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[ruthae]

Hello
I've been following the forum for a little while and it is comforting and at the same time frustrating to know I am not alone in my experience...  First a question, does anyone have experience of switching from Ellesse to Femostan,  can I start taking Femostan 2/10 a week into the progesterone cycle, I am currently on Ellesse 2mg, my Dr thinks I have to wait until I have finished a complete cycle before switching, but I am having such a bad reaction to the Ellesse I really want to stop taking it.  What is the advantage of another week of hell?

My history...I am 48 and have been perimenopausal for the past 2 yrs with many physical symptoms but most debilitating anxiety, irrational thinking, memory loss and difficulty processing data.  I had very erratic periods for a year and then stopped having periods for 4mths.  Having tried herbal solutions with little relief my Dr prescribed Prempac C .62 dose.  This worked very well for 3 months but then symptoms returned, so I was prescribed Prempac 1.3 dose, again this helped, but I soon found the time I was on the progesterone dose the symptoms returned. My Dr prescribed Ellesse 2mg which she said was a different pregesterone, but my symptoms got worse so I asked to be referred to Meno Clinic, and I have had to be signed off on phased sick leave from work.  Clinic finally  suggested on the phone I should try Femoston as both Prempac and Ellesse can cause PMS symptoms, they cannot see me for 6-8 weeks.  My dr would not prescribe without written recommendation from clinic and it will be a wk till that can happen so I went to a private clinic.  My symptoms have now tipped in to depression and I am seeing a counsellor.  I really cannot believe how menopausal women are treated, it has been a constant battle to be taken notice of.  I am hoping Femestron will help - but if not will go back and ask for tailor made solution with separate hormones now I have read the forum.  Thanks for listening and for all the advice in other posts 😊

Now I am anxious no one is going to reply, so crazy I hate myself...

[Mary G]

ruthae, welcome to MM!

Sorry you are having such a difficult time.  In my opinion, you are being prescribed the wrong type of HRT and I cannot imagine what you doctor was thinking prescribing an HRT preparation (Ellesse) which contains norethisterone and is notorious for causing no end of dreadful side effects. 

From my experience, oral HRT is nowhere near as effective as the transdermal variety and I found it to be so ineffectual, it was hardly worth taking it at all. 

I think you need to change to a transdermal, bio identical regime and I would strongly recommend Oestrogel because it is flexible and you can easily adjust the dose - something you will need to do as your own hormones continue to diminish.  Most of us on here use the gel in conjunction with Utrogestan, a bio identical form of progesterone which has far fewer side effects than any of the synthetic progesterone.  It is best to use it vaginally because it is more effective when used in that way and has fewer side effects like breast pain.

My advice is to change to the oestrogen gel and Utrogestan.  Sorry to put the spanner in the works and suggest you change your HRT regime yet again but from what you have said, I doubt you will get on with the Femoston either and having been on many different types of HRT myself, I can tell you that the Oestrogen/Utrogestan HRT combination is the best HRT regime on the market by a very long way.

I hope that helps but please do come back with any questions.

[ruthae]

Thanks Mary G

That sounds like good advice.  I have appointment with my Dr on Thursday to get repeat sick note so will suggest the gel etc.  In fact she asked me if I would use a patch and I said yes but then she prescribed Ellesse. 
Do you think it is worth switching to Femostan in the meantime though ?  I was hoping the menopause clinic would be better than Dr but it is them that has recommended Femoston.  I think my only option is private, where can I get recommendation for menopause specialist someone near Birmingham (the private dr I went to to get the Femoston prescription is only a GP)?

Thank you again

[Mary G]

You could switch to the Femoston as an interim measure - I take it you would just be taking the oestrogen only part.  That would be OK as a temporary measure to keep your oestrogel levels up and then you can do the switch.

I would not recommend the patches.  I found I did not get enough oestrogen from them, they are not very flexible dose wise and they leave a horrible mark which is difficult to get off.  Also, I didn't like going around with a patch stuck to my backside!

I can't understand why you doctor asked you about the patches and then went on to prescribe Ellesse, it doesn't make any sense. 

I don't know any menopause specialists in your area but others might come along with some recommendations.  There is no reason why you doctor should not be able to prescribe the gel and Utrogestan when you go there next week.  You could try quoting the new NICE guidelines which might help.  Why don't you tell the doctor you want the Oestrogel and Utrogestan and you don't want to try anything else?  You mentioned a private clinic that you went to, perhaps they could prescribe it for you? 

By the way, the UK version of Utrogestan doesn't say you can take it vaginally (for no reason whatsoever) but you can and it is used that way practically everywhere else in the world and all private UK specialists recommend it is used vaginally.

 

[Kathleen]

Hello ruthae.

I can't improve on the excellent advice you've had so far but I did want to welcome you to the forum.

 One of the best things about this site is the sympathy expressed by other women who know exactly how emotionally crazy we can be at this time in our lives.

It's a huge comfort to feel truly understood and I'm sure MM will be of great help to you on your journey.

Wishing you well.

K.

[ruthae]

Thanks Mary G,
tbh my Dr looked slightly panic stricken when I cried and suggested something else must be upsetting me, though she did agree to refer me to the local nhs menopause clinic eventually. But it takes 6.8 was to get an appointment in person.  I really don't know why she didn't go down the patch route after she had mentioned it, though sounds like that may not have been best solution anyway!  She is 4th Dr I have seen at the practice, first refused to give HRT until I was post menopausal, the 2nd retired, third went on maternity leave...

Will take Femoston and tell gp what to do, I think I just have to take control!!

Thanks also for pm. I can't respond as it says I am not allowed to send messages.

Also interested to hear people experience at work.  Are there any publication people have given to their work to help them understand, I keep getting told not to be sensitive, toughen up, we are going through it too, why isn't the HRT working yet etc etc...my manager is trying to be understanding but he is finding my anxiety and neediness really frustrating, I think because other colleagues have 'just got on with it' he sees me as being weak. Which normally I am not.

Thanks Kathleen for taking time to respond, you are right it is the reassurance that you are not alone and that the crazy out of controlness will stop that really helps 

[Hurdity]

Hi ruthae

  from me too.

I would like to add that Femoston is the best tolerated of all the oral progestogens so you may well be fine on it - unless as Mary G says you are intolerant to all forms of synthetic progestogen. The type in Femoston is very similar to our own natural progesterone. Regarding switching mid-cycle - the only thing that will happen after you switch is you will most likely experience some progesterone withdrawal symptoms/pmt eg possibly headache or similar, and you should also get a small withdrawal bleed too - so by stopping the progesterone part early you will re-set your cycle. As you were having infrequent periods then this probably won't matter as you may not be having much of your own cycle anyway.

I imagine the reason the doc did not prescribe the patch is because both the combi patch types have synthetic progestogen and the most common one - Evorel - contains the same progestogen as the Elleste duet tablets ie norethisterone - although she could have prescribed separate oestrogen and progesterone as Mary G suggests!

I have been using patch oestrogen and separate progesterone (Utrogestan since 2011) for 9 years and very happy with this regime  - patch or gel is a matter of personal preference and also how well you absorb oestrogen from the different types.

Hope this helps and good luck with the doc

Hurdity x

[ruthae]

Thanks Hurdity

I am already feeling much calmer now I have the alternative medication and an outlet in the forum  (Y).
I was going to start the Femostan on the same point in the pack that I had got to with the Elleste so no dip in progesterone but a different type of both e and p. that should work shouldn't it.?

There are so many variables and finding the right application takes so long if you give everything a full cycle trial.  I wonder that more medical research hasn't been done to test if women are progesterone intolerant.  It seems they try the cheapest method first, but if you take into account the personal cost and sick pay it isn't the cheapest at all...  It is so important to spread the word but difficult as so many women take the suffer in silence option.  Though there does seem to be a renewed emphasis with Womans hour etc.  Or maybe I am noticing it now I am going through it

I've also been having a look around the forum and found that I need to make 10 posts before I can pm. And also the leaflet for Managers.  Will make some comments on those in the other forum threads.

What a great resource this is. Wish I had engaged with it much earlier.

Rx

[Mandz]

Hi ruthae

I can relate a lot to what you are describing, when I first posted on here( my threads just below yours I think) ---- I was horrendously low, with the help and encouragement from the wonderful ladies on here I'm getting a grasp on things and that Its not al " in my head"

Be kind to yourself and re-read the advice these ladies give, they have helped me more than they will ever realise xxxx

Love m xx

[ruthae]

Thanks Mandz

I am very lucky as I have a couple of good people around who try to reassure me to balance the people who think I should just pull myself together, and my OH is very understanding, too understanding really trying to do everything for me which doesn't do my confidence any good.  It really is like being a teenager, nobody can do anything right !
When people say be kind to yourself it makes me cry, because I don't think I deserve it, which us stupid I know. Coucelling should help with that I hope whilst the hormones settle. 

I'm so glad the forum has helped you too.

Rx

[Mandz]

Yes you could be me... People say that to me too and I don't think I deserve it either--I just keep apologising for being this way, but from today I'm going to try.... Really try... And just take the day as it comes, not set myself up for a fall, well try not too!!!

We can do this....if someone told me this time last week I really think if I didn't cry(which I would have) Ida slapped them for being so patronising .....

Love n hugs m xx

[ruthae]

Ha ha, yes rage and devastation seem to be the only two reactions to most situations at the moment...
thoughb some people I know have been cruisingbfor a bruisingbfor a while so maybe now is a good time to put that in motion whils Ii have the excuse.... You've got to laugh haven't you (when you aren't crying, wouldn't have been able to say that on Friday!)
Rx

[Mary G]

ruthae, if you are intolerant to synthetic progestins, it does make HRT much more challenging.  By all means try the Femoston but I honestly think that the transdermal HRT is far more effective for symptom control.  I never found the oral HRT to be very effective but you if you get on with it and you are not intolerant to the synthetic progesterone in it then you might as well stick with it.  That said, I still think you would find the Oestrogel/Utrogestan regime to be much better. 

You are right about the NHS fobbing people off with the cheapest possible stuff, most of which is horrendously outdated and ineffectual.  The oral HRT (with the exception of Angeliq which is expensive) is cheaper than transdermal HRT but you get what you pay for and the reason it is cheaper is because (in my opinion) it is no good.

Please keep us posted and let us know what you decide to do.

[CLKD]

Often the reason the NHS prescribes 'cheaper' versions of medication is because the UK Government won't pay the Pharmaceutical Companies what they ask, therefore medication is sold abroad at the price expected, following years of Research and Development.  Which is expensive.  Which is why we often find that we are given generic medication …….. fortunately I've not reacted to the fillers nor surrounding and the active part of the tablet works for me.  Sometimes people can be sensitive to the fillers etc..

I don't think that the NHS has much choice sometimes  even though it must cost more in the long run?

[ruthae]

Hi Mary G - thanks for advice, will update as I go along.  Day 3 on Femoston and feeling better (so keeping fingers crossed).

Hi CLKD - I know it is easy to criticise the NHS, and I know a lot of people are doing their best to keep it afloat under very trying circumstances, and I do understand that economics rule unfortunately.  I know GPS may be uncomfortable admitting they are prescribing the cheapest but a little bit of 'between the lines' advice from doctors would not go amiss - like pointing people who do not respond to the 'off the peg' HRT to this website for a start!  I found it by googling menopause.  At least then we can be informed and decide what route to take, or advise our GPs to take.  I'm going to print off some MM leaflets and start leaving them in leaflet racks - guerilla leafleting!  I actually started putting stuff on Facebook about it but so few people responded compared to my usual posts, it really is one of the last taboos.

Rx