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[Night_Owl]

Just wondering if anybody is on low dose estrogen and taking Utrogestan 3 monthly - due to progesterone intolerance?

At my last meno clinic review appointment, the issue of progesterone intolerance was re-visited and it was agreed that I could trial extending the time of taking Utrogestan (100mg x 12 nights, v-route) from 6 weeks to 12 weeks.

The provisos are:  that I strictly stay on the 12.5 patch (half Estraderm 25) and have an endo scan after Utro withdrawal bleed (don't usually get a bleed, just a slight 'show', but maybe this time) - and a blood test whilst taking Utro (forgot to ask why).

Great and Yipppee I thought - as me and Utro don't get along - however, I'm now 10 weeks along, estrogen only, and quite surprised to find that I'm feeling a lot more ropey than usual - demotivated, ratty, irritable, uncoordinated, very down, masses of hair loss and stomach feels tender/bit bloated - possibly feels like 'estrogen overload', how I felt on too high patch years ago, tricky to work out what is what though.  Makes me realise once again how difficult it is to fine tune HRT - and the role that progesterone plays.

Just wondering if anybody else is on a long cycle - and how your body reacts to this.

With thanks for any comments.


Night_Owl
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[honeybun]

Although some will be along to shoot me down.....I think there are just as many problems with too much oestrogen as too little.

It can as you describe make you feel really ropey....and a raft of other issues.

The thing is...we try to achieve what we had when we were much younger...oh and fertile. The truth of the matter in my mind, is our older bodies do not need the level of hormones that we end up taking in an attempt to mimic our younger selves.

Sorry I can't really help. I'm taking half a conti patch which suits me really well.

I'm sure someone else will be along soon that is much more help than me.


Honeybun
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[dazned]

Hi I'm on a long cycle but I'm on 1mg estrogen which I take ( tablet form so probably only get half that after passing through my system ) for 10weeks then last 12 days use utrogeston vaginally as well. I'm intolerant to progesterone as well but this seems to be working for me now the first cycle I was a bit like you as if I needed the progesterone sooner rather than later,if that makes sense. This time not so bad maybe you just need to adjust to it . Hope things settle soon.

[Night_Owl]

HB - Totally agree re: too much/artificially high estrogen can be problematic, I remember feeling at my worst on 50, 75 then 100 - I've been on the the absolute lowest dose, 12.5 for a long time now.  Any lower and without any, then migraines get much worse.  Clinic said that as this is such a tiny amount (+ Vagifem 10, bi-weekly), extending the time of taking Utro shouldn't be a problem - however, guess one can never tell what the body will do.  On your Conti patch you're not getting any estro accumulation, which is one less worry, wish I could tolerate conti prog.

Dazned - Thanks, useful to know.  For quite a while I've used the Utro, 6 weekly, with hardly any withdrawal bleed - it's a big jump to twice that - so maybe I'll go 10 weeks next time.  I do feel a bit 'packed out' and like I need the prog sooner too.  Still dreading taking the Utro though!  Glad it's working for you, long may it continue.  How often are you required to have endo scans?

I thought on this longer period of estro only, it may help my hair loss, but the opposite seems to have happened.  Hey ho.  Trial and error, all the way.

[Ursula]

This is an interesting thread. Last month I was fine for the 12 days on Utrogestan. This month on the first day I had a very bad migraine attack...

[Night_Owl]

SJ - Thanks, I hope I can cope with the quarterly use, bloating seems to have lessened a bit.  That's good to hear - you're tolerating the Utro better these days and settled on this regime.  Have you experienced any lessening of hair shedding?

Ursula - As with SJ, I've used Utro long term and have had a variety of bad experiences with it too, including migraines (mine returned with a hideous vengence when my periods stopped) which can come on day 3, day 7 or on withdrawal - or when I'm not even on Utro.  Vag route is definitely better/easier on the body.  Most times I'll have a different experience each time I take it, but I know my problem: progesterone intolerance.  I'm wondering if the combination of the increase in your patch and the Utro has been a bit too much for your body to cope with this month, system overload.  I take Utro 100s instead of 200s but that's only permitted because I'm on such a low dose patch. 

A while back I had a very bad, frightening migraine on Cyclogest (another type of pessary progesterone) and rang the meno clinic for advice - they told me to stop for one or two nights, then resume.  If I got ill again, then to see my GP.  When I re-started, I was okay-ish.  I hope you find a way forward.

[Night_Owl]

oh poor you with that awful itching - and in this hot weather.  Guess you've tried all sorts of (non anti-hist) remedies along the way to control it and the allergic reaction, eg. immune boost, probiotics etc etc.  It's interesting (you mentioned previously) without estrogen the urticaria is worse, so it must calm the immune system in some way.

I know I've inherited Androgenic Alopecia from my mum, so it was always going to happen.

Definitely agree stress plays a major role, for sure - right now I'm having a truly terrible time with my (grieving) dad, he has become unbearable - lo and behold - my migraines / hair loss has increased. 

Hair shedding is still difficult to work out isn't it.  I did have quite a few months earlier this year when I stressed but had minimal hair loss and naively thought it was getting better, but then it started up again, hey ho, just the way it is.  Sorry for the dreary post!

[Hurdity]

Hi Night_Owl

As you know I take Utrogestan on a long cycle but I've never tried 3 months because I am on 50 mcg oestrogen patch and the bleed would be too big after this time. My cycle varies from 6-8 weeks and I am trying to go back to two monthly as I was finding 6 weeks too often!

As you know I take it vaginally. There is no pattern as to when I experience side effects and it seems to vary from one cycle to the next. I usually wake up the first morning feeling very groggy and sort of gradually get used to it. Usually I get progessively more foggy-headed as the days wear on (I do 12 days) and sometimes get a migraine - but like you this can happen at any time - at the start of the Utro, half-way through, or on withdrawal, or not at all, or when I'm not on Utro!  My bleed is a proper bleed although not as heavy as my periods were - last about 6 days with the usual tailing off in  the middle and blip at the end. Perhpas a couple of heavy-ish days. I had a small fibroid found 2 years ago so maybe this contributes to slightly heavier bleed. Every time I have the bleed I think I can't stand to be doing this at 62 but also don't relish the alternatives so grin and bear it.

I wouldn't have thought your hair-shedding would have anything to do with the oestrogen or lack of progresterone - in our fertile days high oestrogen was responsible for our thick lustrous hair - and the quality and thickness declines after menopause with low oestrogen. As you say this can be stress-related as well as due to thyroid issues as someone else said.

Interesting that you barely had a bleed on the 6 week cycle - well I know it's an incredibly low dose of oestrogen but I remember a while back the consultant insisted you did this because you had endo thickening even on v low dose? It is good that you have been able to extend your cycle but I agree maybe go to 8 or 9 weeks or something at first (if you can tolerate it) - just so that your lining doesn't suddenly increase! I think it's probably the stress you are under making you feel as you do - it can't be too much oestrogen at that dose unless it is being converted into something else in your body and not working properly. Perhpas the added oestrogen is behaving differently in your body to your own natural oestrogen, even though it is bio-identical? Did you feel well for at least a week of the month during your menstruating years ie 2nd week (before the oestrogen dip and the prog increase?)

You have been through the mill with all of this and so sorry to hear you are still having to experiment but I would persist with the longer cycle. Maybe one day you will be able to slightly increase the oestrogen again without side effects?

I always feel well when I'm on the oestrogen phase and in fact this time I feel well on the utrogestan too - for the first time I would say - but I started testosterone 2 months ago and that might be helping. Have you tried that at all? I can't remember. It might improve your susceptibility to migraines? I'm hoping this will be the case for me.

Hurdity x

[Night_Owl]

Hurdity, Thanks for your thoughts/advice on this - Agree that six weeks Utro use is too often.  I can well imagine that having the heavy bleeds is not ideal, I really couldn't get on with those and I had awful pain too when on higher dose patch - that is why I ended up going right down to 12.5 - and I had more migraines on the higher dose.

Yes, well remembered - a good while ago, I did have endo thickening to 10mm when I re-started on a 12.5 patch (plus Vagifem) after a break of HRT, trying to come off - and had to take two courses of progesterone and have scans.  The clinic were surprised and said it was a strange occurrence with such a low level of estrogen - and that I am a tough case to treat as I'm (ridiculously) super sensitive to any hormonal change.  Also I suspect other undiagnosed endocrine issues.

I hardly have any withdrawal bleed with 6 weekly Utro use - this I like! - I did wonder if the Utro 100s weren't strong enough and not shedding the lining totally, but scans showed it at 4mm - so all okay - hoping that this will be case after the longer gap.

Not sure if I will increase the estrogen as my biochemistry is so unpredictable - and then more estrogen would mean more progesterone and more often usage - and I prefer Utro 100 to 200.  (They still make me feel horrible though!)

It's baffling how each use of Utro can be different, depending on what, I ask myself? - that's good that you've felt well this time - hmm... wonder if it's due to the added testosterone - interesting... have you felt any other benefits of using test?

A while back, I did try testosterone for quite a few months, maybe I didn't persevere for long enough, it just made me more ratty and not much else - to use it now I would be worried about it increasing circulating test and hair loss.

Clinic said estrogen acts like a protective cap and once meno hits, the cap is off and if you inherit susceptibility to Female Pattern Hair Loss, then the ratio of estro to test changes - test converts to dihydrotestosterone (DHT) which damages and miniaturises the hair follicles - however (sadly) adding in extra estro doesn't redress imbalance and stop the hair loss.  DHT is the enemy of hair.  On every blood test my test is very low - still enough to wreck my hair however! 

In spite of all this, I'm now thinking about your suggestion - that maybe I would be better on 25 patch in the future (and Utro 100 if the clinic would allow) ... will I ever settle, I ask myself ...

The 'dad stress' must be contributing, he's just getting worse, more difficult to deal, no solutions - guess I just have to learn to cope with it.


Thanks to All for your thoughts/comments.



Night_Owl
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ps - I always make so many mistakes when I post and have to go back and correct  d'oh!!!  mushy brain.

[Hurdity]

Hi again Night_Owl

Oh it's all so complicated and unpredictable isn't it? I hope you didn't mind my referring back to something I remember you posting a while back?

Also - what a difference a day ( or two) makes. I spoke to soon as developed a migraine - started as slight headache yesterday and feeling bad on and off today - mainly the nausea, tiredness, headache coming and going and foggy head - so must be the utro and unfortunately the Testost hasn't banished them  .  Still reserving judgement on whether it is doing anything or not - sometimes I think it is, sometimes not. As for libido - I'm not commenting here about that! That isn't the main reason for my taking it though.

I don't really understand about the teststerone and the whole issue about ratios but I was aware that we (ie women generally) start getting hairier (lips and chin) and less hairy (falling out of head) after meno because of the increased amount of T relative to oestrogen even though the absolute amount of oestrogen and testosterone ( free T?) has fallen. Just shows what a delicate balance it all is..... the consultant ( Annie Evans) said if you keep added T within physiologial range for women we shouldn't get the male side effects - so presumably that's why it's important to be taking enough oestrogen as well?

Sorry to hear about your Dad - must be so hard for you ( and him).

Take care

Hurdity xx

[GeordieGirl]

 Still reserving judgement on whether it is doing anything or not - sometimes I think it is, sometimes not. As for libido - I'm not commenting here about that!

Oh go on, you know you want to 
Ok, just a quick answer then - does it work?

My libido's probably on the over active side currently but it's good to know just in case. 

GG x

[Night_Owl]

Yes, Hurdity, it is such a fine balancing act all this HRT malarkey isn't it, trial and error every step of the way.

Sorry to hear about your migraine - hope it has passed now - was also thinking that maybe the T would have a 'protective' effect.  I always get neck knots with migraine - last one was on my birthday at the start of the heatwave (wasn't on Utro) just flipping great.

I didn't make it to 12 weeks estro only - started on Utro (100) last night and immediately had an extremely restless night with disturbing, vivid, scary dreams - was hoping that just maybe after the longer gap my body would in some way react less - wishful thinking, hey ho.

I'm intrigued as to whether the T has perked up things for you - maybe you could update us on your private lives thread when you have a mo.

Hope you're feeling better.


Night_Owl
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