briony]

I could be wrong, but have been told that 10mg of oestrogen in pill form equates to 50 mcg in patch form - though you aren't totally comparing like with like, I know.
I have also been told that the synthetic oestrogen in  ccps is more powerful than the form in HRT  (apart from Qlaira and Zoely, which have bio identical estrogen like HRT).

Really hope your good days continue to be many, but if the odd blip strikes, remember - it's just part of the course (easier said now than when you're in the heat of anxiety, I know!).
x

[Hurdity]

Hi there

Re the Day1 thing. The Day 1-28 are usually in relation to an average 28 day cycle with Day 1 being first day of bleed which should happen a few days after stopping progestogen part of cycle. If you are peri or mess around with your cycle as you did GypsyRoseLee then there is no knowing where you are at all! In other words in peri as your cycles become irregular then sometimes they will override the HRT and breakthrough, and sometiems not. I think it's impossible to try to synchronise!

I am on a long cycle and I don't count days at all. I just work out which 12 days in the cycle I'm going to take the utrogestan, put it in the calendar and that's that - but that's easy if you're post-menopausal. As your cycle gets weaker then the artificial cycle of the HRT will take over.

I have no idea what would be best for you to do in the circumstances! The fact that you stayed on oestrogen only for 1 couple of weeks longer means that your lining will have built up a bit more so may have been ready to start coming away. Alternatively it sounds like your bleed is coming at the right time ie approx 1 month after the last one irrespective of the HRT you have been taking. Therefore as you suggest you could count the bleed as Day 1 again (but finish the course of Utro) but that means you will be taking Utro again soon. No matter though as it will help keep the lining thin especially as you are peri still?

Re the amounts of estradiol in Qlaira and equivalence of patch HRT, as you say Briony it isn't possible to compare exactly, but going by the menu on this site low dose tablet HRT is 1 mg, medium dose would be 2 mg. With patches low dose is 25 mcg medium 50 mcg, high dose is 75 mcg, and 100 mcg is "higher dose" so not quite as you were saying. Low medium and high are very crude approximations because women vary in how much is absorbed but must be given as a rule of thumb for prescribing doctors? So Qlaira is probably not really as high as you have been told - depending on the individual. Yes synthetic oestrogens are much more potent.

Hurdity x

[Briony]

Hi there

Re the Day1 thing. The Day 1-28 are usually in relation to an average 28 day cycle with Day 1 being first day of bleed which should happen a few days after stopping progestogen part of cycle. If you are peri or mess around with your cycle as you did GypsyRoseLee then there is no knowing where you are at all! In other words in peri as your cycles become irregular then sometimes they will override the HRT and breakthrough, and sometiems not. I think it's impossible to try to synchronise!

I am on a long cycle and I don't count days at all. I just work out which 12 days in the cycle I'm going to take the utrogestan, put it in the calendar and that's that - but that's easy if you're post-menopausal. As your cycle gets weaker then the artificial cycle of the HRT will take over.

I have no idea what would be best for you to do in the circumstances! The fact that you stayed on oestrogen only for 1 couple of weeks longer means that your lining will have built up a bit more so may have been ready to start coming away. Alternatively it sounds like your bleed is coming at the right time ie approx 1 month after the last one irrespective of the HRT you have been taking. Therefore as you suggest you could count the bleed as Day 1 again (but finish the course of Utro) but that means you will be taking Utro again soon. No matter though as it will help keep the lining thin especially as you are peri still?

Re the amounts of estradiol in Qlaira and equivalence of patch HRT, as you say Briony it isn't possible to compare exactly, but going by the menu on this site low dose tablet HRT is 1 mg, medium dose would be 2 mg. With patches low dose is 25 mcg medium 50 mcg, high dose is 75 mcg, and 100 mcg is "higher dose" so not quite as you were saying. Low medium and high are very crude approximations because women vary in how much is absorbed but must be given as a rule of thumb for prescribing doctors? So Qlaira is probably not really as high as you have been told - depending on the individual. Yes synthetic oestrogens are much more potent.

Hurdity x

It seems to be one of those things no one agrees on. (Well, one of many!). My GP said 10 mg = 50 mcg patch, which concurs with what Ellie was told (see post Evorel 50). Yet someone else on here was told it was 20mg! I certainly feel like I am on a lot more than when I was on 50/75 mcg patches. The patches never controlled my own hormones whereas - to some extent - the 20/30 mg pills seem to. That said, you really can't compare such different methods of delivery. Trial and error, and what works for the individual, I guess. I can see the appeal of a gel, as you have control of the dose on a day to day basis.