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[Mishi]

Hello,
Sorry to sound melodramatic and/or self-pitying (I keep thinking about women who live in parts of the world where there is no help or sympathy for the menopause) but I'm losing the will to live.  I keep reading stuff about the menopause, peri-menopause, patches vs tablets vs gels, etc. and there doesn't seem to be any clear way out of feeling basically awful with no time schedules or guarantee of ever feeling like my old self or even just like a reasonable human-being ever again.  So many women here appear to be going through the same type of horrible experience but there is no real relief for so many of us - how is that!
I'm 50 and my symptoms started over 5 years ago, erratic periods, increased irritability, hair loss and so on.  They eventually got worse with hot flushes, sore joints, sleeplessness, fatigue and feelings of depression so I went to see a GP who gave me a combi HRT in the form of tablets.  Since then I've tried a few as the progesterone doesn't seem to agree with me.  I'm trying to keep this short and succinct but it's proving difficult.  For about 7months I've been on Estradot 100mcg's patches and also Utrogestan 100mg caps which I'm supposed to start taking in a double dose on the 15th day of my cycle.   After trying the Utrogestan the first time I had such a nasty time with it that I didn't use it again for a few months, which means I've been more or less using the Estradot alone.  I do realise this is probably not a good idea but I find it really hard to literally swallow something that I know is going to make me feel terrible.  When I did convince myself I had to take it, instead of bleeding after the 15 days which is what it says will happen, I started after 3 and it was really heavy and lasted a while.  I thought this might be because of a ‘build up' but the same thing happened the following month, this month in fact.  Excuse the gory detail but the blood is very red from the start and not like ‘period blood' but there were also some smallish clots.  I really have no idea if I'm peri-menopausal or menopausal or what… I do still have a womb though.  I think I'm looking for some kind of reassurance that I haven't done any long term damage by using the Estradot alone?
Although the Estradot has really helped with the physical symptoms I experienced and it initially seemed to help with the feelings of depression, I now feel very down again most of the time.  Strangely enough for me the Utrogestan actually seemed to alleviate the depression for a little while and it definitely helped my sore boobs.  It's all very confusing as to begin with the progesterone was making me feel even worse mentally, which was one of the reasons I didn't want to take it in the first place.  I have finally plucked up the courage to go and see a GP again and attempt to explain my situation.  What really worries me is having to change again from one type of HRT to another as the transitional stage has been very difficult in the past, or even worse, it being stopped altogether. For personal reasons I've avoided asking the GP if I can try anti-depressants along with the HRT but I think I'm going to have to as I'm really beginning to feel out of control at times.  Does anyone have any advice on this topic?  I think I must add that there has been a severe loss in my family and also another incident that has caused distress and division in the family.  I'm only saying this as it's so difficult to unwind everything and know exactly what's causing what sometimes. 
I'm very lucky in as much as I have a really supportive partner but I know it's taking its toll on him too, how could it not!  I could go on and on but think I've already said more than enough and I hope it's not too confusing.

[CLKD]

You go on and on if it helps!  That's why the Forum is helpful.

I can't help with HRT but there are knowledgeable ladies here who can give advice.  I wanted to drop by and say 

Do you need to change your regime at this point? Let us know how you get on.  Browse round, make notes!

[Nina]

Hiya can't you try the utro vaginally? Maybe also 100mgs days 1-25

Also I would snip a bit off the patch to take it to 75. I started on 100 and was okay for a bit then I felt ill and now 75 is brilliant.

There really is a lot of things to try. It's taken me two years to get settled properly so it's not a smooth ride admittedly but it is a worthwhile one 

[Mishi]

Thank you for dropping by, very much appreciated.
I think I've gone on for long enough already - it also takes me ages to type!
I certainly need to change something...

[Mishi]

Thank you also, Nina.  I will keep trying different things. it's just sometimes you feel as if you've hit a massive brick wall, as I'm sure you know.  I think I'll ask the Dr for a lower dosage patch as I'm a bit unsure about cutting some off, although from what I've read a lot of people seem to do it.

[Mary G]

Hello Mishi and welcome to MM!

You are not alone in all of this, it is a minefield.  Sorry you have been having a difficult time, it takes a long time to get your HRT regime right and even then it has its drawbacks.

Progesterone is the achilles heel of HRT and the most difficult part to get right.  Lots of us on here, myself included, are intolerant to all forms of synthetic progestins and to a lesser extent Utrogestan even though it is bio identical.  The problem is, it is a higher dose of progesterone than we would have if we were still menstrating properly. 

First of all, have you thought of taking the Utrogestan vaginally?  I always take it this way and it has fewer side effects like breast pain.  Also, it works more effectively because most of it hits the spot and doesn't get lost in your digestive system.  The weird thing about Utrogestan is that it can make you feel better for the first few days of taking it and then you suddenly find your mood drops after about day 3.  Because I am severely intolerant, I only take 100mg of Utrogestan for 7 days each month and that does help but that is the minimum amount required to do the job.  I also take 2 pumps of Oestrogen gel every day plus a small bead of testosterone.

I think the reason you bled so quickly when you restarted the Utrogestan after taking a break was because you had some build up through not taking it for a while but if you had a robust bleed, I doubt you have anything to worry about.  You could have a womb scan to double check everything is OK. 

If you are happy on the patches (I assume you are) then carry on with them and start taking 100mg Utrogestan vaginally for 7 days each month and see what kind of period you have.  If you get on OK with it, you could then up the dose to 12 days each month.  I think you will see an improvement and fewer side effects.

I think you are on the right track but just need to tweak things a bit.

[CLKD]

"The problem is, it is a higher dose of progesterone than we would have if we were still menstrating properly.  " …….. aahhh …….. no wonder the body/brain gets upset!

[Clovie]

Mishi, hello, I totally get all of your post, it could be me, really!!!!
In fact have you seen my almost identical thread? I wrote it a few days ago, it's called "Feeling so bad..."  if you read it you'll see I am an almost carbon copy of you!

There are a few very knowledgeable ladies (hello Mary G  and thanks again for your advice on my thread! ) who are intolerant  to progesterone. Some great advice and info on here! 

It's very interesting that you and Mary have both said that initially you feel better on the utrogestan, for the first few days - I do too!!! I feel kind of laid back, relaxed and a bit swimmy, but it's a nice feeling - until a few days in and I seem to grow horns and acquire a broomstick and a pitchfork from somewhere!! 

I too don't use the utrogestan like Im supposed to  Im supposed to use it monthly but I use it every 3 months or so.   I can't bear the effects 
 And like you I bleed after 3 or 4 days into it, not at the end of the 12 days.
I understood that to mean its because I still have my own periods going on and am therefore perimenopausal and not post yet. (I might be wrong, perhaps more knowledgeable ladies can come on and explain if I'm wrong? )

Anyway, just to say , you're not alone feeling like you do. Please keep posting on here, Im sure lots of ladies will support you, or feel free to PM me if you want to chat, I'd be happy to 

oh and welcome to MM! 

 

[dazned]

Hi

You could be getting an early bleed because of the linning building up through having the estrogen only for a longer than normal amount of time without it being opposed by progesterone.

[Hurdity]

Hi Mishi

 

As you yourself recognised and Mary G and dazned also pointed out - it is most likely that your heavy bleeding is due to the build up from using oestrogen alone rather than your own cycle kicking in - and that one course of progesterone was not sufficient to shed it - especially as you are on a high dose patch of 100 mcg.

This really is inadvisable as you know! As Mary G says you are unlikely to have done any serious damage, but unopposed oestrogen can lead to endometrial hyperplasia which can lead to cancer so to be avoided. I appreciate that you don't like taking progesterone - there are several of us in this position, but like Mary G, I have only ever used it vaginally - which I know is not to everyone's liking but avoids the digestive issues and metabolism through the liver and some of the unpleasant side effects.

If you are still using 100 mcg patch I would do the full dose of progesterone every month (12 days x 200 mg) if you can until you notice your bleeds becoming less - 7 days is really insufficient to ensure complete shedding of the lining. Has your GP had any input into this? If you are unable to function while taking this amount of progesterone then I would go to GP and ask for referral to a specilaist clinic so that you can be supervised on a lower dose (or progesterone) and be offered scans to check your lining.

You haven't said what your periods were doing in the 12 months or so preceding starting HRT. Do you know how near menopause you are? If you are that intolerant of progesterone I would try to compromise with the oestrogen dose by reducing it - so that you would be able to have a lower dose of progesterone.

It's quite a big drop to go from 100 mcg to 75 mcg so until you are able to I would do as Nina suggests and snip a bit off - not as much as 1/4 patch at first - for 3-4 weeks and then if you are still OK then get your doc to prescribe 75 mcg. It is easier to remain stuck on with the rounded edges on all sides.

I am sorry about your loss and distressing family issues - these will clearly affect your mood and ability to cope with menopausal symptoms - but it should be clear from your cycle whether these are affected by hormones - and I suggest you keep a diary so that you can see if there is a pattern to your moods and feelings.

Hurdity x

[Mishi]

I'd like to thank everyone who has responded to my post, very much appreciated.  I did actually spend some time last night replying and explaining that I don't use any forms of social networking and have never written anything on a forum before (not that I can remember anyway!).  Basically I was trying to point out that I'm a bit inept when it comes to this kind of thing, as well as thanking folk for getting back to me.  Anyway, when I finally came to post it, it just disappeared! Which really demonstrated what I was trying to say.  I'm not entirely sure if it ended up posting somewhere else, or if it did in fact just evaporate... 

So, I'm going to try and keep my posts short and hopefully I won't lose any more of them!

Thanks again ladies.

[Mishi]

Hello Mary G,

Thanks for taking some of the mystery out of the progesterone problem for me.  I think I will ask the Dr if I can try the vaginal Utrogestan and see how it goes.  To be honest I'm really nervous of taking it in any way shape or form but I do realise I have to balance out the Estradot somehow.  I'm not sure I am that happy with the patches but they are better than the pills I've tried.  I only took 100mg Utrogestan per day rather than the recommended 200mg and I dread to think what state I would get into if I took the prescribed amount.  I'm not sure if I misled you or if I've confused myself but my sore breasts seemed to be caused by the Estradot, when I took the Utrogestan the pain went for a while.

It certainly is a minefield but I'll continue tweaking!  Thanks again.

[dazned]

Its the same utrogeston 

You just use the caps vaginally.

[widget49]

Hi Mishi, I'm sorry to hear you're struggling. You've come to the right place for support.

I started taking anti depressants when I was in a bad way a few years ago. Someone on here gave me teriffic advice to write down all my questions for the GP, in case I got over emotional.

I'm glad I did, I was a blubbering mess. The final question on my list was "would anti depressants help me cope?". Immediately she got me to fill out a depression  questionnaire to assess whether I was a bit down or whether suffering from clinical depression. It was distressing to see my score was pretty much off the chart, but it was a turning point. My GP couldn't have been more supportive.

Please do make sure you bring this up with your GP. I left it far too long because I thought I could shake it off myself. But sometimes we need a helping hand, whether that be through medication or talking therapy.  I did both and it worked for me.

Good luck, we're all behind you.

[Mishi]

Hello Clovie,

I did see your post not long after I posted my own and I can honestly say, I feel your pain!  It gave me a bit of a start actually, in a good way (I think).  Well, I'm sure it's the same for everyone on here in as much as it's so good to know you're not losing the plot and you're not entirely alone but it's also hard to know that other people are struggling in the same way you are.
I can really relate to so many things you said in your initial post and I've read it a few times now. You sound very much like the real you is fighting back and I'm sure you're going to win!  Hope that makes sense and that I'm not out of turn saying it!

I'm not sure if im even replying in the right place here but fingers crossed.

Thanks for the warm welcome.