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[rachthemidwife]

Hi. This is my first post after lurking for a while and I could really do with some advice. I started HRT in the peri-menopause and took Elleste Duet until about 3 years ago. Then my symptoms came back and I went to a menopause clinic and was started on Tibolone which helped a little but not much. So I took Femostan Conti (0.5/2.5) which was pretty good for about a year. Then I started getting terrible daytime tiredness and just felt like I had permanent PMS so went back to the Menopause clinic. I started on my new regime 3 weeks ago - Vagifem (amazingly good!), Sandrena 0.5mg every morning and Utrogestan 100mg every night. The first week it felt like waking up and the morning nausea was bearable. Now my nausea lasts all day, I have headaches, tinnitus and tingling lips and dizzyness. In addition, I am having hot flushes. I feel like I am pregnant and I had hideous pregnancies!! So, now that I am nearly 54, should I try doubling up my Sandrena or ask for less progesterone. My instinct says that, as I am now older, I probably need more oestrogen than I did in the perimenopause and early menopause. I know it is about the balance but just don't know how to tell which way to move the balance. Thanks

[SueRoe]

rachel FD, many women have read your post but nobody has answered. This is very unusual for this forum and probably means that your problem is uncommon or complex and nobody is able to offer advice from their own experience. This, in my view, means that you probably need to get your GP's help. Your symptoms sound horrid - nausea is soul-destroying - but tingling lips and dizziness sound like they need GP intervention to me. From what I've heard, there are good and not-so-good menopause clinics. In your shoes I would go to my GP this time. I hope you feel better soon. Let us know how you get on. Good luck

[Taz2]

As regards the post being read by many and no replies - I think that non-members reading the posts also register and they are unable to reply due to not being members.

rachel FD - welcome to the forum - sorry that not more members have responded to your post. Utrogestan can cause nausea in some women and the side effects are supposed to settle down within three months. As Freda says it may be worth getting some pofessional advice and perhaps you could contact the menopause clinic (I used to email mine) to see whether you need to persevere.

You may like to introduce yourself under New Members as I'm sure more members would like to welcome you.

Taz x 

[Limpy]

Hi Rachel FD

Welcome to MM 

Can you get back to the menopause clinic to get your HRT sorted out?
Failing that your GP, tingling lips do not sound good at all. Are the headaches new?
If yes, another good reason to see your GP

[Mary G]

rachel fd, welcome!  I'm 54 too so we have something in common there.  It definitely is not right to be suffering from nausea every day and as Taz2 said, Utrogestan can cause this. I found that Angeliq (a continuous combined HRT) gave me digestive problems and in fact I don't get on with any oral HRT so now I take everything either transdermally or vaginally and it is far more effective.

After much trial and error, I now use three pumps of oestrogen gel daily and I then have to take 100 mg Utrogestan (progesterone) for 7 days per month vaginally although I cheat and usually take about 4 because I am progesterone intolerant - I hope you do not suffer from this too. 

It sounds as though you need to change your regime and you probably need more oestrogen.  I have never heard of Sandrena (is it an oral HRT?) but it sounds like you are taking a very low dose.  It is also worth bearing in mind that taking Utrogestan every day will suppress the oestrogen you are taking and make it less effective.

Hope that helps.

[pepperminty]

Hi Rachel FD,

Sorry you are having a bad time. It can take a while ( no consolation I know ) to get the right regime at different times of the menopause. It can take up to 6 months for your body to adjust to any new types of HRT. It took me 4 months of feeling really awful before I began to feel better. You may have to tough it out for 3 months as you could feel better and if not then a new type of HRT can be given.
 There are many different ones and doses, so there is hope. You need to be under the care of a menopause clinic with a nurse or doctor who hopefully knows their stuff. Or your GP if he has any expertise.
There are so many options and unfortunately you may have to try a few before you get the right one. Do not give up hope. Write a daily diary and take it with you to your nest appointment with a doctor.
It is difficult to say whether you need more/ less oestrogen or a different type of progesterone. If you are progesterone intolerant you can always go on sequential HRT, even if this means you have a period as many ladies do in their 50's as they cannot tolerate continuous progesterone.

Please do not despair as there are many options and there is a good chance that there is one that is right for you.

Pepperminty xx

[Briony]

Hi Rachel - welcome

I cant offer you any advice re progesterone/estrogen since, as others have said, we're all different. Trial and error seems to be the answer for most of us!
With regard to tingling lips, obviously you should get it checked out, but you might be a little reassured to know that a number of us have had 'tinglings' - for me it was firstly various fingers, then my chin and then a while later I had it on my tongue. Interestingly, I fogot to take my pill last week and within 24 hours my ring finger started buzzing!

See number 33 - http://www.34-menopause-symptoms.com/tingling-extremities.htm

Hope you get some answers soon x 

[rachthemidwife]

Thanks for all the replies. I have been away on Scout camp (!!) so just getting to read them. It has been interesting. I felt so nauseous that I decided that I couldn't run the camp feeling like that so opted to stop the Utrogestan for a couple of days and then take it alternate nights. Nausea absent without Utrogestan and now just mild with. Tingling lips gone and the horrible tinnitus that had swept over me the night before camp disappeared too (I get tinnitus anyway and know that some drugs trigger it - aspirin is bad for me and some antibiotics). I do trust my menopause clinic nurse completely (I'm going to the women's centre in Oxford) and will ring her to see what she says about increasing the oestrogen. During my pregnancies I was permanently nauseated and actually threw up daily for the full 9 months. I also couldn't take the combined birth pill dos I felt so wretched so maybe I am just not great with progesterone. I pick up a new prescription tomorrow as I have just run out and plan to double up my oestrogen and take my utrogestan daily (hoping that the balance will be better than just 1 oestrogen to 1 progesterone) until I get ho,d of the menopause nurse. I'll keep you posted. I'll pop over to the new member forum and introduce myself as I think I need to get to know you all a bit better!

[rachthemidwife]

Thanks all. I am just trying 1mg Sandrena and 100mg Utrogestan daily and feeling a wee bit better. I have done my reading and discovered that progesterone can be very troublesome for women with Ehlers Danlos Syndrome which is a genetic condition that I happen to have (never knew!!) it would explain my difficult pregnancies and my complete inability to get on with the combined birth control pill. I hope to get hold of my Oxford clinic nurse (Jan Brockie) on Monday to discuss it with her. Hit flushes still coming but milder and less frequent. Nausea still there but less and tinnitus is settling a bit too so hopefully my inkling that I needed more oestrogen is correct. I really now need to know how low I can take the progesterone in order to keep it all as safe as possible. I'll keep you posted. BTW, I don't get notifications of replies to my posts and, once I've discovered and read them, the thread disappears from my "read replies to your post" bit and I have to go hunting again. I'm sure there must be an easier and less frustrating solution but could do with a pointer or two.

[rachthemidwife]

Aha! So do I have to do that each time I post or just the once?

[Briony]

Just the once. Then you will receive notification of any responses from threads in which you've contributed x